Oral Health in the Finnish Adult Population: Health 2000 Survey

A comprehensive Health 2000 Survey was carried out in 2000–2001.The survey was conducted in two nationally representative random population samples and in a third sample that was followed-up for 20 years. The sample that was studied in most detail comprised 8,028 adults aged 30 years or over. The other two populations surveyed were young adults aged 18 to 29 years and subjects who had participated in the Mini-Finland Survey 20 years earlier. The Health 2000 Survey included an examination of oral health. In subjects aged 30 or over, data on oral health were collected by means of interviews, postal questionnaires, clinical oral examinations (6,335 participants) and panoramic radiography (6,115 participants). This report describes the findings concerning adults aged 30 or over and compares the findings with those obtained in the nationally representative Mini-Finland Survey 20 years earlier. Oral health behaviour The coverage of dental care was high: 69% of all adults and 78% of the dentate adults had visited a dentist during the past two years. Most dentate adults visited a dentist regularly. With respect to dental care received, preventive measures were alarmingly infrequent: only 7% reported having received instructions how to brush teeth. Of men, 46%, and of women, 77%, reported brushing their teeth twice a day. Oral health Among Finnish adults, periodontal diseases and caries were still common, periodontal diseases being the single most common type of oral diseases. Deepened periodontal pockets (4 mm or more) were found in two out of three dentate subjects; even in the youngest age group (30–34) half of the subjects had deepened pockets. Among men 69% and among women 78% of all teeth with periodontal pockets were diagnosed in 25% of the dentate subjects. Caries occurred in 31% of dentate subjects. Of all decayed teeth, 70% was diagnosed in 10% of all dentate subjects. Among subjects aged 30–64 years, 6% had lost all teeth, among subjects aged 65 years or over 44%. every other subject aged 75 years or over had a full denture, and one-fifth of those aged over 55 had a partial removable denture. Oral mucosal lesions occurred frequently in persons who wore removable dentures, and many of the dentures were in need of repair. Of the dentate, 60% had radiographically diagnosed, endodontically treated teeth. Vertical infrabony pockets were seen in 10% of the dentate subjects, and apical periodontitis in 27%, most often in endodontically treated teeth. Differences between population groups Marked socio-economic variety occurred in adult oral health, and it showed a particularly strong association with level of education. People with the least education had the most oral diseases. They also were the least active in oral self-care and thus constitute a highrisk group for poor oral health. There were marked differences in oral health between the age groups, too. Although the youngest adults aged 30–34 enjoyed the best clinically assessed oral health, many of them reported oral health-related symptoms and problems. In the age group 45–64, the dominant characteristics were high numbers of filled teeth, periodontal diseases and radiographic findings. In the oldest age groups a large percentage was edentulous, and many dentate persons wore removable dentures. Among the middleaged and the elderly there was considerable need for prosthetic dental treatment. Women had better oral health than men. Substantial gender differences were observed in health behaviour and oral self-care. Women visited a dentist more often and more regularly than men. Women also took better care of their oral hygiene than men. In northern and eastern Finland edentulousness was more frequent and dentate persons had fewer teeth than in other parts of the country. Changes over the past 20 years Oral health has improved over the past 20 years. The most prominent improvements were the decrease in the prevalences of edentulousness and caries. There have also been significant increases in the use of dental care services in the past 20 years. In 2000, dental check-ups were more frequent than 20 years ago, particularly among those aged 55 or over. In that age group, one in two dentate adults (65% of women and 49% of men) reported having a dental check-up at least once every two years. Brushing teeth at least twice a day was more frequent than 20 years ago, but even so the frequency of brushing among men in 2000 was lower than the frequency was for women 20 years ago. Adult oral health has improved across the whole population. The most prominent improvements were seen in the youngest age groups and in persons with the most education.