Adult Oral Health Survey

About the study

The Adult Oral Health Survey (AOHS) 2023 is the latest in a series of nationally representative surveys of adults’ oral and dental health in England, carried out approximately every ten years since 1968. These surveys, previously known as Adult Dental Health Surveys (ADHS), have been used to estimate the prevalence of dental and oral health conditions. They provide an insight into the health of adults’ teeth and mouths and the need and access of treatment in England.

The AOHS 2023 was commissioned by the Office for Health Improvement and Disparities (OHID) within the Department of Health and Social Care (DHSC). The survey was carried out by a consortium led by the National Centre for Social Research (NatCen). The consortium includes dental academics with experience of oral epidemiology from the following organisations:

• Department of Dentistry at the University of Birmingham
• Faculty of Dentistry, Oral & Craniofacial Sciences at King’s College London
• School of Dental Sciences at Newcastle University
• Dental Public Health Group at the Department of Epidemiology and Public Health at University College London
• Office for National Statistics

The University of Leeds also provided guidance and support to the survey and its design.

Findings 

• The proportion of adults in England reporting having no natural teeth was 2.5%. Prevalence of no natural teeth was higher among those who were older, had lower household incomes, and lived in more deprived areas. This represented a further decrease from 12% and 6% in the 1998 and 2009 surveys respectively.
• Among dentate adults, over a fifth (21%) had at least one tooth with extensive obvious decay (that is decay which had resulted in an obvious cavity affecting the inner dentine tissues or the pulp of the tooth). When those with at least one tooth with non-cavitated decay affecting the inner dentine were included, this represented over two-fifths (41%) of dentate adults with obvious decay affecting at least one tooth.
• When using the most sensitive measure of tooth decay which includes enamel decay, just under two-thirds of adults (64%) had clinical decay present in one or more teeth on the crown or roots of their teeth at the time of the oral examination.
• The proportion of self-reported dentate adults who reported attending the dentist for a regular check-up was gradually increasing until 1998 and remained stable at around 61% of adults in 2009. However, there was a drop of 9 percentage points between 2009 and 2023 when only 52% of the 2,230 self-reported dentate adults reported visiting for a regular dental check-up.
• The most common reasons for infrequent attendance were:
  • being unable to find a dentist (40%)
  • unable to afford the charges (31%)
  • not perceiving a need to do so (27%)
• Large proportions of adults reported that their oral health negatively impacted on their quality of life. Overall, 49% reported that they had experienced an occasional or more frequent oral impact (using the Oral Health Impact Profile-14 (OHIP-14) measure), while 43% reported that their oral health had negatively impacted on their daily life and 22% experienced a severe oral impact (using the Oral Impacts on Daily Performance (OIDP) measure).

Methodology

The AOHS 2023 was designed to be the next face-to-face survey in the series following a gap in data collection. The 2023 survey was a random probability survey, covering adults living in residential households in England. Data collection took place from June 2023 to April 2024. Up to 2 adults aged 16 and older from each eligible household were invited to take part. 

Data collection for the 2023 survey involved a face-to-face interview conducted by a NatCen interviewer in the participant’s home. Interviewers were accompanied by a trained and calibrated dental examiner who performed the oral examination on consenting participants. This took place during the same visit, unlike in previous surveys, where the interview and oral examination were carried out in 2 separate visits. 

A household response rate of 28% was achieved. Overall, 2,285 adults were interviewed and 1,619 of these adults also had an oral examination.