National statistics

Adult oral health survey 2021: report summary

Published 25 January 2024

Applies to England

Main findings

The main findings of the report are:

• two thirds (66%) of adults reported they had very good or good oral health. Twenty-six per cent reported they had fair oral health and 7% reported they had bad or very bad oral health
• ninety-five per cent of adults in England had at least one natural tooth (were dentate). Dentate adults had on average 25.4 natural teeth
• seventy-seven per cent of adults with natural teeth brushed their teeth at least twice a day, in accordance with the current guidance. More than half of adults (59%) who brushed their teeth used an electric toothbrush
• sixty-three per cent of adults said they went to the dentist for regular check-ups, 15% went for occasional check-ups and 18% went to the dentist only when they had trouble with their mouth, teeth or dentures
• a third of adults (33%) said that the cost of dental care had affected the type of dental care or treatment they had received. A quarter (25%) of adults reported they had had to delay dental care or treatment because of the cost
• nearly half of all adults (47%) said they had experienced one or more oral health impacts in the previous 12 months. The most commonly reported impacts were being self-conscious (28%), finding it uncomfortable to eat any foods (24%) and having had painful aching in their mouth (20%)
• 1 in 5 (21%) adults reported at least one severe oral impact that had affected their daily life in the previous 12 months. Performances that were most likely to be severely impacted were avoiding smiling, laughing and showing teeth without embarrassment (12%) and difficulty eating (9%)

Introduction

About the survey

The 2021 adult oral health survey was commissioned by Public Health England (PHE), now the Office for Health Improvement and Disparities (OHID).

The survey was carried out by a consortium led by the National Centre for Social Research (NatCen). The consortium includes the University of Birmingham, King’s College London, the School of Dental Sciences at Newcastle University, the Dental Public Health Group and Department of Epidemiology and Public Health at University College London (UCL), and the Office for National Statistics (ONS).

The University of Leeds and School of Clinical Dentistry, University of Sheffield also provided guidance and support to the survey and its design.

The survey was designed as a continuation of the long-running adult dental health surveys, carried out in the United Kingdom since 1968. The 2021 survey differed from its predecessors in several ways:

• it was carried out using web and paper self-completion questionnaires, rather than by face-to-face interviewing in respondents’ homes
• it was not possible to carry out dental examinations of participants
• the survey covered England only, rather than other nations of the United Kingdom
• the name of the survey was changed to reflect its focus on the health of teeth and mouths

The survey was carried out in February and March 2021 with a representative sample of adults in England aged 16 and over. A sample of 19,286 addresses was selected using random probability methods, and 2 adults per household were invited to take part in the survey.  

A total of 6,343 responses were received from 4,429 households, 24% of the eligible addresses in the sample. Within participating households, 76% of eligible individuals took part. For further information on the survey response, see the accompanying technical report.

The survey questionnaire covered self-assessed oral health, oral health behaviours, service use, barriers to care and impacts of oral health.

This report presents the results of those questions, including analysis to explore variations in need for and access to treatment or advice among different groups in the population. This includes analysis by:

• sex
• age
• NHS region
• household income in quintiles (fifths), adjusted (equivalised) to take account of the number of adults and dependent children, as well as overall household income
• neighbourhood deprivation in quintiles, based on the 2019 English index of multiple deprivation (IMD). IMD is based on 37 indicators, across 7 domains of deprivation. IMD is a measure of the overall deprivation experienced by people living in a neighbourhood, although not everyone who lives in a deprived neighbourhood will be deprived themselves.

Where differences are commented on in the text, these are significant at the 95% confidence level, unless otherwise stated. The significance tests were run for a dependent variable and one independent variable at the time. It is possible that some independent variables are linked (for example, household income quintile and neighbourhood deprivation), and a significant association between a dependent variable and an independent variable is therefore partially explained by another independent variable. Unpicking these associations requires multivariate modelling, which is not covered in these reports.

The report only includes findings from the 2021 survey because differences in the survey methodology mean findings from the Adult Dental Health Survey 2009 and 2021 are not directly comparable.

The adult oral health survey findings are based on participants’ responses at a particular point in time and it is not possible to make inferences about causal relationships. For example, those who said that they visited a dentist for regular check-ups were more likely to have filled or crowned teeth. It is not possible to say those who attend regularly have tooth decay and other problems diagnosed and treated more frequently or whether a history of problems that needed treatment encourages regular attendance.   

Participants were asked about their usual pattern of dental attendance. A small proportion of participants (4%) reported that they had never been to a dentist. Some of these participants gave answers in other parts of the questionnaire that suggested they may have misinterpreted the question about the usual pattern of dental attendance (for example, saying they had had dental treatment). They are included in the analysis with the caveat that is not clear whether they had attended in the past but would describe themselves as someone who did not generally go to the dentist.  

A report of findings about the impact of COVID-19 on oral health and access to care was published in December 2022.

Full technical information about the 2021 adult oral health survey is provided in the technical report.

Further information

You can see detailed technical information, survey reports and data from the 2021 adult oral health survey.

If you have any queries about this report, please email dentalphintelligence@dhsc.gov.uk.

Acknowledgements

The 2021 adult oral health survey was funded by the Office for Health Improvement and Disparities (OHID), Department of Health and Social Care (DHSC).

Along with OHID and DHSC staff, the reports from the survey were prepared by:

• Mari Toomse-Smith, Katie Ridout, Katy Robertson and Elizabeth Fuller (NatCen Social Research)
• Jenny Gallagher and Nigel Pitts (King’s College London)
• John Morris (University of Birmingham)
• George Tsakos and Anja Heilmann (Dental Public Health Group and Department of Epidemiology and Public Health at University College London)
• Richard Holmes (School of Dental Sciences at Newcastle University)
• Gail Douglas (University of Leeds)

We would like to thank all of those who gave up their time to complete the online questionnaire.

We would like to thank everyone who contributed to the work behind and production of the reports, in particular:

• members of the consortium: Kirsty Hill and Vahid Ravaghi (University of Birmingham), Richard Watt (University College London), Dean Fletcher (Office for National Statistics)
• colleagues at NatCen: Richard Boreham
• colleagues at the School of Clinical Dentistry, University of Sheffield: Zoe Marshman