Oral health differs greatly from country to country. In the United States, we have some of the best dentists and dental labs in the world, but even here we see a massive imbalance due to the cost of healthcare, which is some of the highest on the planet.
In the past, we have covered dental tourism and have looked at the ways in which American dental care compares to other countries. But what about tooth loss and dentures? Which countries have the highest rates of tooth loss and the greatest number of denture-wearers, and how do they compare to the United States?
Countries with the Highest Rates of Tooth Loss
Over 176 million Americans have lost at least one tooth, meaning it’s more common than not to have a gap or two in your mouth. 40 million Americans have lost all of their teeth, and many of these are denture wearers.
These numbers seem high, but the US is way down the list when it comes to global tooth loss rates.
Poland
Poland probably isn’t one of the top 5 or even top 10 countries in the world when it comes to tooth loss and bad oral health, but it is often said to be the worst in Europe and deserves its place on this list for that reason.
According to the Supreme Audit Office in Poland, the percentage of edentulous Poles is growing at a rapid rate, even though dental services are provided by the state. In 2011, it reported that 80% of the population didn’t use dental services provided by the National Health Fund. It also noted that a massive 92% of 15-year-olds had dental decay and that 10% of 7-year-olds had never been to the dentist.
On the whole, Poland is not a poor country. Prior to 2020 and the effects of the pandemic, it experienced consistent GDP growth and in 2020, its minimum wage was reported as being higher than in the United States. Its healthcare is also cheaper and much more accessible than in the US, and it has experienced more growth than any other country in the former Eastern Bloc, as well as several other European nations.
Its unemployment rate is also low and there has actually been a labor deficit in recent years. It’s certainly not one of the richest countries in the world, but it’s far from the poorest and is performing much better than its dental health facts would suggest.
On the plus side, the worst figures concerning Poland’s dental health were taken from studies that are now a decade old, and once these are revised, we may see some significant improvements, leading to future generations that have much better teeth and lower rates of tooth loss.
Bolivia
South America has high rates of poverty and people don’t always have the money or the means to access essential medical care. The extreme gulf between the rich and the poor exists in all countries, but it’s at its worst in Bolivia, which has some of the worst rates of tooth decay and tooth loss on the continent.
It has been said that only half of certain demographics own a toothbrush in the country and that tooth decay is incredibly common in the young and old. In fact, the average 12-year-old Bolivian has at least 4 decayed, filled, or missing teeth, and as they age, the risk of multiple tooth loss and complete edentulism rises exponentially.
Bolivia has been through periods of extreme poverty in its recent history and was one of the poorest in South America prior to 2006. It improved massively under the socialist government of Evo Morales, but it seems that there is still a lot of work to be done when it comes to healthcare and changing public habits.
Australia
Australia is a surprise addition to this list, but the official facts make it clear that Aussies have a high rate of tooth loss. According to dental health statistics published on a government health site, 30% of Australians avoid seeing the dentist because they are worried about the cost and a massive 25% of children aged between 5 and 10 have untreated decay in their baby teeth.
Of course, those teeth will fall out and the children can still grow up with a full set of healthy teeth, but the fact that they have so many problems when they are so young indicates that they are adopting harmful habits that will stay with them forever.
Cost is clearly a big issue here, as healthcare isn’t cheap in Australia. It’s not quite as expensive as it is in the United States, but it’s still classed as some of the most expensive in the world. In fact, Aussies spend a lot of money on dental tourism, traveling to countries like Indonesia and Malaysia to get essential oral treatments.
The rates of tooth decay are also much higher in the Aboriginal population, as well as people who live in rural areas of the country.
India
India has some great doctors and dentists and we have talked about it as being a top pick for dental tourism due to the low cost of treatments. However, that only applies if you’re visiting the country from the United States, where wages are much higher.
The average salary in India is just over 30,000 INR or around $410, and the lowest average is 8,000 INR or $110. If you visit for a consultation and full mouth x-ray, followed by a scale and polish and a filling, it could cost you $55. If you’re on the lowest average wage, that’s half your total monthly income just for some very basic treatments.
The equivalent for an American would be spending up to $1,500 for treatments that actually cost between $300 and $400. Things are expensive in the US, but not that expensive!
India’s National Oral Health Program noted that there is a serious disparity between rich and poor when it comes to oral health. In rural areas, 72% of the population has access to just 2% of the country’s dentists, and as they don’t always have the cash to travel, let alone pay for the services, they can’t get to those dentists.
As a result, 95% of the population is said to suffer from gum disease, with only half of them using a toothbrush and around 2% visiting the dentist.
And those figures are not monthly or yearly. It’s not that those people are skipping their recommended twice-yearly appointments but that they are skipping the dentists altogether.
Countries with the Most Denture-Wearers
There isn’t as much information on denture-wearers as there is on tooth loss and tooth decay. However, on a list of countries with the most denture-wearers, the United States would likely be near the top. Not only do we have a surprising number of edentulous residents for a Western country but we also have some great dental labs and dentists, as well as a competitive denture market that offers affordable price points for most of the population.
If you have a lot of money to spend, you can opt for a high-quality set of dentures that will last for years and look and feel like the real thing. If not, you can pick up a set of dentures for less than $500. It’s still a lot of money but when you consider how much they will benefit your life, along with the fact that they will last for 5 years, it will all be worth it.
In terms of market share, Europe purchases way more dentures than North America, which is a surprise considering many European countries rank lower than the United States and Canada for edentulism.
Dentures seem to be more popular in Northern and Central Europe, but that could be down to money and population. It also helps that Europe is home to many major dental labs and dental schools, as well as the small country of Liechtenstein, which is one of the biggest producers of dentures in the world.
In fact, many of the dentures used in Europe and even in North America are produced in this small country.
Generally speaking, countries that have the most denture wearers are not necessarily the ones that have the highest rates of tooth loss or decay. It’s not even about availability or whether or not the culture deems it more acceptable to wear dentures. It all comes down to money.
The higher the GDP and the more affordable the health care, the more likely you are to encounter denture wearers. It makes sense. If you’re struggling to put food on the table and keep a roof over your head, the last thing on your mind is getting a prosthesis in your mouth.
What Factors Affect Tooth Loss and the Number of Denture Wearers
Why are Americans less likely to have lost multiple teeth than people from Bolivia? Why is it acceptable to remain toothless in some countries and not in others?
There are several factors at play here, some obvious, some not:
Money
It’s not just about the haves and the have nots, either. It’s about what that money gets you and whether you can afford to get all of the treatment that you need.
Let’s compare the United States to the United Kingdom as an example.
British people have been stereotyped as having poor dental health, and while it’s a stereotype that they don’t appreciate, most of them will admit that their teeth are not as pristine as the Americans that they see in films and social media every day.
Therein lies the problem and the disparity.
In the United States, if you have money then you have pristine teeth. You get braces when you’re young, crowns when you need them, veneers if you want them, and you don’t have to worry about missing teeth, fillings, and other such treatments. If the worse case scenario happens and you have multiple broken and/or decayed teeth, you can just swap them for implants, veneers, or even a full set of dentures.
These are the people you see on TV and social media, the people who have been placed in the spotlight and have had the money or the insurance needed to get quality oral care.
In the United Kingdom, treatments are free to people with low incomes and disabilities, as well as kids under a certain age. For everyone else, all treatments are grouped into three bands, roughly equating to $32 (examinations, x-rays); $91 (root canals, fillings, extractions), and $397 (crowns, dentures, bridges).
And these things are not grouped together. If you need dentures and require multiple examinations and extractions first, you still only pay that $397.
The problem is that this state healthcare coverage does not extend to cosmetic procedures. If you need a tooth removed and there is no practical purpose to have an implant fitted, that service won’t be provided. If you need veneers, you’re out of luck.
These services are still available outside of the NHS, but they are not cheap.
It’s why people in the United Kingdom will admit that they don’t have the best teeth, even though the country ranks highly on lists of “the best dental care in the world” and has low rates of edentulism.
The same is true for many other countries that have state-sponsored dental care—it’s about providing what is necessary and not what is esthetic.
If you take that state-sponsored care away and don’t have a system of widely available insurance in place, then you get countries that struggle on both the cosmetic and medical side of things. You see high rates of tooth loss, decay, and more.
Geographic Circumstances
To a city-dweller, the idea that you could live so far away from a dental clinic that you don’t have any options seems a little bizarre, but there are millions of people in that position. In the United States, even people in the most rural areas have access, as public transport and cars provide that access. In poorer parts of South America, Asia, and Africa, however, it’s not uncommon for people to live a 6+ hour journey away from the nearest clinics.
And if you don’t have a car or the time and money for a bus journey, that dental clinic might as well be on the other side of the world.
Put yourself in their shoes for a moment. Imagine that you’re on the breadline and struggling to keep a roof over your head. You are in desperate need of dental care, but you don’t have any insurance or other options, and even if you can save up the money to get the treatment, your only option is akin to dental tourism and requires a long trip complete with travel expenses and maybe even a hotel room.
Instead of saving all your life to pay for your child’s college education, your dream home in the hills, or that vacation you always wanted, you’re saving for basic dental treatment.
Cultural Attitudes
If you ask the average American to list the 5 most important features in a prospective date, they’ll list a good smile and white teeth. It’s not just about dating either, as white teeth are also considered to be essential for making a first impression and can help with everything from your social media career, to your social life and relationships.
In other countries, however, it’s not as important.
In countries that are less transfixed by social media and the celebrity lifestyle, we see less of an emphasis on white teeth. More importantly, when there are higher rates of tooth decay and tooth loss, it becomes more acceptable to have yellowed teeth and missing teeth.
It only makes sense. If all your family have no teeth, you might not be so obsessed with the idea of finding a partner with a full set of pearly whites. And if you have no teeth or bad teeth, it’s unlikely that you’ll put good dental hygiene at the top of your list.
Diet and Oral Health
As noted above, it has been said that half of all people in Bolivia own a toothbrush. Low-income Bolivians do not eat as much refined sugar and starches as Americans. They generally don’t start their day with sugar-laden coffee and cereal, nor do they snack on candy and soda. The diet mostly consists of a base of corn and potatoes, as well as beans, grains, and meat.
Still, the starches in those foods can harm your teeth. Bacteria will grow, plaque will form, it will turn into tartar, and eventually, it will harden to the point where it can’t be removed with a brush even if one was being used. From there, they don’t have much of a chance and will eventually suffer from severe dental decay and tooth loss.
It has also been estimated that over a fifth of all Bolivian males and a tenth of all Bolivian females smoke. Smoking has a massively detrimental effect on oral health. It reduces the mouth’s ability to heal itself and stains the teeth, rapidly accelerating the rate of decay.
In the United States, most citizens have a toothbrush and the majority brush their teeth every day. It’s part of the routine, but the same can’t be said for other countries.
Tooth loss is also more common in countries with a high number of smokers, as well as those with a diet rich in sugar.
