Oral Health Index reveals differences between UK and US oral health

The newly published Oral Health Index, which draws on data amassed by Hello Pearl, highlights significant differences in oral health outcomes between the UK and the US and reinforces the importance of identifying dental disease before symptoms develop.

Based on 737 million tooth observations from 26 million dental visits across both countries, the Index found that UK patients in the full-mouth radiograph cohort had an average of 6.36 missing teeth, compared with 2.16 in the US. Around 31% of affected teeth in the UK had been extracted, versus 14.5% in the US.

These findings should not be viewed as a criticism of clinicians. Rather, they reflect how access to care, funding models, appointment pressures and available treatment options can influence whether teeth are restored, monitored or extracted.

The data also highlights an important message: the absence of pain does not necessarily mean good oral health. Early carious lesions, periodontal disease and mineral loss frequently develop without symptoms and may remain undetected without radiographic assessment.

Interpreting radiographs can also be challenging for patients, who often rely solely on verbal explanations from clinicians. Hello Pearl’s Second Opinion platform aims to bridge this gap by analysing dental radiographs and highlighting findings such as suspected caries, periodontal bone loss and calculus deposits directly on the image. The technology is designed to support, not replace, clinical judgement by improving consistency and helping patients better understand their oral health.

Early detection can make a significant difference. Enamel demineralisation identified early may be managed with preventive measures, whereas disease detected later may require restorative treatment or even extraction.

Younger adults carrying a high burden of untreated disease

One of the most striking findings concerns younger adults. Among those aged 18-24, 52% of identified dental disease was untreated, the highest proportion of any age group. In adults aged 75 and over, the figure was 28%, despite a greater overall burden of dental disease. This suggests that older adults are more likely to have had previous treatment, including fillings, crowns and extractions, whereas younger adults may be accumulating untreated disease.

Several factors may contribute to this trend. Young adults often lose continuity of care when leaving home, fail to register with a new practice or deprioritise routine dental visits due to competing financial pressures. Without symptoms, disease progression can easily go unnoticed.

The Index also identified first permanent molars as particularly vulnerable. Although they represent only 14% of the dentition, they accounted for 24% of detected carious lesions and 31% of restorations. Evidence of decay in first molars appeared from around age 17, considerably earlier than in lower incisors, highlighting where preventive efforts may be most beneficial.

Access to care remains a key determinant

The findings suggest that oral health outcomes are influenced as much by access to care as by individual behaviours. Importantly, all individuals included in the dataset had attended a dental practice and undergone radiographic examination, meaning the true burden of undiagnosed disease among those who do not access care is likely to be even greater.

The Index ultimately reinforces a simple message: pain should not be the main reason for seeking dental care. The period between feeling well and being clinically well is often when preventable disease progresses. By helping clinicians identify and communicate pathology earlier, Hello Pearl aims to support interventions when conditions can still be monitored, managed or potentially reversed.

To request a demo, visit hellopearl.com/getdemo.

This article is sponsored by Hello Pearl.