SOCIAL-FACTORS AND SELF-ASSESSED ORAL HEALTH IN SOUTH-AFRICA

The question of what determines the dental needs of a population has been widely debated in the dental literature. Although there is no full agreement, the consensus is that substantial consideration should be given to the people's perceptions of what their needs are, based on self-assessment of their oral health and satisfaction with the appearance of their teeth. These perceptions (self-assessments) are likely to be shaped by their previous experiences with the dental service, their understanding of ''normality'' and knowledge of oral care, which are determined by social factors such as culture, class and race. The purpose of this paper is to examine self-assessed oral health in South Africa according to relevant social factors. In 1988/89 a National Oral Health survey, which included a social survey, was conducted. The data were collected by means of a structured interview, based on a questionnaire, with a sample of 4652 adults aged 20-64 yr. The variables examined in this paper formed part of the items in the questionnaire. There is a higher level of identification that ''something is wrong with teeth'' in (a) lower educational levels (53%-no formal education; 20%-standard 10+); (b) lower income categories (43%-lowest; 16%-highest); (c) among Xhosa (66%), S. Sotho (58%) and Zulu (53%) speaking groups and (d) among Black people (54%). Similar trends are evident in the degree of satisfaction with the appearance of teeth. The results reveal differences in self-assessed oral health among people with different educational standards, income levels, linguistic/cultural characteristics as well as racial groups as defined by the Population Registration Act of 1950. Thus suggesting that these factors should be considered in determining ''dental needs'' for future planning.