Abstract This paper aims to place the findings of the NSW Adult and Child Dental Health Surveys in an international context. The comparator countries are the US and the UK, both of which have well-documented epidemiological dental health data. The US has a mainly private system of dental care, similar to NSW, whereas the UK has primarily a government-funded dental care program. The adult data collected in the last 20 years in all three locations indicates greatly improved oral health with a decline in the proportions of people with no natural teeth. The majority of children have few dental problems but inequality remains with some children in lower socioeconomic groups still having high levels of dental ill health, which contributes to a lower quality of life. Improving population levels of oral health in all three countries will require collective decision-making by stakeholders and politicians to finance plans for action and manage change to help those individuals for whom dental disease is still a major problem.