| 1. |
- Andås, Charlotte Andren, et al.
(författare)
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A new dental insurance scheme - effects on the treatment provided and costs
- 2014
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 38:2, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Goteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.
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| 2. |
- Bratel, John, 1953, et al.
(författare)
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Anamnestic findings from patients with recurrent aphthous stomatitis
- 2014
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:3, s. 143-149
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Tidskriftsartikel (refereegranskat)abstract
- Recurrent aphthous stomatitis (RAS) is a common oral disorder with a prevalence varying between 5% and 66%. RAS appears in three forms; minor, major and herpetiform. The aetiology is unknown.The aim of this study was to evaluate associations between specific anamnestic information and different types of recurrent aphthous stomatitis (RAS). A group of 177 patients (mean age=42.8 years; SD=14.3; range 17-79 years) participated. Data were collected from a structured interview, consisting of 22 questions. Information about i) health status and medication, ii) predisposing factors, iii) RAS experience, iv) previous treatment methods and v) brand of toothpaste was collected. Sixty-eight per cent of the patients were healthy and 44% of the patients were not taking any medication. Forty-one per cent of the patients did not have any apprehension of the reason for their RAS, while stress (15.8%) was the most common apprehended aetiological factor. Sixty-two per cent had one to three minor ulcers at one time. Forty-eight per cent reported having had a major aphthous ulcer at least once.The most frequent symptom reported was pain (53.7%), followed by a smarting sensation (18.6%) and tenderness (4%). The most common treatment for RAS was Zendium™ toothpaste/mouthrinse (28%), followed by corticosteroids (25%). Fifty-four per cent of the patients experienced no relief from the treatment. When toothpaste habits were investigated, Zendium™ was used by 32% of the patients and toothpaste containing sodium-lauryl-sulfatase was used by 32%. There was no positive correlation between the use of Zendium™ toothpaste and the relief of symptoms or the size, number or frequency of the aphthous ulcers. Sixty-four per cent of the patients had never smoked, while 7% were smokers. No positive correlation was found when age, gender, allergy, medication and smoking were correlated to the frequency, number and size of the aphthous ulcers. In conclusion, we found that the aetiology behind RAS is still unclear and probably multifactorial. Standard treatment methods like Zendium™ should perhaps be questioned and this study did not find any support for smoking as a "protective" factor, i.e. having less likelihood of experiencing major problems from RAS.
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| 3. |
- Edblad, Thorsten, et al.
(författare)
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Micro-topography of dental enamel and root cementum.
- 2009
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Ingår i: Swedish dental journal. - 0347-9994. ; 33:1, s. 41-8
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Tidskriftsartikel (refereegranskat)abstract
- The focus for the present study was to characterise dental enamel and cementum at the cervical region of healthy teeth by use of interferometry. The effect of a protein-dissolving enzyme, used for cleaning (Neutrase) on the surface topography, was also evaluated. Knowledge about the normal variation of surface topography of natural teeth is limited. In the design of artificial surfaces, intended to replace the function of lost biological surfaces, detailed knowledge of the latter is therefore of great importance. Nine health caries free premolars were used. The root cementum of three teeth was used for evaluation of Neutrase on the surface. On the six remaining teeth, the differences between the surface textures of enamel and root cementum were evaluated using 3D Interferometry. No statistical significant effect of Neutrase was identified. A significant difference between enamel and root cementum concerning surface topography using the different 3D parameters was recorded. When comparing values from the literature, the topography of artificial materials used in dentistry show similarities with the topography of the enamel and root cementum surfaces evaluated.
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| 4. |
- Frisk, Fredrik, 1971, et al.
(författare)
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Pulp exposures in adults--choice of treatment among Swedish dentists.
- 2013
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Ingår i: Swedish dental journal. - : Sveriges tandläkarförbund. - 0347-9994. ; 37:3, s. 153-60
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Tidskriftsartikel (refereegranskat)abstract
- This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
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| 5. |
- Hallberg, Lillemor R-M, 1942, et al.
(författare)
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Facing a moral dilemma--introducing a dental care insurance within the public dental service.
- 2012
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Ingår i: Swedish dental journal. - : Swedish dental journal. - 0347-9994. ; 36:3, s. 149-56
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Tidskriftsartikel (refereegranskat)abstract
- Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.
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| 6. |
- Hägglin, Catharina, 1955, et al.
(författare)
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Evaluation of a Swedish version of the OHIP-14 among patients in general and specialist dental care.
- 2007
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Ingår i: Swedish dental journal. - 0347-9994. ; 31:2, s. 91-101
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the Swedish version of an oral health-related quality of life (OHRQL) instrument, the short form of the Oral Health Impact Profile (OHIP-14), and to assess OHRQL among patients in general dental care and specialist clinics (periodontics, TMD and implant dentistry) in G?teborg, Sweden. Consecutively selected patients were asked to answer the OHIP-14, the General Oral Health Assessment Index (GOHAI) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 years old) out of 237 (65%) returned the questionnaires. Cronbach's Alpha among the OHIP items was high (0.93) and the corrected item-scale correlation varied between 0.51 and 0.79. The correlation between the OHIP-14 score and the GOHAI was high (-0.83) indicating good criterion validity. The mean additive OHIP-14 score was 22.6 (SD = 10.5). Implant patients scored significantly higher than other patient groups with respect to missing teeth, dentures and mobile teeth. High scores were also associated with perceived poor general health and dissatisfaction with life-situation. The test-retest reliability was assessed in a separate sample (n = 47) and the correlation coefficient was 0.85. The Swedish version of OHIP-14 demonstrated good reliability and validity. The poorer OHRQL reported by the implant patients reflects the strong association found between OHIP score and dentures and missing teeth, while OHIP-14 did not show similar sensitivity to other impacts of oral disorders.
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| 7. |
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| 8. |
- Krekmanova, Larisa, 1959, et al.
(författare)
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Common experiences of pain in children and adolescents - an Exploratory Factor Analysis of a questionnaire
- 2013
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 37:1, s. 31-38
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to reduce everyday and dental treatment pain items included in the extended Children's Pain Inventory (CPI), used in a prior study on Swedish children and adolescents. Another aim was to, by means of exploratory factor analysis (EFA), expose hitherto undiscovered dimensions of the CPI pain variables and thus to improve the psychometric properties of CPI. As some pain items are relevant merely to some individuals, a new and more useful questionnaire construction would enhance the internal validity of the instrument in observational surveys. EFA was applied on the extended CPI instrument. 368 children, 8-19 years old, had answered a questionnaire comprising 10 dental and 28 everyday pain variables. These pain items were analysed using a series of sequentially implemented EFA. Interpretations and decisions on the final number of the extracted factors was based on accepted principles; Kaiser's Eigenvalue >1 criterion, inspection of the scree plot and the interpretability of the items loading. The factors were orthogonally rotated using the Varimax method to maximize the amount of variance. Of all tested EFA models in the analysis, a two, three, four, and five factor model surfaced. The interpretability of the factors and their items loading were stepwise examined; the items were modulated and the factors re-evaluated. A four factor pain model emerged as the most interpretable, explaining 79 % of the total variance depicting Eigenvalues >1.014. The factors were named indicating the profile of the content: Factor I cutting trauma to skin/mucosal pain, Factor II head/neck pain, Factor III tenderness/blunt trauma pain, Factor IV oral/dental treatment pain.
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| 9. |
- Lindskog Stokland, Birgitta, 1959, et al.
(författare)
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Molar position associated with a missing opposed and/or adjacent tooth: a follow up study in women
- 2013
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 37:2, s. 97-105
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to assess (i) the degree of overeruption of molars lacking opposed teeth and (ii) the inclination of molars with a mesial edentulous space and also to study (iii) changes during a 12 year period. The subject sample originated from the prospective population study of women in Gothenburg, Sweden where scanned panoramic radiographs taken with an interval of 12 years were analysed. Tipping as well as overeruption were scored on the two images according to a five-level scale. Sixty-seven subjects fulfilled the inclusion criteria at baseline and were referred to as "the non-extraction group". Further 35 subjects had lost the opposed and/or the adjacent tooth/teeth during the 12-year follow-up period: "the extraction-group". These groups were studied separately and a comparison between these groups was performed. The prevalence of molars tipped more than 15 degrees at baseline was 17.1 % in the upper jaw and 44.3 % in the lower jaw, in the non-extraction group. At baseline overeruption was seen in 25 % of the unopposed upper molars and none of lower molars in the non-extraction group. The prevalence of tipping and overeruption was statistical significant less in the extraction group (P<0.01), than in the non-extraction group at baseline, but at follow-up no statistical significant group differences existed. -The prevalence of tipped molars facing a mesial edentulous space and overerupted unopposed molars increased in adults during the 12-year period but the changes were small. -Overeruption and tipping is most pronounced immediately after extractions.
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| 10. |
- Ostberg, Anna-Lena, et al.
(författare)
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Cross-cultural adaptation and validation of the oral Iimpacts on daily performances (OIDP) in Swedish.
- 2008
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Ingår i: Swedish dental journal. - : Swedish Dental Association. - 0347-9994. ; 32:4, s. 187-95
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim was to assess the validity and reliability of a Swedish version of the Oral impacts on Daily Performance (OIDP) index measuring oral health-related quality of life. MATERIAL AND METHODS: After translation and cultural adaptation, a 3-site sample of 204 adults (20-86 years) was interviewed using the OIDP. Moreover, the study included a self-administered questionnaire and a clinical examination. RESULTS: A total of 39.7% reported at least one oral impact on daily life. The most common performances affected were eating and cleaning teeth (both 20.6%). Oral effects on psychological performances caused the highest impacts. No gender or age differences were demonstrated with respect to having at least one impact. However, among those affected, women, old and young subjects scored higher than men and other ages, respectively, on the OIDP. The face and content validity were deemed good in pilot interviews with laypersons and dental professionals. The construct validity was confirmed, as the OIDP score was consistently associated with self-perceived oral health OR 2.13 (95% CI 1.10-4.10) and other self-rated variables, e.g. satisfaction with oral health OR 2.43 (CI 1.34-4.41), also when accounting for age, gender and socioeconomic differences. Associations were estimated using logistic regression. Lacking 10 or more teeth was associated with a higher OIDP score, which supports the criterion validity of the instrument. In a test-retest analysis Cohen's kappa was 0.77. CONCLUSIONS: The Swedish version of the OIDP appears to be a valid and reliable measure for assessing oral impacts on daily performances.
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