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1.
  • Ahlvin, Anna, et al. (författare)
  • Self-perceived oral health among 19-year-olds in a Swedish County - A comparative study between 2004 and 2011
  • 2016
  • Ingår i: Swedish Dental Journal. - : SWEDISH DENTAL JOURNAL. - 0347-9994. ; 40:1, s. 53-65
  • Tidskriftsartikel (refereegranskat)abstract
    • For decades, Swedish dental professionals have collected clinical epidemiological data from the dental records. To supplement the epidemiology, Ostergotland County Council decided to examine patient perceptions of oral health: self-rated knowledge, self-perceived oral health, and opinions about oral health. The aim was to compare self-perceived oral health among 19-year-olds to determine differences between genders, various municipalities and between 2004 and 2011. This study analysed the responses from two cross-sectional surveys of the entire population of 19-year-olds in Ostergotland County, Sweden, performed in 2004 and 2011. Of the 2,413 (53 %) (50 % men, 50 % women) 19-year-olds who responded to the questionnaire in 2004 and the 3,803 (67 %) (50 % men, 50 % women) in 2011, most 19-year-olds (88.1 % [2004] and 87.5 % [am]) reported satisfaction with their oral health. Around half of the respondents rated their knowledge on periodontitis as low. Boys rated their knowledge about avoiding periodontitis higher than girls (p<0.05 in 2004 and p<0.001 in 2011). In 2004, 84.7 % reported shooting pain. In 2011 that figure was 83.7 %. The respondents expressed some uncertainty about the benefits of fluoride toothpaste (7.5 % in 2004 and 9.3 % in 2011), especially the boys (10.3 % in 2004 and 10.5 % in 2011). Girls reported both a higher social impact and greater concern about aesthetics related to their oral health. They also reported headache (27.5 %) nearly twice as often as boys (14.2 %) (p>0.001). Responses between the municipalities did not differ, with the exception of items regarding periodontitis. Thus, this study found indications that perceptions of oral health and knowledge in Ostergotland County complied with Swedish Dental Act. The study also found patient perceptions of oral health among 19-year-olds to be good.
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2.
  • Ekback, Gunnar, et al. (författare)
  • Reporting dental caries disease in longitudinal studies : a suggestion
  • 2016
  • Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 173-179
  • Tidskriftsartikel (refereegranskat)abstract
    • Sjukdomar och medicinska tillstånd definieras vanligen genom att ett antal kriterier uppfylls och en individ bedöms som frisk från sjukdom när dessa kriterier inte längre föreligger, ofta efter en definierad tidsperiod. Incidens och prevalens mellan olika sjukdomar kan därför ofta jämföras. I longitudinella studier definieras dental karies ofta som förändringar i medeltal av ett index, vanligen DMFT/S. Karies är en livsstilssjukdom som går att bota, men symtomen på kariessjukdom är oftast persisterande vilket innebär att ett sådant index inte redovisar hur många individer som är sjuka under en viss period eller hur många som är botade från själva kariessjukdomen under samma tid utan istället redovisar en livstidsprevalens. Syftet med denna studie var att beräkna karies incidens och karies prevalens utgående från begreppen årsprevalens, kumulativ incidens och incidenstalet (incidensraten). Definition på karies hämtades från ICD-10 (KO2.1) som beskriver diagnosen för karies in i dentin. Som definition på att vara frisk (botad) från kariessjukdom användes en definierad tidsperiod på tre år utan att ny dentinkaries registrerats. Studiepopulationen var 423 individer och bestod av alla 12-åringar i Örebro län, år 1990, och som under sex år deltog i samtliga årliga recall-undersökningar (1990–1995). Av dessa hade 210 dentinkaries (definierat som ICD K02.1) någon gång under de tre åren 1990–1992 medan 213 inte uppvisade dentinkaries någon gång under samma tidsperiod. Under den efterföljande perioden 1993–1995 blev 17 % av de sjuka barnen friska från karies. Av de friska barnen insjuknade 38 individer vilket ger en årlig prevalens av 12 %. Karies hade en incidens rate av 134 fall per 1000 manår (13 %) och en kumulativ incidens på 15 % för ett år, 17 % för två år och slutligen 18% för tre år. Vår definition av den tid som krävs (3 år) för att kunna avgöra om en tidigare sjuk individ kan bedömas som frisk från karies kan i framtiden behöva justeras och fler studier i olika åldrar och populationer behövs för att ytterligare belysa problemställningen. Studien visar på relativt dåligt resultat när det gäller att bota kariessjukdom då endast 17 % av de sjuka blev friskförklarade under en period på tre år. Likaledes är resultaten av preventionen nedslående då hela 12 % av individerna i den friska gruppen blev sjuka. Resultatet bör dock tolkas med försiktighet med tanke på det begränsade antal barn som ingick i studien och risker för selektionsbias mellan grupperna. Under dessa år hade dock individuella kallelseintervall utifrån ett riskperspektiv inte införts hos Folktandvården Örebro utan orsaken till att barn inte kallades årligen berodde vanligtvis på resursbrist hos vårdgivaren. Denna metod att rapportera karies i longitudinella material och därmed definiera karies på individnivå ersätter inte traditionella metoder för att mäta kariesincidens och kariesprevalens. Metoden ger dock en ökad information avseende det antal individer som faktiskt är sjuka i karies. Ett sådant förfaringssätt medför stora fördelar ur planeringssynpunkt för tandvården då fokus blir individer och inte medeltal av ytor eller tänder, och möjliggör dessutom jämförelser mellan dem som faktiskt är sjuka i karies med dem som diagnostiserats med andra sjukdomar.
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3.
  • Ekbäck, Gunnar, 1954-, et al. (författare)
  • How much information is remembered by the patients? : a selective study related to health education on a Swedish public health survey
  • 2012
  • Ingår i: Swedish Dental Journal. - : Sveriges tandläkarförbund. - 0347-9994. ; 36:3, s. 143-148
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to investigate the degree to which patients have perceived that they got questions or advice about eating habits and smoking habits at their last visit at the dental clinic and if this information was differently distributed between different age groups. A further aim was to study whether there were differences in the proportions of questions and advice given to individuals who perceived problems regarding caries and gum bleeding compared to those that did not feel they had problems. The results are based on a postal questionnaire survey,"Life and Health 2008". The study was conducted in a population of women and men aged 18-84 years in 5 counties in Sweden. A total of 68,710 questionnaires were sent out and the response rate was 59.2%. Substantial differences in proportions existed between age groups regarding who received questions and advice related to dental caries and periodontal disease. The differences between age groups regarding information were statistically significant since it was less common that older people got questions and advice than younger.These differences also exist, but less pronounced, between those with disease related problems and those without.Three factors were statistically significantly associated with information. Age, education level and problems with caries or bleeding gums had statistical effect on the prevalence of questions and advice related to eating habits or smoking habits respectively. In conclusion, it is an urgent need of education in methods for dental staff if they want to contribute to changes in life style behaviors for their patients since most patients today don't perceive that they got important disease relevant information at the last dental visit.
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4.
  • Ekbäck, Gunnar, 1954-, et al. (författare)
  • Reporting dental caries disease in longitudinal studies - a suggestion
  • 2016
  • Ingår i: Swedish Dental Journal. - Stockholm, Sweden : Swedish Dental Journal. - 0347-9994. ; 40:2, s. 173-179
  • Tidskriftsartikel (refereegranskat)abstract
    • In general, most infectious and/or lifestyle-related diseases are defined as being present when sufficient signs or symptoms occurs in an individual. The term "sufficient" is a relative concept and a disease can therefore be measured with different degrees of certainty. These symptoms are commonly defined in such a way that it is possible to determine the incidence and prevalence of the disease and also the proportion of individuals that are cured from the disease. If dental caries is an individual disease which can be compared to other diseases regarding incidence and prevalence, it is important to determine for how long an individual must be free from new signs of the disease before being considered cured or free from the disease and to define the "sufficient" signs or symptoms needed for a diagnose. Based on these thoughts, the purpose of this study was to calculate caries incidence and prevalence in a group of adolescents from a definition of dental caries based on ICD-10. This study included all 12 year olds in 1990 who attended a clinical dental examination in 1990-1995 in Orebro County, Orebro, Sweden, yearly during these six years. Dental caries disease at the individual level was defined as Ko2.1 (dentinal caries) according to ICD-bo while freedom of caries was defined as the absence of Ko2.1 during a three-year period. In this study the yearly prevalence was 12%, the three year cumulative incidence was 18% and the incidence rate 13%. Results of this study highlight the poor outcomes in curing caries disease in this age-group, according to the criteria in this study, as only 17% of the children with caries at the outset of the study were free from the disease three years later. Defining both a practical level to measure signs of dental caries, and the period an individual must be free from them to be classified as cured from the disease create new opportunities to compare and communicate the disease of dental caries with other diseases. This way of registration is also of advantage for planning purposes as there the centre of interest must be the individual patient and not the tooth or surface.
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5.
  • Ekbäck, Gunnar, 1954-, et al. (författare)
  • Self-perceived oral health among 19-year-olds in two Swedish counties
  • 2008
  • Ingår i: Swedish Dental Journal. - 0347-9994. ; 32:2, s. 83-93
  • Tidskriftsartikel (refereegranskat)abstract
    • The primary purpose of the present study, which focused on a census of 19-year-olds (2006) attending dental clinics in two Swedish counties, was to describe the frequency distribution of clinically- and self-perceived oral health indicators in terms of DSa (Decayed Surfaces approximal), four global dimensions of oral health and one'all-embracing' oral health measure, according to county of residence and gender. A second purpose was to examine to what extent the clinical indicator of oral health and the global dimensions of self-perceived oral health contribute to the explainable variance of the global single-item indicator. Finally, the study examined whether or not the association of clinically- and self-perceived oral health indicators with the single global oral health indicator varied as a function of gender and place of residence. The study base was 46.5% (n=3658) of all children attending for dental checks (n=7866). The questionnaire included thirteen questions, divided into four global dimensions. These were Knowledge, Quality of life, Social and Function. There was also one 'all-embracing' oral health question, one question about gender and finally information about clinically-registered disease. The findings of this study were that females reported more serious problems than males in the Social and Quality of life dimensions and there were differences between counties in knowledge about oral diseases. The group with poor self-reported oral health in the 'all-embracing' oral health question had significantly more problems with all global dimensions, especially Quality of life and Social dimensions. Statistically-significant two-way interactions occurred between county and Knowledge and between county and Quality of life. This study supports the idea of one or several questions concerning self-perceived oral health to be used as a complement to the traditional epidemiological clinical registration of oral diseases.
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6.
  • Ekbäck, Gunnar, 1954-, et al. (författare)
  • Self-perceived oral health and obesity among 65 years old in two Swedish counties
  • 2010
  • Ingår i: SWEDISH DENTAL JOURNAL. - : Swedish Dental Journal (Sveriges Tandlakarforbund). - 0347-9994. ; 34:4, s. 207-216
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore the association between oral health and obesity. The study was conducted in the spring of 2007 as a postal survey of all inhabitants born in 1942 and living in the two Swedish counties of Orebro and Ostergotland. This questionnaire survey has been conducted every five years since 1992 but has been updated continually with additional questions and for the sweep used here, height and weight data were collected. A total of 8,313 individuals received the questionnaire and 6,078 of those responded (73,1%). The outcome variable oral health was measured using one global question and four detailed questions representing different aspects of oral health. The independent variable Body Mass Index (BMI) was calculated using self-reported height and weight. A difference in oral health between various BMI groups was found. The difference was both statistically significant and of clinical importance, particularly among the group with severe obesity who reported poorer self-perceived chewing capacity, lower satisfaction with dental appearance, increased mouth dryness and fewer teeth and lower overall satisfaction with oral health. In view of the increased risk of poor oral health demonstrated in this study for those with severe obesity, it may be of value to increase cooperation between dental care and primary health care for these patients.
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7.
  • Ordell, Sven, et al. (författare)
  • An analysis of present dental professions in Sweden
  • 2006
  • Ingår i: Swedish Dental Journal. - 0347-9994. ; 30, s. 155-164
  • Tidskriftsartikel (refereegranskat)abstract
    • Dentistry in Sweden is predicted to have a shortage of dentists in the future and the division of labour within dentistry will be a more debated question. In order to forecast the effects of such a shortage the professional status of the involved groups must be made clearer. The objective of this paper is to analyse the emergence and present professional status of clinical dental professions in Sweden. The study was conducted on the basis of theories on professions, and their roles in organizations was analysed.The results were applied on the historical emergence, establishment and consolidation of clinical dental professions in Sweden. The results show that a large sector of salaried dentists has not diminished the professional status of the Swedish dentists. Professional ambitions such as many clinical subspecialties and a strong element of research have not been restrained by the public health ambitions in the Public Dental Health Service (PDHS). Presently, other dental professions are dental hygienists, dental technicians and dental nurses. Of these the only other licensed group, the dental hygienists, are an emerging profession.They have an uphill struggle to obtain a full professional status, mainly because their knowledge domains are neither specific nor exclusive to their group. Development of a common core curriculum on a clearly academic level would enhance their professional status. Dental technicians and nurses are lacking fundamental traits as professions. There appears to be little need for additional groups of clinical professions besides dentists and dental hygienists in Swedish dentistry. In conclusion,this analysis provided better understanding of the present status of the Swedish dental professions, to prepare for future restructuring of the dental care system. Further work will be needed to understand the impact of professional traits on the management of groups of professionals.
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8.
  • Ordell, Sven, et al. (författare)
  • Aspects of the quality of the information contained in radiological referrals
  • 2002
  • Ingår i: Swedish Dental Journal. - Stockholm, Sverige : Sveriges Tandläkarförbund. - 0347-9994. ; 26:3, s. 135-140
  • Tidskriftsartikel (refereegranskat)abstract
    • A referral letter is an important carrier of information, and it is important that it contains what both the recipient and the referrers expect. Based on the concept of perceived quality of service, 126 consecutive referrals from the General Dental Service (GDS) and their associated replies from the Department of Oral Radiology (OR) were mutually evaluated. OR judged that necessary information about the patient was specified in over 80% of the cases, and that information pertinent to the issue and the proposed examination was included in over 90% of the cases. The referrers were very satisfied with the replies they received. Only 1% reported that the information contained in the reply was not satisfactory for the continued care of the patient. Ninety-one per cent reported that they felt the reply to their referral was adequately long. A mutual questionnaire is a practicable tool to ensure quality in the referral process.
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9.
  • Ordell, Sven, et al. (författare)
  • Management structures and beliefs in a professional organisation. An example from Swedish Public Dental Health Services
  • 2010
  • Ingår i: SWEDISH DENTAL JOURNAL. - : Swedish Dental Journal (Sveriges Tandlakarforbund). - 0347-9994. ; 34:3, s. 167-176
  • Tidskriftsartikel (refereegranskat)abstract
    • Work as a dentist is stressful and demanding. In the Public Dental Health Service (PDHS) the heads of clinics have a great influence on the work environment. In turn the heads have to adapt to the overarching policies on management in each County, which create the environment for the clinics. The aims of this paper were to describe the management structure of the PDHS as described by their Chief Dental Officers (CDOs), and to test hypotheses that the management systems had "a logical administrative structure" A postal questionnaire was mailed to all 21 CDOs, who all responded. Context analysis and bivariate correlations were used The PDHS employed on average 60% of all dentists in a county. The numbers of clinics for general dentistry in Sweden was 698, and for specialist care 144 The heads of clinics were dentists in 92%. Four hypotheses were tested 1/ A separate political board did not lead to closer governance of the PDHS. 2/ There was more emphasis on measurable than on qualitative objectives and follow-up 3/ There was only partial correlation between a larger county and a more formalized management. 4/ There was no correlation between size of county and beliefs on advantages of scale There was a widespread belief in advantages with larger clinics both from administrative, and rather surprisingly, from clinical aspects. Two of the four hypotheses could not be corroborated which indicates that the management structures were more,formed by county specific principles. The four hypotheses on administrative behaviour were only partially corroborated. The implications for delivery of care to-sparsely populated areas need to be monitored in view of the beliefs in larger clinics. The limits for decisions by management and for professional discretion must be monitored closely considering their effects on work environment and on the quality of care the professionals are able to deliver
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10.
  • Ståhlnacke, Katri, 1953-, et al. (författare)
  • Self-perceived oral health among 65 and 75 years old in two Swedish counties
  • 2010
  • Ingår i: Swedish Dental Journal. - : Swedish Dental Journal (Sveriges Tandlakarforbund). - 0347-9994. ; 34:2, s. 107-119
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate self-perceived oral health in two elderly populations, ages 65 and 75 years, and its relation to background factors, socioeconomic, individual, and dental health service system factors. Another purpose was to investigate if there were any differences in these respects, between the two age groups, born in 1932 or 1942. In two counties in Sweden, Örebro and Östergötland, all persons born in 1942 have been surveyed by mail every fifth year since 1992. In the year 2007 all persons born in 1932 were also surveyed using the same questionnaire. Those born in 1932 consisted of 3735 persons and those born in 1942 6078 persons. From an outline of a general model of inequalities in oral health data were analyzed with descriptive statistics and contingency tables with ?2 analysis. Multivariable analysis was performed by using multiple regression analysis. Factors related to self-perceived oral health were age group, social network, ethnicity, education, general health, tobacco habits, oral hygiene routines, dental visit habits and cost for care. The self-perceived oral health was overall rather high, especially in view of the studied ages, although it was worse for those of age 75. Socio-economic factors, dental health service system as well as individual lifestyle factors affected self-perceived oral health. To have a satisfying dental appearance, in the aspect of how you are judged by other people, was important for these age groups.This presents a challenge for dental health planners especially since the proportion of older age groups are growing.
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