| 1. |
- Ekback, Gunnar, et al.
(författare)
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Reporting dental caries disease in longitudinal studies : a suggestion
- 2016
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 173-179
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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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| 2. |
- Ekbäck, Gunnar, 1954-, et al.
(författare)
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Reporting dental caries disease in longitudinal studies - a suggestion
- 2016
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Ingår i: Swedish Dental Journal. - Stockholm, Sweden : Swedish Dental Journal. - 0347-9994. ; 40:2, s. 173-179
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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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| 3. |
- Ekbäck, Gunnar, 1954-, et al.
(författare)
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Self-perceived oral health among 19-year-olds in two Swedish counties
- 2008
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 32:2, s. 83-93
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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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| 4. |
- Johansson, Ann-Katrin, 1957, et al.
(författare)
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Eating disorders and signs and symptoms of temporomandibular disorders. A matched case-control study
- 2010
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 34:3
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine signs and symptoms related to temporomandibular disorders (TMD) in patients with eating disorders (ED) and to compare the prevalence with that in sex- and age-matched controls. During a 12-month period, all patients (n=65) who accepted and initiated psychiatric/medical outpatient treatment in an Eating Disorder Clinic/Erikbergsgården, Örebro, Sweden were invited to participate in the study. Of the ED patients, 54 (83 %) accepted participation. ED patients and controls underwent a comprehensive TMD questionnaire and clinical examination. Reported symptoms such as headache, facial pain, jaw tiredness, tongue thrusting, and lump feeling in the throat as well as dizziness, concentration difficulties and sleep disturbances were all significantly more prevalent among ED patients compared to controls. There was also a significantly higher prevalence of clinical TMD signs in the ED patients. Analyses within the ED group showed that those who reported self-induced vomiting reported significantly more heavy feeling in the head, nausea and snoring. Those with binge eating reported significantly more heavy feeling in the head, facial pain, dizzy feeling and concentration difficulties. No significant differences regarding subjective symptoms and clinical signs of TMD were found within the ED group with respect to duration of ED. In conclusion, orofacial pain and TMD related signs and symptoms are significantly more common in ED patients than in matched control subjects. Special emphasis should be made to those who reports vomiting and/or binge eating behaviors.
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| 5. |
- Ordell, Sven, et al.
(författare)
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An analysis of present dental professions in Sweden
- 2006
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 30, s. 155-164
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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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| 6. |
- Ström, Dan, et al.
(författare)
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Management of tinnitus and jaw-muscle tenderness using an intraoral appliance and acupuncture.
- 2013
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 37, s. 105-110
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Tidskriftsartikel (refereegranskat)abstract
- Associations between signs and symptoms from the masticatory system and tinnitus have been reported. The aim of the study was to evaluate the effect of intraoral splint therapy and acupuncture on jaw-muscle tenderness and tinnitus. The study comprised 45 patients (24 men, 21 women; mean age 48 ±12 years) with long standing tinnitus (duration 6.5 ±5.9 years), referred from the audiology department at the University hospital in Örebro, Sweden. A complete audiological survey was performed before referral. Jaw muscles were palpated and the subjective tinnitus evaluated on a 100 mm scale (VAS) at baseline and after one year. All patients received stabilization (Michigan type) splints at start of treatment. After 6 months, non-responders (n=25) were subjected to acupuncture (6 sessions with duration of 30 minutes). Standard statistical methods were used. All patients had tender jaw muscles at palpation. Patients reported a significant decrease of the intensity of tinnitus during the observation period (from 78±20 mm to 52±24 mm after one year; P < 0.001). Only 6 (13 %) of the 45 patients did not report any improvement of their tinnitus. The number of jaw muscles tender to palpation also decreased significantly from 7.9±5.9 to 4.6±5.3; (P < 0.001). In conclusion, all 45 patients with tinnitus had tender jaw muscles. Intraoral splint therapy and acupuncture had a favorable effect on tinnitus and the jaw muscle symptoms. One year after the start of treatment, all but 6 of the 45 patients reported improvement of their tinnitus. Based on the results it is suggested that many tinnitus patients with jaw muscle tenderness can benefit from a treatment including intraoral splint and acupuncture.
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| 7. |
- Ståhlnacke, Katri, et al.
(författare)
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Patient satisfaction with dental care in one Swedish age cohort : part 1 - descriptions and dimensions
- 2007
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 31:2, s. 103-111
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study were to investigate the dimensionality of satisfaction with dental care, to control the reproducibility of the analysis over time, to investigate changes between the two studied years and to relate satisfaction with elapsed time since the most recent visit to dental care. All persons born in 1942 in two counties in Sweden, Orebro and Ostergotland, were surveyed by post in 1992 at the age of 50 and resurveyed at the age of 55. There were 5363 persons responding at both times, constituting the study group. In this study, opinions are analysed about general satisfaction with dental care and about the most recent dental visit. Factor analysis, one-way ANOVA and contingency tables were used. Overall satisfaction was high both as to general satisfaction and as to the most recent dental care visit. Those with their most recent dental visit more than a year ago felt more pain, anxiety and unpleasantness and were also more generally dissatisfied. Of those having experiences of pain, anxiety and unpleasantness at most recent visit, there was an overrepresentation of non regular attenders. Factor analysis showed that the questions used revealed a stable pattern. In conclusion, the overall satisfaction with dental care was high. Differences between the two studied years were small. Persons not visiting dental care within the last year were more dissatisfied both generally and with the most recent visit. A greater number of regular attenders had no feelings of anxiety, pain or unpleasantness at all.
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| 8. |
- Ståhlnacke, Katri, et al.
(författare)
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Patient satisfaction with dental care in one Swedish age cohort : part II - what affects satisfaction
- 2007
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 31:3, s. 137-146
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate satisfaction with dental care in relation to dental care factors, recent dental care experiences, past dental care experiences, general health factors, oral health factors and socio-economic factors and all over time. All persons born in 1942 in two counties in Sweden, Orebro and Ostergötland, were surveyed by post in 1992 at the age of 50, and resurveyed at the age 55. There were 5363 persons responding at both times, constituting the study group. A conceptual theoretical model was constructed to be used as a framework in the analysis. Multiple regression analysis and contingency tables were used. Factors related to satisfaction with dental care were: care organisation, cost for care, visit to dental specialist, time spent in waiting room, regular attendance, reception at dental clinic, feelings of anxiety, taking part of school dentistry, smoking, oral health factors, dental appearance and being dissatisfied 5 years previously. Change between the two study years was affected by perceived oral health, experiences from the most recent dental visit and care organisation. Oral health related factors and dental care factors like cost for care and care organisation were related to satisfaction with dental care. Likewise were experiences from the most recent dental visit and to some extent past care experiences like school dentistry. Almost no correlation was seen between socio-economic factors and satisfaction.
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| 9. |
- Ståhlnacke, Katri, et al.
(författare)
-
Patient satisfaction with dental care in one Swedish age cohort : Part 1 - descriptions and dimensions
- 2007
-
Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 31:2, s. 103-111
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study were to investigate the dimensionality of satisfaction with dental care, to control the reproducibility of the analysis over time, to investigate changes between the two studied years and to relate satisfaction with elapsed time since the most recent visit to dental care. All persons born in 1942 in two counties in Sweden, Orebro and Ostergötland, were surveyed by post in 1992 at the age of 50 and resurveyed at the age of 55. There were 5363 persons responding at both times, constituting the study group. In this study, opinions are analysed about general satisfaction with dental care and about the most recent dental visit. Factor analysis, one-way ANOVA and contingency tables were used. Overall satisfaction was high both as to general satisfaction and as to the most recent dental care visit. Those with their most recent dental visit more than a year ago felt more pain, anxiety and unpleasantness and were also more generally dissatisfied. Of those having experiences of pain, anxiety and unpleasantness at most recent visit, there was an overrepresentation of non regular attenders. Factor analysis showed that the questions used revealed a stable pattern. In conclusion, the overall satisfaction with dental care was high. Differences between the two studied years were small. Persons not visiting dental care within the last year were more dissatisfied both generally and with the most recent visit. A greater number of regular attenders had no feelings of anxiety, pain or unpleasantness at all.
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| 10. |
- Ståhlnacke, Katri, et al.
(författare)
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Patient satisfaction with dental care in one Swedish age cohort : Part II - What affects satisfaction
- 2007
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 31:3, s. 137-146
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate satisfaction with dental care in relation to dental care factors, recent dental care experiences, past dental care experiences, general health factors, oral health factors and socio-economic factors and all over time. All persons born in 1942 in two counties in Sweden, Örebro and Östergötland, were surveyed by post in 1992 at the age of 50, and resurveyed at the age 55. There were 5363 persons responding at both times, constituting the study group. A conceptual theoretical model was constructed to be used as a framework in the analysis. Multiple regression analysis and contingency tables were used. Factors related to satisfaction with dental care were: care organisation, cost for care, visit to dental specialist, time spent in waiting room, regular attendance, reception at dental clinic, feelings of anxiety, taking part of school dentistry, smoking, oral health factors, dental appearance and being dissatisfied 5 years previously. Change between the two study years was affected by perceived oral health, experiences from the most recent dental visit and care organisation. Oral health related factors and dental care factors like cost for care and care organisation were related to satisfaction with dental care. Likewise were experiences from the most recent dental visit and to some extent past care experiences like school dentistry. Almost no correlation was seen between socio-economic factors and satisfaction.
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