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Sökning: WFRF:(Hakeberg Magnus 1954 )

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21.
  • Andersson, Pia, et al. (författare)
  • Psychometric properties of the Dental Hygienist Anxiety Scale in a group of general dental patients.
  • 2013
  • Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 71:3-4, s. 877-882
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Objective. The aim of the present study was to evaluate the psychometric properties of the Dental Hygienist Anxiety Scale (DHAS) in a sample of adult general dental patients. Materials and methods. The DHAS is a questionnaire adapted to assess fear and anxiety of dental hygienist (DH) treatment. The DHAS contains four items and the sum of scores range from 4 (no anxiety) to 20 (extreme fear). A convenient sample of 80 patients in treatment at two DH programs in Sweden were consecutively included in the study. The DHAS was distributed together with questions regarding self-perceived oral health and experience of dental care at the first visit after a clinical examination performed by a DH. Re-test assessments of DHAS were conducted ∼ 2 weeks later in conjunction with the next visit to the DH before treatment (scaling session). Results. The results verified a significant positive correlation between the average DHAS sum of scores and global fear of DH and dentist treatment, perceived pain during the last DH treatment and female gender. The DHAS sum of scores had a high internal consistency, Cronbach's coefficient of 0.89 and 0.87 at the first and at the second assessment, respectively. The test-re-test reliability of the DHAS sum of scores was acceptable, with an intra-class coefficient of 0.82 and Kappa coefficients between 0.49-0.78 for the four single items in the DHAS. Conclusions. These results suggest that the DHAS has acceptable psychometric proprieties and is a valid and reliable scale to assess anxiety in DH treatment.
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22.
  • André Kramer, Ann-Catrin André, et al. (författare)
  • Demographic factors and dental health of Swedish children and adolescents
  • 2016
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:3, s. 178-85
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence.MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used.RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts.CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.
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23.
  • André Kramer, Ann-Catrin, et al. (författare)
  • Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.
  • 2018
  • Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 52:1-2, s. 42-50
  • Tidskriftsartikel (refereegranskat)abstract
    • The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
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24.
  • Andås, Charlotte Andren, et al. (författare)
  • A new dental insurance scheme - effects on the treatment provided and costs
  • 2014
  • Ingår i: Swedish Dental Journal. - 0347-9994. ; 38:2, s. 57-66
  • 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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25.
  • Andås, Charlotte Andren, et al. (författare)
  • Payment systems and oral health in Swedish dental care: Observations over six years.
  • 2016
  • Ingår i: Community Dental Health. - 0265-539X. ; 33:4, s. 257-261
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this longitudinal study of patients in regular dental care was to compare the findings of manifest caries and fillings after a 6-year adherence to either of two optional payment models, the traditional fee-for service (FFS) model, or the new capitation model 'Dental Care for Health' (DCH). Material and methods: Data on manifest caries lesions, the number of fillings and a number of background variables were collected from both a register and a questionnaire completed by 6,299 regular dental patients who met the inclusion criteria. The influence of payment system adherence and background variables on the number of manifest caries lesions at study end was examined by the means of negative binomial regression analysis. Results: The incidence rate ratio of manifest caries lesions after six years in FFS was 1.5 compared to DCH, after controlling for age, gender, education and pre-baseline caries incidence. The number of fillings was higher in FFS than in DCH at study start and at study end, and was also described by a steeper slope. Conclusions: At group level, this study showed a statistically significant difference between the caries situation after six years in DCH compared with FFS, when some important background factors, including pre-baseline caries, were kept constant in a regression model.
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26.
  • Andås, Charlotte Andren, et al. (författare)
  • Twelve years with a capitation payment system in Swedish dental care: longitudinal development of oral health
  • 2021
  • Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Since 2007, patients receiving oral health care within the Public Dental Service in Sweden have had the possibility to choose between the traditional fee-for-service (FFS) payment system or the new capitation payment system, 'Dental Care for Health' (DCH). Payment models are believed to involve different incentive structures for patients and caregivers. In theory, different incentives may lead to differences in health-related outcomes, and the research has been inconclusive. This 12-year longitudinal prospective cohort study of patients in regular dental care analyzes oral health development and self-reported oral health in relation to the patients' level of education in the two payment systems, and compares with the results from an earlier 6-year follow-up. Methods Information was obtained through a questionnaire and from a register from n = 5877 individuals who kept their original choice of payment model for 12 years, 1650 patients in DCH and 4227 in FFS, in the Public Dental Service in Region Vastra Gotaland, Sweden. The data comprised manifest caries prevalence, levels of self-reported oral health and education, and choice of dental care payment model. Analyses were performed with chi square and multivariable regression analysis. Results The findings from the 6-year follow-up were essentially maintained at the 12-year examination, showing that the pre-baseline caries prevalence is the most influential factor for less favorable oral health development in terms of the resulting caries prevalence. Educational level (>= university) showed an increased influence on the risk of higher caries prevalence after 12 years and differed between payment models with regard to the relation to self-rated oral health. Conclusions Differences in health and health-influencing properties between payment models were sustained from 6 to 12 years. Strategies for making use of potential compensatory mechanisms within the capitation payment system to increase oral health equality should be considered.
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27.
  • Andås, Charlotte Andren, et al. (författare)
  • Who chooses prepaid dental care? A baseline report of a prospective observational study
  • 2014
  • Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 146:14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: An optional capitation prepayment system has been implemented in Swedish dental care, supplementary to the traditional fee-for-service scheme within the Public Dental Service. The implementation of a new system may have a variety of preferred and adverse effects, arguably dependent on the individual patient's attitudes, health beliefs and course of action. The aim of this study was to describe potential differences regarding socioeconomic and lifestyle factors, perceived oral health and attitudes towards oral health between patients in the two payment systems. Methods: Questionnaire data were consecutively collected from 13,719 patients, who regularly attended 20 strategically selected clinics within the PDS in Region Vastra Gotaland, before they were offered the choice between the traditional and the new payment system. Results: Capitation patients were more often female and well educated. They had healthier habits, were more motivated to follow self-care advice, more often judged their oral health to be very good and considered oral health to be very significant for their wellbeing. The results were statistically significant and described a gradient. Conclusions: The more explicitly affirmative the answer, the more likely the patient was to choose the prepayment scheme. There appears to be a pattern of differences with respect to important individual views on oral health between patients choosing a capitation system or a fee-for-service system. These differences may be important when assessing outcomes in the new payment system and in public dental care.
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28.
  • Bergenholtz, Gunnar, 1939, et al. (författare)
  • Treatment of pulps in teeth affected by deep caries - A systematic review of the literature.
  • 2013
  • Ingår i: Singapore dental journal. - : World Scientific Pub Co Pte Lt. - 0377-5291. ; 34:1, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.STUDY DESIGN: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.RESULTS: No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.CONCLUSIONS: Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.
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29.
  • Berggren, Ulf, 1948, et al. (författare)
  • Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
  • 1997
  • Ingår i: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated the reported conditioned or cognitive origin of dental phobia in 100 adult patients at a specialized dental phobia clinic. It was shown that a majority of patients reported a conditioned background to their dental fear. Patients' avoidance time and level of dental anxiety corresponded to previously reported data for fearful groups. Individuals with an arousal conditioning etiology of dental fear reported significantly longer avoidance time as compared to individuals with a cognitively learned reaction. With the exception of an elevated level of general fears, most psychometrically assessed emotional reactions were well within normal ranges. However, patients with a non-conditioned, cognitive etiology reported significantly higher levels of trait anxiety and fear of embarrassment. In addition, a separate analysis among women revealed a greater fear of physical injuries among patients with cognitive etiology.
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30.
  • Berggren, Ulf, 1948, et al. (författare)
  • Assessment of patients with phobic dental anxiety.
  • 1997
  • Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated a screening procedure for psychologic distress in adult patients with dental phobia before treatment of dental fear. The screening procedure was performed among 191 individuals in consecutive steps and included a medical/dental history, psychologic interviewing, and testing. Data collected during this process were analyzed and compared with SCL-90(R) data. The screening process was successful in selecting individuals without major psychologic distress problems. Among the excluded patients 91% had general symptoms scores on the SCL-90(R) exceeding a normative population mean, and 95% of included patients had a mean lower than an average for psychiatric outpatients. There were statistically significant differences between included and excluded patients on all subdimensions of the SCL-90. Thus, excluded patients had higher levels of psychologic distress, poorer psychosocial background, and more psychosomatic symptoms. This was accompanied by higher levels of negative attitudes toward dentists and their performance of dentistry, whereas no significant differences were found among the dental fear measures used.
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