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1.
  • Ahlqwist, Margareta, et al. (creator_code:aut_t)
  • Dental status of women in a 24-year longitudinal and cross-sectional study. Results from a population study of women in Göteborg.
  • 1999
  • record:In_t: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 57:3, s. 162-7
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The aim of the study was to describe dental health status among middle-aged and elderly women over a 24-year period. Because of the design of the study it was possible to make both longitudinal and cross-sectional comparisons. The study started in 1968-69 with a combined medical and dental examination of women aged between 38 and 60 years. New dental examinations of these same women were performed in 1980-81 and again in 1992-93, and included new cohorts of 38-year-old women on both occasions. In the cross-sectional perspective, it was shown that the number of edentate individuals decreased significantly during the 24-year period. Among dentate women, the number of remaining teeth and restored teeth increased significantly cross-sectionally. However, the youngest age group, women of 38 years, showed a lower number of restored teeth in the latest study (in 1992-93). There was also a lower number of crowns, root-fillings, and pontics in the latest study for the youngest age group. The two older age groups studied cross-sectionally showed similar numbers in all studies. In the longitudinal study, there was a decrease with time in incidence of edentulism. Among the dentate women in the longitudinal study the number of restored teeth related to those remaining was high (range 76-90%) and did not change much between the studies in the different age groups. There was a clear tendency during the 24-year period in all age groups for more teeth to be restored with crowns rather than different fillings. In conclusion, this population study, with a follow-up of 24 years, shows that dental status improved in that fewer individuals lost all their teeth and younger age groups have more remaining teeth and fewer restorations than previously.
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2.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
  • 1997
  • record:In_t: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
  • swepub:Mat_article_t (swepub:level_refereed_t)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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3.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Assessment of patients with phobic dental anxiety.
  • 1997
  • record:In_t: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
  • swepub:Mat_article_t (swepub:level_refereed_t)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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4.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Factor analysis and reduction of a Fear Survey Schedule among dental phobic patients.
  • 1995
  • record:In_t: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 331-8
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • A fear survey instrument, based on the Fear Survey Schedule-II and five additional fear items, was administered to 109 patients (70 women and 39 men) on a waiting list at a specialized dental fear clinic. The fear survey was analyzed to identify its factorial structure. Five fear factors, explaining 54% of the total variance, were identified concerning areas of "illness and death", "failures and embarrassment", "social situations", "physical injuries", and "animals and natural phenomena". An ad hoc reduction of items was carried out to form a shorter, more practical to use questionnaire, which resulted in factors of four or five items with loadings greater than 0.50. The factors intercorrelated significantly (rp varying between 0.33 and 0.59) and "illness and death" correlated highly with "physical injuries" (rp = 0.59) and "animals and natural phenomena" (rp = 0.56), while "failures and embarrassment" correlated highly to "social situations" (rp = 0.54). Statistically significant, but generally lower correlations were found between each factor and the dental fear measures. The highest correlations were found between fear of "physical injuries" and dental fear. There was also a high and significant correlation between sex and fear of "animals and natural phenomena".
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5.
  • Hakeberg, Magnus, 1954, et al. (creator_code:aut_t)
  • Multivariate analysis of fears in dental phobic patients according to a reduced FSS-II scale.
  • 1995
  • record:In_t: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 339-44
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This study analyzed and assessed dimensions of a questionnaire developed to measure general fears and phobias. A previous factor analysis among 109 dental phobics had revealed a five-factor structure with 22 items and an explained total variance of 54%. The present study analyzed the same material using a multivariate statistical procedure (LISREL) to reveal structural latent variables. The LISREL analysis, based on the correlation matrix, yielded a chi-square of 216.6 with 195 degrees of freedom (P = 0.138) and showed a model with seven latent variables. One was a general fear factor correlated to all 22 items. The other six factors concerned "Illness & Death" (5 items), "Failures & Embarrassment" (5 items), "Social situations" (5 items), "Physical injuries" (4 items), "Animals & Natural phenomena" (4 items). One item (opposite sex) was included in both "Failures & Embarrassment" and "Social situations". The last factor, "Social interaction", combined all the items in "Failures & Embarrassment" and "Social situations" (9 items). In conclusion, this multivariate statistical analysis (LISREL) revealed and confirmed a factor structure similar to our previous study, but added two important dimensions not shown with a traditional factor analysis. This reduced FSS-II version measures general fears and phobias and may be used on a routine clinical basis as well as in dental phobia research.
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6.
  • Hakeberg, Magnus, 1954, et al. (creator_code:aut_t)
  • Repeated measurements of mood during psychologic treatment of dental fear.
  • 1997
  • record:In_t: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:6, s. 378-83
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The aims of the present study were to analyze mood changes during psychologic treatment of dental fear by assessing the rate of improvement. Twenty-one patients who refused conventional dental treatment and reported extreme dental anxiety participated in the study. Levels of dental anxiety and mood were measured with the Dental Anxiety Scale (DAS) and a Mood Adjective Checklist (MACL). MACL included two dimensions, degree of relaxation (r) and pleasantness (h) as experienced in a dental situation. Mood was monitored at each treatment session from base line to termination of the therapy (eight measurements). Two different treatment modalities were used, one with a more cognitive approach (n = 9) and one emphasizing the relaxation component (n = 12). A hierarchical linear models approach was applied to analyze individual change with repeated measurements. The results showed that positive mood changes over time were statistically significant. The mean improvement in mood scores per week and session was estimated for MACL(r) and MACL(h) to be 0.14/week and 0.09/week, respectively. The growth was not affected by DAS levels or treatment mode. This study also illustrated a powerful method for analyzing a longitudinal clinical trial design with repeated measurements.
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7.
  • Hakeberg, Magnus, 1954, et al. (creator_code:aut_t)
  • Reported burning mouth symptoms among middle-aged and elderly women.
  • 1997
  • record:In_t: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 105:6, s. 539-43
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The aims of this investigation were to assess the prevalence of burning mouth symptoms (BM) in a representative population of Swedish middle-aged and elderly women (n=1017) and its relation to general and oral health status. BM was reported by 4.6% (n=47), and 85% of the BM subjects had experienced BM for more than 6 months. A stepwise multiple logistic regression with BM/non-BM as dependent variable showed that 7 covariates were found to be predictive of BM. These variables were medication with antihypertensives, sedatives and female sex hormones. Moreover, headache, tinnitus, dry mouth, and reduced chewing ability were included in the final model.
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8.
  • Hägglin, Catharina, 1955, et al. (creator_code:aut_t)
  • Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state, utilisation of dental services and concomitant factors.
  • 1996
  • record:In_t: Gerodontology. - : Wiley. - 0734-0664 .- 1741-2358. ; 13:1, s. 25-34
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS > or = 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.
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9.
  • Hägglin, Catharina, 1955, et al. (creator_code:aut_t)
  • Variations in dental anxiety among middle-aged and elderly women in Sweden: a longitudinal study between 1968 and 1996.
  • 1999
  • record:In_t: Journal of dental research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 78:10, s. 1655-61
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Cross-sectional studies have shown that older individuals are significantly less dentally anxious than younger ones. However, research has not been able to show if this is a cohort effect or an effect of fear declining with age. If it is a cohort effect, dental anxiety among the elderly may pose a greater-than-expected problem for the providers of dental services. With the exception of longitudinal studies in children and a three-year follow-up on adults, no truly longitudinal epidemiological studies concerning dental anxiety have been performed. The aim of this project was to investigate how dental anxiety changes with aging. In a longitudinal population study of women in Göteborg, Sweden, starting in 1968, 1462 women aged 38 to 54 participated. A representative subsample of 778 women took part in a psychiatric examination where an investigation of dental anxiety was included. The same questions were also included when these women were re-examined in 1974, 1992, and 1996. Three hundred seventy-five women were still eligible for investigation in 1996. In 1968-69, 48 (12.8%) of the participating women assessed themselves as "very afraid" or "terrified" when visiting the dentist, and in 1996 the frequency was 21 (5.6%) among the same women. In 1968-69, 180 women (48%) reported no dental anxiety when visiting the dentist, and 28 years later the frequency was 230 (61%). In the three youngest age groups, dental anxiety decreased significantly (p < 0.001) over the 28-year period. Older compared with younger women reported significantly less dental anxiety, and this was an age effect rather than a cohort effect. Thus, this longitudinal study supported the hypothesis that dental fear, like many other general and specific phobias, declines with age.
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