| 1. |
- Hagman, Jennie, et al.
(författare)
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A psychological intervention for caries active young adults, a randomized controlled trial.
- 2022
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Ingår i: Clinical and experimental dental research. - : Wiley. - 2057-4347. ; 8, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the effect of a brief version of the behavioral intervention Acceptance and Commitment Therapy (ACT) on reducing gingivitis and plaque levels after 18weeks.One hundred thirty-five caries-active young adults (18-25years of age), recruited from two public dental clinics, participated in this parallel group randomized control trial (RCT). Participants in the intervention (n=67) received two ACT sessions in combination with standard information on oral health, and participants allocated to the control group (n=68) received standard information only. Gingivitis and plaque levels were recorded at baseline and at the 9- and 18-week follow-ups. The effect of the intervention versus standard information alone was analyzed by intention-to-treat and per protocol, applying the General Linear Model (GLM). Exploratory analyses for the intervention and control groups were conducted to evaluate the effect of gender and smoking habits on the gingivitis and plaque outcome. The CONSORT guidelines for RCT were followed.A significant decrease in gingivitis and plaque levels was observed over time, irrespective of treatment allocation. However, the ACT intervention was not significantly more effective at reducing gingivitis and plaque scores than standard information alone, even though the intervention participants had maintained their improvement to a greater extent. The exploratory analysis revealed that females improved their gingivitis and plaque levels significantly more than the males in the intervention group (p=0.025 for gingivitis and p=0.013 for plaque).A brief ACT intervention was not proven to be more effective than standard information alone at improving oral health in a sample of young adults with poor oral health. However, ACT seems to have a positive effect on oral health among females. (TRN ISRCTN15009620).
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| 2. |
- Hagman, Jennie, et al.
(författare)
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Oral health and oral health behavior in young adults with caries disease.
- 2021
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Ingår i: BDJ open. - : Springer Science and Business Media LLC. - 2056-807X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and analyze oral health, oral health behaviors, and oral health-related quality of life (OHRQoL) in relation to the level of caries disease among caries-active young adults.This study presents data from a sample of young adults (n=135) with active caries disease who were enrolled in a clinical, randomized controlled trial. The independent variables of sociodemographics, oral health (gingivitis, plaque), oral health behaviors (such as toothbrushing, dental attendance, sugar-containing sweets and drinks), dental anxiety, self-rated oral health, and OHRQoL were collected. Multinomial logistic regression was used to simultaneously evaluate the associations between the independent variables and caries severity.Multinominal logistic regression showed that poor OHRQoL and gingivitis were associated with caries severity in a gradient fashion in accordance with caries disease activity. Also, irregular dental care and frequent consumption of sugary soda were significantly associated with very high caries severity.The risk factors related to caries severity among young adults were poor OHRQoL, gingivitis, consumption of sugary soda and irregular dental care attendance, indicating the need for a combination of different interventions specifically health behavior change. Furthermore, these findings may contribute to identifying high caries-risk individuals.
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| 3. |
- Hagman, Jennie
(författare)
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Young adults and oral health - Oral health behaviors and an intervention for better oral health
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although the oral health among young adults in Sweden is generally good, there are groups where poor oral health remains a problem. The aim of this thesis is to increase our knowledge of oral health and oral health-related behaviors among young adults with caries disease, and to evaluate the ability of a brief form of Acceptance and Commitment Therapy (ACT) to promote oral health and oral health behaviors in this group of individuals at the Public Dental Service Clinics. The studies included are based on a randomized controlled trial carried out in a sample of 18-25-year-olds, with ≥ 2 new approximal dentin caries lesions since their last dental examination. In Study I, we analyzed baseline data to describe oral health, oral health-related quality of life (OHRQoL), oral health behaviors, and the association between different known risk factors for poor oral health and caries severity. The results demonstrate that, in general, the young adults suffered from poor oral health, negatively affected OHRQoL, and they engaged in different oral health risk behaviors. Levels of gingivitis, the frequency of sugary soda consumption, poor OHRQoL and less frequent dental attendance were found to be associated with the caries severity. Study II evaluated the direct effect of ACT on oral health behavior, and Study III evaluated the effect on the levels of gingivitis and plaque at the 9-week and 18-week follow-ups. Study II showed a promising direct effect of ACT on oral hygiene behaviors, in favor of ACT treatment. In Study III, reduced gingivitis and plaque levels were found both in the intervention and the control group. Although slightly lower levels of plaque and gingivitis were maintained in the intervention group at the 18-week follow-up, the improvement was not statistically significantly better than in the control group. The finding in Study I emphasizes the need to develop effective interventions to promote oral health in this subgroup of young adults. Study II and III contribute with important knowledge but also acknowledge the need for further development and evaluation of theory-based interventions in the dental field.
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| 4. |
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| 5. |
- Johanen, Astera, et al.
(författare)
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Trabecular bone patterns as a fracture risk predictor: a systematic review
- 2021
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 79:7, s. 482-491
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods.The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach.The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69.Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.
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| 6. |
- Wide, Ulla, 1964, et al.
(författare)
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Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial.
- 2018
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Ingår i: BMC oral health. - : Springer Science and Business Media LLC. - 1472-6831. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Dental caries is a major public health issue affecting a large proportion of the general population. The disease is associated with behavioural factors and is thus preventable to a high degree. Individuals may need assistance to be able to change their oral health behaviour. There is a lack of such interventions for adults affected by severe caries. The aim of the study was to evaluate the effect of Acceptance and Commitment Therapy (ACT), a form of cognitive behavioural therapy, on oral health behaviour in young adults with poor oral health.The study included a two group parallel randomised controlled trial at general dental clinics, with young adults, 18-25years of age, ≥ two manifest proximal dental caries lesions (n=135); 67 were treated with ACT and 68 with standard disease information only, respectively. Primary outcomes: oral health behaviours (tooth-brushing, flossing, use of toothpicks, and additional fluoride use). The CONSORT principles for RCTs were used, including intention-to-treat and per protocol analyses. The Chi-square, Mann-Whitney, and Wilcoxon Signed Rank tests were applied, including effect sizes.The study groups did not differ with regard to oral health behaviour variables at baseline. The intervention group improved all their oral health behaviours significantly over time (effect sizes, 0.26-0.32), while the control group showed improved behaviours on two measures (flossing and additional use of fluoride, effect sizes, 0.22-0.23).By testing a psychological intervention on young adults (18-25years of age) with a high prevalence of caries, we found an immediate positive effect with improved oral health behaviours.TRN ISRCTN15009620 , retrospectively registered 14/03/2018.
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