| 1. |
- Hallberg, Lillemor R-M, 1942, et al.
(författare)
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Facing a moral dilemma--introducing a dental care insurance within the public dental service.
- 2012
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Ingår i: Swedish dental journal. - : Swedish dental journal. - 0347-9994. ; 36:3, s. 149-56
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Tidskriftsartikel (refereegranskat)abstract
- Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.
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| 2. |
- Nederfors, Tommy, et al.
(författare)
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The relation between xerostomia and hyposalivation in subjects with rheumatoid arthritis or fibromyalgia
- 2002
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 26:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Aim of this study was to evaluate the relation between xerostomia and hyposalivation in 100 subjects with either rheumatoid arthritis or fibromyalgia, and further, to evaluate the predictive value of xerostomia on hyposalivation. Unstimulated and chewing stimulated whole saliva was collected in the morning with the subjects in a strict fasting condition and then about 2 hours later, after intake of a standardised breakfast. All participants filled in a questionnaire, mainly dealing with xerostomia. Forty subjects demonstrated a pathological fasting unstimulated whole saliva secretion rate, the corresponding number for fasting stimulated secretion being 39. For unstimulated, but not for stimulated saliva, the fasting secretion rate was significantly lower than the non-fasting. Xerostomia was reported by 74 subjects, this group having significantly lower both unstimulated and stimulated secretion rates than the non-xerostomic group. On the individual level, the predictive value of xerostomia on hyposalivation showed high sensitivity but unsatisfactory specificity. In conclusion, this study underlines the importance of applying strictly standardised procedures when collecting saliva, and that fasting unstimulated whole saliva is the diagnostic salivary secretion of choice. Finally, xerostomia was found to predict hyposalivation on a group, but not on an individual level.
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| 3. |
- Rythén, Marianne, et al.
(författare)
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Risk indicators for poor oral health in adolescents born extremely preterm.
- 2012
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Ingår i: Swedish dental journal. - 0347-9994. ; 36:3, s. 115-24
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Tidskriftsartikel (refereegranskat)abstract
- Children born extremely preterm often suffer from medical complications that have been shown to affect their oral health as toddlers and school children.The aim of this study was to investigate oral health and possible risk indicators for poor oral health in adolescents born extremely preterm compared with a control group and relate the findings to medical diagnoses at the clinical examination. Also in the same groups, compare the frequency of mineralization disturbances and its relation to postnatal morbidity and treatments. The medical records postnatally,was noted in 45 extremely preterm infants with a gestational age (GA) of <29 weeks, at 12 - 16 years of age and in age and gender matched fullterm controls with 37-43 weeks GA. A dental clinical examination was performed including a salivary examination. Medical diagnoses were noted at the time of the survey. Data from the patient dental records at 3, 6, and 9 years of age was compiled. The findings were related to gestational age, birth weight, neonatal and postnatal medical diagnoses treatments and medical diagnoses at the clinical examination. The result showed that the prevalence of plaque, gingivitis and the occurrence of Streptococcus mutans were higher among adolescents born extremely preterm compared to matched controls, and the saliva secretion was lower in the extremely preterm infants. The frequency of caries did not differ between the groups. Mineralization disturbances were more frequent in the primary dentition and more severe in the permanent dentition among the children born extremely preterm. No association between dental pathology, neonatal and postnatal morbidity and treatments was found. In conclusion, adolescents born extremely preterm have an increased number of risk indicators for a poorer oral outcome compared with the controls and more severe mineralization disturbances. These findings may imply an increased vulnerability for poorer oral health later in life.
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| 4. |
- Bakke, Merete, et al.
(författare)
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Development and evaluation of a comprehensive screening for orofacial dysfunction.
- 2007
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Ingår i: Swedish dental journal. - 0347-9994. ; 31:2, s. 75-84
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English. The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more "yes" for impairment in a domain resulted in one point (maximum NOT-S score 12 points). The mean NOT-S score (+/- SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1 +/- 2.6, and 0.4 +/- 0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 200 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.
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| 5. |
- Brahm, Carl-Otto, 1974, et al.
(författare)
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Dentists' views on fearful patients. Problems and promises.
- 2012
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 36:2, s. 79-89
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Tidskriftsartikel (refereegranskat)abstract
- Abstract A large number of patients treated in the general dental health service in Western countries report dental fear to some degree. Dentists' views of treating these fearful patients are not well described in the literature.Therefore, the aims of the study were to explore dentists' attitudes towards, experience of, and feelings about treating fearful patients. The sample consisted of 1293 members of the Association of Public Health Dentists in Sweden who were asked to respond to a web survey concerning dental fear. The response rate was 69% (n = 889).The majority of the responding dentists stated that dental fear is a problem in routine dental care,treating patients with dental fear is a positive challenge and they felt they were making a contribution.They also reported that treating patients with dental fear is associated with hard work, poor revenues, and little appreciation by employers. Female dentists reported a greater proportion of patients with dental fear and greater self-efficacy regarding the treatment of these patients, compared with their male colleagues. Dentists trained in other EU countries reported stress more often and less perceived contribution when treating fearful patients, compared with colleagues trained in Sweden. CONCLUSION: Dentists' views of treating fearful patients are mainly positive; however, it is problematic that dentists feel stress and that dentists who treat many fearful patients feel their employers do not appreciate their efforts.
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| 6. |
- Jälevik, Birgitta, et al.
(författare)
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Pain sensation and injection techniques in maxillary dento-alveolar surgery procedures in children - a comparison between conventional and computerized injection techniques (The Wand (R))
- 2014
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:2
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Tidskriftsartikel (refereegranskat)abstract
- Local anesthesia, especially palatal injection, is often associated with fear and anxiety. The aim was to compare the sensation of pain when using palatal block technique with computerized injection technique (CIT), to conventional infiltration technique with traditional syringe in surgical procedures involving the palate. Patients referred for bilateral minor maxillary surgical treatments were randomized for traditional infiltration anesthesia on one side and palatal block anesthesia with CIT on the other side. AMSA and P-ASA approaches were used with CIT. The sensation of pain was scored by the VAS scale. Twenty-eight patients were included in the study, whereof 17 (61%) were girls. The median age was 14.8 yrs. (12.6 - 17.8). Bilateral exposure of palatal impacted canines was the most common treatment. The injection pain was significantly lower, (p = 0.009), when using the CIT injection compared to conventional injection. However, with time-consuming surgery, additional CIT analgesic solution had to be injected in the buccal gingiva when suturing, in one fourth of the cases. Patients sedated with nitrous oxide seemed to benefit less from CIT. Computerized injection techniques, including P-ASA and AMSA approaches, reduces the sensation of pain when carrying out less time-consuming palatal dental surgery, especially in non-sedated teenagers.
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| 7. |
- 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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| 8. |
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| 9. |
- Frisk, Fredrik, 1971, et al.
(författare)
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Pulp exposures in adults--choice of treatment among Swedish dentists.
- 2013
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Ingår i: Swedish dental journal. - : Swedish dental association. - 0347-9994. ; 37:3, s. 153-60
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Tidskriftsartikel (refereegranskat)abstract
- This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
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| 10. |
- Hellqvist, Lena, 1960-, et al.
(författare)
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Effect of nicotine-free and nicotine-containing snus on plaque pH in vivo
- 2012
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Ingår i: Swedish Dental Journal. - : Swedish Dental Journal. - 0347-9994. ; 36:4, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Syftet med studien var att utvärdera pH-förändringar i plack in vivo vid användning av olika nikotinfritt och nikotinhaltigt snus. Kolhydratinnehållet i produkterna analyserades också. Tio deltagare, alla snusanvändare, deltog i en experimentell tvärsnittsstudie, vid elva tillfällen, med en veckas mellanrum. Sex nikotinfria och fyra nikotininnehållande produkter på den svenska marknaden ingick i studien och en sackaroslösning användes som kontroll. Deltagarna borstade inte tänderna under tre dagar innan besöket och avstod från att äta, dricka och snusa/röka två timmar före varje test. pH mättes i tre approximalrum upp till 45 minuter med snusprodukten placerad under överläppen. De nikotininnehållande produkterna innehöll endast spår av glukos, fruktos och sackaros (0.5-1%) och stärkelse (1.5%), medan de nikotinfria produkterna innehöll upp till 6.5 % lågmolekylära kolhydrater och 26.0 % stärkelse. Resultatet av pH-mätningarna i plack visade att alla fyra nikotininnehållande produkter höjde pH, till skillnad från tre av de sex nikotinfria produkterna, som sänkte pH betydligt. Dessa pH-förändringar i plack kan ha såväl positiv som negativ effekt på kariesrisken beroende på vilken produkt som används
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