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form:Search_simp_t: L773:1472 6831 > swepub:Level_Refereed_t > language:ENG_t > Holmén Anders

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1.
  • Holmen, Anders, et al. (creator_code:aut_t)
  • Tobacco use and caries risk among adolescents - a longitudinal study in Sweden
  • 2013
  • record:In_t: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 13
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Background: Smoking and the use of smokeless tobacco have a detrimental impact on general and oral health. The relationship to dental caries is however still unclear. As caries is a multi-factorial disease with clear life-style, socio-economic and socio-demographic gradients, the tobacco use may be a co-variable in this complex rather than a direct etiological factor. Our aim was to analyze the impact of tobacco use on caries incidence among adolescents, with consideration to socio-economic variables by residency, using epidemiological data from a longitudinal study in the region of Halland, Sweden. Methods: The study population consisted of 10,068 adolescents between 16-19 years of age from whom yearly data on caries and tobacco use (cigarette smoking and use of smokeless tobacco) were obtained during the period 2006-2012. Reported DMFS increment between 16 and 19 years of age (Delta DMFS) for an individual was considered as the primary caries outcome. The outcome data were compared for self-reported never vs. ever users of tobacco, with consideration to neighborhood-level socio-economy (4 strata), baseline (i.e., 16 years of age) DMFS and sex. The region consists of 65 parishes with various socio-economic conditions and each study individual was geo-coded with respect to his/her residence parish. Neighborhood (parish-level) socio-economy was assessed by proportion of residing families with low household purchasing power. Results:Delta DMFS differed evidently between ever and never users of tobacco (mean values: 1.8 vs. 1.2; proportion with Delta DMFS > 0: 54.2% vs. 40.5%; p < 0.0001). Significant differences were observed in each neighborhood-level socio-economic stratum. Even after controlling for baseline DMFS and sex, Delta DMFS differed highly significantly between the ever and never users of tobacco (overall p < 0.0001). Conclusion: Tobacco use was clearly associated with increased caries increment during adolescence. Hence, this factor is relevant to consider in the clinical caries risk assessment of the individual patient as well as for community health plans dealing with oral health.
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2.
  • Strömberg, Ulf, et al. (creator_code:aut_t)
  • Geo-mapping of time trends in childhood caries risk - a method for assessment of preventive care
  • 2012
  • record:In_t: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 12
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Background: Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time. The aim of this study was to develop the geo-map concept, addressing time trends in caries risk, and demonstrate the novel approach by analyzing epidemiological data from preschool residents in the region of Halland, Sweden. Methods: The study population consisted of 9,973 (2006) and 10,927 (2010) children between 3 to 6 years of age (similar to 77% of the eligible population) from whom caries data were obtained. Reported dmfs >0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region). Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI (R) ArcGIS system. Parish-level socioeconomic data were available. Results: The overall proportion of caries-free (dmfs = 0) children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level) smoothed relative risks (SmRRs) increased from 1.76/0.44 = 4.0 in 2006 to 2.37/0.33 = 7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period. Conclusion: Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive care in child populations.
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Strömberg, Ulf (2)
Twetman, Svante (2)
Magnusson, Kerstin (2)
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