| 1. |
- Andås, Charlotte Andren, et al.
(författare)
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Who chooses prepaid dental care? A baseline report of a prospective observational study
- 2014
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 146:14
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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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| 2. |
- Wennström, Anette, 1975, et al.
(författare)
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Trends in tooth loss in relation to socio-economic status among Swedish women, aged 38 and 50 years: repeated cross-sectional surveys 1968-2004
- 2013
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 13:63
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral diseases are a health problem worldwide. Differences in oral health status may vary with geographical locations, but also within the same country and between groups with different social backgrounds. The specific aims were to describe secular trends in oral health status regarding number of remaining teeth and also to describe differences in socio-economic status, among 38- and 50-year-old women, over a 36-year period. Methods: Cross-sectional health surveys were performed at four occasions; 1968/69 (n=746), 1980/81 (n=532), 1992/93 (n=165) and 2004/05 (n=500), including randomly selected women aged 38 and 50 years. The number of teeth was determined using panoramic radiographs and self-reported measures of marital status, social class, educational level, and income were recorded. Results: The mean number of teeth among women has increased significantly. The educational level has increased while fewer women are married/cohabiting over time. There has been a shift in the social group the women belong to, where proportionally more women were categorized in a higher social group in 2004/05 than in 1968/69. Moreover, there is a significant relationship between fewer teeth and a lower social group, and among the 50-year-old women, this was irrespective of examination year. However, multivariate analyses showed that the risk to be edentulous or not, or to have fewer remaining teeth was significantly higher for women of lower social group, or living alone, in all studies over the 36 year-period. This was independent of age group, even though the risk diminished over the study period. Conclusions: Cohort comparisons of women aged 38 and 50 years during 36 years showed that dental status improved, with (i) a decreasing prevalence of edentulism and, (ii) an increasing number of remaining teeth in dentate individuals over time. Differences due to social group and education were still present, with more remaining teeth in the women in the higher social group. A time trend analysis indicated that in the later examination years the individuals had fewer teeth lost, irrespective of age, marital status and, social group.
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| 3. |
- Wide Boman, Ulla, 1964, et al.
(författare)
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Oral health-related quality of life, sense of coherence and dental anxiety: An epidemiological cross-sectional study of middle-aged women.
- 2012
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Ingår i: BMC oral health. - : Springer Science and Business Media LLC. - 1472-6831. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Background: Few publications report on the relationship between salutogenesis, as measured by the concept of sense of coherence, and oral health-related quality of life. Even less information is to be found when the behavioural aspect of dental anxiety is added. The aim of the present study was to evaluate how oral health-related quality of life is related to sense of coherence and dental anxiety. Method: The study had a cross-sectional design and included 500 randomly selected women in Gothenburg, Sweden, 38 and 50 years of age, from health examinations in 2004–05. The survey included questionnaires covering global questions concerning socio-economic status, oral health/function and dental care behaviour, and tests of oral health-related quality of life, sense of coherence, and dental anxiety. Results: High dental anxiety and low sense of coherence predicted low oral health-related quality of life. In addition, socioeconomic status as measured by income, perceived oral functional status as captured by chewing ability and self-reported susceptibility to periodontal disease were also important predictors of oral health-related quality of life. Conclusion: Dental anxiety and sense of coherence had an inverse relationship with regard to oral health-related quality of life. These associations were stronger than other risk factors for low oral health-related quality of life.
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| 4. |
- Östberg, Anna-Lena, et al.
(författare)
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Oral health and obesity indicators
- 2012
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In western Sweden, the aim was to study the associations between oral health variables and total and central adiposity, respectively, and to investigate the influence of socio-economic factors (SES), lifestyle, dental anxiety and co-morbidity. METHODS: The subjects constituted a randomised sample from the 1992 data collection in the Prospective Population Study of Women in Gothenburg, Sweden (n=999, 38->=78 yrs). The study comprised a clinical and radiographic examination, together with a self-administered questionnaire. Obesity was defined as body mass index (BMI)>=30 kg/m2, waist-hip ratio (WHR)>=0.80, and waist circumference >0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders. RESULTS: The mean BMI value was 25.96 kg/m2, the mean WHR 0.83, and the mean waist circumference 0.83 m. The number of teeth, the number of restored teeth, xerostomia, dental visiting habits and self-perceived health were associated with both total and central adiposity, independent of age and SES. For instance, there were statistically significant associations between a small number of teeth (<20) and obesity: BMI (OR 1.95; 95% CI 1.40-2.73), WHR (1.67; 1.28-2.19) and waist circumference (1.94; 1.47-2.55), respectively. The number of carious lesions and masticatory function showed no associations with obesity. The obesity measure was of significance, particularly with regard to behaviour, such as irregular dental visits, with a greater risk associated with BMI (1.83; 1.23-2.71) and waist circumference (1.96; 1.39-2.75), but not with WHR (1.29; 0.90-1.85). CONCLUSIONS: Associations were found between oral health and obesity. The choice of obesity measure in oral health studies should be carefully considered.
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| 5. |
- Andås, Charlotte Andren, et al.
(författare)
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Twelve years with a capitation payment system in Swedish dental care: longitudinal development of oral health
- 2021
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 21:1
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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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| 6. |
- Carlsson, Viktor, 1980, et al.
(författare)
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Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behaviour - a national Swedish cross-sectional survey
- 2015
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dental anxiety (DA) is a common condition associated with avoidance of dental care and subsequent health-related and psychosocial outcomes, in what has been described as the vicious circle of DA. Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA. More studies are needed to verify the relationship between DA and SOC, especially using population-based samples. There is also a need for studies including factors related to the vicious circle of DA, such as oral health-related quality of life (OHRQoL), in order to further establish the correlates of DA in the general population. Therefore, the aim of this study was to investigate the relationship between DA and SOC, OHRQoL and health-related behaviour in the general Swedish population. Methods: The survey included a randomly selected sample of the adult Swedish population (N = 3500, age 19 - 96 years.). Data was collected by means of telephone interviews. Dental anxiety was measured with a single question. The SOC measure consisted of three questions conceptualising the dimensions of the SOC: comprehensibility, manageability and meaningfulness. The data collection also included the five-item version of the Oral Health Impact Profile (OHIP-5), as a measure of OHRQoL, as well as questions on oral health-related behaviour and socioeconomic status. Statistical analyses were made with descriptive statistics and inference testing using Chi-square, t - test and logistic regression. Results: High DA was associated with low OHRQoL, irregular dental care and smoking. There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses. Dental anxiety was not associated with oral health-related behaviour or socioeconomic status. Conclusions: This cross-sectional national survey gives support to the significant associations between high dental anxiety, avoidance of dental care and health-related outcomes, which may further reinforce the model of a vicious circle of dental anxiety. The results further indicate a weak relationship between dental anxiety and sense of coherence.
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| 7. |
- Guo, Annie, et al.
(författare)
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Dietary intake and meal patterns among young adults with high caries activity : a cross-sectional study
- 2022
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Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity.MethodsThis study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces.ResultsThe High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables.ConclusionThe results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.
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| 8. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women
- 2021
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80years of age. Study design: In a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3mm was calculated. Results: A normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR forseverely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96mm) and women (2.92mm), respectively. The OR for cortical thickness< 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately. Conclusions: Among old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.
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| 9. |
- Werner, Helene, 1987, et al.
(författare)
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A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration.
- 2020
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for effective behavioural interventions in dentistry. This paper presents an innovative behavioural intervention for young adults with dental caries, in an interdisciplinary collaboration between dental personnel and licensed psychologist in general dental care. The intervention has been evaluated in an RCT, with positive effects on oral health behaviour.The intervention, Acceptance and Commitment Therapy (ACT), a recent form of cognitive behaviour therapy (CBT), was adapted to young adult patients (18-25years of age) with high dental caries activity.The intervention included two individual sessions, provided by a clinical psychologist at general dental clinics. The rationale for selecting ACT as the theory base is presented, together with the treatment manual and a case illustration.ACT may be a promising alternative for behavioural interventions in dentistry for patients with oral diseases, specifically dental caries. Interprofessional collaboration between psychologists and dental personnel opens up for new possibilities to help and treat patients with various health issues in public dental care.TRN ISRCTN15009620 www.isrctn.com , retrospectively registered 14/03/2018.
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| 10. |
- 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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