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- André Kramer, Ann-Catrin André, et al.
(författare)
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Demographic factors and dental health of Swedish children and adolescents
- 2016
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:3, s. 178-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence.MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used.RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts.CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.
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| 2. |
- André Kramer, Ann-Catrin André, et al.
(författare)
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Multilevel analysis of dental caries in Swedish children and adolescents in relation to socioeconomic status
- 2019
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 53:1, s. 96-106
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to investigate the variability in dental caries experience in Swedish children and adolescents, at two different area levels: dental clinics and SAMS (small areas for market statistics), with respect to multiple individual socioeconomic factors (SES). Records of manifest caries using the DMFT indices (decayed, missing, filled teeth, dependent variables) were collected from electronic dental records for 300,988 individuals aged 3-19 years (97.3% coverage) from the Region Västra Götaland, Sweden. SES data were obtained from official registers and covered ethnicity, wealth, parental education, and employment. The SES variables were used as an independent aggregated variable - an in dex - categorized in deciles. Age and gender were independently included in the multilevel models. Two-level logistic regression analyses explored the probability of a dental caries experience and the variability (intracluster correlation) within dental clinic areas and SAMS, respectively. The most deprived (10th decile, SAMS level) 3- to 6-year-old children had an OR of 5.00 (95% CI 4.61-5.43) for dental caries experience (deft), compared with children in the 1st to 5th deciles. For older children and adolescents (≥7 years), the corresponding OR (DFT) was 2.25 (95% CI 2.15-2.35). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics. SES was more strongly related to the risk of dental caries experience than age and gender. In conclusion, the associations between SES and dental caries experience in Swedish children and adolescents were strong in the study and strongest in young children at a low level.
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| 3. |
- André Kramer, Ann-Catrin, et al.
(författare)
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Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study
- 2013
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Ingår i: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract AIM: To longitudinally follow and analyse caries prevalence and development in primary dentition in Swedish preschool children from 3 to 6 years of age. STUDY DESIGN: A longitudinal clinical study. METHODS: Three hundred 3-year-old children in the Public Dental Service were consecutively included. The children underwent annual clinical examinations at 3, 4, 5 and 6 years of age, performed by four calibrated dentists in clinical settings. Initial (d1-2) and manifest (d3-5) lesions were registered at surface and tooth level. Radiographs were taken when indicated and possible. STATISTICS: Chi-squared test was used for group comparisons. Friedman's test, Wilcoxon non-parametric test and logistic regression analyses explored caries development over the years. RESULTS: The parents of 271 children agreed to their children participating in the study (total dropout rate at 6 years, 10.3 %). At baseline, 27.3 % of the children had carious lesions (d1-5 mean 0.98, SD ± 2.44), and only 50.6 % of the children were totally caries-free at 6 years (d1-5 mean 1.88, SD ± 2.81). Initial carious lesions made up the greater share at all ages. The greater part of the caries increment occurred between 3 and 4 years of age (p < 0.001). Having initial and/or manifest carious lesions at 3 years of age was a significant explanatory factor for new lesions at 6 years of age (OR 2.29; 95 % CI 1.58-3.31). CONCLUSION: Children with an early caries experience had a high risk of further disease progression. Oral health promotion and prevention programmes should target small children and their carers.
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| 4. |
- André Kramer, Ann-Catrin, et al.
(författare)
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Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.
- 2018
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 52:1-2, s. 42-50
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
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| 5. |
- André Kramer, Ann-Catrin
(författare)
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On dental caries and socioeconomy in Swedish children and adolescents - Clinical and register-based studies
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim was to analyze the dental caries experience among Swedish children and adolescents and explore it with respect to demographic and socioeconomic factors. Study I is a longitudinal clinical study of 271 children, followed from three to six years of age (2003-6), with the aim to analyze initial and manifest caries in the primary dentition. Studies II–IV are cross-sectional registry studies of 300,988 children and adolescents, 3–19 years of age (2007-9). Study II investigated caries with reference to age, gender and geographical area. Study III explored the associations of individual multiple socioeconomic factors on the caries experience. Study IV analyzed the variability in caries experience at different area levels with respect to individual demography and socioeconomics. The results showed that young children with an early caries experience had a high risk of disease progression and initial carious lesions constituted a large share of the disease burden (Study I). Among 18- and 19-year-olds, only one-third had no manifest caries experience. The disease burden was highly skewed at all ages. Females had a higher risk of a caries experience than males before their teens, with a reverse pattern during the teenage years (Study II). Multiple socioeconomic factors had a significant association with the caries experience among children and adolescents, especially the youngest children (Study III). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics (Study IV). In conclusion, disparities in caries experience among Swedish children and adolescents were found with a skewed distribution, within age groups, between genders, between residential areas and in relation to individual socioeconomic status. The findings may serve as a basis for allocating resources in dentistry with the goal/ambition to achieve greater equity of dental health.
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