| 1. |
- Blomqvist, My, et al.
(författare)
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A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder
- 2015
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Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.Methods: Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age-and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.Results: Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.Conclusions: Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.
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| 2. |
- Blomqvist, My
(författare)
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Analysis of behavior and communication during dental appointments in children with attention and learning problems
- 2004
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Attention and learning problems in children are common and have a substantial impact on many situations in the child s daily life. The present thesis investigates the prevalence of behavior management problems (BMP) and the characteristics of communication during dental appointments in a group of children with attention and learning problems compared to a control group. The thesis comprises a retrospective dental record study of BMP and a prospective, detailed video analysis of the behavior of a group of children during a dental recall visit. The first aim was to investigate whether children with attention and learning problems had more dental behavior management problems (BMP), more cancelled and missed appointments, and more traumatic dental injuries compared with a control group. The second aim was to make a detailed analysis of behavioral interactions between the dentist and the child patient with attention and learning problems. All children born in 1991 (n=555) in one Swedish municipality were screened for attention and learning problems with Conner s 10-item questionnaire and a questionnaire focused on executive and learning problems. The dental records of 128 screen-positive index cases and 131 screen-negative control cases were studied from 1 year of age until the child turned 10. BMP on at least one occasion were more common in the index group than in the control group (54% vs. 37%). The percentage of appointments at which the children exhibited BMP was also higher in the index group (13% vs. 7%). No differences were found concerning cancelled or missed appointments or dental traumatic injuries between the two groups. The dental recall visit at 11 years of age for 65 index cases and 60 control cases was recorded on video and analyzed. The interaction between the dentist and the child was scored as verbal and nonverbal initiatives and responses. Total examination time was significantly longer in the index group. The children in the index group took significantly more initiatives, had significantly fewer verbal responses, were less coordinated between verbal and nonverbal responses, and had more missing responses than the children in the control group. In conclusion, the results of this thesis show that children with attention and learning problems had significantly more behavior management problems compared to a control group. The problems in communication observed in the children with attention and learning problems resulted in less two-way communication between the dentist and the child and poorer timing compared to the interaction between the dentist and the children in the control group.
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| 3. |
- Blomqvist, My, et al.
(författare)
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Cognitive ability and dental fear and anxiety
- 2013
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 121:2, s. 117-120
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Tidskriftsartikel (refereegranskat)abstract
- Dental fear and anxiety (DFA), as well as dental behavior management problems, are common in children and adolescents. Several psychological factors in the child, and parental DFA, have been studied and found to correlate to the child's DFA. The aim of this study was to investigate the relationship between cognitive ability and DFA in a population-based group of children with identified behavior and learning problems. In conjunction with a dental examination at 11yr of age, 70 children were assessed with regard to DFA using the Children's Fear Survey Schedule Dental Subscale (CFSS-DS), and their cognitive ability was assessed using the Wechsler Intelligence Scale for Children. In addition, parental DFA was measured using the Corah Dental Anxiety Scale. The results revealed that DFA was significantly correlated to verbal intelligence quotient (IQ) but not to any other cognitive index. A significant correlation was found between parental DFA and child DFA. The results indicate that the child's verbal capacity may be one factor of importance in explaining dental fear in children.
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| 4. |
- Blomqvist, My, et al.
(författare)
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Dental caries in adolescents with attention deficit hyperactivity disorder: a population-based follow-up study.
- 2011
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 119:5, s. 381-385
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Tidskriftsartikel (refereegranskat)abstract
- This study tested the hypothesis that adolescents with attention deficit hyperactivity disorder (ADHD) exhibit a higher prevalence of caries than adolescents in a control group. Thirty-two adolescents with ADHD and a control group of 55 adolescents from a population-based sample, all 17yr of age, underwent a clinical and radiographic dental examination. The mean±SD number of decayed surfaces (DS) was 2.0±2.2 in adolescents with ADHD and 0.9±1.4 in adolescents of the control group. Thirty-one per cent of the adolescents in the ADHD group had no new caries lesions (DS=0) compared with 62% in the control group. Six per cent of the adolescents in the ADHD group were caries free [decayed, missing or filled surfaces (DMFS)=0] compared with 29% in the control group. Adolescents with ADHD also had a higher percentage of gingival sites that exhibited bleeding on probing compared with the control group: 35±39% vs. 16±24% (mean±SD), respectively. At 17yr of age, adolescents with ADHD exhibited a statistically significantly higher prevalence of caries compared with an age-matched control group. Adolescents with ADHD need more support regarding oral hygiene and dietary habits. They should be followed up with shorter intervals between dental examinations to prevent caries progression during adulthood.
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| 5. |
- Blomqvist, My, et al.
(författare)
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Experiences of dental care and dental anxiety in adults with autism spectrum disorder
- 2014
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Ingår i: Autism Research and Treatment. - New York, USA : Hindawi Publishing Corporation. - 2090-1925 .- 2090-1933. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Dental anxiety is associated with previous distressing dental experiences, such as lack of understanding of the dentist intentions, perceptions of uncontrollability and experiences of pain during dental treatment. People with autism spectrum disorder (ASD) are impaired in building flexible predictions and expectations, which is very much needed during a dental visit. The aims of the study were to investigate if people with ASD have more negative dental experiences and a higher level of dental anxiety compared to a matched control group. Forty-seven adults with ASD and of normal intellectual performance, and 69 age- and sex-matched typically developing controls completed questionnaires on previous dental experiences and dental anxiety, the Dental Anxiety Scale, and the Dental Beliefs Survey. The ASD group experienced pain during dental treatments more often than the controls and 22% had repeatedly experienced being forced to dental treatment they were not prepared for, compared to 3% of the controls. A higher level of dental anxiety was reported by the ASD group. Dental treatment and methods for supporting the communication with patients with ASD need to be developed, in order to reduce the negative dental experiences and dental anxiety in people with ASD.
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| 6. |
- Blomqvist, My, et al.
(författare)
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How do children with attention deficit hyperactivity disorder interact in a clinical dental examination? : A video analysis.
- 2005
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 113:3, s. 203-209
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Tidskriftsartikel (refereegranskat)abstract
- Attention deficit hyperactivity disorder (ADHD) is currently the most common behavioural disorder in school-age children. The aim of this study was to perform a detailed analysis of behavioural interactions between the dentist and the child patient with ADHD. All children born in 1991(n=555) in one Swedish municipality were screened for attention and learning problems and assessed for ADHD: Twenty-two children with ADHD and a control group of 47 children without attention and learning problems were included in the study. The dental recall visit was recorded on video. The interaction between the dentist and the child was analyzed in detail and scored as verbal and nonverbal initiatives and responses. Compared to the children in the control group, the children with ADHD made significantly more initiatives, especially initiatives that did not focus on the eaxmination or the dentist. The children with ADHD had fewer verbal responses and more missing responses. In conclusion, the problems in communication resulted in less two-way communication between the dentist and the children with ADHD than the interaction between the dentist and the children in the control group. The children with ADHD had particular difficulties staying focused on the examination.
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| 7. |
- Blomqvist, My
(författare)
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Oral health and behavior in children with attention deficit hyperactivity disorder
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder and has a substantial impact on many situations in the child s daily life. The present thesis investigates the behavior of children with ADHD in a dental setting that is, behavior management problems (BMP), interaction between child and dentist, dental anxiety, and stress and the oral health of these children compared to a control group. The specific aims of this thesis were to test the hypotheses that children with ADHD display more BMP during dental treatment, display more problems in the interaction process with the dentist, exhibit a higher degree of dental anxiety, have a different stress reaction (measured as salivary cortisol) during a dental recall visit and a different diurnal cortisol variation, have a higher prevalence of caries and gingivitis, and have poorer oral health behavior than children in a control group. All children born in 1991 (n=555) in one Swedish municipality were screened for behavior, attention, and learning problems with Conner s 10-item questionnaire and a questionnaire focused on executive and learning problems. Thirty-five children fulfilled the criteria for ADHD and were classified according to whether they had ADHD of the combined, inattentive, or hyperactive-impulsive type. Children with no behavior, attention, and learning problems from the same population constituted a control group. In the first study, dental records of the subjects were obtained and data regarding notes on BMP between 3 and 10 yr of age were compiled. The children underwent a clinical dental examination at age 11 yr, and bite-wing radiographs were taken. The parents completed the Dental Subscale of Children s Fear Survey Schedule (CFSS-DS).In the ADHD group, the prevalence of BMP increased between age 7 and 9 yr. A significant difference between the groups was found at age 8. Compared to controls, children with ADHD had a significantly higher number of decayed, missing, or filled surfaces (DMFS, 1.0 ± 1.5 vs 2.0 ± 3.0, P = 0.032) and decayed surfaces (DS, 0.5 ± 0.9 vs 1.7 ± 3.6, P = 0.016). Differences between the groups in CFSS-DS scores were nonsignificant. In the second study, the dental recall visit at age 11 was recorded on video and analyzed in detail. Interaction between the dentist and the child was scored as verbal and nonverbal initiatives and responses. Compared to the children in the control group, the children with ADHD made significantly more initiatives, especially initiatives that did not focus on the examination or the dentist. The children with ADHD made fewer verbal responses and had more missing responses. These problems in communication resulted in less two-way communication between the dentist and the children with ADHD than between the dentist and the children in the control group. In the third study, the children, all age 13, underwent a clinical dental examination and completed two questionnaires on dietary habits and dental hygiene habits. Differences between the groups regarding DMFS, DS, initial caries lesions, and gingival inflammation were nonsignificant. Forty-eight percent in the ADHD group brushed their teeth every evening compared to 82% in the control group. Corresponding frequencies for brushing the teeth every morning were 48% and 75%. Children with ADHD were 1.74 times more likely to eat or drink more than five times a day than children in the control group. In the fourth study, the children, all age 13, underwent a clinical dental examination and completed the Corah Dental Anxiety Scale (CDAS). Four saliva samples were gathered for analysis of cortisol: one before the dental examination, one after, and two the following morning. The subgroup ADHD with hyperactivity-impulsivity had significantly lower cortisol levels than controls 30 min after awakening. When cortisol values were plotted on a timeline, this subgroup always had lower cortisol concentrations than children in the control group. The correlation between CDAS scores and cortisol concentrations before the dental examination was significant in both the ADHD and the control groups. In conclusion, this thesis found that children with ADHD compared to a control group have more dental behavior management problems; exhibit more problems interacting with the dentist, with particular difficulties staying focused on the examination; do not exhibit a higher degree of dental anxiety, except if the child has several symptoms of hyperactivity or impulsivity; have a blunted cortisol reaction, if the child has several symptoms of hyperactivity or impulsivity; have a higher caries prevalence and incidence at age 11, but not statistically significantly higher at age 13; do not have a higher prevalence of gingivitis; and have poorer oral health behavior.
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| 8. |
- Blomqvist, My, et al.
(författare)
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Oral health, dental anxiety, and behavior management problems in children with attention deficit hyperactivity disorder.
- 2006
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Ingår i: European Journal of Oral Science. - 0909-8836. ; 114:5, s. 385-390
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Tidskriftsartikel (refereegranskat)abstract
- Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The aim of this study was to investigate whether children with ADHD have a higher caries prevalence, a higher degree of dental anxiety, or more dental behavior management problems (BMP) than children of a control group. Twenty-five children with ADHD and a control group of 58 children, all aged 11 yr, were included in the study. The children underwent a clinical dental examination, and bitewing radiographs were taken. The parents completed the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Dental records from the subjects were obtained, and data regarding notes on behavior management problems (BMP) of the children when between 3 and 10 yr of age were compiled. Compared with controls, children with ADHD had significantly higher decayed, missing or filled surfaces (DMFS) (2.0 +/- 3.0 vs. 1.0 +/- 1.5) and significantly higher decayed surfaces (DS) (1.7 +/- 3.6 vs. 0.5 +/- 0.9). Differences between the groups regarding CFSS-DS scores were non-significant. In the ADHD group, the prevalence of BMP increased when the children were between 7 and 9 yr of age. In conclusion, children with ADHD exhibited a higher caries prevalence, did not exhibit a higher degree of dental anxiety, and had more BMP than children of a control group.
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| 9. |
- Dillner, Joakim, et al.
(författare)
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Antibodies to SARS-CoV-2 and risk of past or future sick leave
- 2021
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- The extent that antibodies to SARS-CoV-2 may protect against future virus-associated disease is unknown. We invited all employees (n=15,300) at work at the Karolinska University Hospital, Stockholm, Sweden to participate in a study examining SARS-Cov-2 antibodies in relation to registered sick leave. For consenting 12,928 healthy hospital employees antibodies to SARS-CoV-2 could be determined and compared to participant sick leave records. Subjects with viral serum antibodies were not at excess risk for future sick leave (adjusted odds ratio (OR) controlling for age and sex: 0.85 [95% confidence interval (CI) (0.85 (0.43-1.68)]. By contrast, subjects with antibodies had an excess risk for sick leave in the weeks prior to testing [adjusted OR in multivariate analysis: 3.34 (2.98-3.74)]. Thus, presence of viral antibodies marks past disease and protection against excess risk of future disease. Knowledge of whether exposed subjects have had disease in the past or are at risk for future disease is essential for planning of control measures.Trial registration: First registered on 02/06/20, ClinicalTrials.gov NCT04411576.
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