| 1. |
- Andreassen, R., et al.
(författare)
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Oral health related quality of life in long-term survivors of head and neck cancer compared to a general population from the seventh Tromso study
- 2022
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Both the incidence and survival rate of head and neck cancer (HNC) is increasing, making quality of life of HNC survivors an important issue. Methods In this cross-sectional study we compared the oral health related quality of life (OHRQoL) of long-term HNC survivors to that of a general population cohort from the seventh survey of the Tromso study with the Oral Impact on Daily Performances questionnaire. Comparisons were done with frequency analyses and cross tabulation. We also assessed OHRQoL's association to sociodemographic and oral health related variables in both cohorts as well as with cancer related variables in the HNC cohort with regression analyses. Results The HNC survivors had four times the risk of reporting problems with daily performances compared with the general population cohort. The ability to eat and enjoy food was most frequently affected in both cohorts. Moderate-poor self-rated dental health and general health as well as high frequency of dental visits were significantly associated with poorer OHRQoL. To have a history of oral or pharyngeal cancer was associated with more problems than having a history of laryngeal cancer. Conclusions Our study shows that HNC treatment is associated with a strong and lasting impairment of OHRQoL, highlighting the need to find less toxic, yet effective ways to treat the disease, and to provide easy access to expert dental care at all stages of the disease to minimize morbidity. Given the widespread side effects of cancer treatment, a multidisciplinary approach might be required to improve the OHRQoL of HNC survivors.
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| 2. |
- Asa'ad, Farah, 1983, et al.
(författare)
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Polymorphism in epigenetic regulating genes in relation to periodontitis, number of teeth, and levels of high-sensitivity C-reactive protein and glycated hemoglobin: The Tromsø Study 2015-2016.
- 2023
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Ingår i: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 94:11, s. 1324-37
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to investigate the association between periodontitis and four single nucleotide polymorphisms (SNPs) in genes involved in epigenetic regulation of DNA, and between these same SNPs and tooth loss, high-sensitivity C-reactive protein (hs-CRP), and glycated hemoglobin (HbA1c) levels. Methods: We included participants with periodontal examination (n = 3633, aged: 40-93 years) from the Tromsø Study seventh survey (2015-2016), Norway. Periodontitis was defined according to the 2017 AAP/EFP classification system as no periodontitis, grades A, B, or C. Salivary DNA was extracted and genotyping was performed to investigate four SNPs (rs2288349, rs35474715, rs34023346, and rs10010325) in the sequence of the genes DNMT1, IDH2, TET1, and TET2. Association between SNPs and periodontitis was analyzed by logistic regression adjusted for age, sex, and smoking. Subgroup analyses on participants aged 40-49 years were performed. Results: In participants aged 40-49 years, homozygous carriage of minor A-allele of rs2288349 (DNMT1) was associated with decreased susceptibility to periodontitis (grade A: odds ratio [OR] 0.55; p = 0.014: grade B/C OR 0.48; p = 0.004). The minor A-allele of rs10010325 (TET2) was associated with increased susceptibility to periodontitis (grade A OR 1.69; p = 0.035: grade B/C OR 1.90; p = 0.014). In the entire sample, homozygous carriage of the G-allele of rs35474715 (IDH2) was associated with having ≤24 teeth (OR 1.31; p = 0.018). Homozygous carriage of the A-allele of TET2 was associated with hs-CRP≥3 mg/L (OR 1.37; p = 0.025) and HbA1c≥6.5% (OR 1.62; p = 0.028). Conclusions: In this Norwegian population, there were associations between polymorphism in genes related to DNA methylation and periodontitis, tooth loss, low-grade inflammation, and hyperglycemia.
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| 3. |
- Bongo, Ann Kristine Sara, et al.
(författare)
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Caries experience among adults in core Sámi areas of Northern Norway
- 2021
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 49:5, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Dental caries is a major oral health problem among indigenous people worldwide, but knowledge on this issue among the indigenous Sámi people in Norway is scarce. The aim of the study was to describe dental caries experience in an adult population in core Sámi areas of Northern Norway and to assess the corresponding associations with socio-demographic, socioeconomic and oral health-related behavioural factors. Methods: This cross-sectional study is based on data from the Dental Health in the North study (2033 participants aged 18-75years). A questionnaire was used to collect data on socio-demographic, socioeconomic and oral health-related behavioural factors. Clinical examinations were performed by dentists and dental hygienists at Public Dental Service (PDS) clinics in core Sámi areas of Northern Norway. Results: About 68% (n=1380) of participants reported Sámi ethnicity, and the mean number of decayed (D), missed (M) and filled (F) teeth (T) was 16.2 (standard deviation [SD]=6.7). The mean DMFT was 15.7 (SD=6.7) among Sámi and 17.0 (SD=6.7) among non-Sámi. The mean DT among Sámi was 1.0 (SD=1.6), with a significant, higher prevalence among coastal Sámi (DT=1.3, SD=1.8) than inland Sámi (DT=0.8, SD=1.5). Living in the coastal region, consumption of sugary soft drinks several times a week or daily, toothbrushing less than daily and irregular dental visits were associated with DT. Conclusions: Caries experience among adults in core Sámi areas of Northern Norway was common. Dental caries were more common in the coastal than the inland region, with minor differences in caries experience between Sámi and non-Sámi people within these regions.
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| 4. |
- Bongo, A. K. S., et al.
(författare)
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Periodontal health in an indigenous Sami population in Northern Norway: a cross-sectional study
- 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
- Background The aim of the study was to describe prevalence, severity and distribution of periodontal disease as well as associated risk factors in an indigenous Sami population in Northern Norway, and to investigate differences between the indigenous Sami and the non-Sami population. Methods This cross-sectional study included data from the Dental Health in the North study (N = 2078; 18-75 years). Data on Ethnicity, household income, education, smoking habits, dental attendance, and tooth brushing habits were collected by a questionnaire. Periodontal conditions were assessed by clinical examination. A modified version of the new AAP/EFP classification system of periodontal disease was used to estimate the severity of periodontitis. Three stages were used: 'Non-severe periodontitis', 'Stage II', and stage 'III/IV'. Results Of the total study population 66.5% reported Sami affiliation. The total prevalence of periodontitis was 49.7%, with 20.1% in Stage III/IV, but no differences between Sami and non-Sami. When controlled for sex, age, education, smoking and dental attendance the Sami had higher probability of having more severe stages of periodontitis; Odds Ratio(Stage II) (OR) = 1.3; 95% CI: 1.1-1.7; and ORStage III/IV (OR) = 1.6; 95% CI: 1.1-2.2) compared to non-Sami. The Sami had higher prevalence of periodontal pocket depth (PD) >= 4 mm (t = 1.77; p < 0.001) and PD >= 6 mm (t = 1.08; p = 0.038) than the non-Sami. Conclusions The prevalence of periodontitis was high in communities in the core area of Sami settlement in Northern Norway, regardless of ethnicity. People with Sami ethnicity had more deep periodontal pockets and an increased odds of having severe stages of periodontitis. Future studies should address possible explaining factors behind the potential higher risk of having more severe periodontitis among indigenous people in Sami settlements.
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| 5. |
- Brustad, M., et al.
(författare)
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Oral health in the indigenous Sami population in Norway - the dental health in the North study
- 2020
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 78:2, s. 98-108
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims at presenting the feasibility of using the public oral health clinics in indigenous Sami communities, as arena for a comprehensive data collection for population-based epidemiological oral health research among adults (age, 18-75 years) in a multi-ethnic setting. Material and methods: The study design was cross-sectional. The data collection was incorporated into the clinical procedure at six public dental clinics situated in the Administrative Area for the Sami Language in Finnmark County, Northern Norway, during 2013-2014. Both clinical- and questionnaire-data were collected. The quality of clinical data was thoroughly calibrated and validated. Results: Altogether, 2235 people participated in the study gave a crude response rate at 88.7%. In the final data sample (n = 2034), 56.9% were female. We constructed three ethnic groups (Sami, Mixed Sami/Norwegian and Norwegian). Altogether, 67.7% reported Sami or mixed Sami ethnicity. The internal validity of the clinical data was found to be satisfactory when assessed by comprehensive quality procedure, calibration and reliability assessments. Conclusion: This study design and method assessments provide solid documentation that public dental clinics are suitable as arenas for data collection in epidemiological oral health studies in the Sami population in this region.
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| 6. |
- Dahl, K. E., et al.
(författare)
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Perceived oral health and its association with symptoms of psychological distress, oral status and socio-demographic characteristics among elderly in Norway
- 2018
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 18:93
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is poor knowledge about the extent to which psychological distress influences oral health in older people in Norway. The aim of this study was two-fold: i) to describe the oral health of Norwegian elderly and their levels of psychological distress; and ii) to examine the relationship of psychological distress with self-rated oral health, while controlling for oral status and socio-demographic characteristics, in Norwegian elderly. Methods: Data were retrieved from a national cross-sectional survey conducted by Statistics Norway in 2012 and included information about self-rated oral health, psychological distress (measured using the Hopkins Symptom Checklist 25; HSCL-25), gender, age, civil status, smoking, self-reported number of teeth present and dental attendance for 949 non-institutionalised adults aged 65 years or older. Logistic regression was used to establish whether psychological distress predicts self-rated oral health, controlling for socio-demographic characteristics and oral status. Results: Around 27% of the elderly reported having poor oral health, and 8 % had a HSCL-25 mean score >= 1.75, which indicates higher levels of psychological distress. Among the symptoms listed in the HSCL-25, the most frequently reported problems were lack of energy (1.7 +/- 0.8) and difficulties falling and staying asleep (1.6 +/- 0.7). The likelihood of reporting poor oral health was independently associated with having a mean HSCL-25 score >= 1.75 (OR = 1.89; 95% CI = 1.14-3.15), even when smoking (OR = 1.83; 95% CI = 1.17, 2.87) and having fewer than 20 teeth (OR = 3.49; 95% CI = 2.56, 4.76) were taken into account. Conclusion: Most of the Norwegian elderly in our sample perceived themselves to have good oral health and reported relatively low levels of psychological distress. Higher levels of psychological distress can influence the oral health of the elderly independently of other factors such as smoking and having reduced number of teeth. Dental care professionals should consider screening their elderly patients for psychological distress and individualise the information about dental care for this specific population.
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| 7. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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A person-centred, theory-based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study
- 2022
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:4, s. 237-387
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To test the effectiveness of a person-centred and theory-based educational intervention to increase adolescents′ adherence to adequate oral hygiene behaviour, that is, self-performed periodontal infection control. Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study in which treatment was performed by dental hygienists (DHs) within the Public Dental Service, Västra Götaland, Sweden. Adolescents with poor oral hygiene conditions were invited to participate. The test intervention was based on cognitive behavioural theory and principles, and the DHs used a collaborative communicative approach, inspired by motivational interviewing. The control intervention consisted of conventional information/instruction. Clinical assessments and oral hygiene behaviours were evaluated at 6months. Results: Three-hundred and twelve adolescents were enrolled, of whom 274 followed the treatment to 6-month follow-up. There were significant improvements in gingival bleeding and plaque scores for both treatment groups at 6months, with significantly greater improvements in the test group. Adolescents in the test group brushed their teeth and used interdental cleaning aids more frequently compared to participants in the control group at 6months. Conclusion: A person-centred and theory-based oral health education programme ismore effective than conventional oral health education in improving adolescents' oral hygiene behaviour and periodontal infection control. ClinicalTrials.gov (NCT02906098). © 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.
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| 8. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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Adolescents' self-reported experiences following a person-centred, theory-based educational intervention versus conventional education for improved oral hygiene: Analysis of secondary outcomes of a randomized field study
- 2023
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Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979. ; 51:1, s. 63-73
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse adolescents' self-reported experiences and behavioural outcomes of a person-centred, theory-based intervention in comparison with conventional information/instruction for improved oral hygiene.Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study focusing on the effectiveness of educational interventions for improved oral hygiene. Dental hygienists working within the Public Dental Service, Vastra Gotaland, Sweden, provided treatments, and adolescents with poor oral hygiene conditions were eligible for participation. The person-centred test intervention was based on social cognitive constructs, and motivational interviewing was used as an approach in communication. The control intervention included conventional information/instructions. Clinical examinations were performed, and questionnaires were distributed at baseline and at 6 months. Three-hundred and twelve patients were enrolled, and data from 276 patients, following treatment per protocol, were analysed.Results: The test group was more satisfied with the education about gingivitis (very good: 61% vs. 37%) and communication during therapy (very good: 69% vs. 50%) and reported to a larger extent that they were much more careful regarding their oral hygiene after the treatment (30% vs. 15%) and had higher confidence about keeping up healthy gingival conditions, in comparison with the control group (all p < .01).Conclusions: The person-centred, theory-based intervention was superior in terms of adolescents' experiences of education and communication during therapy and self-reported oral hygiene behavioural outcomes at 6 months, in comparison with conventional information/instruction.
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| 9. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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Changing from disease-centred to person-centred – Swedish dental hygienists' views on a theory-based behavioural intervention for improved oral hygiene among adolescents
- 2024
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Ingår i: International Journal of Dental Hygiene. - 1601-5029 .- 1601-5037.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore dental hygienists' (DHs') views on (i) a person-centred, theory-based, behavioural intervention for improving oral hygiene among adolescents and (ii) professional and organizational factors to consider in the implementation of such an intervention in daily dental practice. Methods: Semi-structured interviews were conducted with 13 DHs who had applied the person-centred, theory-based, behavioural intervention directed at adolescents with poor oral hygiene in a field study within the Public Dental Service, Region Västra Götaland, Sweden. The interviews were audio-taped, transcribed verbatim and analysed using qualitative content analysis. Results: The main theme ‘From individual experts to partners – DHs changing direction from a disease-centred towards a person-centred approach’ illustrated a changed professional approach among DHs, from exerting their roles as experts to encouraging partnership in treatment by supporting the adolescents in taking health behavioural decisions and responsibility for their oral health. The DHs considered the changed approach as challenging, but also more enjoyable, compared to conventional information/instruction. Adequate knowledge and skills, personal interest and willingness for a change as well as support from colleagues and clinic management were identified as prerequisites for implementing the person-centred, theory-based, behavioural intervention in daily practice, while the expenditure of time needed in relation to economic demands in care were seen as barriers. Conclusions: The findings elucidate that DHs considered the application of a person-centred, theory-based, behavioural intervention to be challenging but also enjoyable. For such an intervention to be implemented in daily practice, prerequisites and barriers need to be considered on both personal/professional and organizational levels.
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| 10. |
- Eldh, Ann Catrine, et al.
(författare)
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Supporting first-line managers in implementing oral care guidelines in nursing homes
- 2018
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Ingår i: Nordic Journal of Nursing Research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 38:2, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate the process. By means of a process evaluation with mixed methods, the context and a three-month leadership program was explored, including activities during and in relation to the program, and the effects in terms of oral care CPG implementation plans. While the managers appreciated the intervention and considered improved oral care to be a priority, their implementation plans mainly focused the dissemination of an oral care checklist. The findings suggest that extended implementation interventions engaging both managers and clinical staff are needed, and that a concise intervention does not facilitate first-line managers to adopt behaviors known to facilitate knowledge implementation.
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