| 1. |
- Bergstrom, E. K., et al.
(författare)
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Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention among 12-to 15-Year-Olds in Sweden
- 2019
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 53:3, s. 339-346
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Tidskriftsartikel (refereegranskat)abstract
- Since 2008, FRAMM has been a guideline for caries prevention for all 3- to 15-year-olds in the Vastra Gotaland Region in Sweden and a predominant part is school-based fluoride varnish applications for all 12- to 15-year-olds. The aims were to evaluate dental health-economic data among 12- to 15-year-olds, based on the approximal caries prevalence at the age of 12, and to evaluate cost-effectiveness. Caries data for 13,490 adolescents born in 1993 who did not take part and 11,321 adolescents born in 1998 who followed this guideline were extracted from dental records. Those with no dentin and/or enamel caries lesions and/or fillings on the approximal surfaces were pooled into the "low" subgroup, those with 1-3 into the "moderate" subgroup and those with >= 4 into the "high" subgroup. The results revealed that the low subgroup had a low approximal caries increment compared with the moderate and high subgroups during the 4-year study period. In all groups, there were statistically significant differences between those who took part in the guideline and those who did not. The analysis of cost-effectiveness revealed the lowest incremental cost-effectiveness ratio (ICER) for the high subgroup for decayed and/or filled approximal surfaces (DFSa) and approximal enamel lesions together and the highest ICER for the low subgroup for DFSa alone. To conclude, the FRAMM Guideline reduced the caries increment for adolescents with low, moderate and high approximal caries prevalence. The subgroup with the most favourable cost-effectiveness comprised those with a high caries prevalence at the age of 12. (C) 2019 S. Karger AG, Basel
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| 2. |
- Bergström, Eva-Karin, et al.
(författare)
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Adolescents' experiences of participating in a school-based fluoride varnish programme in Sweden.
- 2012
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Ingår i: Swedish dental journal. - 0347-9994. ; 36:3, s. 133-41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Population-based health promotion with school-based fluoride varnish programmes is becoming more frequent, as these programmes have been implemented in many parts of Sweden during the last five years. The caries-prevention effect is well studied, but as yet there is no study aimed at adolescents'experiences of these programmes. The aim of this study was therefore to describe how a school-based fluoride varnish programme is experienced by participating adolescents. The study was performed as a qualitative study by conducting four focus-groups interviews. In all, 26 adolescents participated, all aged 15. All the participants had several years'experiences of a fluoride varnish programme at school. The participants were asked to describe their experience of participating in the programme.The analysis of the data from the interviews was carried out according to the principles of phenomenography.The three themes that emerged were"Conceptions in relation to the individual", "Conceptions in relation to the school dental nurse"and "Conceptions in relation to the group and school". The result showed that the adolescents experienced that it was positive to take part in a fluoride varnish programme at school and they regarded the school as an important health promotion arena. In spite of this, there were perceptions that were worth reflecting on for school dental nurses, such as feelings of exposure, peer pressure and a perceived lack of information. To further improve these programmes, and thereby increase population-based dental health promotion, it is important to highlight the role of dental personnel, as they are largely responsible for creating the atmosphere.
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| 3. |
- Bergström, Eva-Karin, 1974, et al.
(författare)
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Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat
- 2014
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 42:5, s. 404-411
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat. MethodsThe design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs. ResultsThere were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5years . The caries increment for Group 1 was 1.342.99 (mean +/- SD), 1.24 +/- 2.84 for Group 2, 1.07 +/- 2.66 for Group 3 and 1.25 +/- 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group. ConclusionsIn an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.
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| 4. |
- Bergström, Eva-Karin, 1974, et al.
(författare)
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Caries and costs: an evaluation of a school-based fluoride varnish programme for adolescents in a Swedish region
- 2016
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Ingår i: Community Dental Health. - 0265-539X. ; 33:2, s. 138-144
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Tidskriftsartikel (refereegranskat)abstract
- In 2003, 19 public dental clinics in Vastra Gotaland Region implemented a population-based programme with fluoride varnish applications at school every six months, for all 12 to 15 year olds. In 2008, the programme was extended to include all 112 clinics in the region. Objective: To evaluate caries increment and to perform a cost analysis of the programme. Basic research design: A retrospective design with caries data for two birth cohorts extracted from dental records. Three groups of adolescents were compared. For Group 1 (n=3,132), born in 1993, the fluoride varnish programme started in 2003 and Group 2 (n=13,490), also born in 1993, had no fluoride varnish programme at school. These groups were compared with Group 3 (n=11,321), born in 1998, when the programme was implemented for all individuals. The total cost of the four-year programme was estimated at 400SEK (approximate to 44(sic)) per adolescent. Results: Caries prevalence and caries increment in 15 year olds were significantly lower after the implementation of the programme. Group 2, without a programme, had the highest caries increment. The cost analysis showed that it was a break-even between costs and gains due to prevented fillings at the age of 15. Conclusions: This school-based fluoride varnish programme, implemented on a broad scale for all 12 to 15 year olds, contributed to a low caries increment at a low cost for the adolescents in the Vastra Gotaland Region in Sweden.
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| 5. |
- Bergström, Eva-Karin, 1974, et al.
(författare)
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Dental nurses' experiences of performing a school-based fluoride varnish programme for children and adolescents in Sweden
- 2016
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 40:2, s. 181-190
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Tidskriftsartikel (refereegranskat)abstract
- In many parts of Sweden today, school-based fluoride varnish programmes (FVP) are performed by dental nurses. Studies have shown that the dental personnel are largely responsible for creating the atmosphere related to children's and adolescents' experiences of the programmes. Knowledge of dental nurses' experiences of performing FVP is therefore crucial in order to develop and improve these programmes and the dental health of children and adolescents. The aim of this study was to describe dental nurses' experiences of performing FVP for children and adolescents in Sweden. Fifteen female dental nurses, strategically chosen, aged 40-63, from the Public Dental Service in the Vastra Gotaland Region, Sweden, were individually interviewed. The interviews were transcribed verbatim and analysed according to the phenomenographic approach. Three themes with a total of-n categories, all describing the dental nurses' conceptions of performing FVP, emerged in the analysis. The main conclusions were that in overall terms, performing an FVP was found to be a positive experience for the dental nurses, as it meant meeting children and adolescents in a context in which the children and adolescents are comfortable and relaxed. The opportunity to identify children and adolescents with poor dental health or poor health and to be able to offer them assistance was regarded as a major advantage. In addition, the participants described a feeling of professional development originating from the challenges associated with working in an arena outside the dental clinic.
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| 6. |
- Davidson, Thomas, et al.
(författare)
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Long-Term Cost-Effectiveness through the Dental-Health FRAMM Guideline for Caries Prevention
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:4
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Tidskriftsartikel (refereegranskat)abstract
- A guideline called FRAMM, which is an acronym in Swedish for the most important parts of this guideline, namely “fluoride”, “advice”, “arena”, “motivation” and “diet”, was implemented in 2008 in the Västra Götaland Region in Sweden. This guideline included fluoride varnish applications performed at school twice a year at six-monthly intervals for all 12-to 15-year-olds, together with lessons on oral health. The aim of this analysis was to estimate the long-term cost-effectiveness, using prognostic calculations, of the FRAMM Guideline for 12-to 15-year-olds, compared with routine care, until the participants were 23 years old. A cost-effectiveness analysis was performed from a health care perspective, based on four years of verified data and seven years of prognosis. Data from FRAMM were combined with cost data from price lists in Sweden. The cost-effectiveness was analyzed by relating the difference in costs to the difference in the number of approximal surfaces with fillings and/or dentin lesions (DFSa). The analysis shows that FRAMM was considered dominant compared to the controls in all alternative scenarios, hence costs were prognosed to be lowered and outcomes were prognosed to be improved. A dental health program like the FRAMM Guideline with fluoride varnish during the caries risk period from 12 to 15 years is predicted to be cost-effective in the longer perspective. To further study the actual long-term caries increment after a preventive dental health program would be of great interest to verify these results. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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| 7. |
- Gabre, Pia, et al.
(författare)
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Simplified methods of topical fluoride administration: effects in individuals with hyposalivation.
- 2013
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Ingår i: Special Care in Dentistry. - : Wiley. - 1754-4505 .- 0275-1879. ; 33:3, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to compare fluoride (F) levels in individuals with normal salivary secretion and hyposalivation in connection with their use of F solutions and toothpaste. Seven individuals with normal salivation and nine with hyposalivation rinsed with 0.2% NaF solution for 1 minute. In addition, individuals with hyposalivation performed the following: (i) 0.2% NaF rinsing for 20 seconds, (ii) rubbing oral mucosa with a swab soaked with 0.2% NaF solution, and (iii) brushing with 5,000 ppm F (1.1% NaF) toothpaste. Subjects characterized by hyposalivation reached approximately five times higher peak values of F concentrations in saliva after 1 minute rinsing with the F solution and higher area under the curve (AUC) values. The simplified methods exhibited the same AUC values as did 1 minute of rinsing. Brushing with 5,000 ppm F toothpaste resulted in higher AUC values than did the simplified methods. The F concentrations reached higher levels in individuals with hyposalivation compared to those with normal salivation. The simplified methods tested showed similar effects as conventional methods.
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| 8. |
- Jensen, Olga, 1970, et al.
(författare)
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Fluoride toothpaste and toothbrushing; knowledge, attitudes and behaviour among Swedish adolescents and adults
- 2011
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Ingår i: Swedish dental journal. - 0347-9994. ; 35:4, s. 203-213
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Tidskriftsartikel (refereegranskat)abstract
- The most effective way to administer fluoride is through the regular use of fluoride toothpaste. Adolescents and adults seem to have low awareness of toothbrushing procedures and use of fluoride toothpaste despite frequent dental care. The aim of this study was to describe knowledge, attitudes and behaviour concerning toothbrushing and use of fluoride toothpaste in three age groups in a Swedish population. A qualitative study design was used with the purpose of achieving a deeper understanding of the issue. Data were collected through interviews. A manifest and latent analysis of the text was performed using qualitative content analysis (Grounded theory). The informants were selected strategically to obtain the greatest possible variation in the data. Three age strata representing different stages in life were chosen: 15-16, 30-35 and 60-65 years. Informants were interviewed with support from an interview guide. Open-ended questions were used to focus on the individual’s knowledge, attitudes and behaviour concerning toothbrushing and fluoride toothpaste. Five people from each age group were interviewed in the study. The content areas were knowledge, attitudes and behaviour and the latent analysis identified the areas of empowerment, driving force and guidance as categories. Although the informants showed little knowledge about the reasons for and techniques of using fluoride toothpaste effectively, they described toothbrushing as important and the habit as a priority, giving the theme of this study: toothbrushing with fluoride toothpaste was a priority, despite the lack of knowledge about how to use toothpaste effectively and its positive effects on oral health. In conclusion the state of knowledge concerning toothbrushing and fluoride toothpaste needs to be improved. In addition, people’s desire for a fresh-feeling mouth and to fit in socially must be affirmed and utilized by dental staff in health promotion.
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| 9. |
- Jensen, Olga, 1970, et al.
(författare)
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'I take for granted that patients know' - oral health professionals' strategies, considerations and methods when teaching patients how to use fluoride toothpaste.
- 2014
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Ingår i: International Journal of Dental Hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 12:2, s. 81-88
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to explore the oral health professionals' (OHPs') perspectives regarding their strategies, considerations and methods when teaching their patients the most effective way of toothbrushing with fluoride (F) toothpaste. Methods A qualitative research method was used to collect data. To stimulate interactivity among the participants, interviews were performed in focus groups. Five groups of OHPs, including dentists, dental hygienists and dental nurses, were interviewed a total of 23 individuals. The interviews were analysed using manifest and latent qualitative content analysis. Data were systematically condensed and coded to the relevant phrases that identified their content. Results Three categories were identified in the manifest and latent content analysis: (i) strategies and intentions, (ii) providing oral hygiene information and instruction and (iii) barriers to optimal oral healthcare education. Health promotion and seeing to the patients' best interest were driving forces among the OHPs as well as personal success in their preventive work. They focused on toothbrushing techniques more than on how to use F toothpaste. Barriers to oral health information were cost to the patients and, to some extent, the opinion of the OHPs that some patients were impossible to motivate or that patients already know what to do. Conclusion The OHPs described toothbrushing with F toothpaste as very important, although the plaque removal perspective dominated. They did not focus on how to use F toothpaste, because they believed that knowledge about and appropriate behaviour concerning F toothpaste were already familiar to their patients.
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| 10. |
- Jensen, Olga, 1970, et al.
(författare)
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Is the use of fluoride toothpaste optimal? Knowledge, attitudes and behaviour concerning fluoride toothpaste and toothbrushing in different age groups in Sweden.
- 2012
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 1600-0528 .- 0301-5661. ; 40:2, s. 175-184
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The most effective method to prevent caries is the regular use of fluoride toothpaste. The aim of this study was to evaluate self-care routines in a population by identifying knowledge, attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits. Methods: A questionnaire was sent to 3200 individuals in two municipalities in Sweden. Four age groups representing different life stages were chosen: 15-16, 31-35, 61-65 and 76-80years of age. The participants were selected from the population register by random selection of birth dates. Results: Totally 2023 (63%) individuals answered the questionnaire. The majority (84-94%) in all age groups brushed their teeth twice a day or more often. Good toothpaste behaviour identified as brushing at least twice a day, using at least 1cm toothpaste, brushing 2minutes or longer and using a small amount of water when rinsing was reported by only 10% of the respondents. The factors that increased the odds for having good caries-preventive behaviour were: (i) being female, (ii) being younger than 35years, (iii) having knowledge about fluoride, (iv) finding use of fluoride toothpaste important and (v) rating own oral health as good. Conclusions: The population seems to have embraced regular toothbrushing with fluoride toothpaste to a large extent. However, regarding techniques for using fluoride toothpaste effectively, there was great potential for improvement, especially among the older respondents.
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