| 1. |
- Isaksson, Rita, et al.
(författare)
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Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II : Clinical aspects
- 2000
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Ingår i: Special Care in Dentistry. - Hoboken, NJ : Wiley-Blackwell Publishing Inc.. - 0275-1879 .- 1754-4505. ; 20:3, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel’s knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the Intervention, a statistically significant improvement was recorded for changes In oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.
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| 2. |
- Isaksson, Rita, et al.
(författare)
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Oral treatment need and oral treatment intention in a population enrolled in long-term care in nursing homes and home care
- 2003
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:1, s. 11-18
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate the realistic oral treatment need in a population in southern Sweden enrolled in long-term care (LTC), in nursing homes (NH), or home care (HC), taking into consideration treatment intention. Every third individual enrolled in LTC was selected after proportionally stratifying a total of 866 subjects according to gender. Of these, 732 (85%) were available for a simple clinical oral health evaluation in their own homes. Dental status, oral mucosal status, oral hygiene status, oral mucosal inflammation, and oral mucosal friction were assessed by observational examinations; suspected malignancies were also noted. Oral treatment need was expressed in accordance with the Treatment Need Index (TNI) as no, minor, major, or urgent, while treatment intention was expressed in accordance with the Treatment Intention Index (TII) as the aim to relieve, delay, maintain, or improve. The rationale for using the TII is to offer subjects in this generally frail population oral treatment at an appropriate level, taking their medical condition into consideration. It was found that 61% of the sample had a need not just for an oral health evaluation but also for additional dental treatment, 31% to be accomplished by prophylactic and 30% by reparative or emergency measures; only l % were estimated to be in urgent need. Furthermore, one manifest and one suspected oral malignancy were found. The results indicate that realistic oral treatment need, guided by the examiner’s estimation of the appropriate treatment intention, is modest in this population, but that regular oral screening is mandatory.
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| 3. |
- Nederfors, Tommy, et al.
(författare)
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Ability to estimate oral health status and treatment need in elderly receiving home nursing : a comparison between a dental hygienist and a dentist
- 2000
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 24:3, s. 105-116
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the estimation ability of a dental hygienist to that of a dentist when, independently, recording the oral health status and treatment need in a population of elderly, receiving home nursing. Seventy-three persons, enrolled in a home nursing long-time care programme, were recruited. For the oral examination a newly developed protocol with comparatively blunt measurement variables was used. The oral examination protocol was tested for construct validity and for internal consistency reliability. Statistical analyses were performed using Wilcoxon matched pairs signed rank sum test for testing differences, while inter-examiner agreement was estimated by calculating the kappa-values. Comparing the two examiners, good agreement was demonstrated for all mucosal recordings, colour, form, wounds, blisters, mucosal index, and for the palatal but not the lingual mucosa. For the latter, the dental hygienist recorded significantly more changes. The dental hygienist also recorded significantly higher plaque index values. Also regarding treatment intention and treatment need, the dental hygienist's estimation was somewhat higher. In conclusion, when comparing the dental hygienist's and the dentist's ability to estimate oral health status, treatment intention, and treatment need, some differences were observed, the dental hygienist tending to register "on the safe side", calling attention to the importance of inter-examiner calibration. However, for practical purpose the inter-examiner agreement was acceptable, constituting a promising basis for future out-reach activities.
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| 4. |
- Nederfors, Tommy, et al.
(författare)
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The relation between xerostomia and hyposalivation in subjects with rheumatoid arthritis or fibromyalgia
- 2002
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 26:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Aim of this study was to evaluate the relation between xerostomia and hyposalivation in 100 subjects with either rheumatoid arthritis or fibromyalgia, and further, to evaluate the predictive value of xerostomia on hyposalivation. Unstimulated and chewing stimulated whole saliva was collected in the morning with the subjects in a strict fasting condition and then about 2 hours later, after intake of a standardised breakfast. All participants filled in a questionnaire, mainly dealing with xerostomia. Forty subjects demonstrated a pathological fasting unstimulated whole saliva secretion rate, the corresponding number for fasting stimulated secretion being 39. For unstimulated, but not for stimulated saliva, the fasting secretion rate was significantly lower than the non-fasting. Xerostomia was reported by 74 subjects, this group having significantly lower both unstimulated and stimulated secretion rates than the non-xerostomic group. On the individual level, the predictive value of xerostomia on hyposalivation showed high sensitivity but unsatisfactory specificity. In conclusion, this study underlines the importance of applying strictly standardised procedures when collecting saliva, and that fasting unstimulated whole saliva is the diagnostic salivary secretion of choice. Finally, xerostomia was found to predict hyposalivation on a group, but not on an individual level.
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| 5. |
- Paulsson, Gun, 1945-, et al.
(författare)
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Recall of an oral health education programme by nursing personnel in special housing facilities for the elderly
- 2001
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Ingår i: Gerodontology. - Hoboken, NJ : Blackwell Publishing. - 0734-0664 .- 1741-2358. ; 18:1, s. 7-14
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the recall of oral health knowledge and confidence by nursing personnel in special housing facilities for the elderly, three years after an education programme.Design: A cross sectional design using a questionnaire.Sample: All nursing personnel, a total of 2,901 subjects, in five municipalities in south-western Sweden; of whom 950 had attended the programme. The response rate was 67% (1930 subjects).Intervention: An oral health education programme consisting of four one-hour lessons.Results: The oral health education programme still had an effect on the participants' attitudes towards oral health three years later. When comparing the trained group (OHEP+) which attended the programme with those who did not have training (OHEP-), the perceived ability, opportunity and the knowledge of oral health were significantly better in the former group, p<0.01 Eurther, within the OHEP- group who did not attend the programme there was a significant difference in the perceived ability, opportunity and the knowledge of oral health between those with a higher level of health care education, p<0.01.Conclusions: The effect of an oral health education programme on the participants' attitudes towards oral health persists at least for three years. The data indicate that trainees with a low level of health care education benefit most.
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| 6. |
- Paulsson, Gun, 1945-, et al.
(författare)
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The effect of an oral health education program after three years
- 2003
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Ingår i: Special Care in Dentistry. - New York : Wiley-Blackwell. - 0275-1879 .- 1754-4505. ; 23:2, s. 63-69
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Tidskriftsartikel (refereegranskat)abstract
- Three years after providing an oral health education program (OHEP) to nursing personnel, the authors analyzed the effect of the program on knowledge of the importance of oral health and on perception among the nurses of the possibility to implement oral care in patient care. The study was based on a cross-sectional survey of all nursing personnel (N = 2,901) in five municipalities in the Southwestern Sweden, of whom 950 had attended four one-hour lessons during an OHEP in 1996. The response rate to the survey questionnaire was 67% (1,930 subjects). Statistical analysis was performed by means of descriptive and analytical statistics. The program was shown to have an independent effect on the dependent variables "knowledge of oral health" and "assessment of implementation possibilities," This study has given further evidence of the feasibility of an educational program to improve both knowledge and implementation of oral health care. through interviews with 17 nursing personnel, selected by strategic sampling. Analysis of the transcribed interviews showed that there were four strategies, related to staff education, hospital resources, and leadership motivation. The strategies were grounded in data and emerged from the interaction between the two main categories: 'the valuation of the importance of oral health' and 'the behavior towards oral health maintenance'. They were characterized as the routine, theoretical, practical, and flexible strategies, with the latter considered ideal. As increased knowledge is one important part in enhancing the nursing personnel's ability to perform oral hygiene procedures, there is a need for education among nursing personnel, primarily among those using a routine strategy.
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| 7. |
- Ullbro, Christer, et al.
(författare)
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Cytokines, matrix metalloproteinases and tissue inhibitor of metalloproteinases-1 in gingival crevicular fluid from patients with Papillon-Lefèvre syndrome
- 2004
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:2, s. 70-74
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to compare concentrations of cytokines, matrix metalloproteinases (MMPs) and a metalloproteinase inhibitor (TIMP-1) in gingival crevicular fluids (GCF) from sites with gingival inflammation in 28 young patients with Papillon-Lefevre syndrome (PLS), and in age- and gender-matched controls. Each group consisted of 17 females and 11 males with a mean age of 11.0 years (range 4-22 years). In both groups, anterior upper sites with a clinical diagnosis of gingival inflammation and with pockets < or = 3 mm were selected for sampling of GCF, which was carried out with filter disks inserted into the gingival crevice until saturated. The concentrations of cytokines (IL-1alpha, IL-1beta, TNF-alpha, and IL-8), matrix metalloproteinases (MMP-1, MMP-3, MMP-8, and MMP-9), and their tissue inhibitor (TIMP-1) were analysed using commercial ELISA kits. Significantly higher levels of IL-1beta (P < 0.001) and MMP-8 (P < 0.05) were disclosed among the PLS patients compared with their controls, while the opposite was found for IL-8 (P < 0.05) and MMP-1 (P < 0.001). The individual variations were considerable in both groups. When comparing the expression of cytokines, MMPs, and TIMP-1 in PLS patients with clinically active and non-active periodontitis, the non-active PLS patients showed significantly higher values of IL-1beta than the patients with active periodontal disease (ANOVA, P < 0.01). In conclusion, this study was unable to demonstrate a clear-cut pathognomonic expression of cytokines or MMPs in patients with PLS, but further studies on cytokine and MMP output are warranted.
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| 8. |
- Ullbro, Christer, et al.
(författare)
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Dermatologic and oral findings in a cohort of 47 patients with Papillon-Lefèvre syndrome
- 2003
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Ingår i: The Journal of American Academy of Dermatology. - : Elsevier BV. - 0190-9622 .- 1097-6787. ; 48:3, s. 345-351
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Tidskriftsartikel (refereegranskat)abstract
- Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar hyperkeratosis and early development of aggressive periodontal infection. The aims of this study were to rank the severity of dermatologic and oral affections using a semiquantitative scoring system, and to evaluate whether the severity of the dermatologic changes were correlated to age, degree of periodontal infection, or both. The study included 47 patients with Papillon-Lefèvre syndrome. With no exception both skin and oral changes developed early in life. The dermatologic involvement showed no correlation with age, whereas the periodontal infection was significantly worse in young children with deciduous teeth. A strong correlation was found between the condition of feet and hands, although the scores for the feet were significantly higher. No significant correlation could be demonstrated between the level of periodontal infection and severity of skin affections, supporting the concept that these 2 major components of Papillon-Lefèvre syndrome are unrelated to each other.
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