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1.
  • Fagrell, Tobias G, et al. (författare)
  • Aetiology of severe demarcated enamel opacities--an evaluation based on prospective medical and social data from 17,000 children.
  • 2011
  • Ingår i: Swedish dental journal. - : Swedish Dental Journal (Sveriges Tandlakarforbund). - 0347-9994. ; 35:2, s. 57-67
  • Tidskriftsartikel (refereegranskat)abstract
    • During the 1970s dentists reported an increasing prevalence of a "new" type of enamel disturbance.The disturbance was very specific, with areas of demarcated hypomineralised enamel, and was mostly found in permanent first molars and incisors. Several studies have tried to reveal the aetiology behind the enamel disturbance but sofar no clear factors correlated have been found. The aim of the present study was to evaluate aetiological factors to severe demarcated opacities (SDO) in first permanent molars in a large cohort of children enrolled in the "All Babies in Southeast Sweden" (ABIS) project. ABIS is a prospective study of all children in five Swedish counties born between Oct 1, 1997 and Oct 1, 1999, in all about 17,000 children.They have been followed from birth with recording of a large number of factors on nutrition, diseases, medication, infections, social situation etc. With help from 89 Public Dental Service clinics in the same area preliminary examinations of the children, born between Oct 1,1997 and Oct 1,1999, reported 595 children with severe demarcated opacities (SDO) in first molars.These children and a randomly selected age matched group of 1,200 children were further invited to be examined by specialists in paediatric dentistry. At these examinations 224 severe cases were identified as well as 253 children completely without enamel disturbances among children registered in ABIS.These two groups were analysed according to any correlation between SDO and variables in the ABIS databank. The analyses showed no association between SDO and pre-, peri-, and neonatal data. However, we found a positive association between SDO and breastfeeding for more than 6 months (OR 1.9; 95% CI 1.1-3.2), late introduction of gruel (OR 1.9; 95% CI 1.1-2.9), and late introduction of infant formula (OR 1.8; 95% CI 1.2-2.9). A combination of these three variables increased the risk to develop SDO by more than five times (OR 5.1; 95% CI 1.6-15.7). No significant associations were found to other environmental, developmental, or medical factors. We conclude that nutritional conditions during first 6 months of life may influence the risk to develop severe demarcated opacities in first permanent molars.
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3.
  • Lena Sundell, Anna, et al. (författare)
  • Comparing caries risk profiles between 5-and 10-year-old children with cleft lip and/or palate and non-cleft controls
  • 2015
  • Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 15:85
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model. Methods: The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the childs oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as "high" or "low". Results: Children with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p less than 0.05) and displayed less good oral hygiene (p less than 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67 % but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95 % CI = 1.25-2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk. Conclusion: Children with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.
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4.
  • Norderyd, Ola, et al. (författare)
  • Oral health of individuals aged 3-80 years in Jonkoping, Sweden, during 40 years (1973-2013)
  • 2015
  • Ingår i: Swedish Dental Journal. - : Swedish Dental Journal. - 0347-9994. ; 39:2, s. 57-68
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city ofionkoping, Sweden, in 1973,1983,1993, 2003, and 2o13.The 1973 study constituted a random sample of L000 individuals evenly distributed in the age groups 3, 5,10,15, 20, 30,40, 50, 6o, and 7o yea rs.The same age groups with addition of a group of 8o-year-olds were included in the 1983,1993, 2003, and 2013 studies, which comprised 1,104;1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-6o years were treated by the Public Dental Service amounting to about 5o%. Almost 7o% of the 70- and 80-year-olds were treated by private practitioners. In 2013,10-20% of the individuals in the age groups 30-40 years did not regularly visit neither Public Dental Service nor a private practitioner.The corresponding figures for the individuals 50-80 years old were 4-7%. Similar number of avoidance was reported in the previous studies. In the survey 2013, about 20-30% of the individuals in the age groups 20-50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist.These findings were in agreement with the results from the surveys 1973-2003. Among the younger age groups, 10-15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series. In 2013, the knowledge of the etiology of caries was known by about 6o% of the individuals which was similar to that reported 1973 zoo3.Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries.This percentage was equivalent during the period 1973-2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day.These frequencies have gradually increased during the 40-year period. Around 40% in the age groups 50-8o years used toothpicks regularly in 2013.This is a about 1/3-1/2 less compared to 2003. In the age groups 20-40 years 3-14% used toothpicks for proximal cleaning in 2013. In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3-20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013
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5.
  • Norderyd, Ola, et al. (författare)
  • Oral health of individuals aged 3-80 years in Jonkoping, Sweden during 40 years (1973-2013)
  • 2015
  • Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 39:2, s. 69-86
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973,1983,1993,2003, and 2013 random samples of 1,000;1,104;1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3,5,10,15, 20,30,40,50, 60,70, and 8o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jonkoping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40-70 years was 16,12, 8,1, and 0.3% in 1973,1983,1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013.This was higher than earlier surveys,4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013,43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40 year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 4o and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups-Jo-30-year-olds a major reduction from about 3o% to 15% in mean plaque score was seen between 1973-2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003-2o13.The percentage of tooth sites with gingivitis was for zo years and older about 4o% in 1973. In 2013, the percentage was about15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years:1973-1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003-2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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6.
  • Norderyd, Ola, et al. (författare)
  • Oral health of individuals aged 3-80 years in Jönköping, Sweden, during 40 years (1973-2013) : I. Review of findings on oral care habits and knowledge of oral health.
  • 2015
  • Ingår i: Swedish Dental Journal. - 0347-9994. ; 39:2, s. 57-68
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city of Jönköping, Sweden, in 1973, 1983, 1993, 2003, and 2013. The 1973 study constituted a random sample of 1,000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993, 2003, and 2013 studies, which comprised 1,104; 1,078; 987; and 1,010 individuals, respectively.A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period.During the period 1973–2013, a continous increase of individuals in the age group 20–60 years were treated by the Public Dental Service amounting to about 50%. Almost 70% of the 70- and 80-year-olds were treated by private practitioners. In 2013, 10–20% of the individuals in the age groups 30–40 years did not regularly visit neither Public Dental Service nor a private practitioner. The corresponding figures for the individuals 50–80 years old were 4–7%. Similar number of avoidance was reported in the previous studies.In the survey 2013, about 20–30% of the individuals in the age groups 20–50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist. These findings were in agreement with the results from the surveys 1973–2003. Among the younger age groups, 10–15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series.In 2013, the knowledge of the etiology of caries was known by about 60% of the individuals which was similar to that reported 1973–2003. Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries. This percentage was equivalent during the period 1973–2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day. These frequencies have gradually increased during the 40-year period.Around 40% in the age groups 50–80 years used toothpicks regularly in 2013. This is a about 1/3–1/2 less compared to 2003. In the age groups 20–40 years 3–14% used toothpicks for proximal cleaning in 2013.In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3–20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013
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7.
  • Norderyd, Ola, et al. (författare)
  • Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013) : II. Review of clinical and radiographic findings
  • 2015
  • Ingår i: Swedish Dental Journal. - 0347-9994. ; 39:2, s. 69-86
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973–2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80 years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40–70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30–80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10–20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5–60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40- year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 40 and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups 10–30-year-olds a major reduction from about 30% to 15% in mean plaque score was seen between 1973–2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003–2013. The percentage of tooth sites with gingivitis was for 20 years and older about 40% in 1973. In 2013, the percentage was about 15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years, 1973–1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003–2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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8.
  • Sundell, Anna Lena, et al. (författare)
  • Caries prevalence and enamel defects in 5-and 10-year-old children with cleft lip and/or palate: A case-control study
  • 2016
  • Ingår i: Acta Odontologica Scandinavica. - : TAYLOR & FRANCIS LTD. - 0001-6357 .- 1502-3850. ; 74:2, s. 90-95
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.
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9.
  • Sundell, Anna Lena, 1970- (författare)
  • Children with orofacial clefts : dental caries and health-related quality of life
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background. The current understanding on caries and enamel developmental defects prevalence and frequency, caries risk, health-related quality life (HRQoL) and stress response in young children with cleft lip and/or palate (CL/P) are sparse. In this thesis these aspects were investigated in 5- and 10- year-old children with CL/P in comparison to non-cleft children in the same ages.Design. The studies in this thesis have a cross-sectional case-control design. Participants. The study group consisted of 139 children with CL/P (80 children aged 5 years and 59 aged 10 years) and 313 non-cleft controls (144 children aged 5 years and 169 aged 10 years).Method. Caries was scored according to International Caries Detection and Assessment System (ICDAS II) and developmental enamel defects were measured as presence and frequency of hypoplasia and hypomineralization. Oral hygiene was assessed using Quigley-Hein plaque index. Stimulated saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rates. Information regarding children’s oral hygiene routines, dietary habits and fluoride exposure were collected with questionnaires. Caries risk was evaluated with algorithm-based software, Cariogram while HRQoL was perceived with KIDSCREEN-52. Stress response was analyzed with cortisol concentration in saliva at three different time points using a commercial competitive radioimmunoassay.Results. Caries prevalence (36% versus 18%) and caries frequency (1.2 dmfs versus 0.9 dmfs) was significantly higher in 5-year-old children with CL/P in comparison to non-cleft controls. In 10-yearolds no significant difference was found between children with CL/P and non-cleft controls in caries prevalence (47% versus 38%) or in caries frequency (0.7 DMFS versus 0.5 DMFS). Children with CL/P had significantly higher prevalence of enamel defects, higher counts of salivary lactobacilli and less good oral hygiene. The odds of being categorized with high caries risk were elevated in children with CL/P. Children with CL/P had similar HRQoL and salivary cortisol concentrations as non-cleft controls. However, 10-year-old boys with CL/P had significantly higher cortisol concentrations in the evening than non-cleft boys.Conclusions. Preschool children with CL/P seem to have more caries in the primary dentition than non-cleft controls. Children with CL/P had increased odds of being categorized as high caries risk individuals compared to controls. Some of the contributing factors seem to be higher prevalence of enamel defects, impaired oral hygiene and elevated salivary lactobacilli. Furthermore, as measured with the help of cortisol concentrations in saliva, children with CL/P were not more stressed than noncleft controls and their HRQoL was comparable to a European norm population. It appears that regular comprehensive preventive oral care in children with CL/P is effective in preventing caries development in permanent teeth. However, children with CL/P are at risk of caries development and preventive oral care should be implemented and started earlier than today.
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