| 1. |
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| 2. |
- Andersson, P., et al.
(författare)
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Dental status in nursing home residents with domiciliary dental care in Sweden
- 2017
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Ingår i: Community Dental Health. - : F D I WORLD DENTAL PRESS LTD. - 0265-539X. ; 34:4, s. 203-207
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the dental health status of elderly people in nursing homes receiving domiciliary dental care. Design: Case note review. Clinical setting: Nursing homes in 8 Swedish counties. Participants: Care dependent elderly people (>= 65 years). Methods: Clinical data, including the number of remaining natural teeth, missing and decayed teeth (manifest dental caries) and root remnants, recorded by dentists according to standard practices. Medical and dental risk assessments were performed. Results: Data were available for 20,664 patients. Most were women (69.1%), with a mean age of 87.1 years (SD 7.42, range 65-109). The mean age for men was 83.5 years (SD 8.12, range 65-105). Two or more medical conditions were present in most of the population. A total of 16,210 individuals had existing teeth of whom 10,974 (67.7%) had manifest caries. The mean number of teeth with caries was 5.0 (SD 5.93) corresponding to 22.8% of existing teeth. One in four individuals were considered to have a very high risk in at least one professional dental risk assessment category. Conclusions: Care dependent elderly in nursing homes have very poor oral health. There is a need to focus on the oral health-related quality of life for this group of frail elderly during their final period of life.
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| 3. |
- Andås, Charlotte Andren, et al.
(författare)
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Payment systems and oral health in Swedish dental care: Observations over six years.
- 2016
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Ingår i: Community Dental Health. - 0265-539X. ; 33:4, s. 257-261
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this longitudinal study of patients in regular dental care was to compare the findings of manifest caries and fillings after a 6-year adherence to either of two optional payment models, the traditional fee-for service (FFS) model, or the new capitation model 'Dental Care for Health' (DCH). Material and methods: Data on manifest caries lesions, the number of fillings and a number of background variables were collected from both a register and a questionnaire completed by 6,299 regular dental patients who met the inclusion criteria. The influence of payment system adherence and background variables on the number of manifest caries lesions at study end was examined by the means of negative binomial regression analysis. Results: The incidence rate ratio of manifest caries lesions after six years in FFS was 1.5 compared to DCH, after controlling for age, gender, education and pre-baseline caries incidence. The number of fillings was higher in FFS than in DCH at study start and at study end, and was also described by a steeper slope. Conclusions: At group level, this study showed a statistically significant difference between the caries situation after six years in DCH compared with FFS, when some important background factors, including pre-baseline caries, were kept constant in a regression model.
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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. |
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| 6. |
- Carta, G., et al.
(författare)
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Oral health inequalities in Italian schoolchildren - a cross-sectional evaluation
- 2014
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Ingår i: Community Dental Health. - 0265-539X. ; 31:2, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate which of the following indicators of socio-economic status (SES) has the strongest association with dental caries status in a 6-year-old population: the educational level of each parent (individual-level); the mean price of housing/m(2) in the area where the family resides; or the mean per capita income in the area where the family lives (area-level). Material and Methods: Dental caries was recorded in 2,040 schoolchildren (42.5% boys, 57.5% girls) using decayed/missed/filled surface index (d(3) level) in primary dentition. Parents filled in a standardised questionnaire regarding nationality, level of education, frequency of dental check-up and perception of child's oral health and child's oral hygiene habits. Results: At the individual-level of SES, mothers' educational level was associated with their children's caries severity (chi(2)((9)) (9)= 147.51 p<0.01): as educational level rose the proportion of children with high numbers of carious lesions fell. The two income indicators (area-level SES) were not associated. A multinomial logistic regression model was run for caries risk factors. Caries severity was used as dependent variable and the model was stratified by mothers' educational level. Mothers' perception of child's oral health was the only covariate that was always associated in every caries severity strata and for each level of mothers' education. Conclusions: The present study shows that mothers' educational level is a useful individual SES indicator for caries in Italian children living in a low-income population.
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| 7. |
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| 8. |
- Ekbäck, Gunnar, 1954-, et al.
(författare)
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Caries in five different socio-economic clusters in Orebro county
- 2012
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Ingår i: Community Dental Health. - 0265-539X. ; 29:3, s. 229-232
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study assessed the prevalence of socio-demographic clusters in a Swedish county and the relationship of socio-demographic clusters and caries.METHODS: All 2-19-year-olds (n = 58,573) who attended a routine check-up in Orebro County in 2005-2007 were involved in this study. Initially, two-stage cluster analyses were used to identify outliers. Secondly, the Ward method which is a hierarchical clustering method was used to conduct the final analysis. Bivariate logistic regression was also used to study the relationship between cluster membership and caries. The smallest study unit used in the initial analysis for geographical area is known as key code area, which is a geographical entity defined by the municipalities themselves. Decayed surface (DS/ds) has been used as a measure of dental caries.RESULTS: The county of Orebro clustered in five different socioeconomic clusters. Each cluster was defined by proportion of people over 75 years, native-born, single parents, and those with low incomes and low level of education. Odds ratio (OR) for having DS/ds > 0 in the last dental check-up during 2005-2007 was 1.5 (cluster 1), 1.3 (cluster 2), 1.4 (cluster 3) and 3.8 (cluster 4) compared with the most socioeconomically favoured cluster (cluster 5).CONCLUSION: Cluster analysis of socioeconomic data is a useful tool to identify neighbourhoods with different socio-economic conditions.
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| 9. |
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| 10. |
- Franzén, Cecilia
(författare)
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Dental professionals participating in a home visiting programme for first-time parents
- 2023
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Ingår i: Community Dental Health. - : FDI World Dental Press Ltd.. - 0265-539X. ; 40:2, s. 97-102
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Tidskriftsartikel (refereegranskat)abstract
- Background: A home visiting programme was offered to first-time parents in the south of Sweden to reduce health inequalities among young children and support parents. The programme involved a collaboration between child healthcare nurses and midwives, social work-ers, and dental hygienists/dental nurses. It is unusual for dental professionals to participate in such programmes. Objective: To describe the experiences of collaboration between child healthcare nurses and dental professionals and their views on the programme from a dental perspective. Basic Research Design: Qualitative semi-structured interview study with content analysis. Participants: Four child healthcare nurses, three dental hygienists, and two dental nurses. Results: Analysis identified five themes: contribution of knowledge, reinforced oral health advice, family-based oral health advice, financial considerations, and future role of the dental care. Conclusions: Participants stressed the importance of dental professionals' knowledge, the need for child healthcare nurses and dental professional to conduct home visits together to deliver family-based and reinforced dental advice. They suggested a follow-up visit and the participation of the public dental service before a private dental care provider since most children will visit a public dentist later. The programme was perceived as worth the costs, but for the best utility, the resources should primarily be for non-native parents. Further research should focus on the effect of the home visiting programme on the children's oral health.
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| 11. |
- Fägerstad, Anida, 1978-, et al.
(författare)
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Understanding avoidance and non-attendance among adolescents in dental care : an integrative review
- 2016
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Ingår i: Community Dental Health. - Suffolk, United Kingdom : FDI World Dental Press Ltd.. - 0265-539X. ; 33:3, s. 195-207
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To review articles exploring manifestations of avoidance of or non-attendance to dental care, to identify background and concomitant factors specifically associated with dental avoidance among adolescents.Methods: PubMed, CINAHL and PsychINFO were searched using MeSH terms and keywords covering dental avoidance, non-attendance and non-utilization. Searches were limited to peer-reviewed studies in English, published in 1994– 2014. Twenty-one research articles were included. Data were extracted, ordered, coded, categorized, and summarized according to the integrative review method.Results: The identified factors formed three common major themes: Environmental, Individual and Situational factors. Only seven studies, all from Sweden or Norway, investigated factors associated with dental avoidance. The remaining 14 studies were geographically widespread. Regarding avoidance, the main focus was found to be on individual and situational factors, while environmental factors were more often investigated for the outcome non-attendance.Conclusions: Although a wide variety of environmental, individual and situational factors could be summarized in this review, factors specifically associated with dental avoidance in a context of free dental care still need to be investigated. The possible impacts of cultural background, of tobacco, alcohol or drug use and of psycho-social circumstances deserve further research. Clinical implications of today’s knowledge may be to pay attention to the adolescents’ individual background and everyday life situation, to offer agreed and individualized treatment, taking fears and attitudes into consideration, to avoid painful treatments, and to be alert for early signs of avoidance.
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| 12. |
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| 13. |
- Hakeberg, Magnus, 1954, et al.
(författare)
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Patient characteristics in relation to dental care payment model: Capitation vs fee for service
- 2016
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Ingår i: Community Dental Health. - 0265-539X. ; 33:4, s. 252-256
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Tidskriftsartikel (refereegranskat)abstract
- © BASCD 2016.Objective: To analyse patient profiles in two payment models, the capitation (DCH) and the fee-for-service (FFS) systems, in relation to socioeconomic status, self-reported health and health behavior, as well as patient attitudes to and satisfaction with the DCH model in the Public Dental Service (PDS) in Sweden. Research design and participants: The present survey included a random national sample of the adult population in Sweden. A telemarketing company, TNS SIFO, was responsible for the sample selection and telephone interviews conducted in May 2013. The 3,500 adults (aged ≥19 years) included in the sample gave a participation rate of 49.7%. Results: Individuals choosing DCH were younger. FFS patients rated their health as less good, were less physically active, were more often smokers and had a lower household income. The DCH patients were more satisfied with their payment model than the FFS patients (98% vs 85%). A multivariate analysis showed that three of the variables significantly contributed to the model predicting DCH patients: age, with an odds ratio of 0.95, household income (OR=1.85) and importance of oral health for well-being (OR=2.05). Conclusions: There was a pattern of dimensions indicating the choice of payment model among adult patients in the Swedish Public Dental Service. The patients in DCH had higher socioeconomic position, were younger, rated their oral health as better and were more satisfied with the payment model (DCH) than the patients in the FFS system.
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| 14. |
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| 15. |
- Johansson, Veronica, et al.
(författare)
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Financial systems' impact on dental care : a review of fee-for-service and capitation systems
- 2007
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Ingår i: Community Dental Health. - 0265-539X. ; 24:1, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Objective This review covers the impact of financial systems on dental care. Background Remuneration in fee-for-service (FFS) is done per service provided and in capitation (CAP) per patient enrolled. It may be expected that dentists’ incentive in CAP is to keep the number of services provided at a minimum, while in FFS it is to keep the number of services at a maximum. This should lead to a different impact on care, with the dentists in CAP focusing more on prevention and dentists in FFS more on restorative treatment. Six questions were put: Does CAP increase or decrease caries incidence? Does CAP increase or decrease restorative treatments? Does CAP increase preventive care? Does CAP increase or decrease productivity? Does CAP increase or decrease the dentist’s satisfaction with his/her work? Does CAP increase or decrease the patients’ satisfaction with the oral care provided? Methods Literature was obtained through searches in databases. A format was developed to define the literature of interest. Results CAP decreases restorative treatment and there is a tendency of decreased caries incidence. “Supervised neglect” cannot be established. CAP increases preventive care. A conclusion regarding productivity was not possible. The results on dentist’s satisfaction with work were inconclusive, as were the results regarding patient satisfaction. Conclusions CAP has a different impact on provided care than FFS. More research is needed in this area and focus on efficiency is of importance. This review was funded by the Swedish Research Council.
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| 16. |
- Johansson, Veronica, et al.
(författare)
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Patients' health in contract and fee-for-service care : a descriptive analysis
- 2006
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Ingår i: Community Dental Health. - 0265-539X. ; 23:3, s. 187-188
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- AIM Fee-for-service, paying afterwards for services provided, is the traditional patient financial system in dentistry in Sweden. The public dental health service (PDHS) in Värmland has since 1999 also an alternative system: contract care, where a fixed sum of money is paid annually for dental care, which is then received without additional cost. This study describes demographic as well as general and oral health-related characteristics among patients in a service study comparing the two patient financial systems, fee-for-service and contract care, in the PDHS in Värmland. METHODS A questionnaire was answered by 1,324 patients (response rate 57%). Of the respondents, 52% were in contract care and 48% in fee-for-service. A non-response analysis and a special study of the non-respondents were undertaken. General health was studied with SF-36, measuring health in eight dimensions: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Oral health was studied with OHIP-14, measuring oral health in seven dimensions (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap) and as an index. The demographic factors included gender, age, birth country, marital status, education, and social affinity with neighbourhood and housing area. The data were analysed with contingency tables, Chi-square tests, t-tests, Mann-Whitney non-parametric tests and logistic regression analyses. RESULTS The non-response analysis revealed that the likelihood for answering the questionnaire was higher for women (OR=1.27), for respondents in contract care (OR=1.43) and for each year of life (OR=1.02). A short telephone interview with 40 non-respondents in each financial system indicated that the non-respondents had better oral health than the respondents. The non-respondents had experienced less pain in the mouth, less difficulties doing their usual jobs and had found life more satisfying than the respondents. There were no significant differences in gender or age. In the study population, differences in health were observed between the financial systems. Respondents in contract care had better oral health than those in fee-for-service (p=0.019). They had also better general health in half of the dimensions of SF-36 (physical functioning: p<0.001; role-physical: p=0.002; general health: p<0.001; social functioning: p=0.045), were younger (p<0.001), better educated (p< 0.001), were born in Sweden more often (p<0.001) and were more often married/living with somebody (p=0.011) than were the fee-for-service respondents. The fee-for-service respondents experienced higher social affinity with their housing area (p=0.049). CONCLUSION There was bias in nonresponse. Contract care patients had better general and oral health than patients in fee-for-service. Acknowledgement: The study was financed by the Swedish Research Council.
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| 17. |
- Klingberg, Gunilla, 1960, et al.
(författare)
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Dental fear in an urban Swedish child population: prevalence and concomitant factors.
- 1994
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Ingår i: Community dental health. - 0265-539X. ; 11:4, s. 208-14
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Tidskriftsartikel (refereegranskat)abstract
- In order to establish normative data on the dental subscale of children's fear survey schedule (CFSS-DS), measuring child dental fear, and to study the influence of general fears, parental fears and socio-economic correlates on children's dental fear levels, a questionnaire was sent to parents of a representative sample of 4,505 children aged 4-6, and 9-11-years-old in Göteborg, Sweden. The questionnaire contained the CFSS-DS, a short form of the CFSS measuring general fears, Corah's dental anxiety scale (DAS) (measuring parents' dental fear) and specific questions on parents' employment and the native language in the family. A total of 3,204 responses was received. The overall mean score on CFSS-DS was 23.1, and 6.7 per cent of the children were found to be fearful. Dental fear decreased with increasing age and was positively correlated to general fears. Three variables: age, general fears and maternal dental fear, were found to have a significant impact on the variance of CFSS-DS.
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| 18. |
- Lundegren, Nina, et al.
(författare)
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Analysis of the perceived oral treatment need using Andersen's behavioural model
- 2013
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Ingår i: Community Dental Health. - : John Libbey Publishing. - 0265-539X. ; 30:2, s. 102-107
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate the influence of specific components of Andersen's behavioural model on adult individuals' perceived oral treatment need. Methods: A questionnaire was sent to a randomly selected sample of 9,690 individuals, 20 to 89 years old, living in Skane, Sweden. The 58 questions, some with follow-up questions, were answered by 6,123 individuals; a 63% response rate. Selected for inclusion in the multivariate logistic regression analysis were those questions relating to Andersen's behavioural model, phase five. Responses to "How do you rate your oral treatment need today?" were used as a dependent variable. The 62 questions chosen as independent variables represented the components: individual characteristics, health behaviour and outcomes in the model. Results: Of the independent variables, 24 were significant at the p <= 0.05 level. Low educational level, previously unmet perceived oral treatment need, frequent visiting pattern, perception of worse oral health than one's peers, an external locus of control, and to have received information from one's dental caregiver about a need for oral treatment were all highly significant (p<0.001) variables correlating with high self-perceived oral treatment need. Conclusion: The Andersen behavioural model can be a useful theoretical tool for the study of perceived oral treatment need.
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| 19. |
- Lundqvist, Martina, et al.
(författare)
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Health economic analyses of domiciliary dental care and care at fixed clinics for elderly nursing home residents in Sweden
- 2015
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Ingår i: Community Dental Health. - : Dennis Barber. - 0265-539X. ; 32:1, s. 39-43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Dental care for elderly nursing home residents is traditionally provided at fixed dental clinics, but domiciliary dental care is an emerging alternative. Longer life expectancy accompanied with increased morbidity, and hospitalisation or dependence on the care of others will contribute to a risk for rapid deterioration of oral health so alternative methods for delivering oral health care to vulnerable individuals for whom access to fixed dental clinics is an obstacle should be considered. The aim was to analyse health economic consequences of domiciliary dental care for elderly nursing home residents in Sweden, compared to dentistry at a fixed clinic. Methods: A review of relevant literature was undertaken complemented by interviews with nursing home staff, officials at county councils, and academic experts in geriatric dentistry. Domiciliary dental care and fixed clinic care were compared in cost analyses and cost-effectiveness analyses. Results: The mean societal cost of domiciliary dental care for elderly nursing home residents was lower than dental care at a fixed clinic, and it was also considered cost-effective. Lower cost of dental care at a fixed dental clinic was only achieved in a scenario where dental care could not be completed in a domiciliary setting. Conclusions: Domiciliary dental care for elderly nursing home residents has a lower societal cost and is cost-effective compared to dental care at fixed clinics. To meet current and predicted need for oral health care in the ageing population alternative methods to deliver dental care should be available.
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| 20. |
- Moberg Sköld, Ulla, 1948
(författare)
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Approximal caries increment in relation to baseline approximal caries prevalence among adolescents in Sweden with and without a school-based fluoride varnish programme
- 2016
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Ingår i: Community Dental Health. - 0265-539X. ; 33:4, s. 281-285
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Approximal surfaces are a focal point for caries prevention among adolescents in Sweden and the aims of this study were therefore to evaluate approximal caries incidence and caries progression among adolescents with and without a three-year school-based fluoride varnish programme in relation to approximal caries prevalence at baseline. Basic research design: In all, 758 (89%) 13-year-olds completed the three-year randomised controlled trial. They all used fluoride toothpaste at home and had regular dental check-ups at the public dental clinics. Results: The mean approximal caries incidence for the adolescents who were caries free on these surfaces at baseline was 0.13 (SD 0.54) in the fluoride varnish group and 0.79 (1.93) in the control group. The corresponding values for those who had caries at baseline in these groups were 1.29 (2.21) and 2.62 (3.22) respectively. The latter two groups also had 0.34 (1.00) and 0.70 (1.13) approximal enamel lesions that progressed. All differences were statistically significant (p<0.001). Among those individuals who had approximal caries at baseline, double the number of early approximal enamel lesions in the control group progressed compared with the fluoride varnish group. Conclusions: The school-based fluoride varnish programme inhibited new approximal lesions to a great extent and effectively kept approximal enamel lesions within the enamel among 13-16-year-olds. It is therefore recommended that such a programme is warranted when the approximal surfaces are still caries free in order to keep these surfaces free from caries and keep upcoming approximal enamel lesions within the enamel.
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| 21. |
- Morse, D E, et al.
(författare)
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Dental caries in persons over the age of 80 living in Kungsholmen, Sweden : findings from the KEOHS Project
- 2002
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Ingår i: Community Dental Health. - 0265-539X. ; 19:4, s. 262-267
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, communitydwelling persons over the age of 80 living in Kungsholmen, an area in central Stockholm. This paper reports findings regarding the prevalence and severity of dental caries among the dentate participants. Basic research design: Caries examinations were conducted on eligible persons participating in the Kungsholmen Project, an ongoing, longitudinal study of older adults. Setting: Caries examinations were carried out between 1994 and 1996 at two local clinics by three standardised examiners using defined visual, tactile criteria. Participants: Among 296 potentially eligible participants, 159 were examined, and a total of 129 had at least one tooth. Main outcome measures: The caries examination identified decayed and filled surfaces and missing teeth. Results: Of the dentate subjects examined, 80% had teeth in both arches; 98% had at least one coronal filling; 81% had one or more restored root surfaces. Depending upon age and gender, between 36% and 56% of those examined had untreated coronal caries, and between 54% and 75% had untreated root caries. Conclusions: These findings document the substantial and ongoing impact of dental caries in a sample of generally healthy, community-dwelling older adults and underscore the importance of continued caries prevention and treatment in the aged.
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| 22. |
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| 23. |
- Norman, M., et al.
(författare)
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Urinary fluoride excretion in preschool children after intake of fluoridated milk and use of fluoride-containing toothpaste
- 2017
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Ingår i: Community Dental Health. - Suffolk : FDI World Dental Press Ltd.. - 0265-539X. ; 34:1, s. 27-31
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the urinary fluoride excretion in preschool children after drinking fluoridated milk with 0.185 mg F and 0.375 mg F and to study the impact of use of fluoride toothpaste.Basic research design: Double-blind cross-over study.Participants: Nine healthy children, 2.5-4.5 years of age.Intervention: In a randomized order, participants drank 1.5 dl milk once daily for 7 days with no fluoride added (control), 0.185 mg fluoride added and 0.375 mg fluoride added. The experiment was performed twice with (Part I) and without (Part II) parental tooth brushing with 1,000 ppm fluoride toothpaste. The fluoride content in the piped drinking water was 0.5 mg F/L.Main outcome measure: Urinary fluoride excretion.Results: The 24-hour urinary fl uoride excretion/kg body weight varied from 0.014 mg F for the placebo intervention and non-fluoride toothpaste to 0.027 mg F for the 0.375 mg intervention with use of 1,000 ppm fluoride toothpaste. The difference compared with the placebo intervention was not statistically significant for any of the interventions when fluoride toothpaste was used (p⟩0.05) while it was statistically significantly different when non-fluoride toothpaste was used (p⟨0.05).Conclusions: All sources of fluoride must be considered when designing community programs. With 0.5 mg F/L in the drinking water and daily use of fluoride toothpaste, most children had a fluoride intake optimal for dental health. In this setting, additional intake of fluoride milk was within safe limits up to 0.185 mg/day while conclusions about the safety of 0.375 mg/day were uncertain.
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| 24. |
- Ordell, Sven, et al.
(författare)
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Dental hygienists as primary oral health providers and their degree of professionalism
- 2006
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Ingår i: Community Dental Health. - 0265-539X. ; 23:3, s. 169-170
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The number of active dentists in Sweden will fall sharply in the next decade and will partially be countered by an increased number of dental hygienists. The acceptance of this transition to primary oral health care by hygienists will be dependent on many factors; among them will be the perceived service quality offered by the dental hygienists, which may depend on how their professional status is perceived. Aim To find out whether the professional status of Swedish dental hygienists is such that it is possible to meet the demands from the population. Methods The professional status of Swedish dentists and dental hygienists was analysed by the variables suggested by Greenwood (1957). [Greenwood E. Social Work.1957 2: 45-55.] Results The variables used point to shortcomings in the professional status of Swedish dental hygienists. Dentists in Sweden constitute a strong profession, while dental hygienists are emerging as a profession. They lack a coherent and systematic theory in their academic education. Their fields of expertise are not exclusive to their group and that further weakens their professional status. They will probably not meet the service quality that is presently expected by the population. Many factors will have to be combined to make possible the necessary transition from dentists to dental hygienists as primary providers of oral health care. One of them is that the expected level of service must be adjusted to the available personnel. Conclusions The professional status of the dental hygienists needs to be consolidated and strengthened by a more homogenous curriculum. Acknowledgements: This study was supported by the dental commissioning unit in Östergötland County Council.
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| 25. |
- Ordell, S, et al.
(författare)
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Understanding politics? Some lessons from Swedish dentistry.
- 2009
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Ingår i: COMMUNITY DENTAL HEALTH. - : World Dental Press; 1998. - 0265-539X. ; 26:4, s. 239-243
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Tidskriftsartikel (refereegranskat)abstract
- Background Medical and dental care are dependent on political settings or legislation and financing. The professionals in these organisations need to understand the political logic that shapes the environment of their organisation. A description of Swedish dentistry and recent legislation reports from commissions and bills to parliament from 1997 are analysed. Aim The aims are to describe changes in the environment for dentistry in Sweden from 1998, to analyse the underlying political logic, and to point to some lessons to be learned. Method The description is analysed using theories from strategic management and from decision-making. Results The objectives changed from a formal emphasis on prevention to insurance against high cost for the patient. Some ideas keep recurring in the political debates even if scientific logics contradict them. Conclusions Health care system research methods and the "garbage can" model of decision-making can be used to describe and to gain a better understanding of the politically governed environment. Some political issues keep recurring in spite of earlier rational rejections. A better understanding of the political logic that forms the environment for an organisation is needed for a successful adaptation to that environment.
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| 26. |
- Pilgård, Göran, et al.
(författare)
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Values about good work for Swedish oral surgeons and general practice dentists
- 2006
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Ingår i: Community Dental Health. - 0265-539X. ; 23:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim Dentists in the Public Dental Health Service (PDHS) in Sweden seem to have a larger discrepancy between ideal and reality with regard to good work than do other academic groups in Sweden. [ Aronsson G, Bejerot E, Härenstam A. Public Personnel Management 1999;28:197-215., Hjalmers K, Söderfeldt B, Axtelius B. Acta Odontol Scand 2004;62:107-10.] This study investigates how oral surgeons and female general practice dentists (GPDs), two groups in the PDHS, perceived good work, both in an ideal world and in reality, as well as to compare if there was a discrepancy between the two. Methods A questionnaire containing twelve items about good work (Aronsson 1999) was sent to the oral surgeons and to the female GPDs. There were 106 oral surgeons from 22 oral and maxillofacial surgery (OMFS) clinics in Sweden. Of them, 90% responded to the questionnaire. The GPDs were 183 female dentists without any managerial position, working in one region in Sweden. Of them, 94% responded to the questionnaire. Results The oral surgeons and the GPDs rated highest the following two criteria: The job should be intellectually stimulating (91% of both the oral surgeons and the GPDs considered this as very important) and the job should provide opportunities to have an influence on important decisions (82% and 85% of the oral surgeons and the GPDs, respectively, considered this as very important). Opportunity for career advancement was more important for the oral surgeons and this was the only criterion, where the gap between ideal and reality was wider for the oral surgeons than it was for the GPDs. Conclusions The main result was that the criteria for an ideal work situation among the oral surgeons corresponded to those among the female GPDs. For all aspects but one, however, the discrepancy between ideal and reality with regard to good work was wider for the female GPDs. Acknowledgements: Supported by FoU-centre in Southern Älvsborg County, Sweden.
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| 27. |
- Sampogna, Francesca, et al.
(författare)
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Quality of life in patients with dental conditions : comparing patients' and providers' evaluation
- 2009
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Ingår i: Community Dental Health. - 0265-539X. ; 26:4, s. 234-238
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To measure the agreement between patients and their caregivers in evaluating patients’ oral quality of life. Basic research design. Cross-sectional study. Clinical setting. Data collected in four Swedish dental clinics in 2004. Participants. Consecutive patients. Data were completed for 444 patients. Fifteen dentists and 12 dental hygienists agreed to participate. Interventions. For each patient, the patient him/herself and his/her caregiver completed the 14-item Oral Health Impact Profile (OHIP-14), a specific instrument used to measure quality of life in oral conditions, with higher scores indicating a worse quality of life. Information on personal and clinical characteristics of patients were also collected. Main outcome measures. Median OHIP-14 scores given by caregivers and patients were calculated and compared in different subgroups of patients. Cohen’s kappa was calculated to measure the agreement between the evaluation of patients and caregivers. Results. OHIP-14 scores median values were 3.0 among patients and 9.0 among caregivers. Caregivers always gave a higher score than patients, especially in older patients and patients with lower education. The concordance between patients’ and caregivers’ evaluation was very low (for different OHIP-14 cutoffs: Cohen’s kappa from 0.10 to 0.15). Conclusions. In this study, great discrepancies were observed between patients and caregivers in the evaluation of patients’ oral quality of life, with caregivers overestimating the burden of dental conditions on patients. It is important to improve patient-caregiver communication, in order to increase patient satisfaction and provide better care. A good patient-caregiver relationship is essential for the patients’ well-being and their adherence to treatment.
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| 28. |
- Sjögren, Petteri, et al.
(författare)
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Reliability methodology in caries epidemiological studies conducted in the Nordic countries between 1990 and 2001
- 2007
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Ingår i: Community Dental Health. - 0265-539X. - 0265-539X ; 24:2, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe and analyse the reporting of methodology relating to reliability in caries epidemiological studies conducted in the Nordic countries between 1990 and 2001. Basic research design. Basic research design Literature searches were conducted in the Medline database, and reference lists of all obtained publications were scrutinised for additional studies. Publications fulfilling the inclusion criteria were assessed for study design, and methodological aspects relating to reliability were assessed according to recommendations for evidence-based medicine (EBM). The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence was evaluated. Main outcome measures Reporting of predetermined methodological items relating to reliability and the frequency of endorsement of the assessed items were of primary interest. Results Initially, 724 publications were located in the literature searches. Of 133 eligible publications obtained, 32 fulfilled the inclusion criteria and remained throughout the analyses. The majority of the studies reported the reliability methodology, which was generally inadequate. The frequencies of endorsement ranged from 0% to 69 %. All publications contributed to a low strength of evidence. In this context, it was proposed that prospective longitudinal studies with a random sample selection be classified as type-2 (2b) level of evidence. Conclusion There seems to be a need to improve the reporting and the methodology relating to reliability in caries epidemiological publications. Reporting of random sample selection and at least two of the items assessed seems to discriminate between high and low quality with respect to the reported methodology relating to reliability.
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| 29. |
- Sjögren, Petteri, et al.
(författare)
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Reliability methodology in caries epidemiological studies conducted in the Nordic countries between 1990 and 2001
- 2007
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Ingår i: Community Dental Health. - : FDI World Dental Press Ltd. - 0265-539X. ; 24:2, s. 97-104
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe and analyse the reporting of methodology relating to reliability in caries epidemiological studies conducted in the Nordic countries between 1990 and 2001. Basic research design. Basic research design Literature searches were conducted in the Medline database, and reference lists of all obtained publications were scrutinised for additional studies. Publications fulfilling the inclusion criteria were assessed for study design, and methodological aspects relating to reliability were assessed according to recommendations for evidence-based medicine (EBM). The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence was evaluated. Main outcome measures Reporting of predetermined methodological items relating to reliability and the frequency of endorsement of the assessed items were of primary interest. Results Initially, 724 publications were located in the literature searches. Of 133 eligible publications obtained, 32 fulfilled the inclusion criteria and remained throughout the analyses. The majority of the studies reported the reliability methodology, which was generally inadequate. The frequencies of endorsement ranged from 0% to 69 %. All publications contributed to a low strength of evidence. In this context, it was proposed that prospective longitudinal studies with a random sample selection be classified as type-2 (2b) level of evidence. Conclusion There seems to be a need to improve the reporting and the methodology relating to reliability in caries epidemiological publications. Reporting of random sample selection and at least two of the items assessed seems to discriminate between high and low quality with respect to the reported methodology relating to reliability.
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| 30. |
- Sjögren, Petteri, et al.
(författare)
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Validation methodology in publications describing epidemiological registration methods of dental caries : a systematic review
- 2003
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Ingår i: Community Dental Health. - 0265-539X. ; 20:4, s. 251-259
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to describe and systematically review the methodology and reporting of validation in publications describing epidemiological registration methods for dental caries.Basic research methodology: Literature searches were conducted in six scientific databases. All publications fulfilling the predetermined inclusion criteria were assessed for methodology and reporting of validation using a checklist including items described previously as well as new items. The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence, was evaluated.Main outcome measures: Reporting of predetermined items relating to methodology of validation and the frequency of endorsement of the assessed items were of primary interest.Results: Initially 588 publications were located. 74 eligible publications were obtained, 23 of which fulfilled the inclusion criteria and remained throughout the analyses. A majority of the studies reported the methodology of validation. The reported methodology of validation was generally inadequate, according to the recommendations of evidence-based medicine. The frequencies of reporting the assessed items (frequencies of endorsement) ranged from four to 84 per cent. A majority of the publications contributed to a low strength of evidence.Conclusion: There seems to be a need to improve the methodology and the reporting of validation in publications describing professionally registered caries epidemiology. Four of the items assessed in this study are potentially discriminative for quality assessments of reported validation.
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| 31. |
- Sonbul, Helal, 1974, et al.
(författare)
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The effect of a modified fluoride toothpaste technique on buccal enamel caries in adults with high caries prevalence: a 2-year clinical trial
- 2011
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Ingår i: Community Dental Health. - 0265-539X. ; 28:4, s. 292-296
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the preventive effect of a “modified fluoride (F) toothpaste technique” on the incidence and progression of buccal/ lingual enamel caries among Saudi adults with high caries prevalence. Method: Adults were randomly assigned to test and control groups. Test group patients were instructed to use the provided F toothpaste twice a day as follows: 1, use 2cm toothpaste; 2, brush for 2min; 3, swish the toothpaste slurry around the teeth for about half a minute before spitting it out; and 4, no post-brushing water rinsing and no eating/drinking for 2hr. The patients in the control group (n=57) were instructed to continue using their regular F toothpaste twice a day without any further instructions. The patients’ compliance in the test group was assessed after 2 years. Results: Of 175 adults, 113 completed the study. The test group (n=56) had a lower enamel mean caries incidence 0.56 (sd 1.04) than the control group (n=57), 1.01 (1.00) (p<0.05), with a preventive fraction of 44%. There was no difference regarding enamel caries progression or arrested caries. The caries incidence in the test group was higher in the subgroup of patients who rinsed with water post-brushing and who only brushed once a day (p<0.05). Conclusion: The “modified fluoride toothpaste technique”, as practised over the 2 years in a Saudi population with high caries prevalence, had a preventive effect on the incidence of buccal/lingual enamel caries but not on the progression.
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| 32. |
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| 33. |
- Stein, L., et al.
(författare)
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Exploring the association between oral health literacy and alexithymia
- 2015
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Ingår i: Community Dental Health. - 0265-539X. ; 32:3, s. 143-147
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Tidskriftsartikel (refereegranskat)abstract
- Low health literacy and alexithymia have separately been emphasized as barriers to patient-practitioner communication, but the association between the two concepts has not been explored. Objective: To test the hypothesis that low oral health literacy and alexithymia are associated. Method: Adults (n=127) aged 21-80 years (56% women) participated in this cross-sectional study. Oral health literacy was assessed using the interview-based Adult Health Literacy Instrument for Dentistry (AHLID) with scores from 1-5. The self-administered Toronto Alexithymia Scale (TAS-20) was used to assess three distinct TAS-20 factors and TAS-20 total score. Results: Significant negative correlations between AHLID scores and TAS-20 factors 2, 3 and TAS-20 total score were found. Regression analyses showed that TAS-20 factor 3, externally-oriented thinking (beta=-0.21, SE=0.02, p=0.017), and TAS-20 total score (beta=-0.18, SE=0.01, p=0.036) were significant predictors of AHLID level. Conclusion: The hypothesis that low oral health literacy is associated with alexithymia was supported. This finding proposes that alexithymia may be considered as a possible factor for low oral health literacy. However, the correlations are not strong, and the results should be regarded as a first step to provide evidence with additional research on this topic being needed.
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| 34. |
- Stenebrand, Agneta, et al.
(författare)
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Dental anxiety and oral health in 15-year-olds : a repeated cross-sectional study over 30 years
- 2015
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Ingår i: Community Dental Health. - 0265-539X. ; 32:4, s. 221-225
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To report the prevalence of dental anxiety in Swedish 15-year-olds over a 30-year period (1973-2003) and how dental anxiety relates to oral health. Basic research design: The study used a repeated cross-sectional design. Participants: In 1973, 1983, 1993, and 2003, random samples of 96 to 107 15-year-olds were selected from the city of Jönköping, Sweden, 405 overall. Main Outcome Measures: Dental anxiety (DA) and its association with oral health (caries, gingivitis, plaque, fillings) were analysed (α=0.05). Results: The proportions of dentally anxious during the period were 38% (n=37) in 1973, 26% (n=28) in 1983, 18% (n=15) in 1993 and 13% (n=12) in 2003 a clearly decreasing trend with time. The strongest predictor of DA was gender, with girls reporting higher levels of DA. In three of the four examination years, adolescents with DA had more filled permanent surfaces than those without DA. Those with DA had a greater caries experience only in 1973. No associations were found between DA and plaque or gingivitis. Multivariate logistic modelling confirmed that DA decreased over time and that girls had higher levels of DA. Conclusions: This study showed a clear decrease in DA in 15-year-olds over a 30-year period, with a greater proportion of girls being more dentally anxious. The results also indicate a relationship between DA and oral health; the dentally anxious having more filled surfaces and, only in 1973, more decayed tooth surfaces.
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| 35. |
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| 36. |
- Svensson, Lisa, et al.
(författare)
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Dental anxiety, concomitant factors and change in prevalence over 50 years
- 2016
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Ingår i: Community Dental Health. - 0265-539X. ; 33:2, s. 121-126
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse the prevalence of Dental Anxiety (DA) in the general adult population of Sweden, to study concomitant factors of DA and also to compare the prevalence of DA in 1962 with that in 2013. Method: The national study for 2013 included 3,500 individuals, randomly selected from the Swedish population. The data sampling was performed as a telephone survey including 38 questions and this report is a selection of those questions with the focus on DA. The national study from 1962 was a face-to-face survey of 1,331 individuals randomly selected from the Swedish population. Both surveys were conducted by the same company. Results: In 2013, severe DA was reported in 4.7%, moderate DA in 4.5%, low DA in 9.8% and no DA in 80.9% of the subjects. Most (72.9%) of the subjects who reported severe DA attended dental care regularly. Important predictive factors of DA were age, gender, education, and self-rated poor oral and general health. The analysis showed a decrease in the prevalence of DA between 1962 and 2013, specifically a change towards more individuals reporting no dental anxiety (38.5% vs. 80.9%) but also smaller proportions of individuals having low and high DA (46.4% vs 9.8% and 15.1% vs 9.2%, respectively). Conclusions: In this national representative sample of Swedish adults the prevalence of severe DA was 4.7%. The main finding revealed a significant decrease of the prevalence of DA over 50 years.
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| 37. |
- Virtanen, Jorma, et al.
(författare)
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Childrens Use of Dentist Services in Four Nordic Countries
- 2006
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Ingår i: COMMUNITY DENTAL HEALTH. - 0265-539X. ; 23, s. 171-172
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Tidskriftsartikel (refereegranskat)abstract
- An increase in the use of services offered for children by general practitioners has taken place since the 1980s in the Nordic countries. Aim: To compare differences in childrens use of dental services in four Nordic countries between the 1980s and the 1990s and to analyse trends during the period. Methods: The participants were 12,000 children aged 2-17 years in Finland, Iceland, Norway and Sweden. Cross-sectional population surveys using random samples comprising 3000 children were conducted in 1984 and 1996. Time trends in the use of dental services were studied in each country by age, gender, parents highest level of education, and living area. The main outcome was dental services utilization that was based on the responses to a questionnaire item asking whether the parents had consulted a dentist / a dental nurse with regard to their childrens oral health during the previous three months. Results: The percentage of children who had used dental services varied from 50% in 1984 in Norway to 38% in 1996 in Sweden. A clear time trend towards decreasing utilization of dental services (p<0.05) was found in all countries except in Finland where utilization of dental services increased significantly (p<0.05) between 1984 and 1996. Odds ratios for time trends (1984=1.00) varied from 0.66 (95% CI 0.58-0.75) in Sweden to 0.71 (0.62-0.81) in Iceland. The corresponding figures in Finland were 1.32 (1.16-1.48). In Finland and Norway, children in families with lower a education used more dental services than those in families with higher education. Conclusions: Between the 1980s and the 1990s childrens use of dental services has decreased significantly in the four Nordic countries. Increased use of individual recall intervals in oral health care might partly explain this finding.
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| 38. |
- Wang, Nina J., et al.
(författare)
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Recall intervals and time used for examination and prevention by dentists in child dental care in Denmark, Iceland, Norway and Sweden in 1996 and 2014
- 2018
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Ingår i: Community Dental Health. - : F D I WORLD DENTAL PRESS LTD. - 0265-539X. ; 35:1, s. 52-57
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of the present study was to explore intervals between regular dental examination and the time dentists spent for examination and preventive dental care of children in 1996 and 2014.Participants and Methods: In Denmark, Norway and Sweden, random samples of dentists working with children were included, while in Iceland all dentists were mailed questionnaires. Complete information was provided by 1082 of 1834 dentists (64%) in 1996 and 1366 of 2334 dentists (59%) in 2014. Results were assessed using chi-square and analysis of variance with post-hoc tests.Results: Some trends were consistent in all countries, but considerable differences in routines between the countries persisted during the period. The most used and maximum planned recall intervals were on average 14.8 (sd 4.8) and 18.5 (sd 4.6) months in 2014, respectively 3.1 and 3.5 months longer than in 1996 (p<0.05). In 2014 dentists used ample time delivering preventive care to children. Dentists reported spending significantly more time providing preventive care for caries risk children than for other children both in 1996 and 2014. Concurrent with extended intervals, dentists reported spending longer performing routine examinations in three of the four countries in 2014 than in 1996.Conclusions: This study of trends in dental care delivered by dentists during recent decades showed moves towards extended recall intervals and preventive care individualized according to caries risk. In addition, extending intervals could necessitate more time for a routine dental examination.
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| 39. |
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| 40. |
- Yaghoobi, H, et al.
(författare)
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The role of the mothers' sense of coherence in predicting dental caries risk in children
- 2022
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Ingår i: Community Dental Health. - 0265-539X. ; 39:3, s. 206-210
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Individuals with a stronger sense of coherence (SOC) often show healthier behaviors. As parents, especially mothers, are behavioral role models for their children, this study aimed to explore the role of the mothers' SOC in prediction of the risk of dental caries in a sample of children aged 11-12 years old.DESIGN: Cross-sectional study with 173 mother-child pairs enrolled by multi-stage sampling from four public schools in Torbat-e-Heydarieh, Iran. The data were obtained, using a demographic-health information sheet and the SOC-13 scale. Dental examinations of children were performed using the decay, missing and filled teeth index for primary (dmft) and permanent teeth (DMFT). Poisson regression analyses estimated the role of the mothers' SOC in predicting the relative risk (RR) of children's dental caries.RESULTS: Mean dmft and DMFT were 3.4 ± 3.1 and 2.7 ± 2.9 respectively (medium severity). After controlling for demographic and health variables in regression models, greater maternal SOC indicated a protective effect against dental caries in primary (RR: 0.96; 95% CI:0.96-0-97) and permanent teeth (RR: 0.96; 95% CI: 0.95-0.97) of their children.CONCLUSIONS: With greater maternal SOC, the risk of children's dental caries decreased. Whilst this relationship was not as strong as in previous studies in other countries, it can be a platform for further research and perhaps planning to identify children who are at a greater risk of dental caries before starting dental examinations in schools.
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| 41. |
- Östberg, AL, et al.
(författare)
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A gender perspective of self-perceived oral health in adolescents : associations with attitudes and behaviours
- 2001
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Ingår i: Community Dental Health. - : World Dental Press; 1998. - 0265-539X. ; 18:2, s. 110-116
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population. Design A census survey. Self-reported questionnaires were answered anonymously in a standardised manner in classrooms. Attitudes studied included the importance of sound teeth and feelings towards visits to the dentist. Behaviours were represented by floss usage and sweets consumption. Setting All senior and upper secondary level schools in Skaraborg County, Sweden. Subjects 17,280 students, aged 13-18 years, Outcome measures Self-perceived oral health. represented by a single-item rating: satisfaction with the appearance of the teeth: self-assessed gum bleeding and a perceived oral health (POH) index. Results Recognising sound teeth as important was a predominating attitude among the respondents (boys 94%, girls 97%) and was significantly associated with a good perceived oral health overall. Individuals who experienced visits to dentist as unpleasant (boys 36%, girls 43%) were less likely to perceive good oral health as single-item rated (OR for boys 0.55[0.49, 0.63], girls 0.40[0.34, 0.47]). Regular use of floss had a small protective effect on bleeding gums. Daily sweets consumption showed a significant and inverse association with self-perceived oral health as single-item rated (OR for boys 0.53[0.44, 0.66], girls 0.49[0.40, 0.60]). Girls, more often than boys, perceived their oral health to be good, except in the perception of the appearance of their teeth. Conclusions It is concluded that the strong associations between attitudes and self-perceived oral health should be recognised in strategies for oral health promotion and that gender differences must be considered.
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