| 1. |
- Bernson, Jenny M, et al.
(författare)
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Adaptive coping strategies among adults with dental fear. Further development of a new version of the Dental Coping Strategy Questionnaire
- 2012
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 70:5, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this study was to further develop and investigate a newly constructed 15-item questionnaire on strategies for coping with dental treatment, used by fearful adult patients undergoing regular dental care and those with phobic avoidance. Materials and Methods. The dental coping strategy questionnaire (DCSQ-15) was distributed to 77 individuals with dental phobic avoidance and 94 fearful patients undergoing regular dental care. Previous analyses of a 20-item coping questionnaire (DCSQ-20) revealed that 2 of 4 identified factors predicted regularity or phobic avoidance of dental care. However, one of these factors was considered related to catastrophizing thoughts and not to coping strategies and it was therefore removed in the present study. Results. The reduced 15-item questionnaire was analyzed to identify its factor structure and a 5-factor solution was found. The five factors were labeled (i) ‘self-efficacy’, (ii) ‘self-distraction’, (iii) ‘distancing’, (iv) ‘praying’ and (v) ‘optimism’. The factors of ‘praying’ and ‘optimism’ correlated significantly with dental anxiety and were assessed significantly higher and lower respectively, among individuals with phobic avoidance. A logistic regression analysis revealed that ‘optimism’, together with gender and dental anxiety, was predictive of the regularity or phobic avoidance of dental care.
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| 2. |
- Bernson, Jenny M, et al.
(författare)
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Dental coping strategies, general anxiety, and depression among adult patients with dental anxiety but with different dental-attendance patterns
- 2013
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 121:3, s. 270-276
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the differences in characteristics and outcome between two consecutive series of patients admitted to hospital with chest pain in a 20-year perspective. Particular emphasis is placed on changes in outcome in relation to the initial electrocardiogram (ECG). SUBJECTS: In the two periods, 1986-1987 and 2008, all patients with chest pain admitted to the study hospitals in Gothenburg, Sweden, were included. RESULTS: Five thousand and sixteen patients were registered in a period of 21 months in 1986-1987 and 2287 patients were registered during 3 months in 2008. In a comparison of the two time periods, the age of chest pain patients was not significantly different (mean age 60.1 ± 17.8 years in 1986-1987 and 59.8 ± 19.1 years in 2008, p=0.50). There was a lower prevalence of previous angina pectoris, congestive heart failure and current smoking in the second period, whereas a history of acute myocardial infarction, hypertension and diabetes mellitus had become more prevalent. The use of cardio-protective drugs increased and ECG changes indicating acute myocardial ischemia on admission to hospital decreased. Length of hospitalisation was reduced from a median of 5 days to 3 days (p<0.0001). A significant decrease in 30-day and 1-year mortality was found (3.8% in 1986-1987 vs 2.0% in 2008 and 9.9% vs 6.3% respectively, p<0.0001 for both comparisons). CONCLUSIONS: During a period of 20 years, the characteristics and outcome of patients admitted to hospital with chest pain changed. The most important changes were a lower prevalence of ECG signs indicating acute myocardial ischemia on admission, shorter hospitalisation time and a lower 30-day and 1-year mortality.
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| 3. |
- Bernson, Jenny M, et al.
(författare)
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'Making dental care possible - a mutual affair'. A grounded theory relating to adult patients with dental fear and regular dental treatment
- 2011
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Ingår i: European Journal of Oral Sciences. - Copenhagen : Munksgaard Forlag. - 0909-8836 .- 1600-0722. ; 119:5, s. 373-380
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Tidskriftsartikel (refereegranskat)abstract
- Dental fear is a common and widespread problem, which can cause severe stress. Even so, most patients with dental fear undergo regular dental treatment in spite of their fear and many enjoy good oral health. The aim of this study was to obtain a deeper understanding of how patients with dental fear manage to undergo dental treatment. Fourteen patients with dental fear, who undergo regular dental care, were interviewed. Qualitative analysis of the transcribed interviews was performed according to the principles of grounded theory. A conceptual framework was generated, and the main concern was identified as 'making dental care possible - a mutual affair'. Four additional categories explained how patients handled their dental fear and how dental care became possible. The strategies were labelled 'taking part in a mental wrestling match', 'trust-filled interaction with dental staff', 'striving for control' and 'seeking and/or receiving social support'. The results showed that making dental care possible for patients with dental fear is a mutual challenge that requires interplay between dental staff and patients, involving verbal and non-verbal communication reflecting respect, attention, and empathy. Moreover, a balance between nearness and distance and between professional and personal treatment is required.
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| 4. |
- Elfström, Magnus, et al.
(författare)
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Validation of the Swedish version of the clinical outcomes in routine evaluation outcome measure (CORE-OM)
- 2013
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 20:5, s. 447-455
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to perform an initial validation of a Swedish translation of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). The CORE-OM is a broad self-report instrument of psychological problems, designed as an outcome measure for evaluating the effects of psychological therapy. Participants included a non-clinical group of 229 university students and a clinical group of 619 persons from four primary care sites. The Swedish CORE-OM showed excellent acceptability, high internal consistency and test-retest reliability, as well as acceptable convergent validity. There was strong differentiation of the clinical and non-clinical samples, with the clinical group scoring significantly more psychological problems than the non-clinical group. Sensitivity to change was demonstrated in psychological treatments in primary care. Overall, the psychometric characteristics of the Swedish CORE-OM were very similar to the original UK data. Nevertheless, the validity of the Swedish version needs to be examined more in detail, in larger and more diverse samples. Our results so far, however, provide support for using the Swedish CORE-OM as a psychological problems measure. To our knowledge, there are few other relatively short measures in Swedish that are free to reprint that meet the demands for psychometric properties and utility in primary care settings in which patients typically present a broad range of psychological problems.
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| 5. |
- Östberg, Anna-Lena, et al.
(författare)
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Oral impacts on daily performances : associations with self-reported general health and medication
- 2009
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Ingår i: Acta Odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 67:6, s. 370-376
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of the present study was to examine the impact of general diseases and medication on oral health-related quality of life (OHRQoL) in a Swedish adult population using the Swedish version of Oral Impacts on Daily Performances (OIDP). Material and methods. A three-site sample of 200 adults (20-86 years; participation rate 70%) was interviewed using the OIDP, and a medical anamnesis was performed in 2006-7. A self-reported questionnaire provided complementary socio-economic data. Results. The burden of medical diagnoses and medications was greatest among the older participants in the study. The mean number of medicines in regular users was: ≥60 years, 3.6 (SD 2.6); 40-59 years, 1.9 (SD 1.5); and 20-40 years, 1.9 (SD 1.8) (p =0.013). There were no gender differences in general health or medication variables. Self-reported health, medical diagnoses and medication were significantly and consistently associated with the OIDP score: subjects with ≥1 diagnosis, OR 2.22 (95% CI 1.19-4.14) and subjects with ≥1 medicines, OR 1.85 (95% CI 1.01-3.40) versus those without diagnoses or medication. However, there was a clear gradient: OIDP scores increased with increasing numbers of diagnoses and medicines. Conclusion. The Swedish version of the OIDP was found useful for measuring impacts of general health and medication on OHRQoL. Dental care should pay special attention to patients with medical conditions or who are on medication, because these patients are more likely to experience oral impacts on daily performances.
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| 6. |
- Abrahamsson H, Kajsa, et al.
(författare)
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Evaluation of the Dental Hygienist Beliefs Survey : test-retest assessment in a group of general dental patients
- 2012
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Ingår i: International Journal of Dental Hygienie. - 1601-5037. ; 10:1, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the Dental Hygienist Beliefs Survey (DHBS) and the test–retest reliability of DHBS in a group of general dental patients. Material and methods: The DHBS, which is a questionnaire constructed to assess patients’ specific attitudes towards dental hygienists (DHs), was distributed together with the Dental Anxiety Scale adapted to specifically assess fear of DH treatment (DHAS). It was hypothesized that DHBS would correlate with DHAS and gender. The questionnaires were consecutively distributed to 80 patients at their first visit and after a clinical examination performed by a DH student. Retest assessments of DHBS were conducted approximately two weeks later in conjunction with the next visit at the DH student and before treatment (scaling session). The final study sample included 77 adult general dental patients in treatment at an education clinic for DH students. Results: The results verified a statistically significant correlation between DHBS and DHAS. The DHBS sum of scores showed high internal consistency with Cronbach’s a coefficient of 0.88 and 0.91 at the first and second assessments, respectively, and the test–retest reliability of the DHBS was acceptable with intraclass correlation coefficient of 0.76. No statistically significant association was found between DHBS and gender. Conclusion: The results suggest that the DHBS is a reliable and stable scale to use to assess patients’ specific attitudes towards DHs. Moreover, DH beliefs are associated with fear of DH treatment.
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| 7. |
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| 8. |
- Abrahamsson, Kajsa, et al.
(författare)
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Dental beliefs : factor structure of the revised dental beliefs survey in a group of regular dental patients
- 2009
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 117:6, s. 720-727
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.
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| 9. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Attitudes to dental hygienists: evaluation of the Dental Hygienist Beliefs Survey in a Swedish population of patients and students.
- 2007
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 5:2, s. 95-102
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate and test the psychometric properties of the Dental Hygienist Beliefs Survey (DHBS) in a Swedish sample of different patient groups and students. It was hypothesized that negative dental hygienist beliefs would discriminate between fearful and non-fearful study groups. The DHBS was distributed together with the revised Dental Beliefs Survey (DBS-R) and the Dental Anxiety Scale (DAS). The study sample included 394 subjects (130 students, 144 general dental patients, 90 periodontal patients and 30 patients on a waiting list for dental fear treatment). The results verified that the DHBS discriminates well between dentally fearful and non-fearful study groups. The DHBS had high internal consistency (Cronbach's alpha = 0.96-0.98) in all the groups. The correlation between the DHBS and the DBS-R was high (rho = 0.82, P < 0.001). Furthermore, the DHBS correlated significantly with the DAS, as well as with a low but significant correlation to age (more negative attitudes in younger age groups) and gender (more negative attitudes amongst women). Regression analysis showed that gender and the DHBS items: 23, 16 and 28, i.e. items related to feeling helpless, worries/fears not being taken seriously and fear about 'bad news' possibly preventing treatment, were the most important predictors of dental fear. The results suggest that the DHBS may be a valid and reliable scale to use in order to assess patient's specific attitudes to dental hygienists. However, the psychometric properties including test-retest analysis and the underlying factor structure of the DHBS need to be further explored.
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| 10. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Dental beliefs: evaluation of the Swedish version of the revised Dental Beliefs Survey in different patient groups and in a non-clinical student sample.
- 2006
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 114:3, s. 209-15
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate and to test the psychometric properties of a Swedish version of the revised Dental Beliefs Survey (DBS-R) in different patient groups and in a non-clinical sample of students. It was hypothesized that negative dental beliefs, assessed using the DBS-R, would discriminate between fearful and non-fearful study groups. The questionnaire was distributed together with the Dental Anxiety Scale (DAS). The sample included 550 adults who responded to the questionnaires (206 students, 177 general dental patients, 105 periodontal patients and 62 patients at a waiting list for dental-fear treatment). The internal drop-out rate was low. The results confirmed that the DBS-R discriminates well between fearful patients and the other study groups. The DBS-R had a high internal consistency in all the study groups. Furthermore, the DBS-R correlated significantly with age (higher values in younger age groups) and the DAS. Regression analyses showed that the DBS-R subdimensions of 'communication' and 'control'/or 'trust', respectively, were significant predictors for dental fear. The results suggest that the DBS-R is a reliable and valid instrument for use in different Swedish patient- and non-clinical population groups in order to assess attitudes to dentists. However, the underlying factor structure of the DBS-R needs to be further explored and established.
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| 11. |
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| 12. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Evaluation of the Dental Hygienist Beliefs Survey; test-retest assessment in a group of general dental patients.
- 2012
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5037 .- 1601-5029. ; 10:1, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- To cite this article: Int J Dent Hygiene DOI: 10.1111/j.1601-5037.2011.00521.x Abrahamsson KH, Andersson P, Krok L, Hakeberg M. Evaluation of the Dental Hygienist Beliefs Survey; test-retest assessment in a group of general dental patients. Abstract: Objective: To evaluate the Dental Hygienist Beliefs Survey (DHBS) and the test-retest reliability of DHBS in a group of general dental patients. Material and methods: The DHBS, which is a questionnaire constructed to assess patients' specific attitudes towards dental hygienists (DHs), was distributed together with the Dental Anxiety Scale adapted to specifically assess fear of DH treatment (DHAS). It was hypothesized that DHBS would correlate with DHAS and gender. The questionnaires were consecutively distributed to 80 patients at their first visit and after a clinical examination performed by a DH student. Retest assessments of DHBS were conducted approximately two weeks later in conjunction with the next visit at the DH student and before treatment (scaling session). The final study sample included 77 adult general dental patients in treatment at an education clinic for DH students. Results: The results verified a statistically significant correlation between DHBS and DHAS. The DHBS sum of scores showed high internal consistency with Cronbach's a coefficient of 0.88 and 0.91 at the first and second assessments, respectively, and the test-retest reliability of the DHBS was acceptable with intraclass correlation coefficient of 0.76. No statistically significant association was found between DHBS and gender. Conclusion: The results suggest that the DHBS is a reliable and stable scale to use to assess patients' specific attitudes towards DHs. Moreover, DH beliefs are associated with fear of DH treatment.
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| 13. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Phobic avoidance and regular dental care in fearful dental patients: a comparative study.
- 2001
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 16, s. 188-196
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Tidskriftsartikel (refereegranskat)abstract
- The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.
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| 14. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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The importance of dental beliefs for the outcome of dental-fear treatment.
- 2003
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 111:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome.
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| 15. |
- Afshari, Mariam, 1989-, et al.
(författare)
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Development of an oral health-related quality of life questionnaire on neurosensory disturbances after orthognathic surgery - a pilot study.
- 2022
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 80:8, s. 635-640
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Tidskriftsartikel (refereegranskat)abstract
- Development of a new questionnaire, Oral Health-Related Quality of Life - Neurosensory Disturbances after Orthognathic Surgery (OHRQL-NDO), designed to measure the effects of neurosensory disturbance (NSD) on patients' oral health-related quality of life (OHRQL) and to evaluate reliability and validity of this questionnaire.A questionnaire including 11 items was constructed. Thirty patients with NSD affecting the lower lip and/or chin following orthognathic surgery were included. Convergent validity was assessed by comparing OHRQL-NDO with OHIP-14 and two global questions. Test-retest reliability was assessed by asking the patients to complete OHRQL-NDO at two different occasions with an interval of two to threeweeks.The internal consistency, measured with Cronbach's alpha, was 0.84. The test-retest reliability, measured with ICC, was 0.89 (95% CI 0.77-0.95). The correlation between the mean sum score for the OHRQL-NDO and the mean sum score for the OHIP-14 was r=0.75, using Pearson correlation coefficient. The correlations between the mean total score for the OHRQL-NDO and the global questions 1 and 2 were r=0.74 and r=0.72, respectively.The current instrument OHRQL-NDO is a promising test, but needs further development to better capture the different aspects of OHRQL. Further tests of the questionnaire must follow in other samples to finalize the instrument.
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| 16. |
- Ahlqwist, Margareta, et al.
(författare)
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Dental status of women in a 24-year longitudinal and cross-sectional study. Results from a population study of women in Göteborg.
- 1999
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 57:3, s. 162-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe dental health status among middle-aged and elderly women over a 24-year period. Because of the design of the study it was possible to make both longitudinal and cross-sectional comparisons. The study started in 1968-69 with a combined medical and dental examination of women aged between 38 and 60 years. New dental examinations of these same women were performed in 1980-81 and again in 1992-93, and included new cohorts of 38-year-old women on both occasions. In the cross-sectional perspective, it was shown that the number of edentate individuals decreased significantly during the 24-year period. Among dentate women, the number of remaining teeth and restored teeth increased significantly cross-sectionally. However, the youngest age group, women of 38 years, showed a lower number of restored teeth in the latest study (in 1992-93). There was also a lower number of crowns, root-fillings, and pontics in the latest study for the youngest age group. The two older age groups studied cross-sectionally showed similar numbers in all studies. In the longitudinal study, there was a decrease with time in incidence of edentulism. Among the dentate women in the longitudinal study the number of restored teeth related to those remaining was high (range 76-90%) and did not change much between the studies in the different age groups. There was a clear tendency during the 24-year period in all age groups for more teeth to be restored with crowns rather than different fillings. In conclusion, this population study, with a follow-up of 24 years, shows that dental status improved in that fewer individuals lost all their teeth and younger age groups have more remaining teeth and fewer restorations than previously.
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| 17. |
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| 18. |
- Andersson, P, et al.
(författare)
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Clinical correlates of oral impacts on daily performances.
- 2010
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5037 .- 1601-5029. ; 8:3, s. 219-26
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the associations between oral health measures and oral health-related quality of life as captured by OIDP (oral impacts on daily performances).
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| 19. |
- Andersson, Pia, 1955-, et al.
(författare)
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Psychometric properties of the Dental Hygienist Anxiety Scale in a group of general dental patients
- 2013
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Ingår i: Acta Odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 71:3-4, s. 877-882
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of the present study was to evaluate the psychometric properties of the Dental Hygienist Anxiety Scale (DHAS) in a sample of adult general dental patients. Materials and methods. The DHAS is a questionnaire adapted to assess fear and anxiety of dental hygienist (DH) treatment. The DHAS contains four items and the sum of scores range from 4 (no anxiety) to 20 (extreme fear). A convenient sample of 80 patients in treatment at two DH programs in Sweden were consecutively included in the study. The DHAS was distributed together with questions regarding self-perceived oral health and experience of dental care at the first visit after a clinical examination performed by a DH. Re-test assessments of DHAS were conducted ∼ 2 weeks later in conjunction with the next visit to the DH before treatment (scaling session). Results. The results verified a significant positive correlation between the average DHAS sum of scores and global fear of DH and dentist treatment, perceived pain during the last DH treatment and female gender. The DHAS sum of scores had a high internal consistency, Cronbach's coefficient of 0.89 and 0.87 at the first and at the second assessment, respectively. The test-re-test reliability of the DHAS sum of scores was acceptable, with an intra-class coefficient of 0.82 and Kappa coefficients between 0.49-0.78 for the four single items in the DHAS. Conclusions. These results suggest that the DHAS has acceptable psychometric proprieties and is a valid and reliable scale to assess anxiety in DH treatment.
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| 20. |
- Andersson, Pia, et al.
(författare)
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Psychometric properties of the Dental Hygienist Anxiety Scale in a group of general dental patients.
- 2013
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 71:3-4, s. 877-882
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. The aim of the present study was to evaluate the psychometric properties of the Dental Hygienist Anxiety Scale (DHAS) in a sample of adult general dental patients. Materials and methods. The DHAS is a questionnaire adapted to assess fear and anxiety of dental hygienist (DH) treatment. The DHAS contains four items and the sum of scores range from 4 (no anxiety) to 20 (extreme fear). A convenient sample of 80 patients in treatment at two DH programs in Sweden were consecutively included in the study. The DHAS was distributed together with questions regarding self-perceived oral health and experience of dental care at the first visit after a clinical examination performed by a DH. Re-test assessments of DHAS were conducted ∼ 2 weeks later in conjunction with the next visit to the DH before treatment (scaling session). Results. The results verified a significant positive correlation between the average DHAS sum of scores and global fear of DH and dentist treatment, perceived pain during the last DH treatment and female gender. The DHAS sum of scores had a high internal consistency, Cronbach's coefficient of 0.89 and 0.87 at the first and at the second assessment, respectively. The test-re-test reliability of the DHAS sum of scores was acceptable, with an intra-class coefficient of 0.82 and Kappa coefficients between 0.49-0.78 for the four single items in the DHAS. Conclusions. These results suggest that the DHAS has acceptable psychometric proprieties and is a valid and reliable scale to assess anxiety in DH treatment.
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| 21. |
- André Kramer, Ann-Catrin André, et al.
(författare)
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Demographic factors and dental health of Swedish children and adolescents
- 2016
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:3, s. 178-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence.MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used.RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts.CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.
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| 22. |
- André Kramer, Ann-Catrin André, et al.
(författare)
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Multilevel analysis of dental caries in Swedish children and adolescents in relation to socioeconomic status
- 2019
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 53:1, s. 96-106
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to investigate the variability in dental caries experience in Swedish children and adolescents, at two different area levels: dental clinics and SAMS (small areas for market statistics), with respect to multiple individual socioeconomic factors (SES). Records of manifest caries using the DMFT indices (decayed, missing, filled teeth, dependent variables) were collected from electronic dental records for 300,988 individuals aged 3-19 years (97.3% coverage) from the Region Västra Götaland, Sweden. SES data were obtained from official registers and covered ethnicity, wealth, parental education, and employment. The SES variables were used as an independent aggregated variable - an in dex - categorized in deciles. Age and gender were independently included in the multilevel models. Two-level logistic regression analyses explored the probability of a dental caries experience and the variability (intracluster correlation) within dental clinic areas and SAMS, respectively. The most deprived (10th decile, SAMS level) 3- to 6-year-old children had an OR of 5.00 (95% CI 4.61-5.43) for dental caries experience (deft), compared with children in the 1st to 5th deciles. For older children and adolescents (≥7 years), the corresponding OR (DFT) was 2.25 (95% CI 2.15-2.35). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics. SES was more strongly related to the risk of dental caries experience than age and gender. In conclusion, the associations between SES and dental caries experience in Swedish children and adolescents were strong in the study and strongest in young children at a low level.
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| 23. |
- André Kramer, Ann-Catrin, et al.
(författare)
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Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.
- 2018
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Ingår i: Caries Research. - : S. Karger AG. - 0008-6568 .- 1421-976X. ; 52:1-2, s. 42-50
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
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| 24. |
- Andås, Charlotte Andren, et al.
(författare)
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A new dental insurance scheme - effects on the treatment provided and costs
- 2014
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 38:2, s. 57-66
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Goteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.
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| 25. |
- 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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| 26. |
- Andås, Charlotte Andren, et al.
(författare)
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Twelve years with a capitation payment system in Swedish dental care: longitudinal development of oral health
- 2021
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Since 2007, patients receiving oral health care within the Public Dental Service in Sweden have had the possibility to choose between the traditional fee-for-service (FFS) payment system or the new capitation payment system, 'Dental Care for Health' (DCH). Payment models are believed to involve different incentive structures for patients and caregivers. In theory, different incentives may lead to differences in health-related outcomes, and the research has been inconclusive. This 12-year longitudinal prospective cohort study of patients in regular dental care analyzes oral health development and self-reported oral health in relation to the patients' level of education in the two payment systems, and compares with the results from an earlier 6-year follow-up. Methods Information was obtained through a questionnaire and from a register from n = 5877 individuals who kept their original choice of payment model for 12 years, 1650 patients in DCH and 4227 in FFS, in the Public Dental Service in Region Vastra Gotaland, Sweden. The data comprised manifest caries prevalence, levels of self-reported oral health and education, and choice of dental care payment model. Analyses were performed with chi square and multivariable regression analysis. Results The findings from the 6-year follow-up were essentially maintained at the 12-year examination, showing that the pre-baseline caries prevalence is the most influential factor for less favorable oral health development in terms of the resulting caries prevalence. Educational level (>= university) showed an increased influence on the risk of higher caries prevalence after 12 years and differed between payment models with regard to the relation to self-rated oral health. Conclusions Differences in health and health-influencing properties between payment models were sustained from 6 to 12 years. Strategies for making use of potential compensatory mechanisms within the capitation payment system to increase oral health equality should be considered.
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| 27. |
- Andås, Charlotte Andren, et al.
(författare)
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Who chooses prepaid dental care? A baseline report of a prospective observational study
- 2014
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 146:14
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Tidskriftsartikel (refereegranskat)abstract
- Background: An optional capitation prepayment system has been implemented in Swedish dental care, supplementary to the traditional fee-for-service scheme within the Public Dental Service. The implementation of a new system may have a variety of preferred and adverse effects, arguably dependent on the individual patient's attitudes, health beliefs and course of action. The aim of this study was to describe potential differences regarding socioeconomic and lifestyle factors, perceived oral health and attitudes towards oral health between patients in the two payment systems. Methods: Questionnaire data were consecutively collected from 13,719 patients, who regularly attended 20 strategically selected clinics within the PDS in Region Vastra Gotaland, before they were offered the choice between the traditional and the new payment system. Results: Capitation patients were more often female and well educated. They had healthier habits, were more motivated to follow self-care advice, more often judged their oral health to be very good and considered oral health to be very significant for their wellbeing. The results were statistically significant and described a gradient. Conclusions: The more explicitly affirmative the answer, the more likely the patient was to choose the prepayment scheme. There appears to be a pattern of differences with respect to important individual views on oral health between patients choosing a capitation system or a fee-for-service system. These differences may be important when assessing outcomes in the new payment system and in public dental care.
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| 28. |
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| 29. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Treatment of pulps in teeth affected by deep caries - A systematic review of the literature.
- 2013
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Ingår i: Singapore dental journal. - : World Scientific Pub Co Pte Lt. - 0377-5291. ; 34:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.STUDY DESIGN: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.RESULTS: No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.CONCLUSIONS: Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.
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| 30. |
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| 31. |
- Berggren, Ulf, 1948, et al.
(författare)
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Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
- 1997
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Ingår i: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the reported conditioned or cognitive origin of dental phobia in 100 adult patients at a specialized dental phobia clinic. It was shown that a majority of patients reported a conditioned background to their dental fear. Patients' avoidance time and level of dental anxiety corresponded to previously reported data for fearful groups. Individuals with an arousal conditioning etiology of dental fear reported significantly longer avoidance time as compared to individuals with a cognitively learned reaction. With the exception of an elevated level of general fears, most psychometrically assessed emotional reactions were well within normal ranges. However, patients with a non-conditioned, cognitive etiology reported significantly higher levels of trait anxiety and fear of embarrassment. In addition, a separate analysis among women revealed a greater fear of physical injuries among patients with cognitive etiology.
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| 32. |
- Berggren, Ulf, 1948, et al.
(författare)
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Assessment of patients with phobic dental anxiety.
- 1997
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated a screening procedure for psychologic distress in adult patients with dental phobia before treatment of dental fear. The screening procedure was performed among 191 individuals in consecutive steps and included a medical/dental history, psychologic interviewing, and testing. Data collected during this process were analyzed and compared with SCL-90(R) data. The screening process was successful in selecting individuals without major psychologic distress problems. Among the excluded patients 91% had general symptoms scores on the SCL-90(R) exceeding a normative population mean, and 95% of included patients had a mean lower than an average for psychiatric outpatients. There were statistically significant differences between included and excluded patients on all subdimensions of the SCL-90. Thus, excluded patients had higher levels of psychologic distress, poorer psychosocial background, and more psychosomatic symptoms. This was accompanied by higher levels of negative attitudes toward dentists and their performance of dentistry, whereas no significant differences were found among the dental fear measures used.
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| 33. |
- Berggren, Ulf, 1948, et al.
(författare)
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Factor analysis and reduction of a Fear Survey Schedule among dental phobic patients.
- 1995
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Ingår i: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 331-8
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Tidskriftsartikel (refereegranskat)abstract
- A fear survey instrument, based on the Fear Survey Schedule-II and five additional fear items, was administered to 109 patients (70 women and 39 men) on a waiting list at a specialized dental fear clinic. The fear survey was analyzed to identify its factorial structure. Five fear factors, explaining 54% of the total variance, were identified concerning areas of "illness and death", "failures and embarrassment", "social situations", "physical injuries", and "animals and natural phenomena". An ad hoc reduction of items was carried out to form a shorter, more practical to use questionnaire, which resulted in factors of four or five items with loadings greater than 0.50. The factors intercorrelated significantly (rp varying between 0.33 and 0.59) and "illness and death" correlated highly with "physical injuries" (rp = 0.59) and "animals and natural phenomena" (rp = 0.56), while "failures and embarrassment" correlated highly to "social situations" (rp = 0.54). Statistically significant, but generally lower correlations were found between each factor and the dental fear measures. The highest correlations were found between fear of "physical injuries" and dental fear. There was also a high and significant correlation between sex and fear of "animals and natural phenomena".
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| 34. |
- Berggren, Ulf, 1948, et al.
(författare)
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Relaxation vs. cognitively oriented therapies for dental fear.
- 2000
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Ingår i: Journal of dental research. - 0022-0345 .- 1544-0591. ; 79:9, s. 1645-51
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive therapy has been reported for the treatment of dental phobia, but comparisons with other behavioral treatments are scarce. This study investigated the outcome of two modes of treatment for phobic dental fear. Relaxation and cognitively oriented therapy were compared in a sample of 112 adult fearful dental patients. The patient made questionnaire assessments of background and outcome variables, and the specialist dentist rated successful/non-successful outcome. It was shown that a higher number of patients who received cognitively oriented therapy completed the treatment program, while anxiety was more reduced among patients who received relaxation-oriented therapy. Dropout during the initial phobia therapy with a psychologist was related to lower motivation (willingness to engage in treatment), while failures during dental treatment after the completion of therapy were related to higher levels of general fear and anxiety. A multiple logistic regression model explaining 67% of the variance revealed that the risk of failure was only slightly increased by general fears, while patients with low (below median) motivation ran a 3.6-times-higher risk of dropping out. In conclusion, it was shown that the two treatment methods were both effective in reducing dental phobic reactions. However, while cognitively oriented therapy resulted in a higher number of patients completing therapy, relaxation-oriented treatment generally resulted in a more significant reduction in dental fear as well as in general anxiety and fear. Motivation was found to be a significant predictor of successful treatment outcome.
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| 35. |
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| 36. |
- Bergius, Marianne, 1950, et al.
(författare)
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Prediction of prolonged pain experiences during orthodontic treatment
- 2008
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Ingår i: American Journal of Orthodontics and Dentofacial Orthopedics. - : Elsevier BV. - 1097-6752 .- 0889-5406. ; 133:3
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: In this study, we investigated prolonged pain reactions in teenage orthodontic patients during a common orthodontic treatment. The aim was to examine factors predicting pain at the end of a follow-up week after placement of elastic separators. METHODS: Fifty-five patients (ages, 12-18 years) were included. Baseline assessments were made of perceived intensity of general and dental pain experiences, motivation for treatment, dental anxiety, and personality factors (self-esteem and temperament). Pain intensity was assessed on a visual analog scale, and pain medications were recorded. The patients were separated into pain and no-pain groups according to pain experiences at day 7. RESULTS: The pain group (mainly girls) had significantly higher ratings of treatment pain than in the non-pain group at all times measured except for the treatment day. Bivariate and multiple logistic regressions showed significant predictive power from motivation, dental anxiety, activity temperament, and vaccination pain. CONCLUSIONS: In this adolescent patient sample, low motivation for orthodontic treatment, high ratings of vaccination pain, elevated dental anxiety level, and low activity temperament characterized patients reporting pain 1 week after the elastic separators were placed.
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| 37. |
- 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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| 38. |
- Berteus Forslund, Helene, 1952, et al.
(författare)
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Number of teeth, body mass index, and dental anxiety in middle-aged Swedish women
- 2002
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Ingår i: Acta Odontol Scand. - 0001-6357 .- 1502-3850. ; 60:6, s. 346-52
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Tidskriftsartikel (refereegranskat)abstract
- Risk factors for poor dental health include obesity, low socio-economic status, poor dietary habits, and dental anxiety. The aim of this study was to explore the complex relation between body mass index (BMI) and number of teeth in middle-aged women taking education, dietary intake patterns, dental care utilization, and dental anxiety into account. Three groups of women (37-60 years): reference women (group I, BMI 23.8 +/- 3.1 kg/m2), obese women (group II, BMI 35.0 +/- 2.6 kg/m2), and severely obese women (group III, BMI 41.0 +/- 3.4 kg/m2) were included. Questionnaires were used to assess education, smoking, number of teeth, dental care utilization, dental anxiety, dietary intake, and meal patterns. Age, education, and smoking habits did not differ significantly between groups. However, there were significant global differences in number of teeth (27.2 +/- 3.4, 23.0 +/- 9.2, 24.7 +/- 5.9) and reported daily energy intake (9756 +/- 3363 kJ, 10344 +/- 3850 kJ, 11970 +/- 3786 kJ in groups I, II, and m, respectively). In a multiple regression model, a lower number of teeth was independently associated with higher age, higher BMI, lower education, irregular dental care, high dental anxiety, higher energy intake, and lower iron intake. These variables explained 25% of the variation in number of teeth. In conclusion, BMI is an independent predictor of number of teeth in middle-aged women when socio-economic, dietary, and psychological factors are taken into account.
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| 39. |
- Björkelund, Cecilia, 1948, et al.
(författare)
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Secular trends in cardiovascular risk factors with a 36-year perspective: observations from 38- and 50-year-olds in the Population Study of women in Gothenburg
- 2008
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:3, s. 140-6
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Tidskriftsartikel (refereegranskat)abstract
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Sweden. cecilia.bjorkelund@allmed.gu.se OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.
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| 40. |
- Blomstrand, Ann, et al.
(författare)
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Forty-four-year longitudinal study of stroke incidence and risk factors - the Prospective Population Study of Women in Gothenburg
- 2022
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 40:1, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Objective To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. Design Prospective population study. Setting Gothenburg, Sweden, with similar to 450,000 inhabitants. Subjects A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years. Main outcome measures Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60. Results Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts. Conclusions Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.
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| 41. |
- Bratel, John, 1953, et al.
(författare)
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Anamnestic findings from patients with recurrent aphthous stomatitis
- 2014
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:3, s. 143-149
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Tidskriftsartikel (refereegranskat)abstract
- Recurrent aphthous stomatitis (RAS) is a common oral disorder with a prevalence varying between 5% and 66%. RAS appears in three forms; minor, major and herpetiform. The aetiology is unknown.The aim of this study was to evaluate associations between specific anamnestic information and different types of recurrent aphthous stomatitis (RAS). A group of 177 patients (mean age=42.8 years; SD=14.3; range 17-79 years) participated. Data were collected from a structured interview, consisting of 22 questions. Information about i) health status and medication, ii) predisposing factors, iii) RAS experience, iv) previous treatment methods and v) brand of toothpaste was collected. Sixty-eight per cent of the patients were healthy and 44% of the patients were not taking any medication. Forty-one per cent of the patients did not have any apprehension of the reason for their RAS, while stress (15.8%) was the most common apprehended aetiological factor. Sixty-two per cent had one to three minor ulcers at one time. Forty-eight per cent reported having had a major aphthous ulcer at least once.The most frequent symptom reported was pain (53.7%), followed by a smarting sensation (18.6%) and tenderness (4%). The most common treatment for RAS was Zendium™ toothpaste/mouthrinse (28%), followed by corticosteroids (25%). Fifty-four per cent of the patients experienced no relief from the treatment. When toothpaste habits were investigated, Zendium™ was used by 32% of the patients and toothpaste containing sodium-lauryl-sulfatase was used by 32%. There was no positive correlation between the use of Zendium™ toothpaste and the relief of symptoms or the size, number or frequency of the aphthous ulcers. Sixty-four per cent of the patients had never smoked, while 7% were smokers. No positive correlation was found when age, gender, allergy, medication and smoking were correlated to the frequency, number and size of the aphthous ulcers. In conclusion, we found that the aetiology behind RAS is still unclear and probably multifactorial. Standard treatment methods like Zendium™ should perhaps be questioned and this study did not find any support for smoking as a "protective" factor, i.e. having less likelihood of experiencing major problems from RAS.
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| 42. |
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| 43. |
- Bratel, John, 1953, et al.
(författare)
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The effect of LongoVital on recurrent aphthous stomatitis in a controlled clinical trial.
- 2005
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Ingår i: Oral health & preventive dentistry. - 1602-1622. ; 3:1, s. 3-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to evaluate the effect of daily intake of LongoVital (LV) (herbal vitamin tablets) in the prevention of RAS. MATERIALS AND METHODS: A group of 78 consecutively referred patients was enrolled to a three-months pretreatment period. Fifty subjects were then randomly allocated to an LV-group (n = 25) or a placebo group (N = 25). A double blind, stratified-randomised clinical case-control study was performed during six months. Number and size of the ulcers were registered by the patients using a standardized chart. The degree of discomfort was recorded on a 100 mm horizontal visual analogue scale (VAS-scale). RESULTS: The three-months pretreatment period revealed that the most dominant symptoms were pain (78%) followed by burning sensation (18%). No significant differences between the two groups were found during this period when a comparison was made at the end of the study. After the intervention period the number of aphthous ulcers/month decreased significantly in the LV-group (p = 0.02). The number of days in pain/month were also reduced (p < 0.001). If a 50% reduction of number of aphthous ulcers and days in pain were considered as clinically relevant, no statistical significant differences were found between the groups. CONCLUSION: Thus, no strong evidence was found that justified a recommendation of LV as a general drug for treatment of RAS.
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| 44. |
- Bratel, John, 1953, et al.
(författare)
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Treatment of oral infections prior to heart valve surgery does not improve long-term survival
- 2011
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Ingår i: Swedish Dental Journal. - 0039-6745. ; 35:2, s. 49-55
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate the importance of preoperative elimination of oral infections and oral health for survival after heart valve surgery In a group of patients (n=149; treatment group, GP group), oral health was examined and dental treatment was performed 3-6 months prior to heart valve surgery. In a second group (n=103; control group, SP group), oral health was examined postoperatively, but patients did not receive dental treatment prior to surgery. Sixteen years after heart valve surgery was performed, morbidity endpoint data were obtained. Differences in survival between the two groups and the influence of differences in oral health were analyzed. Fewer patients survived in the study group (37%) compared with the control group (45%). Mean survival was 122.9 months in the GP group compared with 143.3 months in the SP group, including time to death and those alive at the endpoint (p=0.018). A positive relationship was found between the number of teeth and survival, with RR = 0.98 (95% CI 0962-0.996 (p=0.016)).The deaths from heart valve disease were 18% in the GP group and 7% in the SP group (chi2=3.65, df=1, p=0.56). At the long-term follow-up,the results of the present study show,that it was not possible to demonstrate that dental treatment before heart valve surgery improved survival. Therefore, the need for extensive dental treatment prior to heart valve surgery may be reconsidered.
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| 45. |
- Bäck, Karin, et al.
(författare)
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Occurrence of signs of osteoarthritis/arthrosis in the temporomandibular joint on panoramic radiographs in Swedish women
- 2017
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 45:5, s. 478-484
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine the prevalence and incidence of radiographic signs of osteoarthritis/osteoarthrosis (OA) in the temporomandibular joint (TMJ) among middle-aged and older women. Methods: Data were collected from ongoing representative, longitudinal and repeated cross-sectional studies in Gothenburg, Sweden. Panoramic radiographs (PAN) have been taken regularly since 1968. The cohorts were systematically selected from the female population at the ages of 38, 50, 62 and 74. Condylar alterations indicative of OA (flattening/osteophyte/erosion) were evaluated in a total of 5234 PANs by one examiner under standardized conditions. Intra-examiner reliability was good. Sensitivity was poor, and specificity was acceptable in relation to computed tomography. Results: The prevalence of signs of OA in the TMJ was 18% on panoramic radiographs at the age of 38, gradually increasing with age. At the age of 62, the prevalence was 38%, and it was stable around 45% in the older age groups. The highest incidence rate of OA was between the ages of 55 and 65. Bilateral OA was uncommon. Flattening was the most prominent finding. Conclusion: The prevalence of signs of OA in the TMJ, including remodeling, evaluated on panoramic radiographs in representative cohorts of women, increases substantially with age. Around one in every five middle-aged women and almost every second woman of older ages can be expected to have some radiographic alteration in the TMJ. The highest proportion with new findings of OA is to be found among older middle-aged women.
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| 46. |
- Bäck, Karin, et al.
(författare)
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Orofacial pain and its relationship with oral health-related quality of life and psychological distress in middle-aged women.
- 2020
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 78:1, s. 74-80
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the relationship between subjective symptoms of orofacial pain and oral health-related quality of life (OHRQoL), as well as psychological distress in population-based middle-aged women. Material and methods: The two study samples comprised 1059 women, 38 and 50years old, in representative cross-sectional studies. Women with long-lasting, frequent pain or headaches, related to temporomandibular disorders (TMD), with moderate-to-high estimates were analysed in relation to the non-case group. OHRQoL was measured using the Oral Health Impact Profile (OHIP-5). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) and Sense of Coherence (SOC-13). Results: Women with orofacial pain (n=82, 7.7%) had a significantly higher mean score on the OHIP-5, HADS-A and HADS-D and a lower mean score for SOC-13. In a multivariable logistic regression, orofacial pain was statistically significantly associated with poorer OHRQoL (OR = 1.2) and signs of depression (HADS-D) (OR = 2.0). A higher score for SOC-13 protected from the experience of orofacial pain (OR = 0.95). Conclusion: Orofacial pain was associated with poorer OHRQoL and signs of psychological distress. In interpreting the value of SOC, women with orofacial pain also appear to have a poorer adaptive capacity.
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| 47. |
- Bäck, Karin, et al.
(författare)
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Relation between osteoporosis and radiographic and clinical signs of osteoarthritis/arthrosis in the temporomandibular joint: a population-based, cross-sectional study in an older Swedish population.
- 2017
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Ingår i: Gerodontology. - : Wiley. - 1741-2358 .- 0734-0664. ; 34:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to elucidate the relation between osteoporosis and osteoarthritis/arthrosis (OA) in the temporomandibular joint (TMJ).General epidemiological data support the hypothesis that osteoporosis and OA are inversely correlated but is not conclusively investigated in the TMJ.A group of 114 representative elderly women and men, randomised from a comprehensive population study in Gothenburg, Sweden, had bone mineral density established with whole-body, dual-energy X-ray absorptiometry (DXA) as part of a health survey. In addition, dental examinations were performed, including panoramic radiographs exposed as an overview of the TMJ's and jaws. In 88 of the 80-year-old participants (48 women and 40 men), a clinical orofacial examination according to the RDC/TMD system was performed.A diagnosis of osteopenia/osteoporosis was found in 36% of the 114, with a statistically different greater proportion of women. Condylar alterations evaluated from panoramic radiographs were observed in 34%, with no significant gender difference. No significant differences were found in the proportion of individuals with osteopenia/osteoporosis and any condylar radiographic alteration or not. Forty-one of the clinically examined subjects, 47%, fulfilled the criteria for an RDC/TMD diagnosis with no gender difference. All participants graded the orofacial pain as low chronic pain. An opening capacity of <40 mm denoted a higher risk of having pain in the temporomandibular system. No association was found between clinical diagnosis of RDC/TMD and osteopenia/osteoporosis.The prevalence of osteopenia/osteoporosis appears not to be of importance for radiological or clinical findings of OA in the TMJ.
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| 48. |
- Cabrera-Moksnes, Claudia, 1966, et al.
(författare)
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Can the relation between tooth loss and chronic disease be explained by socio-economic status? A 24-year follow-up from the population study of women in Gothenburg, Sweden.
- 2005
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Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 20:3, s. 229-36
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the association between number of missing teeth and all cause, cardiovascular, and cancer mortality as well as morbidity and to explore whether socio-economic factors mediate this association. An ongoing prospective cohort study of 1462 Swedish women included a dental survey in 1968/69 with follow-up until 1992/93. The dental examination included a panoramic radiographic survey and a questionnaire. Number of missing teeth at baseline was analysed in a Cox proportional hazards model to estimate time to mortality and morbidity. Number of missing teeth, independently of socio-economic status variables (the husband's occupational category, combined income, and education) was associated with increased all cause mortality and cardiovascular disease mortality respectively (relative risk (RR): 1.36; 95% confidence interval (95% CI): 1.18-1.58) and (RR: 1.46; 95% CI: 1.15-1.85 per 10 missing teeth), but no associations were found for cancer mortality (RR: 1.18; 95% CI: 0.91-1.52). The relation between poor oral health and future cardiovascular disease could not be explained by measures of socio-economic status in this study.
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| 49. |
- Carlsson, Sven G., 1935, et al.
(författare)
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Dental anxiety - a joint interest for dentists and psychologists.
- 2013
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Ingår i: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 221-224
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Tidskriftsartikel (refereegranskat)abstract
- This introductory article to the Symposium on Behavioral and Community Dentistry aims to describe the development of research and clinical work on dental anxiety, and includes a discussion of the historical background and the evolution since the 1970s. In view of its pioneering activities in this regard, special focus is placed on research and development at the Institute of Odontology of the University of Gothenburg, Sweden.
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| 50. |
- Carlsson, Viktor, 1980, et al.
(författare)
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Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behaviour - a national Swedish cross-sectional survey
- 2015
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Ingår i: Bmc Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dental anxiety (DA) is a common condition associated with avoidance of dental care and subsequent health-related and psychosocial outcomes, in what has been described as the vicious circle of DA. Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA. More studies are needed to verify the relationship between DA and SOC, especially using population-based samples. There is also a need for studies including factors related to the vicious circle of DA, such as oral health-related quality of life (OHRQoL), in order to further establish the correlates of DA in the general population. Therefore, the aim of this study was to investigate the relationship between DA and SOC, OHRQoL and health-related behaviour in the general Swedish population. Methods: The survey included a randomly selected sample of the adult Swedish population (N = 3500, age 19 - 96 years.). Data was collected by means of telephone interviews. Dental anxiety was measured with a single question. The SOC measure consisted of three questions conceptualising the dimensions of the SOC: comprehensibility, manageability and meaningfulness. The data collection also included the five-item version of the Oral Health Impact Profile (OHIP-5), as a measure of OHRQoL, as well as questions on oral health-related behaviour and socioeconomic status. Statistical analyses were made with descriptive statistics and inference testing using Chi-square, t - test and logistic regression. Results: High DA was associated with low OHRQoL, irregular dental care and smoking. There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses. Dental anxiety was not associated with oral health-related behaviour or socioeconomic status. Conclusions: This cross-sectional national survey gives support to the significant associations between high dental anxiety, avoidance of dental care and health-related outcomes, which may further reinforce the model of a vicious circle of dental anxiety. The results further indicate a weak relationship between dental anxiety and sense of coherence.
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