| 1. |
- Havsed, Kristian, et al.
(författare)
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Multivariable prediction models of caries increment : a systematic review and critical appraisal.
- 2023
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Ingår i: Systematic Reviews. - : BioMed Central (BMC). - 2046-4053. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Multivariable prediction models are used in oral health care to identify individuals with an increased likelihood of caries increment. The outcomes of the models should help to manage individualized interventions and to determine the periodicity of service. The objective was to review and critically appraise studies of multivariable prediction models of caries increment.METHODS: Longitudinal studies that developed or validated prediction models of caries and expressed caries increment as a function of at least three predictors were included. PubMed, Cochrane Library, and Web of Science supplemented with reference lists of included studies were searched. Two reviewers independently extracted data using CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) and assessed risk of bias and concern regarding applicability using PROBAST (Prediction model Risk Of Bias ASessment Tool). Predictors were analysed and model performance was recalculated as estimated positive (LR +) and negative likelihood ratios (LR -) based on sensitivity and specificity presented in the studies included.RESULTS: Among the 765 reports identified, 21 studies providing 66 prediction models fulfilled the inclusion criteria. Over 150 candidate predictors were considered, and 31 predictors remained in studies of final developmental models: caries experience, mutans streptococci in saliva, fluoride supplements, and visible dental plaque being the most common predictors. Predictive performances varied, providing LR + and LR - ranges of 0.78-10.3 and 0.0-1.1, respectively. Only four models of coronal caries and one root caries model scored LR + values of at least 5. All studies were assessed as having high risk of bias, generally due to insufficient number of outcomes in relation to candidate predictors and considerable uncertainty regarding predictor thresholds and measurements. Concern regarding applicability was low overall.CONCLUSIONS: The review calls attention to several methodological deficiencies and the significant heterogeneity observed across the studies ruled out meta-analyses. Flawed or distorted study estimates lead to uncertainty about the prediction, which limits the models' usefulness in clinical decision-making. The modest performance of most models implies that alternative predictors should be considered, such as bacteria with acid tolerant properties.TRIAL REGISTRATION: PROSPERO CRD#152,467 April 28, 2020.
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| 2. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Med en salutogen blick för att främja oral hälsa
- 2022
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Ingår i: Aktuel Nordisk Odontologi. - : Universitetsforlaget. - 1902-3545 .- 2058-7538. ; 47:1, s. 33-47
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Tidskriftsartikel (refereegranskat)abstract
- Tandvården är främst präglad av ett patogent synsätt med fokus på riskfaktorer och behandling. Om vi istället sätter på oss salutogena glasögon kan vi med detta synsätt se individens livssituation och dennes resurser för att främja hälsosamma vanor. Tandvårdspersonal kan stödja individen genom personcentrerade samtal och på så sätt skapa delaktighet och motivation och uppmuntra individen till att använda sin kapacitet och resurser i syfte att påverka sin orala hälsa. Tandvården är också en viktig hälsofrämjande arena som bör samverka med andra arenor utanför kliniken och integrera den orala hälsan med allmänhälsan. Att arbeta med hälsoresurser och främjande bestämningsfaktorer enligt en salutogen grundsyn för ett hälsofrämjande arbete i praktiken är en framgångsfaktor för en jämställd och god hälsa för alla.
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| 3. |
- Nordström, Marie, et al.
(författare)
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Common resilience factors among healthy individuals exposed to chronic adversity : a systematic review
- 2023
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:3, s. 176-185
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Forskningsöversikt (refereegranskat)abstract
- Objective: To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.Materials and methods: The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).Results: A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.Conclusions: Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.
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| 4. |
- Nordström, Marie, et al.
(författare)
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Karies : världens vanligaste icke smittsamma sjukdom
- 2024
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 121
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Tidskriftsartikel (refereegranskat)abstract
- More than 2.8 billion individuals worldwide suffer from untreated caries. Over ninety-five percent of all 50-year-olds in Sweden have caries experience. Caries is the most common cause of dental restorations and tooth loss. Tooth loss is associated with cardiovascular diseases, dementia, and death. Periapical tooth infections caused by caries can spread and cause severe infection, however rarely with lethal outcome. Sugars are a common risk factor for caries and other noncommunicable diseases such as cardiovascular diseases, diabetes, and obesity. Caries is a consequence of sugar-provoked acid production and dysbiosis in the tooth biofilm (dental plaque). There are several conditions which may increase the risk for dental caries, such as different medical conditions and medications which may cause dry mouth. Treatment costs for caries are high.
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| 5. |
- Nordström, Marie, et al.
(författare)
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Some young adults can maintain good oral health despite socioeconomic challenges
- 2024
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Ingår i: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722.
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Tidskriftsartikel (refereegranskat)abstract
- The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.
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