| 1. |
- 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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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- Geraets, Wil Gm, et al.
(författare)
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Changing trabecular patterns in panoramic radiographs of Swedish women during 25 years of follow-up.
- 2020
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Ingår i: Dento maxillo facial radiology. - 0250-832X. ; 49:6
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Tidskriftsartikel (refereegranskat)abstract
- The radiographic trabecular pattern on dental radiographs may be used to predict fractures. The aim of this study was to analyze longitudinal changes in the mandibles of 145 females between 1980 and 2005.Panoramic radiographs were obtained in 1980 and 2005. On 290 radiographs, regions of interest (ROIs) were selected in the ramus, angle and body. In all ROIs, the orientation was measured in 36 directions with the line frequency deviation method. The effects of ageing were analyzed for the fracture and the non-fracture groups separately.During the follow-up, 61 females suffered fractures of the hip, wrist, spine, leg or arm. The fracture and non-fracture groups displayed dissimilar age changes in each investigated ROI. All significant changes pertained to increasing values of line frequency deviation. With increasing age, the trabecular network in the mandible lost details and the trabeculae became more aligned in their main direction. In the "ramus", the alignment was to the 110-120˚ axis, parallel to the posterior and anterior ramus border. In the "angle", the alignment was to the 135-150˚ axis, parallel to the oblique line, and in the "body" ROI to the 150-175˚ direction, approximately parallel to the occlusal plane and inferior cortex.Most changes were consistent with the notion that the bone aged less severely in the non-fracture group. In the fracture group, the findings indicate that bone loss leads to redistribution of the remaining bone tissue in such a way that the trabeculae are accentuated perpendicular to the principal loading.
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| 6. |
- Guo, Annie, et al.
(författare)
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Dietary intake and meal patterns among young adults with high caries activity : a cross-sectional study
- 2022
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Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity.MethodsThis study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces.ResultsThe High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables.ConclusionThe results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.
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| 7. |
- Hagman, Jennie, et al.
(författare)
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A psychological intervention for caries active young adults, a randomized controlled trial.
- 2022
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Ingår i: Clinical and experimental dental research. - : Wiley. - 2057-4347. ; 8, s. 239-247
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the effect of a brief version of the behavioral intervention Acceptance and Commitment Therapy (ACT) on reducing gingivitis and plaque levels after 18weeks.One hundred thirty-five caries-active young adults (18-25years of age), recruited from two public dental clinics, participated in this parallel group randomized control trial (RCT). Participants in the intervention (n=67) received two ACT sessions in combination with standard information on oral health, and participants allocated to the control group (n=68) received standard information only. Gingivitis and plaque levels were recorded at baseline and at the 9- and 18-week follow-ups. The effect of the intervention versus standard information alone was analyzed by intention-to-treat and per protocol, applying the General Linear Model (GLM). Exploratory analyses for the intervention and control groups were conducted to evaluate the effect of gender and smoking habits on the gingivitis and plaque outcome. The CONSORT guidelines for RCT were followed.A significant decrease in gingivitis and plaque levels was observed over time, irrespective of treatment allocation. However, the ACT intervention was not significantly more effective at reducing gingivitis and plaque scores than standard information alone, even though the intervention participants had maintained their improvement to a greater extent. The exploratory analysis revealed that females improved their gingivitis and plaque levels significantly more than the males in the intervention group (p=0.025 for gingivitis and p=0.013 for plaque).A brief ACT intervention was not proven to be more effective than standard information alone at improving oral health in a sample of young adults with poor oral health. However, ACT seems to have a positive effect on oral health among females. (TRN ISRCTN15009620).
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| 8. |
- Hagman, Jennie, et al.
(författare)
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Oral health and oral health behavior in young adults with caries disease.
- 2021
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Ingår i: BDJ open. - : Springer Science and Business Media LLC. - 2056-807X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and analyze oral health, oral health behaviors, and oral health-related quality of life (OHRQoL) in relation to the level of caries disease among caries-active young adults.This study presents data from a sample of young adults (n=135) with active caries disease who were enrolled in a clinical, randomized controlled trial. The independent variables of sociodemographics, oral health (gingivitis, plaque), oral health behaviors (such as toothbrushing, dental attendance, sugar-containing sweets and drinks), dental anxiety, self-rated oral health, and OHRQoL were collected. Multinomial logistic regression was used to simultaneously evaluate the associations between the independent variables and caries severity.Multinominal logistic regression showed that poor OHRQoL and gingivitis were associated with caries severity in a gradient fashion in accordance with caries disease activity. Also, irregular dental care and frequent consumption of sugary soda were significantly associated with very high caries severity.The risk factors related to caries severity among young adults were poor OHRQoL, gingivitis, consumption of sugary soda and irregular dental care attendance, indicating the need for a combination of different interventions specifically health behavior change. Furthermore, these findings may contribute to identifying high caries-risk individuals.
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| 9. |
- Johanen, Astera, et al.
(författare)
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Trabecular bone patterns as a fracture risk predictor: a systematic review
- 2021
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 79:7, s. 482-491
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods.The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach.The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69.Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.
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| 10. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women
- 2021
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80years of age. Study design: In a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3mm was calculated. Results: A normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR forseverely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96mm) and women (2.92mm), respectively. The OR for cortical thickness< 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately. Conclusions: Among old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.
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