| 1. |
- Barzangi, Jir, 1978-, et al.
(författare)
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Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden : a phenomenographic study
- 2019
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 77:8, s. 566-573
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore and describe ways of experiencing and perceiving the Eastern African practice of infant dental enucleation (IDE) among immigrants of Somali origin living in Sweden.Material and methods: Six informants, three men and three women aged 26-54 years, were recruited for semi-structured individual interviews. Phenomenographic analysis of the interview transcripts was performed.Findings: Informants described four ways of experiencing and perceiving IDE: as an effective, necessary treatment; as a disputed tradition; as an alternative to failure; and as a desperate measure. The experiences and perceptions were highly influenced by the contexts the informants had been in, namely, communities in which traditional treatments were used frequently, in which other people were influential over their daily lives, and in which negative experiences of formal health care were common, as well as other difficult circumstances beyond the informants' individual control. Conclusions: The findings contribute to deepened understanding of IDE and the importance of context to the practice of it. Further, the findings deepen understanding of the decision to have the practice performed on infants, which may help dental and health care personnel to adequately communicate with individuals of Somali origin about the harmfulness of IDE.
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| 2. |
- Barzangi, Jir, 1978-
(författare)
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Infant Dental Enucleation in Sweden : Perspectives on a Practice among Residents of Eastern African Origin
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Infant dental enucleation (IDE) is a practice consisting of the removal of deciduous canine tooth buds in infants. Practiced mainly in Eastern Africa, the purpose is to treat or to prevent bodily symptoms and diseases. IDE can cause both general and oral complications. The occurrence of IDE among Eastern African immigrants in a few European countries has been reported. However, knowledge surrounding the practice in Sweden was poor. The overall aim of this work was to explore IDE in the Swedish context. Four studies were conducted. Paper I presents a review of scientific publications. An overview of IDE was gained, and some knowledge gaps were identified. Paper II describes a cross-sectional study to determine the prevalence of IDE in small children. Dental records of 1133 children (mean age 4.6 years, SD 1.4) from a multi-ethnic area were studied. Missing deciduous canines without any registered reason were documented. One or more deciduous canines were missing in 21% of the children with known Eastern African origin (n=101), compared to only three children in the rest of the population (n=1032). Six adults of Somali origin were interviewed to explore their experiences and perceptions of IDE (paper III). These experiences and perceptions were categorised in four essentially different ways: an effective and necessary treatment, a disputed tradition, an option to failure and a desperate measure. Their experiences and perceptions were found to be highly influenced by contexts. In the final study (paper IV), the knowledge, experiences and attitudes among dental and health care personnel were examined. Questionnaires were sent to licensed personnel working in emergency departments, midwifery and child health centres, school health services and public dental health services in ten municipalities. Less than 20% had any knowledge of IDE, while 12.5% of the respondents encountering children had seen at least one patient subjected to IDE. Different attitudes were reported between clinical settings regarding responsibilities and possibilities concerning the management and prevention of IDE. From the findings presented in this thesis, it was concluded that there is a need for initiatives to increase awareness of and knowledge on IDE among dental and health care professionals. Legally obligated responsibilities in these professions regarding IDE need to be clarified, and initiatives should include guidelines regarding both the management of IDE and its prevention in Sweden. Educational programmes should also be produced for residents of Eastern African origin to change their perceptions of IDE, and a culturally sensitive approach should be adopted to ensure that such programmes are effective.
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| 3. |
- Ekback, Gunnar, et al.
(författare)
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Reporting dental caries disease in longitudinal studies : a suggestion
- 2016
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- Sjukdomar och medicinska tillstånd definieras vanligen genom att ett antal kriterier uppfylls och en individ bedöms som frisk från sjukdom när dessa kriterier inte längre föreligger, ofta efter en definierad tidsperiod. Incidens och prevalens mellan olika sjukdomar kan därför ofta jämföras. I longitudinella studier definieras dental karies ofta som förändringar i medeltal av ett index, vanligen DMFT/S. Karies är en livsstilssjukdom som går att bota, men symtomen på kariessjukdom är oftast persisterande vilket innebär att ett sådant index inte redovisar hur många individer som är sjuka under en viss period eller hur många som är botade från själva kariessjukdomen under samma tid utan istället redovisar en livstidsprevalens. Syftet med denna studie var att beräkna karies incidens och karies prevalens utgående från begreppen årsprevalens, kumulativ incidens och incidenstalet (incidensraten). Definition på karies hämtades från ICD-10 (KO2.1) som beskriver diagnosen för karies in i dentin. Som definition på att vara frisk (botad) från kariessjukdom användes en definierad tidsperiod på tre år utan att ny dentinkaries registrerats. Studiepopulationen var 423 individer och bestod av alla 12-åringar i Örebro län, år 1990, och som under sex år deltog i samtliga årliga recall-undersökningar (1990–1995). Av dessa hade 210 dentinkaries (definierat som ICD K02.1) någon gång under de tre åren 1990–1992 medan 213 inte uppvisade dentinkaries någon gång under samma tidsperiod. Under den efterföljande perioden 1993–1995 blev 17 % av de sjuka barnen friska från karies. Av de friska barnen insjuknade 38 individer vilket ger en årlig prevalens av 12 %. Karies hade en incidens rate av 134 fall per 1000 manår (13 %) och en kumulativ incidens på 15 % för ett år, 17 % för två år och slutligen 18% för tre år. Vår definition av den tid som krävs (3 år) för att kunna avgöra om en tidigare sjuk individ kan bedömas som frisk från karies kan i framtiden behöva justeras och fler studier i olika åldrar och populationer behövs för att ytterligare belysa problemställningen. Studien visar på relativt dåligt resultat när det gäller att bota kariessjukdom då endast 17 % av de sjuka blev friskförklarade under en period på tre år. Likaledes är resultaten av preventionen nedslående då hela 12 % av individerna i den friska gruppen blev sjuka. Resultatet bör dock tolkas med försiktighet med tanke på det begränsade antal barn som ingick i studien och risker för selektionsbias mellan grupperna. Under dessa år hade dock individuella kallelseintervall utifrån ett riskperspektiv inte införts hos Folktandvården Örebro utan orsaken till att barn inte kallades årligen berodde vanligtvis på resursbrist hos vårdgivaren. Denna metod att rapportera karies i longitudinella material och därmed definiera karies på individnivå ersätter inte traditionella metoder för att mäta kariesincidens och kariesprevalens. Metoden ger dock en ökad information avseende det antal individer som faktiskt är sjuka i karies. Ett sådant förfaringssätt medför stora fördelar ur planeringssynpunkt för tandvården då fokus blir individer och inte medeltal av ytor eller tänder, och möjliggör dessutom jämförelser mellan dem som faktiskt är sjuka i karies med dem som diagnostiserats med andra sjukdomar.
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| 4. |
- Ekbäck, Gunnar, 1954-, et al.
(författare)
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Reporting dental caries disease in longitudinal studies - a suggestion
- 2016
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Ingår i: Swedish Dental Journal. - Stockholm, Sweden : Swedish Dental Journal. - 0347-9994. ; 40:2, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- In general, most infectious and/or lifestyle-related diseases are defined as being present when sufficient signs or symptoms occurs in an individual. The term "sufficient" is a relative concept and a disease can therefore be measured with different degrees of certainty. These symptoms are commonly defined in such a way that it is possible to determine the incidence and prevalence of the disease and also the proportion of individuals that are cured from the disease. If dental caries is an individual disease which can be compared to other diseases regarding incidence and prevalence, it is important to determine for how long an individual must be free from new signs of the disease before being considered cured or free from the disease and to define the "sufficient" signs or symptoms needed for a diagnose. Based on these thoughts, the purpose of this study was to calculate caries incidence and prevalence in a group of adolescents from a definition of dental caries based on ICD-10. This study included all 12 year olds in 1990 who attended a clinical dental examination in 1990-1995 in Orebro County, Orebro, Sweden, yearly during these six years. Dental caries disease at the individual level was defined as Ko2.1 (dentinal caries) according to ICD-bo while freedom of caries was defined as the absence of Ko2.1 during a three-year period. In this study the yearly prevalence was 12%, the three year cumulative incidence was 18% and the incidence rate 13%. Results of this study highlight the poor outcomes in curing caries disease in this age-group, according to the criteria in this study, as only 17% of the children with caries at the outset of the study were free from the disease three years later. Defining both a practical level to measure signs of dental caries, and the period an individual must be free from them to be classified as cured from the disease create new opportunities to compare and communicate the disease of dental caries with other diseases. This way of registration is also of advantage for planning purposes as there the centre of interest must be the individual patient and not the tooth or surface.
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| 5. |
- Unell, Lennart, et al.
(författare)
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Dental status and self-assessed chewing ability in 70-and 80-year-old subjects in Sweden
- 2015
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Ingår i: Journal of Oral Rehabilitation. - : Wiley-Blackwell. - 1365-2842 .- 0305-182X. ; 42:9, s. 693-700
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80-than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability.
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