| 1. |
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| 2. |
- Kvale, Gerd, et al.
(författare)
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Dental fear in adults: a meta-analysis of behavioral interventions.
- 2004
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 32:4, s. 250-64
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this meta-analytic and systematic quantitative approach is to examine the effects of behavioral interventions for dental anxiety and dental phobia. METHODS: Eighty studies were identified where dental fear treatment with behavioral methods was evaluated. Thirty-eight of 80 met entry criteria and were included in a meta-analysis. RESULTS: The calculated effect sizes (ESs) for self-reported anxiety after intervention indicate positive changes in 36 of the 38 studies and no changes in two. The overall ES = 1.8 (95% CI: 1.6, 1.8). The percent of subjects with post-treatment dental visits in the first 6 months post-treatment varied between 50 and 100%. The overall ES for attendance at dental visits, weighted by sample size, is 1.4 (95% CI: 1.3, 1.6). The homogeneity analysis indicates that the studies cannot be adequately described in one ES. The reported percentage of subjects with a dental visit between 6 months and 4 years post-treatment varied from 48 to 100%. The overall weighted ES for visiting the dentist, adjusted for drop-outs in the studies, is 1.2 (95% CI: 0.99, 1.4). CONCLUSIONS: Despite extensive heterogeneity, changes in self-reported anxiety represent medium to large ESs. Patients signing up for a behavioral intervention for dental fear can be expected to report a significant reduction in their fear, and this effect generally seems to be lasting. Mean long-term attendance ( >4 years after treatment) is 77%.
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| 3. |
- Oscarson, Nils, et al.
(författare)
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Cost-effectiveness of different caries preventive measures in a high-risk population of Swedish adolescents
- 2003
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 31:3, s. 169-178
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: A total of 3373 12-year-olds agreed to participate in an intervention study evaluating different caries preventive measures. The study, titled 'Evaluation of caries preventive measures', was performed between 1995 and 1999 at 26 dental health clinics throughout Sweden. At the start of the study, the subjects were classified as individuals at high or low risk of developing caries. The high-risk group consisted of 1165 subjects. The children in the high-risk group were randomly assigned to one of four preventive programs. The programs represent a step-wise increase in fluoride content, contact with dental personnel and cost. The aim of the present cost-effectiveness analysis (CEA) study performed from a societal perspective is to compare costs and consequences of caries preventive programs in a caries high-risk population. By 'costs' is meant both treatment costs and costs contributed by the patient and the patient's family. Costs contributed by patients and their families consist of out-of-pocket expenses, transportation costs, and time. Conclusions are that it is important to consider the perspective from which a study is carried out. Costs contributed by the patient and the patient's family have a high impact on total costs for children and younger adolescents but decrease with time as the adolescents get older. The present study shows an incremental cost-effectiveness of 2043 SEK (8.54 SEK = 1 US dollar, December 1999) per averted decayed enamel and dentine missing and filled surface (DeMFS), of which treatment costs represent 1337 SEK using the unit cost for a nurse. This means a yearly cost of approximately 334 SEK.
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| 4. |
- Stenlund, Hans, et al.
(författare)
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Caries incidence rates in Swedish adolescents and young adults with particular reference to adjacent approximal tooth surfaces : a methodological study
- 2003
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 31:5, s. 361-367
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: The objective was to assess the dependence of the caries status of the adjacent approximal surface on the incidence of approximal caries. METHODS: At baseline, the material consisted of a cohort of 536 Swedish children. The individuals were followed through annual bitewing radiographs from the age of 11-13 to 21-22 years. A radiographic scoring system was used to assess the caries status of the surfaces: scores 0 and 1 = sound surface to score 4 = caries in the outer half of the dentine. A model was used to calculate the dependence of the caries status of adjacent approximal tooth surfaces. The unit of analysis was a pair of adjacent approximal surfaces and in all, 12 pairs of posterior approximal surfaces were analysed. RESULTS: The individual caries rates of the 24 posterior approximal surfaces ranged from 1.3 to 8.3 new caries lesions per 100 tooth surface-years. The caries rate of an approximal tooth surface depended on the caries status of the adjacent surface: a sound surface next to a sound surface had a relatively small risk of developing caries, while the risk increased 1.6-32.3 times if the adjacent surface was in a caries state as judged radiographically. The distal surface of the first molar developed caries more often than the mesial surface of the second molar. CONCLUSIONS: The caries rate of an approximal tooth surface was 1.6-32.3 times higher if the adjacent surface was in a caries state compared to when the latter was sound.
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| 5. |
- Ståhlnacke, Katri, et al.
(författare)
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Perceived oral health : changes over 5 years in one Swedish age-cohort
- 2003
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 31:4, s. 292-299
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The purpose of this study was to investigate if a change in the social gradients in perceived oral health occurred over a 5-year period, 1992-97, using a cohort population from two Swedish counties. Methods: In 1992, a cross-sectional mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Örebro and Östergotland, and altogether there were 8888 persons. In 1997, the same population was sent a new questionnaire. The cohort, comprising the same respondents from 1992 and 1997, was of 5363 persons. An index of perceived oral health was constructed out of three questionnaire variables: satisfaction with teeth, chewing ability and the number of remaining teeth. This index value was set as a dependent variable in a regression model. Reports of toothache were investigated in a separate logistic regression model. Results: There were obvious social gradients in the perceived oral health index both in 1992 and in 1997. Marital status, foreign birth, education and occupation were all substantially related to the perceived oral health. The change in perceived oral health was analyzed. Almost half of the cohort (47.4%) showed no change at all. Those with increased and those with decreased health were rather evenly distributed on both sides, with 22.0% with better health in 1997 and 30.6% with worse health. Gender and education were related to toothache experience. Conclusion: Changes have been moderate in the perceived oral health in this cohort, despite the rather drastic changes in the remuneration of dental care during this study time. On the other hand, this also means that the social differences remain, despite the official goals of increased equity.
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| 6. |
- Hugoson, Anders, et al.
(författare)
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Caries prevalence and distribution in 20-80-year-olds in Jönköping, Sweden, in 1973, 1983, and 1993
- 2000
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Ingår i: Community Dentistry and Oral Epidemiology. - 0301-5661 .- 1600-0528. ; 28:2, s. 90-96
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Tidskriftsartikel (refereegranskat)abstract
- In 1973, a cross-sectional study on oral health status was performed on 1000 individuals in the age groups 3-70 years in Jönköping, Sweden. In 1983 and 1993, new cross-sectional studies were carried out in the age groups 3-80 years. The aim of the present study was to analyze caries prevalence and distribution in the three investigations 1973, 1983, and 1993 in the age groups 20-80 years. In the younger age groups (20-40 years), a larger proportion of individuals with good oral health was found in 1993 than in 1973 or 1983. A steady increase in the number of teeth in the age groups 40-80 years could be found, which was also reflected in the increasing number of decayed and filled tooth surfaces (DFS) in the same age groups. A marked decrease in proximal DFS in 20-50-year-olds in 1993 compared to 1973 and 1983 was found. However, a rather large and unchanging group of individuals suffering from severe caries was also observed. This situation demands an individualized caries treatment strategy based on risk assessment.
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| 7. |
- Hugoson, Anders, et al.
(författare)
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Caries prevalence and distribution in 3-20-year-olds in Jönköping, Sweden, in 1973, 1978, 1983, and 1993.
- 2000
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Ingår i: Community Dentistry and Oral Epidemiology. - 0301-5661 .- 1600-0528. ; 28:2, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- Four cross-sectional studies were carried out in 1973, 1978, 1983, and 1993 to collect clinical and radiographic epidemiological data on the dental health status of the inhabitants of Jönköping, Sweden. The aim of the present paper was to use these data to analyze trends in the development of caries among children and adolescents between 1973 and 1993. Approximately 500 randomly selected individuals evenly distributed among the age groups 3, 5, 10, 15, and 20 years participated in each study. The main results show that the numbers of caries-free individuals increased in all age groups. In 1993, the mean number of decayed and filled tooth surfaces in the primary (dfs) and the permanent (DFS) dentition in all age groups was less than half of that found in 1973. Most of this decrease took place during the first 5 years, i.e., between 1973 and 1978. Between 1978 and 1983, only minor changes were observed. There was a further reduction of approximately 30%-50% in dfs/DFS between 1983 and 1993 in 3-, 5-, 10-, and 20-year-olds. The frequency distributions of dfs/DFS for 5- and 15-year-olds revealed an increasing skewness over time: in 1993, a large majority of the children and adolescents had a low or moderate caries severity while only a small group had high scores of dfs/DFS.
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| 8. |
- Hägglin, Catharina, 1955, et al.
(författare)
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Factors associated with dental anxiety and attendance in middle-aged and elderly women.
- 2000
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Ingår i: Community dentistry and oral epidemiology. - 0301-5661 .- 1600-0528. ; 28:6, s. 451-60
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyze the association between dental anxiety, dental attendance, health status and social factors. Our previous studies have shown that dental anxiety declines with age and is associated with poor oral health. In addition, correlations between dental anxiety, dental utilization and dental status have been revealed. However, the association of these factors with general health and social factors has not been analyzed in our previous studies. In a study of women's health in Göteborg, Sweden in 1992, 1.017 urban women aged 38 to 84 years took part in a series of investigations including clinical examinations, interviews and questionnaires. In addition to descriptive and simple inference statistics, a two-part multiple logistic regression model was utilized to investigate dental anxiety and dental utilization. Dental fear was less prevalent among older women, dentate or not, although 10% of females 62 years of age and older still reported high dental anxiety (DAS > or = 12). 94% of the younger (< or = 62 yr) and 76% of the older (> or = 70 yr) women reported regular dental attendance. When separating all women into dentate and edentulous groups, 94% of the dentate and 11% of the edentulous respondents reported regular dental care. Due to the large difference in dental attendance between dentate and edentulous women, these groups were analyzed separately. Multiple logistic regression analyses showed that the following factors were associated with irregular dental utilization among dentate women: high dental anxiety, fewer teeth and restorations, more caries, poorer chewing ability and dissatisfaction with dental esthetics. In the multiple regression for dental anxiety, high fear was shown to be associated with irregular dental care, age (younger), fewer teeth, dissatisfaction with dental esthetics and lower scores on the SF-36 mental health scale. A separate analysis showed that individuals with high fear and regular, as opposed to irregular, dental attendance had more teeth at a statistically significant level, which were less often decayed and more often restored. In spite of the group with high fear and irregular attendance having fewer teeth, their level of decay was seven times higher. Overall, the results indicate a strong association between dental fear and dental attendance. Weak associations were found among socio-economic, dental health and general health factors.
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| 9. |
- Wendt, Lill-Kari, et al.
(författare)
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On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years : a cohort study
- 2001
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Ingår i: Community Dentistry and Oral Epidemiology. - 0301-5661 .- 1600-0528. ; 29:4, s. 302-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26-27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P<0.001). This longitudinal study showed that pit and fissure sealants-applied during childhood-have a long lasting, caries-preventive effect.
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| 10. |
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| 11. |
- Glendor, Ulf, et al.
(författare)
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Direct and indirect costs of dental trauma in Sweden : a 2-year prospective study of children and adolescents
- 2001
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 29:2, s. 150-160
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study total costs, including direct costs (health care service, loss of personal property, medicine and transport) and indirect costs (loss of production or leisure) of dental trauma to children and adolescents with special reference to predictors. METHODS: The study was based on a random sample of 192 children and adolescents with a dental trauma reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years. RESULTS: On average, health care service costs represented 2,955 SEK (SD=3,818) and total costs 4,569 SEK (SD=3,053) for dental trauma to permanent teeth, and 837 SEK (SD=898) and 1,746 SEK (SD=1,183) for trauma to primary teeth. The most extensive type of indirect cost was loss of production or leisure, which averaged 1,286 SEK (SD=1,830) for injuries to permanent teeth and 699 SEK (SD=1,239) for injuries to primary teeth. Multiple regression analysis of demographic and dental injury variables showed that complicated trauma was of special importance to costs for permanent and primary teeth injuries. The average relative increase in total costs to patients and companions for complicated injury to permanent teeth was 140% (95% confidence interval [CI], 66-248%) for patients and 132% (95% CI, 54-249%) for companions. Lack of access to a dental clinic near the place of residence could increase the average total costs of injuries to permanent teeth by 91% for companions (95% CI, 20-204%) and for primary teeth by 134% (95% CI, 38-296%). CONCLUSIONS: Dental traumas result in both direct and indirect costs, with a predominance of direct costs. The direct costs primarily depend on degree of severity, while indirect costs are mostly due to compromised access to health care service. Traumas to permanent teeth are especially costly and, due to additional maintenance, the care may continue for several years. This study has drawn attention to the significant implications of dental trauma to patient and companion, a new area where further studies are warranted.
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| 12. |
- Helgason, AR, et al.
(författare)
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Tobacco prevention in Swedish dental care
- 2003
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 0301-5661. ; 31:5, s. 378-385
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Tidskriftsartikel (refereegranskat)
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