| 1. |
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| 2. |
- Bratthall, Douglas, et al.
(författare)
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Cariogram - a multifactorial risk assessment model for a multifactorial disease
- 2005
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 33:4, s. 256-264
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This paper reviews some common methods for the assessment of caries risk. It also describes a new way of illustrating the caries risk profile of an individual, the Cariogram. Past caries experience and socioeconomic factors are often used for prediction of caries. As prediction models, the methods are simple, inexpensive and fast. However, they are not risk models, as they do not specify which particular risk factors are operating. Various biological factors can be used for risk assessment. Common ones are bacteria, diet and host factors. Taken separately, these biological factors often have limited predictive values. Socioeconomic factors often have a heavy impact on the biological factors as they can explain why an individual, for example, has a cariogenic diet or neglects oral hygiene. The biological factors are the immediate cause of the cavities. Caries experience is an illustration of how the host copes up with the biological activity. To facilitate the interpretation of biological data, the Cariogram was developed. It is a computer program showing a graphical picture that illustrates a possible overall caries risk scenario. The program contains an algorithm that presents a 'weighted' analysis of the input data, mainly biological factors. It expresses as to what extent different etiological factors of caries affect caries risk. The Cariogram identifies the caries risk factors for the individual and provides examples of preventive and treatment strategies to the clinician.
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| 3. |
- Flink, Håkan, et al.
(författare)
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Prevalence of hyposalivation in relation to general health, body mass index and remaining teeth in different age groups of adults
- 2008
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 36:6, s. 523-531
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:Several studies have been conducted on the prevalence of hyposalivation in older adults but no population-based studies in younger adults. Therefore, our aims were to determine the prevalence of very low and low unstimulated (UWSFR) and stimulated (SWSFR) whole salivary flow rates in different age groups between 20 and 69 years, and to analyse the relationship between hyposalivation, subjective oral dryness and predictors of reduced flow rate.METHODS:A randomized and stratified cross-sectional study including 1427 dental patients was conducted. UWSFR and SWSFR were measured, numbers of remaining teeth recorded and a questionnaire answered regarding subjective oral dryness, general diseases, use of drugs, body mass index (BMI) and use of tobacco.RESULTS:The prevalence of very low (<0.1 ml/min) and low (0.10-0.19 ml/min) UWSFR was similar for different age groups up to 50 years, ranging between 10.9-17.8% and 17.3-22.7%, respectively. The prevalence of very low UWSFR was significantly higher for women aged 50-69 years than for younger women. For men, prevalence of very low UWSFR was higher at 60-69 years. The prevalence of very low (<0.7 ml/min) and low (0.70 - 0.99 ml/min) SWSFR was between 0-5.5% and 0.8-8.2%, respectively, for the different age groups 20-69 years. Multiple logistic regression revealed that age above 50 years, female gender, having fewer than 20 teeth, and taking xerogenic drugs significantly increased the risk of very low UWSFR. For very low SWSFR, only having fewer than 20 teeth and taking more than two drugs were significant. In the younger individuals (<50 years) only BMI > 25 for very low UWSFR and diagnosed disease for very low SWSFR were found significant. In this younger subset, female gender combined with having fewer than 27 teeth was significant for low UWSFR.CONCLUSIONS:Hyposalivation is prevalent in younger adults, among whom it is associated with diagnosed disease and high BMI, while after age 50 years it is associated with medication. It is also associated with gender and with fewer remaining teeth.
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| 4. |
- Geraets, Wil G, et al.
(författare)
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Osteoporosis and the general dental practitioner : reliability of some digital dental radiological measures
- 2007
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:6, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Dental radiographs are relatively inexpensive and are regularly made of a large fraction of the adult population; therefore, they represent an enormous potential as a screening tool for osteoporosis. Monitoring the population by means of dual X-ray absorptiometry (DXA), which is currently the most accepted method for diagnosing osteoporosis, involves enormous costs and facilities. In previous studies, it was shown that the radiographic trabecular pattern shows correlations with the bone mineral density (BMD) as measured by DXA. The objective of this study was to assess the reproducibility of the quantitative analysis of the trabecular pattern on dental radiographs. METHODS: Six regions of interest were selected manually on three digital radiographic images of 20 women. This process was performed 10 times resulting in 1200 image samples. For each image sample 26 parameters were measured. The reliability of the parameters was evaluated by means of Cronbach's alpha. RESULTS: Of the values of Cronbach's alpha 83% is at least 0.9 and 99% is at least 0.8. CONCLUSIONS: The measurements of the parameters used in this study are very reproducible. Therefore, the manual selection of the regions of interest does not introduce large amounts of noise. The imaging parameters potentially offer an accurate tool for the prediction of BMD values. PMID: 18039288 [PubMed - in process]
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| 5. |
- Gerdin, Elisabeth Warnberg, et al.
(författare)
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Dental caries and body mass index by socio-economic status in Swedish children
- 2008
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 36:5, s. 459-465
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the present study was to evaluate the association between dental caries, childhood body mass index (BMI), and socioeconomic status in Swedish children. Methods: The study cohort consisted of 2303 10-year-old children with data on socioeconomic status, BMI at 4, 5, 7 and 10 years of age, and caries at 6, 10 and 12 years of age. Anthropometric measures were carried out by trained nurses according to standardized routines. The occurrence of caries was registered from county records, and the children were classified into one of five socioeconomic clusters based on their census registration address. Results: Caries prevalence decreased with increasing socioeconomic status at all ages, whereas childhood BMI and proportion of overweight/obese children were unrelated to socioeconomic status. Obese, but not overweight, children had more caries affected teeth than non-obese, and BMI had an independent, though weak, effect on caries variation in multiple regression. Interestingly, overweight/obese 4-year-olds, who had normal body weight at 5, 7 and 10 years of age, had significantly less caries than children who had normal body weight from 4 to 10 years of age. Conclusions: Overweight and caries prevalence are significantly associated in Swedish children. However, the association is weak. Nevertheless, the concept that child dental services and child welfare services can benefit from joint programs is supported.
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| 6. |
- Hintao, J, et al.
(författare)
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Root surface and coronal caries in adults with type 2 diabetes mellitus.
- 2007
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:4, s. 302-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the effect of type 2 diabetes mellitus (DM) on coronal and root surface caries and to investigate some factors suspected of being related to or interacting with DM, that may be associated with coronal and root surface caries. METHODS: A stratified cross-sectional study was conducted in 105 type 2 diabetic patients and 103 non-diabetic subjects of the same age and gender. Coronal and root surface caries, exposed root surfaces, periodontal status, stimulated salivary functions, oral hygiene status, oral health behaviors, and counts of mutans streptococci and lactobacilli were measured. RESULTS: Type 2 diabetic patients compared with non-diabetic subjects had a higher prevalence of root surface caries (40.0% versus 18.5%; P = 0.001), a higher number of decayed/filled root surfaces (1.2 +/- 0.2 versus 0.5 +/- 0.1; P < 0.01) and a higher percentage of generalized periodontitis (98.1% versus 87.4%; P < 0.01); but the prevalence and decayed/filled surface of coronal caries was not significantly different (83.8% versus 72.8% and 8.0 +/- 9.4 versus 6.3 +/- 7.5 respectively). The factors associated with root surface caries included type 2 DM, a low saliva buffer capacity, more missing teeth, and existing coronal caries; whereas wearing removable dentures, more missing teeth, a high number of lactobacilli, and a low saliva buffer capacity were associated with coronal caries. CONCLUSION: Type 2 DM is a significant risk factor for root surface, but not for coronal caries. Periodontal disease should be treated early in type 2 diabetic subjects to reduce the risk of subsequent root surface caries.
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| 7. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Methodological assessment of behavioural problem dimensions in adults with dental fear.
- 2007
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Ingår i: Community Dent Oral Epidemiol. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:3, s. 186-194
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In the assessment and treatment of persons with dental fear, there may be other psychological/behavioural factors than fear itself and traditional measures of psychopathology that should be considered. Longitudinal natural history studies are needed to find such variables. The present study investigated whether the same behavioural problem dimensions (internalizing, externalizing, attention) found among children and adolescents with behaviour management problems and/or dental fear could also be found among severely fearful adult patients. METHODS: The participants were 230 consecutive adult patients applying for treatment for severe dental anxiety at a specialized clinic. Patients completed a version of the Rutter behaviour questionnaire that was adapted for adults. Comparison data were the Hospital Anxiety and Depression scale and self-rated anger evoked by dental fear. Background data, including dental fear, were also collected. Descriptive statistics, principal components analyses, group comparisons and correlations were calculated. RESULTS: Of the three behaviour problems scales we adapted for adults, two (Internalizing and Attention) had acceptable psychometric properties and meaningful relations with the comparison variables. In contrast, the third problem scale (Externalizing) proved to have less satisfactory properties and relations, especially for men. Patients with severe phobia had higher levels of problem behaviours than patients with less severe phobia. CONCLUSIONS: Internalizing and Attention scales for adults seem promising for use in future prospective studies of the natural history of dental fear. The Externalizing scale, however, needs to be studied with a wider range of comparison variables and measures of social desirability.
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| 8. |
- Macfarlane, Tatiana V, et al.
(författare)
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Orofacial pain in young adults and associated childhood and adulthood factors: results of the population study, Wales, United Kingdom.
- 2009
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 1600-0528 .- 0301-5661. ; 37:5, s. 438-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study was to investigate the prevalence of orofacial pain (OFP) among young adults (30-31 years old) and to determine the effect of childhood and adulthood risk factors on the occurrence of OFP. METHODS: Prospective cohort study to investigate dental and social effects of malocclusion and effectiveness of orthodontic treatment was conducted in Wales, United Kingdom. At 20-year follow-up 337 subjects aged 30-31 participated (74% from previous follow-up aged 19-20 and 33% from the baseline) and were asked about OFP. RESULTS: The prevalence of OFP was 23% (95% CI: 19%, 28%). Childhood factors, socio-demographic, lifestyle, health behavior factors, history of orthodontic treatment and tooth wear were not associated with OFP. Participants with OFP were more likely to report that their teeth did not fit together properly [odds ratio (OR) = 12.4, 95% CI: 2.7-56.5) and reported previous trauma to the jaws (2.3; 1.3-4.2). Both diurnal and nocturnal teeth clenching and grinding were significantly associated with OFP (3.1; 1.4-7.1). Participants with frequent headaches had increased risk of having OFP (3.7; 1.6-8.4) while having reported 4-10 types of pain in other parts of the body other than the head, was associated with OR = 9.2 (3.7-23.0). An increased tendency to have OFP was seen in those individuals with higher levels of psychological distress (2.3; 1.4-3.9), high score on Life Event Inventory (2.6; 1.3-5.3), depressive symptoms (2.2; 1.2-4.0) and stress (2.2; 1.2-4.0). High self-esteem associated with lower risk of OFP (0.5; 0.3-0.9). CONCLUSIONS: This study shows that OFP is frequently reported by young adults aged 30-31 and supports a multifactorial etiology with factors from many domains, including local mechanical factors, psychological and co-morbidities. However, none of the childhood factors considered in this study were associated with OFP in adulthood.
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| 9. |
- Ståhlnacke, Katri, et al.
(författare)
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Changes over 5 years in utilization of dental care by a Swedish age cohort
- 2005
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 33:1, s. 64-73
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVE: The purpose of this study was to investigate the temporal development of the utilization of dental care, in relation to socio-economic factors and also considering perceived oral health, attitudes to dental care, dental anxiety, care organisation and changes in the way that dental care is paid for. A conflict model was used as a theoretical framework. METHODS: In 1992, a mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Orebro and Ostergotland, as part of a cross-sectional study. This study group numbered 8888 persons. In 1997, the same population was sent a new questionnaire. There were 5363 persons who completed the questionnaire in both 1992 and 1997. Changes in utilization of dental care were analysed. RESULTS: An increase in personal expenditure for care was obvious, 42% paid more in 1997 compared with 1992. In the study, 7% had prolonged their time since most recent visit and 12% had less frequent visits. In regression models, education, occupation, place of residence, country of birth, marital status, gender, dental anxiety, having poor perceived oral health and poor general health were associated with utilization. Care organisation factors showed there was a greater probability of having higher utilization and higher cost of care when private practitioners provided the care. CONCLUSION: Small changes in the utilization of dental care occurred during this study time. Inequality in utilization existed and socio-economic factors affected utilization as well as health perception and dental anxiety. Changes in the cost of care did not affect utilization appreciably, probably because of a selected population with high price elasticity. Having a private care provider compared with one in the public system affected the probability of having higher utilization and higher cost for care.
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| 10. |
- Thorstensson, Helene, et al.
(författare)
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Does oral health say anything about survival in later life? Findings in a Swedish cohort of 80+ years at baseline.
- 2009
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 1600-0528 .- 0301-5661. ; 37:4, s. 325-32
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Oral health is an integral part of general health; oral health contributes to and is influenced by a nexus of inputs from biological, psychological, and social functioning. Little is known about the relationship between markers of oral health and subsequent survival in late life. Objectives: The aim of this study was to examine the relative importance of oral health indicators in the context of demographic and psychosocial variables on subsequent survival during an 8-year period in a population-based sample of the oldest-old. METHODS: The study sample comprised 357 individuals with a median age of 86 years who were selected from participants in the comprehensive longitudinal Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) study, which examined monozygotic and dizygotic twins aged 80 years and older on five occasions at 2-year intervals. The OCTO-Twin study includes a broad spectrum of biobehavioural measures of health and functional capacity, personality, well-being, and interpersonal functioning. Oral health variables were number of teeth, per cent decayed and filled surfaces (DFS%), and periodontal disease experience. A longevity quotient (LQ), the ratio between years actually lived and those statistically expected, was determined. The survival categories were shorter than expected, as expected, or longer-than-expected. Multivariate analyses and the Kaplan-Meier method were used in the survival analyses. RESULTS: No associations between LQ and number of teeth, edentulousness, and periodontal disease experience were found. But survival of men with severe periodontal disease experience was shorter than expected. DFS% was significantly associated with survival. Individuals with a low number of decayed and filled surfaces (DFS) had a shorter-than-expected survival time compared with those with high DFS scores. The overall predictor of survival was cognitive status, independent of age and gender when dental variables were analysed in the context of psychosocial factors. In addition, number of teeth, smoking, and better financial status in childhood and during working life were also significant predictors. CONCLUSIONS: Oral health was significantly associated with subsequent survival in a sample of oldest-old individuals, although psychosocial factors were stronger predictors.
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| 11. |
- Tillberg, Anders, et al.
(författare)
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Changes in health over time in patients with symptoms allegedly caused by dental restorative materials
- 2005
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons, Inc. - 0301-5661 .- 1600-0528. ; 33:6, s. 427-437
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Tidskriftsartikel (refereegranskat)abstract
- Abstract – Objectives: In Sweden, many patients with symptoms allegedly caused by their dental materials have exchanged their restorations, but the effects of the exchange have been insufficiently investigated. Therefore, the aim of the study was to describe the change in health over time for these patients and the hypothesis was that the patients could be divided based on their symptoms and that the ability to recover differs between these groups. Furthermore, we also examined if other factors such as replacement of dental restorative materials and follow-up time had any impact on the perceived health status.Methods: A questionnaire was sent to 614 patients who had been referred to the School of Dentistry, Umeå, Sweden, with symptoms allegedly caused by dental restorative materials. The response rate was 55%.Results: The risk of having any further complaints was higher for patients with complex symptoms (P = 0.03) and these patients had exchanged their restorations to a significantly larger extent than the others (P = 0.03). The remaining complaints was more frequent among men (P = 0.02). Exchange of dental restorative materials had no significant impact on the ability to recover completely. However, the patients who had exchanged their restorations completely perceived a significantly larger alleviation of their symptoms than the others (P < 0.01), although the frequency of most of the symptoms had increased.Conclusions: Patients with complex symptoms had a more unfavorable long-term prognosis concerning persistent complaints than those with localized symptoms only. Furthermore, the results indicate that the patients might experience health improvements after removal of their dental restorative materials. The reason for this improvement, however, is unclear. Further analyses regarding other possible explanations than the ‘odontological/medical’ are needed.
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| 12. |
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| 13. |
- Österberg, Tor, et al.
(författare)
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Number of teeth – a predictor of mortality in 70-year-old subjects
- 2008
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 36:3, s. 258-268
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate if number of teeth at age 70 is an independent predictor of mortality. Methods: Within the gerontological population studies in Göteborg, Sweden, four birth cohorts born in 1901/02, 1906/07, 1911/12 and 1922 were examined cross-sectionally at 70 years of age. The total number of participants in the odontological cohorts was 1803. Mortality data were collected from the national Swedish health registers. Cox regression models were used to measure the association between mortality and number of teeth with adjustment for covariates like health factors, socio-economic and lifestyle factors. Results: The prevalence of edentulism showed a marked change from 51 % in the first cohort to 16 % in the last cohort. The 7-year mortality rate was 14 % in women and 28 % in men, and highest in edentulous men in the last two cohorts (42 % and 47 %, respectively). The 7-year mortality including all four cohorts showed a hazard ratio of 0.96 (95 % CI = 0.94-0.98; P < 0.001) for number of teeth with adjustment for cohort. The corresponding 18-year mortality including the three first cohorts showed a hazard ratio of 0.98 for women and 0.97 for men. Number of teeth was an independent statistically significant predictor of 7-year mortality in both genders and of 18-year mortality in men. Conclusions: The result showed that each remaining tooth at age 70 decreased the 7-year mortality risk by 4 %. The difference between edentulous subjects and dentate subjects with ≥ 20 teeth regarding 7-year mortality was significantly higher in the last compared to the first cohort. The number of teeth was a significant predictor of mortality independent of health factors, socio-economic status and life style.
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| 14. |
- Österberg, Tor, et al.
(författare)
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Secular trends of dental status in five 70-year-old cohorts between 1971 and 2001.
- 2006
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 34:6, s. 446-54
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study, which are part of the gerontological and geriatric population studies in Göteborg, Sweden (H70), were to describe cohort differences and trends in dental status and utilization of dental care in 70-year-olds. The study is based on five cohorts examined in 1971/72, 1976/77, 1981/82, 1992/93 and 2000/01 (called cohort I, II, III, V and VI, respectively). The total number of participants was 2290 and varied between 386 and 583 in the different cohorts. The proportion of dentate 70-year-olds changed gradually from 49% in the first to 93% in the last cohort. The mean number of teeth in the dentate 70-year-olds was 14 in cohort I and 21 in cohort VI. The proportion of subjects with 20 or more teeth changed from 13% in cohort I, to 20% in cohort III, and to 65% in cohort VI. In cohort I, 76% of the 70-year-olds had some kind of removable denture; 37% in cohort III, but only 17% in cohort VI. About 20% of all 70-year-olds in cohort I reported regular yearly visits to a dentist. The corresponding figures in cohort III and cohort VI were 50% and 80%, respectively. Even though positive cohort trends were observed in all studied subgroups, factors such as low education, smoking, being un-married, having high waist circumference and being physically inactive were negatively associated with dental status at the end of the study period as well as at the beginning.
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