| 1. |
- Norberg, C., et al.
(författare)
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Body mass index (BMI) and dental caries in 5-year-old children from southern Sweden
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 40:4, s. 315-322
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of the present survey was to study the association between dental caries and body mass index (BMI) in Swedish preschool children (born in 1999). Methods A population-based and cross-sectional study design was used comprising all 920 5-year-old children in a defined area in and around the city of Lund. Anthropometric measures for the calculation of BMI were retrieved for each child from recordings at Child Health Care Centers (CHC). The occurrence of caries and fillings in the primary dentition, defined as deft (decayed, extracted, or filled primary teeth) and dt (decayed primary teeth), was collected from the children's dental records. Results The mean BMI was 16.1 (no differences between boys and girls). About 19.2% were overweight, of which 5.1% were obese. Overweight or obese children did not have higher deft or dt than others. However, children with low BMI (below -1 SD of national mean values for Swedish 5-year-olds) had statistically significantly higher deft and dt than children with normal BMI. Conclusions Children with low BMI may be at risk of caries development. Low BMI may be associated with eating habits endangering dental health.
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| 2. |
- Alm, A., et al.
(författare)
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Caries in adolescence - influence from early childhood
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 40:2, s. 125-133
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse the relationship between caries determinants in early childhood and caries prevalence in proximal surfaces in adolescents at the age of 15 years. Methods: The present longitudinal study is part of a series of surveys of oral health in 671 children followed from 1 to 15 years of age. Data were selected from examinations, interviews and questionnaires at 1, 3 and 6 years and bitewing radiographs at 15 years of age. Uni- and multivariable logistic regression analyses were performed to identify caries-related determinants. The outcome variable was carious lesions and fillings (DFa) in approximal tooth surfaces at 15 years of age. Statistical comparisons were made between caries-free teenagers, DFa = 0 and teenagers with DFa > 0, DFa 4 and DFa 8, respectively. Results: In the final logistic regression analyses, caries experience at 6 years and mother's self-estimation of her oral health care as being less good to poor remained statistically significant and were related to caries in all three caries groups (i.e. DF > 0, 4 and 8) at 15 years of age. The consumption of sweets at 1 year remained statistically significant, with a caries experience of DF 4 and 8. The variables 'parents born abroad' and female gender were statistically significantly associated with DFa 4 and DFa 8, respectively. Furthermore, infrequent toothbrushing habits at 3 years of age and failure to attend the examination at 1 year were statistically significantly associated with caries at 15 years in the univariable analyses. Conclusion: Early caries experience, consumption of sweets at an early age and mother's self-estimation of her oral health care as being less good to poor are associated with approximal caries in adolescents. The study indicates that caries determinants identified during early childhood have a strong impact on approximal caries in adolescence.
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| 3. |
- Berthelsen, Hanne, et al.
(författare)
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Good Work for dentists - a qualitative analysis
- 2010
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:2, s. 159-170
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study explores dentists' perceptions of Good Work in the meaning of positive and rewarding aspects in their work in contrast to a traditional problem-centred focus on work life. Methods: Nine informants were selected among Danish and Swedish general dental practitioners to obtain variation as to country of origin, gender, age and clinical work experience. Semi-structured, in-depth interviews were audio-recorded and transcribed verbatim in the original language. Statements concerning positive aspects of work were used for systematic text condensation according to the principles of Giorgi's phenomenological analysis, as modified by Malterud, generalizing descriptions reflecting aspects of Good Work. Selection of participants continued until saturation of the emerging categories was achieved. Results: The core of Good Work emanates from the clinical encounter: from the relation with the patient and from the opportunity to carry out high quality odontological handicraft. Social relations at the workplace, as well as organizational values and conditions were perceived as influencing the opportunities to achieve the rewarding aspects from the clinical encounter. Conclusions: The results implicate a need for developing a work-environmental model with intrinsic as well as extrinsic rewards when dealing with human service organizations. At policy level it is necessary to address the professional culture.
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| 4. |
- Berthelsen, Hanne, et al.
(författare)
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Measurement of social support, community and trust in dentistry
- 2011
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 39:4, s. 289-299
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Relationships among people at work have previously been found to contribute to the perception of having a good work. The aim of the present paper was to develop scales measuring aspects of social support, trust, and community among dentists, and to evaluate psychometric properties of the scales. Material and methods: In 2008, a questionnaire was sent to 1835 general dental practitioners randomly selected from the dental associations in Sweden and Denmark. The response rate was 68% after two reminders. Principal Component Analysis was applied to 14 items and scales were established based on the resulting factors. Internal consistency was evaluated by Cronbach’s alpha. Differential Item Functioning (DIF) with respect to gender, nationality and employment sector was analysed using ordinal logistic regression methods. Construct validity was assessed in relation to selfrated health and a range of work satisfaction outcomes. Results: The percentage of missing values on the items was low (range 0.7%–3.8%). Two scales (range 0–100) were established to measure ‘Community with Trust’ (nine items, mean = 79.2 [SD = 13.4], Cronbach’s alpha = 0.89) and ‘Collegial Support’ (five items, mean = 70.4 [SD = 20.8], Cronbach’s alpha = 0.89). DIF of only minor importance was found which supported cultural equivalence. The two scales were weakly positively correlated with each other. ‘Community with Trust’ was in general more strongly correlated with work satisfaction variables than ‘Collegial Support’ was. Conclusions: Stability and internal consistency of the scales were considered as satisfactory. Content validity and construct validity were considered as good. Further validation in other populations is recommended.
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| 5. |
- Celeste, R. K., et al.
(författare)
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Trends in socioeconomic disparities in oral health in Brazil and Sweden
- 2011
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 39:3, s. 204-212
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the dynamics of trends in socioeconomic disparities in oral health in Brazil and Sweden among adults, to assess whether trends follow expected patterns according to the inverse equity hypothesis.Methods: In Sweden, we obtained nationally representative data for the years 1968, 1974, 1981, 1991 and 2000, and in Brazil, for 16 state capitals in 1986 and in 2002. Trends in the prevalence of ‘edentulism’ and of ‘teeth in good conditions’ were described in two groups aged 35–44 with lower and higher economic standards, respectively.Results: There was an annual decline in disparities in ‘edentulism’ of 0.4 percentage points (pp) (95% CI = 0.2–0.7) in Brazil and 0.7pp (95% CI = 0.5–0.9) in Sweden, as a result of improvements in both income groups. Concerning ‘teeth in good conditions’, in Brazil, there was improvement only in the higher income group and absolute disparities have increased (0.5pp annually), while in Sweden, there was a nonsignificant decrease (0.3pp annually) with improvements in both groups. Since 1991 in Sweden and in 2002 in Brazil, our measures of socioeconomic disparities in ‘edentulism’ were not statistically significant. Trends did not differ by sex or dental visit.Conclusions: Despite improvements in both income groups and a decrease in disparities in ‘edentulism’, the poorer group in Brazil has seen no improvement in ‘teeth in good conditions’ and disparities have increased. It appears that Brazil and Sweden reflect different stages of trend for ‘teeth in good conditions’ and the same stages for ‘edentulism’, represented by the inverse equity hypothesis.
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| 6. |
- Christell, Helena, et al.
(författare)
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A framework for costing diagnostic methods in oral health care : an application comparing a new imaging technology with the conventional approach for maxillary canines with eruption disturbances
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 40:4, s. 351-361
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims were (i) to propose a framework for costing diagnostic methods in oral health care and (ii) to illustrate the application of the framework to the radiographic examination of maxillary canines with eruption disturbances. Methods: The framework for costing, following Drummond et al.(2005), includes three elements: (i) identification of different resources used in producing and delivering the service, (ii) measurement of the amount of each resource required and (iii) valuation of the resources in monetary terms. Four data collection instruments were designed – a protocol for apportioning the cost of capital equipment to each diagnostic procedure, separate forms for recording consumable items, for the time of different health care providers used for a diagnostic examination and a patient survey for calculation of the total cost to the patient associated with the examination. The framework was applied to the radiographic examination of maxillary canines with eruption disturbances comparing two imaging methods: (i) a new method with cone beam computed tomography and panoramic radiography and (ii) a conventional method using intraoral and panoramic radiography. The primary analysis was performed from the perspective of the health care system. A separate analysis included patient costs with health care system costs to provide a societal perspective. Comparison of the two perspectives allows consideration of whether any costs savings to the health care system are generated at the expense of greater costs for patients and their families. Data for the cost-analysis were retrieved from 47 patients (mean age 14 years) referred to a department of radiology for examination of maxillary canines. Results:Application of the framework for costing allowed us to compare the resources used to perform examinations of the two methods. The mean total cost per examination for the new method was 128.38€ and 81.80€ for the conventional method, resulting in an incremental cost per examination of the new method of 46.58€. Conclusions: The application of the framework demonstrates the feasibility of measuring and comparing the total costs as well as the distribution of total costs between providers and patients for different approaches to this common examination.
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| 7. |
- Franzén, Cecilia
(författare)
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Boundary work of dentists in everyday work
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 40:4, s. 377-384
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Tidskriftsartikel (refereegranskat)abstract
- Objective The Swedish policy objectives in dental care provision – to meet public demands for dental care and to increase the cost-effectiveness of the service – require dentists to work in teams with dental hygienists and dental nurses. This study focused on the role of dentists in the distribution of work tasks within teams in one Swedish Public Dental Service organisation. Dental clinics were viewed as micro-political arenas in which dentists attempt to demarcate professional boundaries in response to teamwork. Methods Semi-structured interviews, observations and documents were used. The interviewed individuals were seven dentists employed at two clinics, the managers of each clinic and the general manager. The dentists were interviewed to investigate how they defend or blur professional boundaries. They were also observed at work. The clinic managers and the general manager were interviewed to identify their expectations of dentists concerning work division. The documents comprised organisational plans and annual reports. Results Dentists demarcated professional boundaries by utilising various power resources: treatment responsibility, specialist knowledge, discretion, and avoidance of work considered to be low status work. The dentists also contributed to blurred boundaries between themselves and the other dental professionals by discussing patient treatment, giving and receiving advice, and assisting the others in skill development. Conclusion Although dentists' boundary work could obstruct implementation of policy objectives, dentists' behaviour contributed to effective collaboration within the teams.
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| 8. |
- Gustafsson, Annika, et al.
(författare)
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Child dental fear as measured with the Dental Subscale of the Children's Fear Survey Schedule : the impact of referral status and type of informant (child versus parent)
- 2010
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:3, s. 256-266
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The first aim of this methodological study was to investigate the agreement between self-ratings of Children's Fear Survey Schedule (CFSS-DS). The second aim was to explore using differentiated cut-off scores, and to compare these cut-off scores with those commonly used. Methods: Three different data collections included study groups (n = 497) of children and adolescents who had been referred to specialized pediatric dentistry clinics, and reference groups (n = 499) of dental patients and children rating the analyses were limited to the Ostergotland sample (n = 210 + 228). Patients and their accompanying parents (mainly mothers) were asked to fill in the CFSS-DS independently. Cut-off scores on the CFSS-DS scale were determined using receiver-operating characteristic analysis; patient-parent agreement was illustrated with Bland-Altman plots. Results: The patient-parent agreement was modest, particularly among those who were referred because of dental behaviour management problems (DBMP). Cut-off scores differentiated by age and gender, suggested by exploration according to two different methods, were with few exceptions clearly below the standard cut-off score. Conlusion: The validity of parental ratings of their children dental fear should be questioned, particularly in high-fear populations. Self-ratings should, as far as possible, be used to complement parental ratings. One consequence of using the standard cut-off score is the risk of overlooking some patients needs for special attention. Further research is needed to establish and validate age-and gender-differentiated cut-off scores on the CFSS-DS.
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| 9. |
- Jensen, Olga, 1970, et al.
(författare)
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Is the use of fluoride toothpaste optimal? Knowledge, attitudes and behaviour concerning fluoride toothpaste and toothbrushing in different age groups in Sweden.
- 2012
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Ingår i: Community dentistry and oral epidemiology. - : Wiley. - 1600-0528 .- 0301-5661. ; 40:2, s. 175-184
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The most effective method to prevent caries is the regular use of fluoride toothpaste. The aim of this study was to evaluate self-care routines in a population by identifying knowledge, attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits. Methods: A questionnaire was sent to 3200 individuals in two municipalities in Sweden. Four age groups representing different life stages were chosen: 15-16, 31-35, 61-65 and 76-80years of age. The participants were selected from the population register by random selection of birth dates. Results: Totally 2023 (63%) individuals answered the questionnaire. The majority (84-94%) in all age groups brushed their teeth twice a day or more often. Good toothpaste behaviour identified as brushing at least twice a day, using at least 1cm toothpaste, brushing 2minutes or longer and using a small amount of water when rinsing was reported by only 10% of the respondents. The factors that increased the odds for having good caries-preventive behaviour were: (i) being female, (ii) being younger than 35years, (iii) having knowledge about fluoride, (iv) finding use of fluoride toothpaste important and (v) rating own oral health as good. Conclusions: The population seems to have embraced regular toothbrushing with fluoride toothpaste to a large extent. However, regarding techniques for using fluoride toothpaste effectively, there was great potential for improvement, especially among the older respondents.
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| 10. |
- Johansson, Veronica, et al.
(författare)
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Multivariate analyses of patient financial systems and oral health-related quality of life
- 2010
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:5, s. 436-444
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Since 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, has two co-existing patient financial systems, i.e. ways for the patient to pay for dental care services. Alongside the traditional system of fee-for-service payment, i.e. paying afterwards for provided services, a new system of contract care is offered. In this system, dental care is covered by a contractual agreement, for which the patient pays an annual fee and receives care covered by the contract without additional costs. The aim of this article was to study whether patient financial system was associated with oral health-related quality of life (OHRQoL). Methods: A questionnaire was answered by 1324 randomly selected patients, 52% from contract care and 48% from fee-for-service. The questionnaire contained questions about how much one was prepared to pay for dental care, how much one paid for dental care the previous year, OHIP-14 (measured OHRQoL), dental anxiety, humanism of caregiver, SF-36 (measured general health), multidimensional health locus of control, sense of coherence (SOC), self-esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The material was analysed with a hierarchical block method of multiple regression analysis. Results: When controlling for all other variables, patient financial system was one of the strongest associations with OHRQoL: patients in fee-for-service had worse OHRQoL than those in contract care. OHRQoL was also associated with general health, SOC and to some extent also with psychological and economic factors. Of the social variables, only being foreign born was significant: it was associated with worse OHRQoL. Conclusions: Patient financial system was associated with OHRQoL when controlling for confounding factors: patients in contract care had better OHRQoL than those in fee-for-service care.
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| 11. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Sense of coherence and its relationship with oral health-related behaviour and knowledge of and attitudes towards oral health
- 2011
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 39:6, s. 542-553
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the relationship between sense of coherence (SOC), oral health–related behaviour, knowledge of and attitudes towards oral health in an adult Swedish population.Methods: A cross-sectional design with a stratified random sample of 910 individuals aged 20, 30, 40, 50, 60, 70 and 80 years were invited to the study, from Jönköping, Sweden. The investigation used the Swedish short version of the SOC questionnaire comprising 13 items and self-reported questions about oral health habits and knowledge of and attitudes towards oral health. In addition, a self-report questionnaire to elicit demographic information was included.Results: A total of 525 individuals, 261 men and 264 women, answered all the 13-item SOC questions, which constituted the final number of the participants. After adjustment for all the sociodemographic factors included in the analysis, individuals with a stronger SOC had twice as high a chance of having healthier behaviour, including a lower frequency of snacks and drinks between meals, as well as a more positive attitude, such as the importance of having one’s own teeth as one gets older, satisfaction with their own teeth, perceiving their teeth as good and no feeling of dental fear, compared with individuals with a poorer SOC. Moreover, SOC and a good knowledge of caries were significantly associated after adjustment for age and gender.Conclusions: SOC was significantly associated with several oral health–related behaviours, attitudes towards oral health and knowledge of dental caries. When working with oral health promotion, SOC could be a way for promoting a better understanding of the behaviour and attitudes of individuals and for enabling dental personals to use that knowledge for the guidance of the individual.
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| 12. |
- Strömberg, Ella, et al.
(författare)
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Oral status, oral hygiene habits and caries risk factors in home-dwelling elderly dependent on moderate and substantial supportive care for daily living.
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 1600-0528 .- 0301-5661. ; 40:3, s. 221-229
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Tidskriftsartikel (refereegranskat)abstract
- Abstract – Objectives: Elderly people with disabilities have an increased risk of developing oral diseases as compared with the healthy elderly. The aim of this study was to investigate oral hygiene habits, clinical variables related to oral self-care and caries risk in elderly individuals living at home with moderate and substantial needs of home care. Methods: A random sample of 151 elderly people with moderate needs and 151 with substantial needs of home care were examined. Data concerning general health, social conditions and oral hygiene habits were collected using a questionnaire. Data showing the prevalence of caries, plaque scores and gingival bleeding were obtained through clinical examinations. Results: Elderly subjects with substantial needs of home nursing had more active caries (P < 0.01) and more often gingival bleeding (P < 0.05), as compared with elderly people with moderate needs. Forty-nine per cent of the elderly with moderate needs performed acceptable self-care, as compared with 25% of the individuals with substantial needs. Good self-care was associated with women, low plaque scores, less bleeding and less caries. Factors increasing the risk of having caries were low saliva secretion, high plaque scores and a large number of fillings, while having a dentist and good oral hygiene habits increased the chance of not developing caries. Conclusions: Good oral hygiene habits were associated with less prevalence of plaque and oral disease in the elderly irrespective of extent of needs of home nursing. However, the elderly with moderate needs more often performed good self-care, indicating that the possibilities of strengthening self-care and learning new routines are better when functions are less affected.
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| 13. |
- Sundström, Anna, 1969-, et al.
(författare)
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Stressful negative life events and amalgam-related complaints
- 2011
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 39:1, s. 12-18
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The role of stressful life events in the onset of self-reported amalgam-related complaints is unclear. The aim of this study was to examine the relationship between life events and amalgam-related complaints. Method: The participants were selected from a longitudinal population-based study. One-to-one matching of 337 participants with amalgam-related complaints to 337 participants without such complaints was performed. For 81 of the participants with amalgam-related complaints and their matched controls, data was also available approximately 5 years before the onset of complaints, making longitudinal analysis possible. All participants completed questionnaires assessing the occurrence of 55 life events. Results: The results showed that many participants with amalgam-related complaints experienced negative life events before and at the onset of amalgam-related complaints. They also reported more unexpected and uncontrollable events difficult to adjust to in comparison with controls. The groups did not differ on positive or neutral life events. Somatic illness or surgical operation was the most common life event. Death of a very close family member and a major change in financial situation were also commonly reported. Conclusions: This study indicates that adverse negative life events could play a vital role in understanding and explaining amalgam-related complaints.
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| 14. |
- Åstrøm, Anne Nordrehaug, et al.
(författare)
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Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and Sweden
- 2010
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:2, s. 110-119
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: No studies have tested oral health-related quality of life models in dentate older adults across different populations.OBJECTIVES: To test the factor structure of oral health outcomes within Gilbert's conceptual model among 65-year olds in Sweden and Norway. It was hypothesized that responses to 14 observed indicators could be explained by three correlated factors, symptom status, functional limitations and oral disadvantages, that each observed oral health indicator would associate more strongly with the factor it is supposed to measure than with competing factors and that the proposed 3-factor structure would possess satisfactory cross-national stability with 65-year olds in Norway and Sweden.METHODS: In 2007, 6078 Swedish- and 4062 Norwegian adults borne in 1942 completed mailed questionnaires including oral symptoms, functional limitations and the eight item Oral Impacts on Daily Performances inventory.RESULTS: Model generation analysis was restricted to the Norwegian study group and the model achieved was tested without modifications in Swedish 65-year olds. A modified 3-factor solution with cross-loadings, improved the fit to the data compared with a 2-factor- and the initially proposed 3-factor model among the Norwegian [comparative fit index (CFI) = 0.97] and Swedish (CFI = 0.98) participants. All factor loadings for the modified 3-factor model were in the expected direction and were statistically significant at CR > 1. Multiple group confirmatory factor analyses, with Norwegian and Swedish data simultaneously revealed acceptable fit for the unconstrained model (CFI = 0.97), whereas unconstrained and constrained models were statistically significant different in nested model comparison.CONCLUSIONS: Within construct validity of Gilbert's model was supported with Norwegian and Swedish 65-year olds, indicating that the 14-item questionnaire reflected three constructs; symptom status, functional limitation and oral disadvantage. Measurement invariance was confirmed at the level of factor structure, suggesting that the 3-factor model is comparable to some extent across 65-year olds in Norway and Sweden.
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| 15. |
- Åstrøm, Anne Nordrehaug, et al.
(författare)
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Socio-behavioral predictors of changes in dentition status : a prospective analysis of the 1942 Swedish birth cohort
- 2011
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 39:4, s. 300-310
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Using a prospective cohort design, this study assessed loss of natural teeth between ages 50 and 65. Guided by a conceptual framework grouping variables according to the life-course stage at which they would be expected to operate, this study assessed the impacts of socio-behavioral and disease-related factors on tooth loss between ages 50 and 65.METHODS: In 1992, all 50-year-olds in two counties of Sweden were invited to participate in a longitudinal questionnaire survey. Of the total population of 8,888 subjects, 6,346 responded (71.4%). Of the 6346 subjects who completed the 1992 questionnaire, 4,143 (65%) completed postal follow-ups at ages 55, 60 and 65.RESULTS: For the total sample, the prevalence of having lost at least some teeth increased from 76% at age 50-85.5% at age 65. A total of 14% women and 13% men changed from having all teeth in 1992 to having tooth loss in 2007. Stepwise logistic regression analyses focused on predictors of tooth loss between 1992 and 2007. The following life-stage predictors achieved or approached statistical significance with respect to overall tooth loss; country of birth and education (early life and young adult life stage), marital status, dental care avoidance because of high cost, smoking and reporting consistent pain (middle-age and early-old-age life stage).CONCLUSION: Fewer substantial proportions of the 1942 cohort experienced tooth loss between ages 50 and 65. Tooth loss was highly prevalent from age 50 and increased moderately with increasing age. Oral disease-related factors and socio-behavioral characteristics such as refraining from dental care because of financial limitations, acting at earlier and later life-course stages were major risk factors for having tooth loss. Early primary prevention of smoking and increased equitable access to dental care might improve tooth retention throughout the transition from middle age to early-older age.
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| 16. |
- Åström, Anne N, et al.
(författare)
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Use of dental services throughout middle and early old ages : a prospective cohort study
- 2013
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Ingår i: Community Dentistry and Oral Epidemiology. - : Blackwell Munksgaard. - 0301-5661 .- 1600-0528. ; 41:1, s. 30-39
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Focusing on a Swedish 1942 birth cohort, this study describes the trend of dental health care utilization between age 50 and 65 and identifies major determinants of dental visiting habits using Andersen's model as adapted for dentistry as a theoretical framework. METHOD: In 1992, a census of 50 year olds in two counties of Sweden was invited to participate in a longitudinal questionnaire survey. Of the total population of 8888 subjects, 6346 responded (71%). Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow ups in 1997, 2002 and 2007. RESULTS: 83.3% and 3.2% of the cohort remained stable with respect to use and nonuse of regular dental care. Cochran's Q test revealed that the proportions reporting regular use decreased from 93% at age 50-87% at age 65 (P < 0.001). Generalized estimated equations revealed the following covariates; gender (females), country of birth (native born), marital status (married), perceived quality of dental care (good perceptions), dental care utilization as a child, remaining teeth and perceived oral problems. The influence of the variable time, functioning as a measure of period/ageing, maintained a statistically significant relationship with regular utilization after adjusting for all covariates in the model. CONCLUSION: Regular use of dental health care services decreased slightly but statistically significantly from age 50 to 65 and was most prevalent in socio-economically advantaged groups, among those with remaining own teeth, subjects who perceived oral problems and reported high quality dental care. The results have implications for planning of elderly dental health care and required dental workforce in Sweden and countries with similar welfare systems.
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| 17. |
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| 18. |
- Åstrøm, Anne Nordrehaug, et al.
(författare)
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Long-term routine dental attendance : influence on tooth loss and oral health-related quality of life in Swedish older adults
- 2014
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 42:5, s. 460-469
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Few studies have investigated the effect of long-term routine dental attendance on oral health between middle-aged and older adults, using a prospective cohort design. This study aimed to assess routine dental attendance (attending dentist in the previous 12 months for dental checkups) from age 50 to 65 years. Moreover, this study examined whether long-term routine dental attendance contributes to oral health-related quality of life, OHRQoL, and major tooth loss independent of social factors and the type of treatment sector utilized. Whether oral health impacts of long-term routine attendance varied with type of treatment sector utilized was also investigated.METHOD: In 1992, a census of the 1942 cohort in two counties of Sweden participated in a longitudinal questionnaire survey conducted at age 50 and again after 5, 10, and 15 years. Information was collected on a wide range of health- and oral health-related aspects. Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow-ups in 1997, 2002, and 2007.RESULTS: Routine dental attendance decreased from 69.1% at age 50-64.2% at age 65. Adjusted logistic regression analyses revealed that individuals reporting long-term routine attendance (routine attendance in both 1992 and 2007) were 0.3 (95% CI 0.2-0.5) times less likely than their counterparts who were nonroutine attenders to report oral impacts. According to generalized estimating equations (GEE), individuals who reported long-term routine attendance were 0.6 (95% CI 0.4-0.7) times less likely than nonroutine attenders to have major tooth loss across the survey years. The effect of long-term routine attendance on OHRQoL was stronger in public than in private dental healthcare attenders.CONCLUSION: Routine attendance decreased from age 50-65 years. Long-term routine attendance had positive impact on major tooth loss and OHRQoL supporting the principle of encouraging annual dental attendance for preventive checkups among older people.
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| 19. |
- Bergström, Eva-Karin, 1974, et al.
(författare)
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Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat
- 2014
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 42:5, s. 404-411
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat. MethodsThe design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs. ResultsThere were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5years . The caries increment for Group 1 was 1.342.99 (mean +/- SD), 1.24 +/- 2.84 for Group 2, 1.07 +/- 2.66 for Group 3 and 1.25 +/- 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group. ConclusionsIn an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.
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