| 1. |
- Anticona Huaynate, Cynthia, 1983-, et al.
(författare)
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Assessing inequities in unmet oral care needs among adults in Sweden : An intersectional approach
- 2023
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 51:3, s. 428-435
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The goal of the Swedish oral healthcare system is to achieve good oral health and equitable access to care for the entire population. However, considerable inequities in oral health and care are evident and occur across a range of social dimensions. This study uses an intersectional approach to examine complex inequities in unmet oral care needs among adults in Sweden over the period 2004–2021.Methods: Data were obtained from 14 Health on Equal Terms surveys conducted during 2004–2021. The final sample was 129 473 individuals aged 26–84 years. Applying intersectional analysis of individual heterogeneity and discriminatory accuracy, inequities in unmet oral care needs were estimated across 48 intersectional strata defined by gender, age, educational level, individual disposable income and immigrant status.Results: A high risk of unmet oral care needs was found among strata consisting of immigrants and those with low income. However, being an immigrant and/or having a low income did not universally entail a high risk but varied by the social position along other axes, particularly age and education. The discriminatory accuracy was moderate.Conclusion: Groups with certain social disadvantages are highly heterogeneous themselves. An intersectionality approach is important to prevent the risk of stigmatizing large heterogenous groups while failing to identify the most vulnerable strata. The discriminatory accuracy analysis suggested that further policy and/or interventions may be the most effective if approaching the whole population, combined with selected targeted interventions directed at the most disadvantaged social strata.
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| 2. |
- Berthelsen, Hanne, et al.
(författare)
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Does staff-assessed care quality predict early failure of dental fillings? : A prospective study
- 2020
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 48:5, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients.Methods: This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis.Results: The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures.Conclusions: Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects of quality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.
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| 3. |
- Bongo, Ann Kristine Sara, et al.
(författare)
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Caries experience among adults in core Sámi areas of Northern Norway
- 2021
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 49:5, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Dental caries is a major oral health problem among indigenous people worldwide, but knowledge on this issue among the indigenous Sámi people in Norway is scarce. The aim of the study was to describe dental caries experience in an adult population in core Sámi areas of Northern Norway and to assess the corresponding associations with socio-demographic, socioeconomic and oral health-related behavioural factors. Methods: This cross-sectional study is based on data from the Dental Health in the North study (2033 participants aged 18-75years). A questionnaire was used to collect data on socio-demographic, socioeconomic and oral health-related behavioural factors. Clinical examinations were performed by dentists and dental hygienists at Public Dental Service (PDS) clinics in core Sámi areas of Northern Norway. Results: About 68% (n=1380) of participants reported Sámi ethnicity, and the mean number of decayed (D), missed (M) and filled (F) teeth (T) was 16.2 (standard deviation [SD]=6.7). The mean DMFT was 15.7 (SD=6.7) among Sámi and 17.0 (SD=6.7) among non-Sámi. The mean DT among Sámi was 1.0 (SD=1.6), with a significant, higher prevalence among coastal Sámi (DT=1.3, SD=1.8) than inland Sámi (DT=0.8, SD=1.5). Living in the coastal region, consumption of sugary soft drinks several times a week or daily, toothbrushing less than daily and irregular dental visits were associated with DT. Conclusions: Caries experience among adults in core Sámi areas of Northern Norway was common. Dental caries were more common in the coastal than the inland region, with minor differences in caries experience between Sámi and non-Sámi people within these regions.
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| 4. |
- Borglin, Linnea, et al.
(författare)
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The life cycle analysis of a dental examination : Quantifying the environmental burden of an examination in a hypothetical dental practice
- 2021
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 49:6, s. 581-593
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Global sustainability is considered the number one health concern facing our planet. Dental care is currently not provided in a sustainable way. This study aims to quantify the potential environmental burden of an examination in a hypothetical dental practice and identify major contributors to environmental harm.MATERIALS AND METHODS: A life cycle analysis was performed for the life cycle of an examination of one patient in a hypothetical dental practice. The equipment and products analysed were those available at the Faculty of Dentistry, Malmö University. The Ecoinvent version 3.5 database and the life cycle assessment software tool OpenLCA version 1.10 were chosen for this study.RESULTS: Normalized results indicate that the impact categories to which the modelled examination most significantly contributes are water scarcity, freshwater eutrophication and human toxicity (cancer effects). The major contributors or hotspots relating to the environmental harm of an examination procedure are soaps and detergents, disposable bibs, surface disinfection, stainless-steel instruments, clothing, water use and wastewater.CONCLUSION: Normalized results indicate that the potential environmental impact of an examination compared to one individual's impact per year is minimal. Considering the potential number of dental examinations and other dental procedures performed every year puts the findings in another perspective. This paper touches on some of the ways that the environmental burden of an examination could be reduced. Small changes to everyday practice, such as always making sure the dishwasher and washing machines are full when turned on, using less environmentally damaging soaps, more sustainable clothing alternatives and using necessary instruments could significantly reduce dentistry's environmental impact. Changes in materials and practice may result in potential trade-offs. Research would need to be carried out comparing the environmental burden of any alternatives. We hope in the near future that there will be more evidence relating to products used within dental care settings, potential trade-offs and dentistry's environmental burden.
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| 10. |
- Dong, Qingshan, et al.
(författare)
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Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital : A case study in the General Hospital of the Central Theater Command, Wuhan, China
- 2021
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 49:6, s. 557-564
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The impact of the worldwide COVID-19 pandemic on the dental community is evident. Dental education programmes and academic activities have suffered from the ramifications of the pandemic. This study aimed to depict the impacts of the COVID-19 epidemic on the clinical services and academic activities in the department of stomatology of a tertiary hospital in Wuhan, China.Methods: We obtained historical data of the Department of Stomatology from the Health Information System of the General Hospital of Central Theater Command, Wuhan, China between January 2018 and June 2020. Mean, standard deviation and median with interquartile range were used to summarize the variables. Line plots were used to illustrate the temporal trend. The Kruskal-Wallis equality-of-populations rank test was used to compare the difference between groups.Results: A significant decrease was noted in the monthly average number of patients seeking outpatient services for the year 2020, which were decreased by two-thirds from 2018 to 2020. The number of emergency cases also decreased significantly by 57.6% in 2020. The monthly number of teaching hours decreased from 3.8 +/- 1.5 in 2018 and 4.7 +/- 1.4 in 2019 to 1.7 +/- 1.9 in 2020. The number of interns also decreased by more than 77.0% in 2020.Conclusions: The impacts of COVID-19 in the stomatology clinic were significant with notable decreases in clinical services and education offered to the stomatology students. There is a need to find solutions to keep as many dental professionals as needed remaining on the frontline of oral health care.
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| 11. |
- Edman, Kristina, 1958-, et al.
(författare)
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'Periodontal health and disease in an older population : A 10-year longitudinal study'
- 2022
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 50:4, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018. Methods This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65 years and 75 years in 2008. Results The mean number of teeth decreased significantly over the ten-year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period. Conclusions Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.
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| 13. |
- Gormley, Alexander, et al.
(författare)
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Subtypes of early childhood caries predict future caries experience
- 2023
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 51:5, s. 966-975
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test whether postulated subtypes of early childhood caries (ECC) are predictive of subsequent caries experience in a population-based cohort of Swedish children.Methods: The study included children aged between 3 and 5 years at study entry with dental records available for at least 5 years of follow-up. Dental record data were retrieved from the Swedish Quality Registry for Caries and Periodontal disease (SKaPa) for the initial and follow-up visits. Participants who had ECC at study entry were assigned to one of five ECC subtypes (termed classes 1-5) using latent class modelling of tooth surface-level caries experience. Subsequent experience of caries was assessed using the decayed, missing and filled surfaces indices (dmfs/DMFS) at follow-up visits, and compared between ECC subtypes using logistic and negative binomial regression modelling.Results: The study included 128 355 children who had 3 or more dental visits spanning at least 5 years post-baseline. Of these children, 31 919 had caries at the initial visit. Baseline ECC subtype was associated with differences in subsequent disease experience. As an example, 83% of children who had a severe form of ECC at age 5 went on to have caries in the permanent dentition by the end of the study, compared to 51% of children who were caries-free at age 5 (adjusted odds ratio of 4.9 for new disease at their third follow-up).Conclusion: ECC subtypes assigned at a baseline visit are associated with differences in subsequent caries experience in both primary and permanent teeth. This suggests that the development and future validation of an ECC classification can be used in addition to current prediction tools to help identify children at high risk of developing new caries lesions throughout childhood and adolescence.
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| 15. |
- Jönsson, Birgitta, 1962, et al.
(författare)
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The role of psychosocial factors and treatment need in dental service use and oral health among adults in Norway
- 2020
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 48:3, s. 215-224
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aimed to explore whether population characteristics were associated with the use of dental services, individual's personal oral health practices, dental caries and oral health-related impacts using the revised Andersen's behavioural model as the theoretical framework. Methods This cross-sectional study included participants from a Norwegian general population (N = 1840; 20-79 years) included in the Tromstannen-Oral Health in Northern Norway (TOHNN) study. The variables included in the model were social structure (income, education, urbanization), sense of coherence (SOC), enabling resources (difficulties accessing the dentist, declined treatment, dental anxiety), treatment need, use of dental services, toothbrushing frequency, sugary soda drink consumption, decayed teeth and oral health-related impacts (OHIP-14). Structural equation modelling was used to test the direct and indirect effects within Andersen's behavioural model of access and health outcomes. Results Andersen's behavioural model fit the data well and explained a large part of the variance in use of dental services (58%), oral health-related impacts (48%) and, to a lesser extent, decayed teeth (12%). More social structures and a stronger SOC was associated with more enabling resources, which in turn, was associated with more use of dental services. Social structures were not directly associated with use of dental services or decayed teeth but were predictive of oral health-related impacts. A stronger SOC was associated with more frequent toothbrushing, less soda drink consumptions, fewer decayed teeth and less oral health-related impacts. Self-perceived need did not predict dental attendance but was associated with decayed teeth. A less frequent use of dental services, less frequent toothbrushing and more frequent sugary soda drink consumption were associated with more decayed teeth. Decayed teeth were not associated with oral health-related impacts. Conclusion The findings suggests that, in addition to focusing on reducing socioeconomic inequalities in relation to oral health in the Norwegian population, it is also important to consider how people perceive their own resources (eg financial, psychological, social) as well as their access to dental care in order to support regular dental attendance and potentially, in turn, enhance oral health.
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| 16. |
- Mac Giolla Phadraig, Caoimhin, et al.
(författare)
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Behaviour support in dentistry : A Delphi study to agree terminology in behaviour management.
- 2024
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour.METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.
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| 17. |
- Mac Giolla Phadraig, Caoimhin, et al.
(författare)
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Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management
- 2024
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour.Methods: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.
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| 20. |
- Yekkalam, Negin, 1981-, et al.
(författare)
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Social determinants of self-reported oral health among Sámi in Sweden
- 2023
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 51:6, s. 1258-1265
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the prevalence of poor self-reported oral health and to identify socio-demographic, socio-economic and cultural-related risk factors associated with poor oral health among Sámi in Sweden.Methods: A Sámi sample frame was constructed drawing from three pre-existing registers. All identified persons aged 18–84 were invited to participate in the study during February–May 2021. Among the 9249 invitations, 3779 answered the survey. The frequencies of the independent variables in terms of socio-economic, socio-demographic and cultural-related factors as well as the outcome, self-reported oral health, were calculated first. Prevalence ratios (PRs) and their 95% confidence interval (95% CI) were estimated to assess the relationship between the independent variables and the outcome.Results: Overall, 32.5% of the participants reported a poor oral health with a higher prevalence among men compared to women. Among the socio-demographic factors, being old (PR: 1.99; 95% CI: 1.59–2.51), unmarried (PR: 1.17; 95% CI: 1.03–1.33) and divorced or widow-er (PR: 1.27; 95% CI: 1.09–1.46) were statistically associated to poor self-reported oral health. Among the socio-economic factors, a low education level (PR: 1.56; 95% CI: 1.29–1.89), belonging to the poorest quintile (PR: 1.63; 95% CI: 1.35–1.96), and experiencing difficulties to make ends meet several times during the last 12 months (PR: 1.74; 95% CI: 1.51–1.99) were statistically significant related to poor oral health.Conclusions: The self-reported oral health among Sámi in Sweden appears to be worse than that of the general Swedish population. Several socio-economic and socio-demographic factors were found to be strongly associated with poor self-reported oral health. Targeted interventions addressing these social determinants are needed to reduce inequalities in oral health among the Sámi population.
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| 21. |
- Åstrøm, Anne Nordrehaug, et al.
(författare)
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Role of behavioural and age-related factors in the long-term impact of tooth loss on oral health-related quality of life: A 25-year follow-up of Swedish older adults
- 2023
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Ingår i: Community Dentistry and Oral Epidemiology. - : Munksgaard International Publishers. - 0301-5661 .- 1600-0528. ; 51:5, s. 918-926
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to assess any long-term association between tooth loss at age 50 and subsequent impaired oral health-related quality of life, OHRQoL, at age 65, 70 and 75, adjusted for time invariant socio-demographic-and time variant behavioural and age-related factors in terms of disadvantages with functional, social, health and psychological concerns. As a second aim, this study examined whether behavioural- and age-related factors played a role in explaining any long-term association between early tooth loss and subsequent OHRQoL.
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| 22. |
- Östberg, Anna-Lena, et al.
(författare)
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A longitudinal study of the impact of change in socioeconomic status on dental caries in the permanent dentition of Swedish children and adolescents
- 2020
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 48:4, s. 271-279
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The overall aim was to analyse longitudinally the development of dental caries in the permanent dentition of children and adolescents in a Swedish region, in relation to possible change in socioeconomic status (SES). Methods A total of 259 448 individuals in western Sweden were followed over a 3-year period, through dental journal records at baseline (3-19-year-olds) and 1-3 dental check-ups during the follow-up period. Official socioeconomic register information (ethnicity, wealth, parental education and employment) was available at both baseline and follow-up. Data were used both as independent single variables and combined in an index. Gender, age and caries status at baseline and the examination years were included as covariates in the regression models. Results Associations over time were found between SES and dental caries in young people. A persistently low SES was associated with the greatest risk of both new and accumulated (decayed plus filled teeth/approximal surfaces) caries; however, any change in SES, whether improved or worsened, led to a greater risk. An increased risk of new caries events was identified for those who were older at baseline and by examination year. On average, the increase per year in decayed and/or filled teeth and in approximal surfaces was 0.23 and 0.12, respectively. Conclusion SES was shown to be an important risk factor for dental caries over time in young Swedish people. Prevention programmes should pay particular attention to the needs of socioeconomically vulnerable individuals and groups.
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