| 1. |
- Ahlvin, Anna, et al.
(author)
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Self-perceived oral health among 19-year-olds in a Swedish County - A comparative study between 2004 and 2011
- 2016
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In: Swedish Dental Journal. - : SWEDISH DENTAL JOURNAL. - 0347-9994. ; 40:1, s. 53-65
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Journal article (peer-reviewed)abstract
- For decades, Swedish dental professionals have collected clinical epidemiological data from the dental records. To supplement the epidemiology, Ostergotland County Council decided to examine patient perceptions of oral health: self-rated knowledge, self-perceived oral health, and opinions about oral health. The aim was to compare self-perceived oral health among 19-year-olds to determine differences between genders, various municipalities and between 2004 and 2011. This study analysed the responses from two cross-sectional surveys of the entire population of 19-year-olds in Ostergotland County, Sweden, performed in 2004 and 2011. Of the 2,413 (53 %) (50 % men, 50 % women) 19-year-olds who responded to the questionnaire in 2004 and the 3,803 (67 %) (50 % men, 50 % women) in 2011, most 19-year-olds (88.1 % [2004] and 87.5 % [am]) reported satisfaction with their oral health. Around half of the respondents rated their knowledge on periodontitis as low. Boys rated their knowledge about avoiding periodontitis higher than girls (p<0.05 in 2004 and p<0.001 in 2011). In 2004, 84.7 % reported shooting pain. In 2011 that figure was 83.7 %. The respondents expressed some uncertainty about the benefits of fluoride toothpaste (7.5 % in 2004 and 9.3 % in 2011), especially the boys (10.3 % in 2004 and 10.5 % in 2011). Girls reported both a higher social impact and greater concern about aesthetics related to their oral health. They also reported headache (27.5 %) nearly twice as often as boys (14.2 %) (p>0.001). Responses between the municipalities did not differ, with the exception of items regarding periodontitis. Thus, this study found indications that perceptions of oral health and knowledge in Ostergotland County complied with Swedish Dental Act. The study also found patient perceptions of oral health among 19-year-olds to be good.
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| 2. |
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| 3. |
- Bergström, Eva-Karin, 1974, et al.
(author)
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Dental nurses' experiences of performing a school-based fluoride varnish programme for children and adolescents in Sweden
- 2016
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In: Swedish Dental Journal. - 0347-9994. ; 40:2, s. 181-190
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Journal article (peer-reviewed)abstract
- In many parts of Sweden today, school-based fluoride varnish programmes (FVP) are performed by dental nurses. Studies have shown that the dental personnel are largely responsible for creating the atmosphere related to children's and adolescents' experiences of the programmes. Knowledge of dental nurses' experiences of performing FVP is therefore crucial in order to develop and improve these programmes and the dental health of children and adolescents. The aim of this study was to describe dental nurses' experiences of performing FVP for children and adolescents in Sweden. Fifteen female dental nurses, strategically chosen, aged 40-63, from the Public Dental Service in the Vastra Gotaland Region, Sweden, were individually interviewed. The interviews were transcribed verbatim and analysed according to the phenomenographic approach. Three themes with a total of-n categories, all describing the dental nurses' conceptions of performing FVP, emerged in the analysis. The main conclusions were that in overall terms, performing an FVP was found to be a positive experience for the dental nurses, as it meant meeting children and adolescents in a context in which the children and adolescents are comfortable and relaxed. The opportunity to identify children and adolescents with poor dental health or poor health and to be able to offer them assistance was regarded as a major advantage. In addition, the participants described a feeling of professional development originating from the challenges associated with working in an arena outside the dental clinic.
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| 4. |
- Cederlund, Andreas, et al.
(author)
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Caries treatment in Swedish adults : effectiveness, costs and equity. A 4-year follow-up study of data from the Swedish national dental health register
- 2016
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 223-234
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Journal article (peer-reviewed)abstract
- Planering och styrning av tandvård på nationell nivå bör baseras på utvärderingar av jämlik fördelning, effektivitet och kostnader. Med inrättandet av tandhälsoregistret vid Socialstyrelsen öppnas möjligheter för studier av tandvårdens processer och resultat. Syftet med studien var att utifrån två identifierade kohorter longitudinellt följa och analysera frekvens och kostnader för ny fyllning eller tandkrona på tidigare restaurerad tand (omgörningar) samt relationen mellan förebyggande tandvårdsåtgärder i relation till reparativ och restaurativ tandvård orsakad av karies. Med hjälp av tandhälsoregistret studerades två kohorter omfattande den vuxna befolkningen. En longitudinell modell användes för uppföljning. I den första kohorten följdes 1 878 887 tänder hos 1 088 923 patienter mellan 42 och 48 månader. I den andra kohorten följdes 1 703 147 patienter under en period av mellan 48 och 54 månader. Fördelning av tandvård för olika åldersgrupper visade att kohorterna var representativa för hela patientgruppen. Fördelning av tandvårdsbesök varierade mellan 140 och 160 räknat per 1 000 invånare trots olika geografiska förutsättningar. Resultaten baserade på den första kohorten visar att 76% av tänderna inte fick någon ytterligare åtgärd med fyllning eller tandkrona under uppföljningsperioden, och att för resterande 24% av tänderna fick 77% endast en ny åtgärd. Det förelåg ingen könsskillnad, däremot skillnader på upp till tre intakta tänder mellan olika regioner. Resultat från den andra kohorten visade heller ingen könsskillnad. De genomsnittliga kostnaderna för reparativa åtgärder på grund av karies ökade gradvis i relation till ökade kostnader för förebyggande åtgärder. Vidare var kostnaderna för reparativa åtgärder lägre ju längre tid som följde mellan förebyggande åtgärder. Det nationella tandhälsoregistret utgör en värdefull källa för forskning om tandvård. Longitudinella registerdata för reparationer och preventiva åtgärder kan användas för att studera effektivitet, kostnader och jämlik fördelning av tandvård. Resultaten har en potential för förbättrad styrning av tandvården.
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| 5. |
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| 6. |
- Ekback, Gunnar, et al.
(author)
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Reporting dental caries disease in longitudinal studies : a suggestion
- 2016
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 173-179
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Journal article (peer-reviewed)abstract
- Sjukdomar och medicinska tillstånd definieras vanligen genom att ett antal kriterier uppfylls och en individ bedöms som frisk från sjukdom när dessa kriterier inte längre föreligger, ofta efter en definierad tidsperiod. Incidens och prevalens mellan olika sjukdomar kan därför ofta jämföras. I longitudinella studier definieras dental karies ofta som förändringar i medeltal av ett index, vanligen DMFT/S. Karies är en livsstilssjukdom som går att bota, men symtomen på kariessjukdom är oftast persisterande vilket innebär att ett sådant index inte redovisar hur många individer som är sjuka under en viss period eller hur många som är botade från själva kariessjukdomen under samma tid utan istället redovisar en livstidsprevalens. Syftet med denna studie var att beräkna karies incidens och karies prevalens utgående från begreppen årsprevalens, kumulativ incidens och incidenstalet (incidensraten). Definition på karies hämtades från ICD-10 (KO2.1) som beskriver diagnosen för karies in i dentin. Som definition på att vara frisk (botad) från kariessjukdom användes en definierad tidsperiod på tre år utan att ny dentinkaries registrerats. Studiepopulationen var 423 individer och bestod av alla 12-åringar i Örebro län, år 1990, och som under sex år deltog i samtliga årliga recall-undersökningar (1990–1995). Av dessa hade 210 dentinkaries (definierat som ICD K02.1) någon gång under de tre åren 1990–1992 medan 213 inte uppvisade dentinkaries någon gång under samma tidsperiod. Under den efterföljande perioden 1993–1995 blev 17 % av de sjuka barnen friska från karies. Av de friska barnen insjuknade 38 individer vilket ger en årlig prevalens av 12 %. Karies hade en incidens rate av 134 fall per 1000 manår (13 %) och en kumulativ incidens på 15 % för ett år, 17 % för två år och slutligen 18% för tre år. Vår definition av den tid som krävs (3 år) för att kunna avgöra om en tidigare sjuk individ kan bedömas som frisk från karies kan i framtiden behöva justeras och fler studier i olika åldrar och populationer behövs för att ytterligare belysa problemställningen. Studien visar på relativt dåligt resultat när det gäller att bota kariessjukdom då endast 17 % av de sjuka blev friskförklarade under en period på tre år. Likaledes är resultaten av preventionen nedslående då hela 12 % av individerna i den friska gruppen blev sjuka. Resultatet bör dock tolkas med försiktighet med tanke på det begränsade antal barn som ingick i studien och risker för selektionsbias mellan grupperna. Under dessa år hade dock individuella kallelseintervall utifrån ett riskperspektiv inte införts hos Folktandvården Örebro utan orsaken till att barn inte kallades årligen berodde vanligtvis på resursbrist hos vårdgivaren. Denna metod att rapportera karies i longitudinella material och därmed definiera karies på individnivå ersätter inte traditionella metoder för att mäta kariesincidens och kariesprevalens. Metoden ger dock en ökad information avseende det antal individer som faktiskt är sjuka i karies. Ett sådant förfaringssätt medför stora fördelar ur planeringssynpunkt för tandvården då fokus blir individer och inte medeltal av ytor eller tänder, och möjliggör dessutom jämförelser mellan dem som faktiskt är sjuka i karies med dem som diagnostiserats med andra sjukdomar.
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| 7. |
- Ekbäck, Gunnar, 1954-, et al.
(author)
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Reporting dental caries disease in longitudinal studies - a suggestion
- 2016
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In: Swedish Dental Journal. - Stockholm, Sweden : Swedish Dental Journal. - 0347-9994. ; 40:2, s. 173-179
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Journal article (peer-reviewed)abstract
- In general, most infectious and/or lifestyle-related diseases are defined as being present when sufficient signs or symptoms occurs in an individual. The term "sufficient" is a relative concept and a disease can therefore be measured with different degrees of certainty. These symptoms are commonly defined in such a way that it is possible to determine the incidence and prevalence of the disease and also the proportion of individuals that are cured from the disease. If dental caries is an individual disease which can be compared to other diseases regarding incidence and prevalence, it is important to determine for how long an individual must be free from new signs of the disease before being considered cured or free from the disease and to define the "sufficient" signs or symptoms needed for a diagnose. Based on these thoughts, the purpose of this study was to calculate caries incidence and prevalence in a group of adolescents from a definition of dental caries based on ICD-10. This study included all 12 year olds in 1990 who attended a clinical dental examination in 1990-1995 in Orebro County, Orebro, Sweden, yearly during these six years. Dental caries disease at the individual level was defined as Ko2.1 (dentinal caries) according to ICD-bo while freedom of caries was defined as the absence of Ko2.1 during a three-year period. In this study the yearly prevalence was 12%, the three year cumulative incidence was 18% and the incidence rate 13%. Results of this study highlight the poor outcomes in curing caries disease in this age-group, according to the criteria in this study, as only 17% of the children with caries at the outset of the study were free from the disease three years later. Defining both a practical level to measure signs of dental caries, and the period an individual must be free from them to be classified as cured from the disease create new opportunities to compare and communicate the disease of dental caries with other diseases. This way of registration is also of advantage for planning purposes as there the centre of interest must be the individual patient and not the tooth or surface.
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| 8. |
- Ekbäck, Gunnar, 1954-, et al.
(author)
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What factors can be protective for both self-rated oral health and general health?
- 2015
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In: Swedish Dental Journal. - Stockholm : Swedish Dental Journal. - 0347-9994. ; 39:2, s. 99-107
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Journal article (peer-reviewed)abstract
- The aim of this study was to analyze if the same protective factors are significant for both self-rated health and oral health. It was hypothesized that these factors should be the same.The material is based on a population sample of 17 113 women and men aged 18-84years in one county in central Sweden.The response rate was 61%.The data were collected through a postal questionnaire "Life and Health" in 2008.The questionnaire comprised of 149 questions and was divided into a number of areas, e.g. socioeconomic conditions, quality of life, social relations, lifestyle, and health. To analyze the strength of the protective factors whilst taking into account the relationships between the various independent variables, multivariate analyses were conducted using binary multiple logistic regression. The outcome measures with the strongest association to general health is belonging to the age group 18-34 years, positive faith in the future, good sleeping pattern and to be employed/ self-employed/retired.The outcomes with the strongest association to oral health are good finances, belonging to the age group 18-34years, to be born in Sweden and positive faith in the future.Conclusions.This study shows that, in.general, the same protective factors are significant for both self-rated health and self-rated oral health, making it possible to use the same approach to strengthen both general health and oral health. One important outcome, not often considered, is having positive faith in the future. It is a task for the health care system to strengthen people's faith in the future, partly through a very high quality care when needed, but also through active health promotion that increases the chances of a healthy life, both from a public health perspective as from an oral health perspective.
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| 9. |
- Flink, H., et al.
(author)
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Patient-reported outcomes of caries prophylaxis among Swedish caries active adults in a long-term perspective
- 2016
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In: Swedish Dental Journal. - : Tandläkarförbundet. - 0347-9994. ; 40:1, s. 101-110
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Journal article (peer-reviewed)abstract
- The aim of this study was to measure patient-reported outcomes of caries prophylaxis and to compare them with previously documented efforts in dental offices. A questionnaire was mailed to 134 caries active (CA)and 40 caries inactive (CI) adult patients treated at a Swedish public dental service clinic. The overall response rate was 69%. The questionnaire included items regarding patient perceived caries prophylaxis in relation to:1) treatment and recommendations given by the dental personnel, 2) performed self-care and 3) perceived and expected effects. The responses were studied for their association to clinical data, extracted retrospectively from the patients' dental records. The mean follow up time was >16 years. Information about caries prophylaxis (p=0.01 and recommendations for self-care (p=0.04) were given more often to the CA group than to the CI group. Supplementary examinations and recommendations of self-care risk treatments were more frequent in the CA group (p<0.001). CA patients also made more frequent extra efforts at home to avoid caries by changing their eating habits (p<0.001), improving their oral hygiene (p=0.04) and using extra fluoride (p=0.00l). In the CA group, 60% did not consider that the extra prophylaxis efforts had made them caries inactive, and 40% were not satisfied with the outcome. Most patients (>90%) hoped that the outcome of caries prophylactics would be a reduced number of cavities. The patient-perceived experiences of caries prophylaxis-were in concordance with dental records. Both the dentists and the caries active middle-aged Swedish adults were aware of the need for extra prophylaxis. The caries active patients perceived having made extra home care efforts, but had not experienced that they had become free from caries.
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| 10. |
- Fägerstad, Anida, 1978-, et al.
(author)
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Dental fear among children and adolescents in a multicultural population : a cross-sectional study
- 2015
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In: Swedish Dental Journal. - Stockholm : Swedish Dental Journal. - 0347-9994. ; 39:2, s. 109-120
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore dental fear in a multicultural population of child and adolescent dental patients, with background, gender, age, and socioeconomic status taken into account. A specific aim was to investigate whether the level of DF differed between patients with a non- Swedish background and patients with a Swedish background.In conjunction with a routine visit to the dental clinic, 301 patients (8-19 years old) assessed their dental fear on the Children's Fear Survey Schedule - Dental Subscale, using self-ratings. Following an interview protocol, patients' and their parents' country of birth, and parents' education and occupation/employment were registered. An interpreter was present when needed.Self-rated dental fear was almost equal among patients coming from a non-Swedish background and patients with a Swedish background. Girls scored higher than boys and younger children scored slightly higher compared to older children, but the pattern of dental fear variation was inconsistent. Socioeconomic status differed between the groups with a non- Swedish vs. a Swedish background, but no impact on dental fear was revealed. When children and adolescents with a non-Swedish vs. a Swedish background were modelled separately, female gender and younger age had an impact on dental fear only in the group with a Swedish background.No differences in dental fear were found between children and adolescents from non-Swedish vs. Swedish backgrounds. Dental fear variations according to gender and age were more pronounced in the group with a Swedish background compared to the group with a non-Swedish background. No impact of socioeconomic status could be revealed.
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