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. - : Swedish dental association. - 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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11. |
- Fägerstad, Anida, et al.
(author)
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Dental fear among children and adolescents in a multicultural population – a cross-sectional study : Dental fear in a multicultural population
- 2015
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In: Swedish Dental Journal. - 0347-9994. ; 39, 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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12. |
- Hedlund, Camilla, et al.
(author)
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Success rate, costs and long-term stability of treatment with activator/headgear combinations
- 2016
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In: Swedish Dental Journal. - 0347-9994. ; 40:1, s. 67-77
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Journal article (peer-reviewed)abstract
- The aims of this study were to evaluate treatment outcome with activator-headgear combinations carried out by general dental practitioners, overall costs, long-term stability and patients' satisfaction with treatment outcome. Patients who were recommended to start treatment in 2006 were included in this study (n = 97). Inclusion criteria were: Class II Division 1 with at least half a cusp width distal molar relationship, overjet ≥ 6 mm and presence of dental records. Data were collected, pre-treatment, post-treatment and 3 years after treatment for those with favorable outcome. Patients at follow-up completed a questionnaire about satisfaction with treatment outcome, perceived pain and discomfort during treatment, and subjective need for additional treatment. Eighty-five patients were analyzed, 52 boys and 33 girls (mean age 11.2 years SD 1.39). Thirty-five patients had successful treatment outcome, 15 partially successful and 35 had an unsuccessful outcome. Total costs for all 85 patients amounted to SEK 1 405 000 including both direct and indirect costs. Thirty-eight patients participated in the 3-year follow-up. Treatment outcomes were then categorized as successful in 28 patients, partially successful in 9 patients and 1 patient was judged as unsuccessful. Median values on VAS (0-100) for overall satisfaction with treatment and treatment outcome were high, 78 and 84 respectively. Median value for perceived pain and discomfort during treatment was 42. Just over half of the patients had a favorable treatment outcome. Patients with favorable outcome were stable over time and satisfied with treatment.
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13. |
- Hellovist, Lena, et al.
(author)
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Dental caries and associated factors in a group of Swedish snus users
- 2015
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In: Swedish Dental Journal. - 0347-9994. ; 39:1, s. 47-54
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n=102), all habitual snus users for >= 10 years. The control group (n=101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for >= 10 years. A clinical and radiographic examination and a questionnaire were completed.The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p=0.005). There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p=0.000). Furthermore, snus users had a mean gingival index (+/- SD) for the whole dentition of 20.4 +/- 18.2, while the index for non-users was14.4 +/- 13.9 (p=0.009); the corresponding values for teeth 13-23 were 14.9 +/- 20.6 and 7.7 +/- 11.9 respectively (p=0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different cariesassociated factors.
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14. |
- Klingberg, Gunilla
(author)
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Editorial
- 2016
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:1
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Journal article (other academic/artistic)
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15. |
- Koole, Sebastiaan, et al.
(author)
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Using clinical cases to stimulate active learning in a short periodontal continuing professional development course
- 2015
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In: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 39:1, s. 1-10
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Journal article (peer-reviewed)abstract
- A case-based approach was used in a two-day periodontal continuing professional development course as a strategy to stimulate active learning. The present study investigates the outcome of this course format in terms of feasibility, perceived efficiency as a learning approach and reported individual learning goals. The study was performed in five identical courses entitled 'risk analysis and treatment in periodontal patients' at Malmo University between 2011-2014. Before the course, clinical cases were used to activate participants' prior knowledge and to attune their focus on the course content. During the course, cases were discussed to synchronise theory with practical application. A pre- and end-course questionnaire were developed to evaluate participants' characteristics (age, clinical expertise, experience and expectations), perceptions on feasibility and instructiveness and emerged individual learning goals. The participants (39 dentists and 78 dental hygienists) reported an average preparation time of 62 minutes (range 2-190) and had positive perceptions on the accessibility, instructiveness and difficulty of cases. Expectations ranged between refreshing, acquiring new knowledge and mastering the course subject. Most reported learning goals were related to daily clinical practice including the development of a treatment plan, when to continue non-surgical treatment or to extract teeth/perform surgery, the approach to periodontitis, how to motivate non-compliant patients and when to refer. Conclusion:The use of clinical cases to stimulate active learning in a short-term continuing professional development periodontal course was positively perceived by the dentists and dental hygienists in terms of feasibility and learning potential.
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16. |
- Korduner, Eva-Karin, et al.
(author)
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The Shortened Dental Arch concept from the perspective of Swedish General Dental Practitioners : a qualitative study
- 2016
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:1, s. 1-11
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Journal article (peer-reviewed)abstract
- The aim was to study the cognizance of and attitudes towards the Shortened Dental Arch (SDA) concept among Swedish General Dental Practitioners (GDPs) and the application of the SDA concept in their treatment planning using Qualitative Content Analysis. Eleven Swedish GDPs were purposively selected and all agreed to participate. In-depth semi-structured interviews were conducted and covered treatment considerations concerning two patient cases and the participants' reflections regarding pre-formulated statements about the SDA concept. Qualitative content analysis was used to analyze this data. The emerging theme was "the SDA concept is irrelevant" in the sense of the GDPs disregarding treatments providing dentitions with loss of posterior teeth. There was a strong reluctance to extract teeth, without consideration of the SDA concept, and a firmly patient-focused attitude towards the needs, age and financial situation of the patients. Within the limitations of this study, Swedish GDPs show little or no cognizance of the SDA concept and it does not seem to be applied in their treatment planning. The results show that the qualitative methodology can be beneficial for further understanding of cognizance and attitudes towards the SDA concept
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17. |
- Leisnert, Leif, et al.
(author)
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Diagnoses and treatment proposals in periodontal treatment : A comparison between dentists, dental hygienists and undergraduate students
- 2015
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In: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 39:2, s. 87-97
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Journal article (peer-reviewed)abstract
- The aim of this study is to find out how professionals in Swedish dental care perform diagnostic procedures in general. Is there a common ground between dentists and dental hygienists concerning sharing different job assignments in an effective way? Are the methods of treatment used in accordance with degree of severity of the disease and to what extent is proposed treatment in accordance with the National Guidelines? A questionnaire consisting of three different patient cases with periodontal disease was sent to 804 private practitioners, 809 dentists in Dental Public Service, 802 dental hygienists and 40 dental students on their final semester at the Dental School in Malmo.The questionnaire was completed by 1,103 respondents (47%). A majority of all practitioner groups (94%) found that a relatively healthy patient had disease, the risk for developing further disease was deemed none too low by 97%, but 91% wanted to give preventive care. A vast majority suggested more dental care to healthy patients as compared to patients with severe periodontal disease. In Conclusion the two groups, i.e. dentists and dental hygienists, did not to a sufficiently high degree share views on diagnosis and treatment, in order to optimize the resources in dentistry. The delivery of dental care was not in line with the severity of disease and too much attention was paid to the needs of relatively healthy persons.To change this pattern, the incentives in and structure of the national assurance system could be adapted. Furthermore, the knowledge basis for periodontal diagnosis and treatment needs, with special reference to the National Guidelines, should to a higher degree be shared by all caregivers.
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18. |
- Milosavljevic, Aleksandar, et al.
(author)
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Diagnostic accuracy of carious lesions in digital radiographs at a public dental clinic - can it be improved by optimizing viewing conditions and further education?
- 2016
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 40:2, s. 235-242
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Journal article (peer-reviewed)abstract
- Objective:This study investigated the diagnostic accuracy of digital dental radiography for detecting carious lesions on approximal surfaces before and after optimization of the environment, and after joint training on evaluation and review of x-rays. A further aim was to evaluate differences in diagnostic accuracy between general dental practitioners (GDPs) and dental hygienists (DHs). Materials and methods:One hundred extracted teeth (premolars and molars) underwent standardized radiography. Eleven participants (seven GDPs and four DHs) evaluated digital images for approximal carious lesions in three sessions: (1) at current conditions with no optimization or further training, (2) under optimized viewing conditions, and (3) under optimized viewing conditions after a short educational session. Receiver operating characteristic curves were used to evaluate the results. Histological evaluation was made and served as a criterion standard for differentiating sound teeth and teeth with carious lesions. Kappa statistics evaluated intra-observer agreement. Results: Diagnostic accuracy in the GDP group differed significantly for all types of carious lesions between the first and third evaluations (p=0.002), and also between the second and third (p=0.015). Diagnostic accuracy also differed significantly for carious lesions into the dentin between the first and third evaluations (p=0.010) and between the second and third (p=0.015). Conclusion: Most of the staff had optimized the environment when evaluating digital radiographs. A short educational session highlighting the difficulty of caries diagnostics in digital dental radiography can increase diagnostic accuracy. Diagnostic accuracy in the detection of approximal carious lesions on digital radiographs did not differ between GDPs and DHs.
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19. |
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20. |
- Norderyd, Ola, et al.
(author)
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Oral health of individuals aged 3-80 years in Jonkoping, Sweden during 40 years (1973-2013)
- 2015
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 39:2, s. 69-86
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Journal article (peer-reviewed)abstract
- The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973,1983,1993,2003, and 2013 random samples of 1,000;1,104;1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3,5,10,15, 20,30,40,50, 60,70, and 8o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jonkoping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40-70 years was 16,12, 8,1, and 0.3% in 1973,1983,1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013.This was higher than earlier surveys,4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013,43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40 year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 4o and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups-Jo-30-year-olds a major reduction from about 3o% to 15% in mean plaque score was seen between 1973-2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003-2o13.The percentage of tooth sites with gingivitis was for zo years and older about 4o% in 1973. In 2013, the percentage was about15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years:1973-1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003-2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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21. |
- Norderyd, Ola, et al.
(author)
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Oral health of individuals aged 3-80 years in Jönköping, Sweden, during 40 years (1973-2013) : I. Review of findings on oral care habits and knowledge of oral health.
- 2015
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In: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 39:2, s. 57-68
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Journal article (peer-reviewed)abstract
- The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city of Jönköping, Sweden, in 1973, 1983, 1993, 2003, and 2013. The 1973 study constituted a random sample of 1,000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993, 2003, and 2013 studies, which comprised 1,104; 1,078; 987; and 1,010 individuals, respectively.A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period.During the period 1973–2013, a continous increase of individuals in the age group 20–60 years were treated by the Public Dental Service amounting to about 50%. Almost 70% of the 70- and 80-year-olds were treated by private practitioners. In 2013, 10–20% of the individuals in the age groups 30–40 years did not regularly visit neither Public Dental Service nor a private practitioner. The corresponding figures for the individuals 50–80 years old were 4–7%. Similar number of avoidance was reported in the previous studies.In the survey 2013, about 20–30% of the individuals in the age groups 20–50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist. These findings were in agreement with the results from the surveys 1973–2003. Among the younger age groups, 10–15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series.In 2013, the knowledge of the etiology of caries was known by about 60% of the individuals which was similar to that reported 1973–2003. Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries. This percentage was equivalent during the period 1973–2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day. These frequencies have gradually increased during the 40-year period.Around 40% in the age groups 50–80 years used toothpicks regularly in 2013. This is a about 1/3–1/2 less compared to 2003. In the age groups 20–40 years 3–14% used toothpicks for proximal cleaning in 2013.In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3–20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013
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22. |
- Norderyd, Ola, et al.
(author)
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Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013) : II. Review of clinical and radiographic findings
- 2015
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In: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 39:2, s. 69-86
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Journal article (peer-reviewed)abstract
- The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973–2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80 years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40–70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30–80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10–20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5–60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40- year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 40 and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups 10–30-year-olds a major reduction from about 30% to 15% in mean plaque score was seen between 1973–2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003–2013. The percentage of tooth sites with gingivitis was for 20 years and older about 40% in 1973. In 2013, the percentage was about 15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years, 1973–1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003–2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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23. |
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24. |
- Ramberg, Per, 1949, et al.
(author)
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A randomized controlled cross-over study of the effect of alcohol-free chlorhexidine and essential oils on interleukin-1 levels in crevicular fluid
- 2016
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In: Swedish Dental Journal. - 0347-9994. ; 40:2, s. 143-152
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Journal article (peer-reviewed)abstract
- Aim of the study was to determine the effect of an alcohol-free chlorhexidine mouth rinse and an essential oils containing mouth rinse on pro-inflammatory cytokine levels in gingival crevicular fluid in participants who continue to perform their regular mechanical oral hygiene regimes and normal dietary practice. Twenty adult volunteers (mean age: 59 years) participated in the double-blind randomised controlled cross-over study. Three mouth rinses were used during 16-day periods as an adjunctive to regular mechanical oral hygiene: a solution with alcohol-free chlorhexidine (CHX; Paroex (R)), a solution with essential oils (EO; Listerine (R)), and water (negative control).The mouth rinse periods were separated by 3-month washout periods. At days o (baseline) and 17 (end) of each mouth rinse period, gingival crevicular fluid (GCF) was collected at different tooth sites and analyzed with ELISA technique for IL-1 alpha, IL-1 beta and IL-1ra levels. No significant correlations between clinical parameters (OHI and GI) and cytokine concentrations were observed, regardless of mouth rinse regimen.The generalized linear models revealed that none of the mouth rinses had a statistically significant impact on IL-1 concentrations in GCF. Large inter-individual variations were observed for the levels of IL-1 alpha, IL-1 beta and IL-1ra. Also the changes in concentrations between day o and day17 for the mouthrinses showed large intra-individual variations. It can be concluded that neither the alcohol-free chlorhexidine nor the mouth rinse containing essential oils reduced the levels of IL-1 alpha, IL-1 beta and IL-1ra in GCF.
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25. |
- Rüdiger, Stefan G, et al.
(author)
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Protein and bacteria binding to exposed root surfaces and the adjacent enamel surfaces in vivo
- 2015
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In: Swedish Dental Journal. - 0347-9994. ; 39:1, s. 11-22
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Journal article (peer-reviewed)abstract
- Exposure of root surfaces due to inflammatory tissue breakdown is a clinical characteristic of periodontitis. The gingival margin may further recede during treatment. Pellicles and early dental plaque on enamel surfaces of periodontitis patients have previously been described.The binding properties of exposed root surfaces, which may affect the incorporation of proteins from especially the GCF into the enamel pellicle and thereby early dental plaque formation are largely unknown.The aim of this study was to examine if exposed root surfaces could affect pellicle and initial dental plaque formation on the enamel surface by the analysis of proteins and early adhering bacteria binding to the exposed root surfaces and to the adjacent, gingival enamel surface. Supragingival pellicle and plaque samples were taken from exposed root surfaces and the adjacent enamel surfaces in eleven surgically treated periodontitis patients. For comparison, samples were taken from enamel surfaces of teeth not in need of treatment. Additionally, subgingival bacterial samples were taken. Pellicle proteins were analysed by SDS-PAGE, immunoblotting and image analysis, and bacterial samples by culturing. Significantly more plasma proteins and bacteria were found on the exposed root surfaces than on the enamel.The depth of the gingival recessions was negatively correlated to the amount of plasma proteins in the enamel pellicle./Artv'nomyces spp.were most frequently found on the exposed root surfaces.The total viable counts and streptococci (%TVC) were positively correlated between subgingival samples and samples from the root surface and enamel of surgically treated teeth. A positive correlation was also found for the findings of Gram-negative anaerobes in subgingival samples and samples from the enamel surface. Our findings suggest that an exposed root surface has binding properties different from an enamel surface and could affect early biofilm formation on the adjacent enamel surface.
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