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- Kirkinen, Tita, et al.
(författare)
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Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden
- 2023
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:8, s. 615-621
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study evaluates the agreement of data on dental caries between electronic dental records and data retrieved from the national SKaPa-registry (Swedish Quality Registry for caries and periodontal disease), with special reference to e/M in deft/DMFT.Methods In a random sample of 500 6- and 12-year-old children having received dental care in 2014 in the county region of Värmland, Sweden, the diagnostic accuracy of data in electronic dental records with corresponding data obtained from the SKaPa-registry was compared by using Cohen’s Kappa and Intraclass correlation coefficient (ICC).Results For dft/DFT the Kappa was 0.95, and ICC 0.98 (total population). For deft/DMFT in the total population the Kappa was 0.80 and ICC 0.96. For 6-year-olds (deft) the Kappa was 0.89 and ICC 0.99 and for 12-year-olds (DMFT) the Kappa was 0.70, and ICC 0.83. The corresponding figures for Kappa and ICC when excluding individuals without caries (deft/DMFT = 0) were: Total population 0.63 and 0.94; 6-year-olds 0.79 and 0.99; 12-year-olds 0.42 and 0.68.Conclusion Agreement between data in the dental records and SKaPa was very high for dft/DFT confirming that transfer from the dental records to the SKaPa-registry is safe and correct. As the accuracy of deft/DMFT was considerably lower than for dft/DFT we advise against using deft/DMFT data from SKaPa for research purposes at this point.
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| 2. |
- Kirkinen, Tita
(författare)
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Dental health and dental care in children in out-of-home care
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- More than 26,000 children and young people are placed in out-of-home care in Sweden every year. Several studies show that children placed in out of home care have poorer health during childhood and are generally in poorer physical condition later in life. The overall aim of this thesis was to study dental health and dental care in children in out-of-home care (OHC), through registry-based research. Paper I was a registry-based study of dental health care utilisation among young adults who as children had been placed in societal out-of-home care. These young adults had more emergency dental visits and more extractions and fewer regular scheduled dental check-ups than their peers who had never experienced OHC.Paper II was a systematic review/HTA to evaluate organisational models intended to ensure that children and young people in out-of-home care will receive health and dental care. We were unable to identify any study, of low or medium risk of bias, which examined the effects of organisational models on provision of health and dental care for children and young people in foster care and in institutions.Papers III and IV were validation studies of the Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa), undertaken to determine the accuracy of the registry and whether it was appropriate for application in the next study (Paper V) and for other research purposes. For dft/DFT, the validation studies showed high agreement between the data in the patient records and the SKaPa registry. However, e/M in deft/DMFT was shown to be uncertain.Paper V was a registry-based study linking different registries, to investigate dental health and dental care in children in OHC. This study showed that children in OHC have more caries and undergo fewer dental health assessments than those who have never been placed in OHC. There was a difference in dental health examinations before and after the year 2017, with higher frequencies of assessments after the legislative amendment in 2017. However, differences remain.
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| 3. |
- Kirkinen, Tita
(författare)
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The Swedish Out-of-Home Care Children Cohort (SweOHC) : evaluation of dental health and dental care
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Children in out-of-home care (OHC) are at greater risk of ill health than other children in the community. The aim of this registry-based cohort study was to compare the oral health and dental care needs of children in OHC with those of other children in Sweden, by merging data from different Swedish registries. A further aim was to analyse whether children in OHC received more dental examinations after 2017, following implementation of a law requiring mandatory health evaluations prior to placement.Methods: We identified an exposed cohort of Swedish children and young people, 0–19 years old, who had been placed in OHC 2010-2018(N=59,348), and an unexposed cohort, five times larger, matched for age, sex and county of residence (N=296,730). Data on dental health, dental care, socioeconomic background and medical diagnoses were retrieved from several registries.Results: During the study period, children in OHC received relatively fewer regular, scheduled dental examinations (4.35 vs. 4.94; p=0.000). More children entering OHC in 2018 received dental examinations (72,86%) compared with 2016 (66,78%) (p=0.000), but this was still lower than the proportion of controls. Moreover, during the study period, dental caries affected more teeth in children in OHC than in the controls (dft 6-year-olds 1.54 vs. 0.72; p=0.000, and DFT 12-year-olds 1.14 vs. 0.70; p=0.000), more extractions and more emergency dental appointments than children who had never been in OHC. Conclusion:Not only do children in OHC have poorer oral health than other children, they also receive less support from the dental health services. It seems that society has failed in its mission to ensure that children in OHC are not disadvantaged with respect to health and access to comprehensive healthcare. Thus, there is an urgent need for reappraisal of guidelines, legislation, and organizational models for providing dental care to children and adolescents in OHC.
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