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Åstrøm, A. N., Ekbäck, G., Ordell, S. & Gulcan, F. (2018). Changes in oral health-related quality of life (OHRQoL) related to long-term utilization of dental care among older people. Acta Odontologica Scandinavica, 1-8
Open this publication in new window or tab >>Changes in oral health-related quality of life (OHRQoL) related to long-term utilization of dental care among older people
2018 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, p. 1-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To examine whether long-term utilization of dental care, treatment with fillings and crowns and persistent tooth loss between age 50 and 65 years associate with subsequent changes in OHRQoL from age 65 to 70 years.

METHOD: In 1992, a census of 50-year-olds received invitation to participate in a questionnaire survey. Of 6346 respondents, 3585 completed follow-ups in 1997, 2002, 2007 and 2012. OHRQoL was measured using the Oral Impacts on Daily Performances (OIDP) inventory.

RESULTS: Around 70.4%, 11.2% and 18.4% confirmed respectively, no change, worsening, and improvement in OIDP scores between age 65 and 70 years. Compared to those being permanent non-routine dental attenders, ORs of improving and worsening of OIDP were respectively, 0.4 and 0.6 if being a permanent routine dental attender. ORs for improving OIDP was 1.6 if reporting persistent specialist attendance and 2.5 if having received crowns and fillings. Participants with permanent tooth loss were most likely to both worsen and improve OIDP.

CONCLUSION: Long-term routine dental attendance and permanent tooth loss occurred as predictors simultaneously for improvement and worsening of OIDP. Accumulation of advantages and disadvantages throughout the life-course increases and decreases the probability of improvement and worsening in OIDP among older people in Sweden.

Place, publisher, year, edition, pages
Informa Healthcare, 2018
Keywords
Oral health, dental care, older adults
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-67062 (URN)10.1080/00016357.2018.1474249 (DOI)29772930 (PubMedID)
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-06-04Bibliographically approved
Gülcan, F., Ekbäck, G., Ordell, S., Klock, K. S., Lie, S. A. & Åstrøm, A. N. (2018). Exploring the association of dental care utilization with oral impacts on daily performances (OIDP): a prospective study of ageing people in Norway and Sweden. Acta Odontologica Scandinavica, 76(1), 21-29
Open this publication in new window or tab >>Exploring the association of dental care utilization with oral impacts on daily performances (OIDP): a prospective study of ageing people in Norway and Sweden
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2018 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 21-29Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen's model.

METHODS: Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data.

RESULTS: Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only.

CONCLUSIONS: In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Oral health; dental care utilization; OIDP; Andersen's behavioural model; cohort
National Category
Public Health, Global Health, Social Medicine and Epidemiology Dentistry
Identifiers
urn:nbn:se:oru:diva-62485 (URN)10.1080/00016357.2017.1375555 (DOI)000426893500003 ()28891363 (PubMedID)2-s2.0-85029453177 (Scopus ID)
Note

Funding agencies:

Public Dental Health Services in Norway, University of Bergen

Norwegian Research Council (Grant no 213516) 

Department of Dentistry, Örebro County, Sweden

Dental Commissioning Unit, Östergötland County, Sweden

Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2018-03-27Bibliographically approved
Astrøm, A. N., Ekbäck, G., Ordell, S., Lie, S. A. & Gulcan, F. (2017). Dental hygienist attendance and its covariates in an ageing Swedish cohort. European Journal of Oral Sciences, 125(6), 487-494
Open this publication in new window or tab >>Dental hygienist attendance and its covariates in an ageing Swedish cohort
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2017 (English)In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 125, no 6, p. 487-494Article in journal (Refereed) Published
Abstract [en]

Delegation of tasks between professional groups is important to make health-care services accessible and effective for ageing people. Focussing on a Swedish 1942 birth cohort and guided by Andersen's Behavioral Model, this study assessed dental hygienist attendance from age 50 to age 70 and identified covariates at the population-averaged and person-specific levels. In 1992, a census of 50-yr-old subjects was invited to participate in a questionnaire survey. Of the 6,346 respondents, 3,585 completed follow-ups in 1997, 2002, 2007, and 2012. Multiple logistic regression analysis was conducted using a marginal model and a random intercept model. Cochran's Q test revealed that significantly more respondents confirmed dental hygienist attendance in 2012 than in 1992 (57.2% in 2012 vs. 26.0% in 1992). Population-averaged ORs for dental hygienist attendance across time were 3.5 at age 70 yr compared with age 50 yr (baseline); 2.0 if being a regular rather than an irregular dental attendee; and 0.7 if being of non-native origin compared with native origin. The corresponding person-specific ORs were 8.9, 3.2, and 0.5. Consistent with Andersen's Behavioral Model, predisposing, enabling, and need-related factors were associated with dental hygienist attendance at population-averaged and person-specific levels. This has implications for promoting dental hygienist attendance among ageing people.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Behavioral model, dental hygienist attendance, multilevel analyses, older people
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-62831 (URN)10.1111/eos.12385 (DOI)000415054200010 ()29083073 (PubMedID)2-s2.0-85033215386 (Scopus ID)
Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2018-08-11Bibliographically approved
Ekbäck, G. & Ordell, S. (2017). Self-perceived taste disturbance: a 20-year prospective study of a Swedish 1942 birth cohort. Gerodontology, 34(2), 180-186
Open this publication in new window or tab >>Self-perceived taste disturbance: a 20-year prospective study of a Swedish 1942 birth cohort
2017 (English)In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 34, no 2, p. 180-186Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to assess the impact of dental care factors, general health factors and socio-economic factors on perceived taste disturbance (PTD) over time and to assess the stability of or change in PTD in a panel of individuals as they progressed from middle age (50 years) to early old age (70 years).

Materials and methods: Data collection was conducted from a cohort study beginning in 1992, when the participants were 50 years old, and again 5, 10, 15 and 20 years later. Stability and change in PTD were described using cross-tabulation. Perceived taste disturbance over the 20-year survey period was modelled using the generalised estimating equation (GEE).

Results: The prevalence of PTD during a 5-year period found in this study ranged from 2.4 to 2.9%, the latter in individuals between 60 and 70 years of age. Women generally had PTD more often than men. The longitudinal analysis showed that problems with bad breath (OR = 3.6), blisters (OR = 3.4), burning mouth (OR = 3.4) and self-perceived health (OR = 2.7) were the most important factors explaining PTD.

Conclusions: This study showed that PTD does not increase between 50 and 70 years of age in ordinary community-living individuals. There were no long-term impacts on PTD over time from socio-economic factors, and over time, there were a limited number of factors contributing to the effect. Bad breath, blisters, burning mouth and self-perceived health are important factors for the dentist to discuss with the patient in the case of PTD.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
longitudinal study, older people, oral health, PTD
National Category
Dentistry Geriatrics
Identifiers
urn:nbn:se:oru:diva-57859 (URN)10.1111/ger.12244 (DOI)000400306000005 ()27500585 (PubMedID)2-s2.0-84983002222 (Scopus ID)
Note

Funding Agencies:

Department of Dentistry, Region Örebro County  

Dental Commissioning Unit, Region Östergötland County 

Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2017-09-05Bibliographically approved
Ekbäck, G., Ordell, S., Palmetun-Ekbäck, M., Ekbäck, G., Unell, L. & Johansson, A.-K. (2016). Reporting dental caries disease in longitudinal studies - a suggestion. Swedish Dental Journal, 40(2), 173-179
Open this publication in new window or tab >>Reporting dental caries disease in longitudinal studies - a suggestion
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2016 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 2, p. 173-179Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Stockholm, Sweden: Swedish Dental Journal, 2016
Keywords
dental caries, incidence, longitudinal, prevalence, terminology
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-53649 (URN)000386982400007 ()
Note

Funding Agencies:

Department of Dentistry, Örebro County, Sweden

Dental Commissioning Unit, Östergotland County, Sweden

Available from: 2016-11-28 Created: 2016-11-25 Last updated: 2018-04-25Bibliographically approved
Ekbäck, G., Ordell, S. & Ståhlnacke, K. (2016). Satisfaction with dental care and life-course predictors: A 20-year prospective study of a Swedish 1942 birth cohort?. Acta Odontologica Scandinavica, 74(3), 194-201
Open this publication in new window or tab >>Satisfaction with dental care and life-course predictors: A 20-year prospective study of a Swedish 1942 birth cohort?
2016 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 3, p. 194-201Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to assess the impact of care experience, health factors and socioeconomic factors on satisfaction with dental care across time and to assess the stability or change in levels of self-reported satisfaction with dental care in individuals as they progress from middle age to early old age.

Materials and methods: The present work is based on five separate data collections from a cohort study with 3585 individuals responding in all years of the survey. Data collection was conducted in 1992 when the subjects were 50 years of age and again 5, 10, 15 and 20 years later. Absolute stability in satisfaction with dental care was assessed by calculating the proportion of individuals who maintained their position in the same category from one survey period to another. Changes across time were tested using Cochran's Q test. Satisfaction with dental care across the 20-year survey period was modeled using the generalized estimating equation (GEE).

Results and conclusion: The result showed that 85% of women and 83% of men remained satisfied with dental care. Binomial GEE revealed no statistical significant change in satisfaction with dental care between 1992-2012. In sum, this study has shown that this age group, born in 1942, was stably satisfied with dental care between age 50 and age 70, despite all changes during this time period. Females are more satisfied than men and the most important factors are the experience of attention during the last visit, satisfaction with dental appearance and good chewing capability.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Elderly, longitudinal, survey
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-48752 (URN)10.3109/00016357.2015.1075587 (DOI)000369294700005 ()26329502 (PubMedID)2-s2.0-84956653437 (Scopus ID)
Note

Funding Agencies:

Department of Dentistry, Örebro County

Dental Commissioning Unit, Östergotland County

Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2017-11-30Bibliographically approved
Gülcan, F., Ekbäck, G., Ordell, S., Lie, S. A. & Åstrøm, A. N. (2016). Social predictors of less frequent dental attendance over time among older people: population-averaged and person-specific estimates. Community Dentistry and Oral Epidemiology, 44(3), 263-273
Open this publication in new window or tab >>Social predictors of less frequent dental attendance over time among older people: population-averaged and person-specific estimates
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2016 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 44, no 3, p. 263-273Article in journal (Refereed) Published
Abstract [en]

Objectives: Longitudinal studies considering social disparities in the utilization of dental services are scarce. Repeated measures should be accounted for by the use of appropriate statistical methods. The purpose of this study was first to describe the patterns of less frequent dental attendance (less than once a year) over time from the age of 65-70 in Norwegian and Swedish 1942 cohorts. Second, this study estimated the influence of predisposing, enabling and need-related social predictors using marginal model with robust variance estimators and random intercept model, RIM, to account for the clustered structure of the repeated observations. Third, the study aimed to compare the estimates of associations between social predictors and less frequent dental attendance derived from marginal and random intercept models.

Methods: In 2007 and 2012, all residents born in 1942 in selected counties of Norway and Sweden were invited to participate in a questionnaire survey. In Norway, the response rate was 58.0% (n = 4211) in 2007 and 54.5% (n = 3733) in 2012 with a follow-up rate of 70%. The corresponding figures in Sweden were 73.1% (n = 6078) and 72.2% (n = 5697), with a follow-up rate of 80%. Marginal and random intercept models were fitted for population-averaged and person-specific estimates. Design effects were calculated by comparing the results from ordinary logistic regression analyses and the marginal model with robust variance estimators. The proportion of the total variation due to differences between persons was reported using the intraclass correlation coefficient (ICC).

Results: Less frequent dental attendance declined from 14.5% to 12.2% in Norway and from 13.6% to 12.9% in Sweden. According to marginal and random intercept models, time-invariant (gender, country of birth, education) and time-variant social predictors (working status, social network, marital status, smoking and perceived health) contributed to less frequent dental attendance. A likelihood ratio test confirmed that adjustment for clustered observations was appropriate. The ICC was 0.90 in Norway and 0.85 in Sweden.

Conclusions: The prevalence of less frequent dental attendance was low and dropped by increasing age from 65 to 70 years. Both at population and at person-specific levels, being advantaged on social aspects protects against less frequent dental attendance after 65 years of age in the Norwegian and Swedish cohorts investigated.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2016
Keywords
Clustering, dental attendance, longitudinal studies, repeated measures
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-50333 (URN)10.1111/cdoe.12214 (DOI)000374323900010 ()26854281 (PubMedID)2-s2.0-84958794130 (Scopus ID)
Note

Funding Agencies:

Public Dental Health Services in Norway

University of Bergen

Norwegian Research Council 213516

Department of Dentistry, Örebro County

Dental Commissioning Unit, Östergötland County, in Sweden

Available from: 2016-05-19 Created: 2016-05-19 Last updated: 2018-07-10Bibliographically approved
Gulcan, F., Nasir, E., Ekbäck, G., Ordell, S. & Åstrøm, A. N. (2015). Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden (vol 14, 59, 2014). BMC Oral Health, 15, Article ID 58.
Open this publication in new window or tab >>Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden (vol 14, 59, 2014)
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2015 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, article id 58Article in journal (Refereed) Published
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-44812 (URN)10.1186/s12903-015-0043-5 (DOI)000354234600001 ()25962724 (PubMedID)2-s2.0-84929158817 (Scopus ID)
Available from: 2015-06-03 Created: 2015-06-03 Last updated: 2018-06-30Bibliographically approved
Unell, L., Johansson, A., Ekbäck, G., Ordell, S. & Carlsson, G. E. (2015). Dental status and self-assessed chewing ability in 70-and 80-year-old subjects in Sweden. Journal of Oral Rehabilitation, 42(9), 693-700
Open this publication in new window or tab >>Dental status and self-assessed chewing ability in 70-and 80-year-old subjects in Sweden
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2015 (English)In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 42, no 9, p. 693-700Article in journal (Refereed) Published
Abstract [en]

The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80-than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
dry mouth, edentulism, general health, gerodontology, logistic regression, mastication
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-46403 (URN)10.1111/joor.12299 (DOI)000362599200008 ()25882481 (PubMedID)2-s2.0-84941943778 (Scopus ID)
Note

Funding Agencies:

Department of Dentistry, Örebro County, Sweden

Dental Commissioning Unit, Östergötland County, Sweden

Available from: 2015-11-04 Created: 2015-11-04 Last updated: 2017-12-01Bibliographically approved
Ekbäck, G. & Ordell, S. (2015). Does different wording of a global oral health question provide different results?. Acta Odontologica Scandinavica, 73(4), 250-257
Open this publication in new window or tab >>Does different wording of a global oral health question provide different results?
2015 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 4, p. 250-257Article in journal (Refereed) Published
Abstract [en]

Objective: Focusing on 70-year-old adults in Sweden and guided by the conceptual framework of International Classification of Impairments, Disabilities and Handicaps (ICIDH), the purpose of this study was to examine the extent to which socio-demographic characteristics, self-reported oral disease and social/psychological/physical oral health outcome variables are associated with two global measures of self-assessed satisfaction with oral health in Swedish 70-year-olds and if there is a degree of discordance between these global questions.

Background: It has become an important task to create a simple way to measure self-perceived oral health. In these attempts to find practical ways to measure health, the 'global oral health question' is a possible tool to measure self-rated oral health, but there is limited knowledge about how important the wording of this question is.

Materials and methods: In 2012, a questionnaire was mailed to all persons born in 1942 in two Swedish counties, Örebro (T) and Östergötland (E). The total population of 70-year-olds amounted to 7889. Bivariate analyses were conducted by cross-tabulation and Chi-square statistics. Multivariate analyses were conducted using binary multiple logistic regression.

Results: The two global oral health question of 70-year-olds in Sweden was mainly explained by the number of teeth (OR = 5.6 and 5.2), chewing capacity (OR = 6.9 and 4.2), satisfaction with dental appearance (OR = 19.8 and 17.3) and Oral Impact on Daily Performance (OIDP) (OR = 3.5 and 3.9). Conclusion. Regardless of the wording, it seems that the concept of a global oral health question has the same main determinants.

Keywords
Elderly; Global oral health question; OHRQoL
National Category
Dentistry
Identifiers
urn:nbn:se:oru:diva-38722 (URN)10.3109/00016357.2013.794390 (DOI)000351506000002 ()23919598 (PubMedID)2-s2.0-84925071221 (Scopus ID)
Note

Funding Agencies:

Department of Dentistry, Örebro County

Dental Commissioning Unit, Östergotland County

Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2017-12-05Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8969-1650

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