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  • 1.
    Blomqvist, My
    et al.
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Bejerot, Susanne
    Örebro universitet, Institutionen för läkarutbildning. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Dahllöf, Göran
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder2015Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, artikel-id 81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.

    Methods: Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age-and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.

    Results: Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.

    Conclusions: Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.

  • 2.
    Flink, Håkan
    et al.
    Centre for Clinical Research, Västmanland County, Uppsala University, Uppsala, Sweden; Public Dental Clinic, Public Dental Health, Västmanland County, Sala, Sweden.
    Tegelberg, Åke
    Centre for Clinical Research, Västmanland County, Uppsala University, Uppsala, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden; Postgraduate Dental Education Center, Public Dental Service, Region Örebro County, Örebro, Sweden.
    Arnetz, Judith E
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing MI, USA.
    Birkhed, Dowen
    ODONT-KONSULT Dowen Birkhed, Malmö, Sweden.
    Patient-reported negative experiences related to caries and its treatment among Swedish adult patients.2017Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 17, nr 1, artikel-id 95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: It has been suggested that dental caries should be regarded as a chronic disease as many individuals repeatedly develop new caries lesions. How this is perceived by caries active patients is unclear. The aim of this study was to measure patient-reported attitudes and negative experiences related to caries and dental treatment.

    METHODS: 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 questionnaire included items regarding patient-reported oral health; attitudes towards caries and efforts to prevent them; and negative experiences related to caries and dental treatment. Questionnaire data were supplemented with data on caries and caries prophylaxis from patients' dental records. Exploratory factor analysis was conducted on items related to patients' perceptions of problems to see whether scales could be created. Experiences, perceptions and dental records of CA and CI patients were compared.

    RESULTS: The overall response rate was 69%. Dental records confirmed that CA patients had significantly more decayed teeth per year and a longer period of caries-active time than CI patients. Factor analysis resulted in 3 distinct scales measuring problems related to caries; 1) caries-related information; 2) negative experiences; and 3) negative treatment/staff attitudes. A fourth scale measuring perceived problems related to caries was also created. The CA group reported significantly more problems related to caries and dental treatment, received significantly more caries-related information, and reported significantly more negative treatment experiences compared to CI patients.

    CONCLUSIONS: Caries prophylaxis methods need to be improved in order to better meet the needs of caries active patients and to create a more positive experience with dental care.

  • 3.
    Gulcan, Ferda
    et al.
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway .
    Nasir, Elwalid
    Örebro County Council, Örebro, Sweden .
    Ekbäck, Gunnar
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Ordell, Sven
    Dental Commissioning Unit, Östergötland County Council, Linköping, Sweden; Linköping University, Linköping, Sweden.
    Åstrøm, Anne Nordrehaug
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway .
    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)2015Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, artikel-id 58Artikel i tidskrift (Refereegranskat)
  • 4.
    Gülcan, Ferda
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway .
    Ekbäck, Gunnar
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Ordell, Sven
    Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
    Lie, Stein Atle
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway .
    Åstrøm, Anne Nordrehaug
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway .
    Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden2015Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, artikel-id 20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with "the latent effect life course model", it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions.

    Methods: Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up.

    Results: Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss.

    Conclusion: The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities tooth loss related to marital status declined, and inequalities related to social network increased.

  • 5.
    Gülcan, Ferda
    et al.
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Nasir, Elwalid
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekbäck, Gunnar
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Örebro County Council, Örebro, Sweden.
    Ordell, Sven
    Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
    Åstrøm, Anne Nordrehaug
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    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 Sweden2014Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 14, artikel-id 59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Oral health-related quality of life, OHRQoL, among elderly is an important concern for the health and welfare policy in Norway and Sweden. The aim of the study was to assess reproducibility, longitudinal validity and responsiveness of the OIDP frequency score. Whether the temporal relationship between tooth loss and OIDP varied by country of residence was also investigated.

    METHODS: In 2007 and 2012, all inhabitants born in 1942 in three and two counties of Norway and Sweden were invited to participate in a self-administered questionnaire survey. In Norway the response rates were 58.0% (4211/7248) and 54.5% (3733/6841) in 2007 and 2012. Corresponding figures in Sweden were 73.1% (6078/8313) and 72.2% (5697/7889), respectively.

    RESULTS: Reproducibility of the OIDP in terms of intra-class correlation coefficient (ICC) was 0.73 in Norway and 0.77 in Sweden. The mean change scores for OIDP were predominantly negative among those who worsened, zero in those who did not change and positive in participants who improved change scores of the reference variables; self-reported oral health and tooth loss. General Linear Models (GLM) repeated measures revealed significant interactions between OIDP and change scores of the reference variables (p < 0.05). Stratified analysis revealed that the mean OIDP frequency score worsened in participants who became dissatisfied- and improved in participants who became satisfied with oral health. Compared to participants who maintained all teeth, those who lost teeth were more likely to experience improvement and worsening of OIDP across both countries. The two-way interaction between country and tooth loss was not statistically significant.

    CONCLUSIONS: Changes in OIDP at the individual level were more pronounced than the percentage distribution of OIDP at each point in time would suggest. The OIDP frequency score showed promising evaluative properties in terms of acceptable longitudinal validity, responsiveness and reproducibility among older people in Norway and Sweden. This suggests that the OIDP instrument is able to detect change in the oral health status that occurred over the 5 year period investigated. Norwegian elderly were more likely to report worsening in OIDP than their Swedish counterparts. Disease prevention should be at focus when formulating the health policy for older people.

  • 6.
    Johansson, Ann-Katrin
    et al.
    Dept Clin Dent Cariol, Fac Med & Dent, NUniv Bergen, Bergen, Norway.
    Johansson, Anders
    Dept Clin Dent Prosthodont, Fac Med & Dent, Univ Bergen, Bergen, Norway.
    Nohlert, Eva
    Clin Res Ctr, Västerås, Sweden; Uppsala Univ, Uppsala, Sweden.
    Norring, Claes
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. Stockholm Ctr Eating Disorders, R&D Unit,Ctr Psychiat Res, Stockholm Cty Council, Karolinska Inst, Stockholm, Sweden; Dept Clin Dent Community Dent, Fac Med & Dent, Univ Bergen, Bergen, Norway.
    Astrom, Anne Nordrehaug
    Dept Clin Dent Community Dent, Fac Med & Dent, Univ Bergen, Bergen, Norway.
    Tegelberg, Åke
    Region Örebro län. Postgrad Dent Educ Ctr, Region Örebro County, Örebro, Sweden; Fac Odontol, Malmö Univ, Malmö, Sweden.
    Eating disorders: knowledge, attitudes, management and clinical experience of Norwegian dentists2015Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, artikel-id 124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods: In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results: The participation rate was 40 % (47 % women and 53 % men). Their knowledge about ED was often retrieved from common media sources and the greater part of the participants reported they had seen very few patients with ED during their professional career. Female dentists reported superior knowledge about ED compared to males, but the former experienced greater difficulties to inform about the condition. Referrals of the patient to other health facilities were significantly more common among female compared to male dentists. The majority of dentists (76 %) reported a need of more education related to ED management. Conclusions: The Norwegian dentists in this study reported limited clinical experience and insufficient knowledge regarding ED. There is therefore a need to increase both undergraduate and continuing education in this field, which can improve preventive and management measures that a dentist can provide for ED patients.

  • 7.
    Molarius, Anu
    et al.
    Competence Centre for Health, Västmanland County Council, Västerås, Sweden; Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.
    Engström, Sevek
    Competence Centre for Health, Västmanland County Council, Västerås, Sweden; Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Flink, Håkan
    Public Dental Service, Västmanland County Council, Västerås, Sweden.
    Simonsson, Bo
    Competence Centre for Health, Västmanland County Council, Västerås, Sweden.
    Tegelberg, Åke
    Region Örebro län. Centre for Clinical Research, Uppsala University, Västerås, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden.
    Socioeconomic differences in self-rated oral health and dental care utilisation after the dental care reform in 2008 in Sweden2014Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 14, artikel-id 134Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aims of this study were to determine self-rated oral health and dental attendance habits among Swedish adults, with special reference to the role of social inequalities, after the Swedish dental care reform in 2008.

    Methods: The study is based on a survey questionnaire, sent to 12,235 residents of a Swedish county, in 2012. The age group was 16-84 years: 5,999 (49%) responded. Using chi-square statistics, differences in prevalence of self-rated oral health and regular dental attendance were analysed with respect to gender, age, educational level, family status, employment status and country of birth. Self-rated poor oral health was analysed by multivarite logistic regression adjusting for the different socio-demographic factors, financial security and having refrained from dental treatment for financial reasons.

    Results: Three out of four respondents (75%) reported fairly good or very good oral health. Almost 90% claimed to be regular dental attenders. Those who were financially secure reported better oral health. The differences in oral health between those with a cash margin and those without were large whereas the differences between age groups were rather small. About 8% reported that they had refrained from dental treatment for financial reasons during the last three months. Self-rated poor oral health was most common among the unemployed, those on disability pension or on long-term sick leave, those born outside the Nordic countries and those with no cash margin (odds ratios ranging from 2.4 to 4.4). The most important factor contributing to these differences was having refrained from dental treatment for financial reasons.

    Conclusion: The results are relevant to strategies intended to reduce social inequalities in oral health, affirming the importance of the provision of equitable access to dental care.

  • 8.
    Åkesson, Marie-Louise
    et al.
    Department of Odontology, Section of Cariology, Umeå University, Umeå, Sweden.
    Gerdin, Elisabeth Wärnberg
    Örebro universitet, Institutionen för läkarutbildning. Dental Research Department, Public Dental Service, Region Örebro County, Örebro, Sweden.
    Söderström, Ulf
    Department of Public Dental Service, County council of Västerbotten, Umeå, Sweden.
    Lindahl, Bernt
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Johansson, Ingegerd
    Department of Odontology, Section of Cariology, Umeå University, Umeå, Sweden.
    Health-related quality of life and prospective caries development2016Ingår i: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 16, artikel-id 15Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The present study was conducted to prospectively assess the association between health-related quality of life (HRQoL) and the development of dental caries in adults in northern Sweden. The SF-36 questionnaire was used to estimate HRQoL.

    Methods: Adults who had (i) participated in a population-based health screening in northern Sweden between 2003 and 2009 and had completed the SF-36 questionnaire, and (ii) received a dental check-up within 1 year (n = 15,615) were included in the study. Of these, 9,838 had a second caries examination 2-7 years after the baseline recording. Information regarding SF-36, lifestyle factors and medical conditions was retrieved by questionnaires, and anthropometric status and blood lipid levels were measured. The association between dental caries (outcome) and SF-36 scores (exposure) with the inclusion of potential confounders was analysed by linear and logistic regression.

    Results: Caries increment increased significantly with decreasing scores for both physical and mental dimensions of SF-36 in women, but no association was seen in men. However, lifelong caries experience (DMFS) increased linearly with decreasing physical HRQoL in both men and women; this was also observed for the single dimension of mental HRQoL. The crude odds ratio for being in the highest caries quintile compared to the lowest when having the poorest physical HRQoL compared with the best physical HRQoL was 1.88 (95 % CI: 1.54-2.3). Several factors were identified as potential confounders in the associations between DMFS and SF-36 scores, including education level, smoking, age, medications, higher levels of total cholesterol, triglycerides, systolic blood pressure, body mass index and sugar intake. Except for education level and smoking, the effect sizes for the association between gradually decreasing SF-36 scores and increasing caries were generally moderate.

    Conclusions: Increased development of caries was associated with low physical HRQoL and some aspects of mental HRQoL. The mechanisms underlying these associations, which are likely confounded by both biological and lifestyle factors, remain to be elucidated. The study implies that, when possible, subjects with poor HRQoL would benefit from caries prevention measures meeting the underlying situation.

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