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  • 1.
    Astrøm, Anne N.
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekbäck, Gunnar
    Örebro University, School of Medical Sciences. Örebro University Hospital. Region Örebro County, Örebro, Sweden.
    Ordell, Sven
    Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
    Lie, Stein A.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Gulcan, Ferda
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Dental hygienist attendance and its covariates in an ageing Swedish cohort2017In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 125, no 6, p. 487-494Article in journal (Refereed)
    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.

  • 2.
    Ekbäck, Gunnar
    et al.
    Department of Dentistry, Örebro County Council, Örebro, Sweden; Institute of Clinical Odontology-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Åstrøm, Anne Nordrehaug
    Institute of Clinical Odontology-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Klock, Kristin
    Institute of Clinical Odontology-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ordell, Sven
    Dental Commissioning Unit Östergötland County Council, Linköping, Sweden; Department of Oral Public Health, Malmö University, Malmö, Sweden.
    Unell, Lennart
    Department of Oral Public Health, Malmö University, Malmö, Sweden; Post Graduate Dental Education Centre, Örebro County Council, Örebro, Sweden.
    Satisfaction with teeth and life-course predictors: a prospective study of a Swedish 1942 birth cohort2010In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 118, no 1, p. 66-74Article in journal (Refereed)
    Abstract [en]

    This study aimed to assess the stability or change in satisfaction with teeth among Swedish adults between the ages of 50 and 65 yr, and to identify the impact of socio-demographics and of clinical and subjective oral health indicators on participants' satisfaction with teeth during that period. Self-administered standardized questionnaires were used as part of a longitudinal study. In 1992, 1997, 2002, and 2007 all residents (born in 1942) of two Swedish counties were invited to participate in the study. A total of 63% women and 66% men reported being satisfied with their teeth between 50 and 65 yr of age. The corresponding figures, with respect to dissatisfaction, were 7% and 6% respectively. Generalized estimated equation models revealed a decline in the odds of being satisfied with advancing age, which was particularly important in subjects with lower education, tooth loss, and smokers. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age. Promotion of a healthy adult lifestyle and improved access to quality oral healthcare might increase the likelihood of people being satisfied with their teeth throughout the third age-period in both genders.

  • 3.
    Gustafsson, Annika
    et al.
    Postgrad Dent Educ Ctr, Dept Pedodont, Publ Dent Hlth Serv, Örebro, Sweden.
    Broberg, Anders G.
    Dept Psychol, Univ Gothenburg, Gothenburg, Sweden.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Örebro University Hospital, Örebro, Sweden.
    Berggren, Ulf
    Inst Odontol, Sahlgrenska Acad, Unit Dent Behav Sci, Univ Gothenburg, Gothenburg, Sweden.
    Arnrup, Kristina
    Örebro University, School of Health and Medical Sciences. Postgrad Dent Educ Ctr, Dept Pedodont, Publ Dent Hlth Serv, Örebro, Sweden.
    Possible predictors of discontinuation of specialized dental treatment among children and adolescents with dental behaviour management problems2010In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 118, no 3, p. 270-277Article in journal (Refereed)
    Abstract [en]

    This study aimed to identify potential predictors of non-attendance among children and adolescents with dental behaviour management problems (DBMP). A group of 179 patients, 7.5-19 yr of age, was grouped into 56 'non-attenders' (discontinued treatment, missed appointments, or >= 20% cancellations) and 123 'attenders'. In addition to data from an introductory interview and dental recordings, baseline data from psychometric measures of fear and other personal and parental characteristics were included in logistic regression analyses and tree-based modelling. The non-attenders had higher scores on impulsivity and sociability and lower socio-economic status (SES) than the attenders, and they lived more often in single-parent families. Logistic regression analyses and tree-based modelling point to SES and parental anxiety as important predictors for non-attendance within this group of children and adolescents. To predict, and possibly to prevent, non-attendance among children and adolescents referred for specialized dental care because of DBMP, we must consider their lives and family situations as well as their personal characteristics and oral health status. Further research should focus on whether the observed associations between non-attendance and factors such as personal characteristics, family and psychosocial factors, and previous dental experiences, also hold for those who remain in regular dental care.

  • 4.
    Johansson, Ann-Katrin
    et al.
    Department of Clinical Dentistry – Cariology, Faculty of Medicine and Dentistry, University of Bergen, Bergen.
    Johansson, Anders
    Department of Clinical Dentistry – Prosthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Unell, Lennart
    Örebro County Council, Örebro, Sweden.
    Ekbäck, Gunnar
    Örebro County Council, Örebro, Sweden.
    Ordell, Sven
    Östergötland County Council, Linköping; Department of Oral Public Health, Malmö University, Malmö.
    Carlsson, Gunnar E.
    Department of Prosthetic Dentistry, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects2009In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 117, no 1, p. 13-19Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the changes in prevalence of xerostomia in subjects from 50 to 65 yr of age. Questionnaires were sent to all subjects who were born in 1942 and were living in two Swedish counties in 1992, 1997, 2002, and 2007. The analyses focused on those who answered the questionnaires both in 1992 and in 2007. The response rate was 71.4% (n = 6,346) in 1992 and 73.1% (n = 6,078) in 2007. Of those who answered the questionnaire in 1992, 74.3% (n = 4,714) also responded in 2007. There was an almost linear increase in the prevalence of xerostomia at the four study time-points (i.e. when the subjects were 50, 55, 60, and 65 yr of age). Xerostomia was more prevalent at night than during the day. The pooled prevalence of night-time and daytime xerostomia was 6% at 50 yr of age and 15% at 65 yr of age, and it was higher in women than in men on both occasions. Logistic regression analyses showed that impaired health and smoking were significantly associated with daytime xerostomia but not with night-time xerostomia. Despite the increase in prevalence of xerostomia from 50 to 65 yr of age, there was considerable variation during the observation period. The incidence rate was 13% (507/4,015) and the disappearance rate was 42% (104/250) (dichotomized answers).

  • 5.
    Johansson, Ann-Katrin
    et al.
    Department of Clinical Dentistry & Cariology, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Norring, Claes
    Stockholm Center for Eating Disorders and Center for Psychiatry Research, Department of Clinical Neuroscience, Stockholm County Council/Karolinska Institutet, Stockholm, Sweden.
    Unell, Lennart
    Örebro University Hospital.
    Johansson, Anders
    Department of Clinical Dentistry & Prosthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Eating disorders and oral health: a matched case-control study2012In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 120, no 1, p. 61-68Article in journal (Refereed)
    Abstract [en]

    The aim was to compare the oral health status of patients with eating disorders (EDs), with sex-and age-matched controls, with a view to identify self-reported and clinical parameters that might alert the dental healthcare professional to the possibility of EDs. All patients who entered outpatient treatment in an ED clinic during a 12-month period were invited to participate. Of 65 ED patients who started psychiatric/medical treatment, 54 agreed to participate. Eating disorder patients and controls answered a questionnaire and underwent dental clinical examinations. Multivariate analysis identified significantly higher ORs for ED patients to present dental problems (OR = 4.1), burning tongue (OR = 14.2), dry/cracked lips (OR = 9.6), dental erosion (OR = 8.5), and less gingival bleeding (OR = 1.1) compared with healthy controls. Sensitivity and specificity for the correct classification of ED patients and controls using the five variables was 83% and 79%, respectively. The ED patients with vomiting/binge eating behaviors reported worse perceived oral health (OR = 6.0) and had more dental erosion (OR = 5.5) than those without such behavior. In ED patients with longer duration of the disease, dental erosion was significantly more common. In conclusion, oral health problems frequently affect ED patients, and this needs to be considered in patient assessment and treatment decisions.

  • 6.
    Lopes, David
    et al.
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Arnrup, Kristina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Robertson, Agneta
    Department of Pediatric Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lundgren, Jesper
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden; Research and Development Service Odontology, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
    Validating the dental subscale of the children's fear survey schedule using Rasch analysis2013In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 121, no 3, p. 277-282Article in journal (Refereed)
    Abstract [en]

    Rasch analysis was used to examine the validity of the Children's Fear Survey Schedule Dental Subscale (CFSS-DS). Data were collected from parents of children in regular dental care (n=240) and from parents of children referred to a specialized pediatric dental clinic (n=200). The Rasch model is a probabilistic model in which estimations are based on the relationship between person ability and item difficulty, and the present study investigated the validity of the CFSS-DS through analysis of person and item fit, dimensionality, ordering of thresholds, local dependency, and differential item functioning. The results show multidimensionality of the original scale, and an adjusted version consisting of six items with good fit to the model is suggested. The adjusted scale makes interval-level analysis possible, and time efficiency and elimination of previously criticized items argue in favor of the adjusted scale.

  • 7.
    Åstrøm, Anne N.
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Lie, Stein A.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekbäck, Gunnar
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Gülcan, Ferda
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ordell, Sven
    Dental Commissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
    Self-reported dry mouth among ageing people: a longitudinal, cross-national study2019In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 127, no 2, p. 130-138Article in journal (Refereed)
    Abstract [en]

    Focusing on Swedish and Norwegian cohorts of community-dwelling older adults between age 65 and 70, this study aimed to identify predictors of the prevalence and incident cases of daytime and night-time xerostomia. It was hypothesized that the prevalence increases with increasing age and is higher in women than in men and that the prevalence of persistent xerostomia and the 5-yr-incident cases are higher in people with consistent use of medication and need for health care. Of the Norwegian participants who completed the 2007 survey (age 65 yr), 70% (n = 2,947) participated in 2012. Individuals participating in both 2007 and 2012 constituted the Swedish panel (80%, n = 4,862). The prevalence of xerostomia was higher in women than in men and increased from age 65 to age 70, most markedly in the Swedish cohort. The risk of persistent xerostomia was greatest for participants with consistent use of medication (OR = 1.3) and contact with a physician (OR = 2.3). The risk of incident cases of xerostomia during daytime was greatest for participants with recent and consistent use of medication and recent contact with a physician. Dental professionals should identify patients with xerostomia, emphasize early prevention, and alleviate oral symptoms in collaboration with physicians.

  • 8.
    Åstrøm, Anne Nordrehaug
    et al.
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekbäck, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro County Council, Örebro, Sweden.
    Lie, Stein A
    Department of Clinical Dentistry-Community Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ordell, Sven
    Dental Comissioning Unit, Östergötland County Council, Linköping University, Linköping, Sweden.
    Life-course social influences on tooth loss and oral attitudes among older people: evidence from a prospective cohort study2015In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 123, no 1, p. 30-38Article in journal (Refereed)
    Abstract [en]

    This study examined the relationship of trajectories in social condition with oral attitudes and major tooth loss, using the social mobility and accumulation life-course models in a cohort. Whether social-condition inequalities remained stable or changed from 65 yr of age to 70 yr of age was investigated. In 1992, 6,346 inhabitants born in 1942 and residing in two Swedish counties agreed to participate in a prospective survey. Of the participants in 1992, 3,585 (47.6% men) completed questionnaires in 1997, 2002, 2007, and 2012. In line with the social-mobility model, the prevalence of negative oral attitudes and major tooth loss in participants at 65 and 70 yr of age showed a consistent gradient according to social-condition trajectory, whereby it was lowest among those who were persistently high and highest among those who were persistently low, with the upwardly and downwardly mobile categories being intermediate. A linear graded association between the number of periods with disadvantaged social condition and oral health supported the accumulation model. Both the social mobility and accumulation life-course models were supported. Social-condition differentials in negative oral attitudes and tooth loss seem to remain stable or to narrow weakly after the usual age of retirement.

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