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  • 1.
    Ahlvin, Anna
    et al.
    Linköping University. Region Östergötland, Public Dental Health Care.
    Warnberg Gerdin, Elisabeth
    Regional Örebro County, Sweden.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Self-perceived oral health among 19-year-olds in a Swedish County - A comparative study between 2004 and 20112016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 1, p. 53-65Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Astrom, A. N.
    et al.
    University of Bergen, Norway.
    Gulcan, F.
    University of Bergen, Norway.
    Ekback, G.
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Linköping University.
    Long-term healthy lifestyle patterns and tooth loss studied in a Swedish cohort of middle-aged and older people2015In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 13, no 4, p. 292-300Article in journal (Refereed)
    Abstract [en]

    The promotion of a healthy lifestyle has become an issue of public health importance in the context of ageing populations and increasing prevalence of chronic diseases. Objective(i) To estimate changes in use of fluoridated tooth paste, use of tooth picks, smoking and alcohol consumption and (ii) to examine whether experience with incident or prevalent tooth loss predict healthy lifestyle transitions from age 50 to 70. MethodIn 1992, 6346 individuals born in 1942 agreed to participate in a prospective cohort study and 3585 completed follow-up questionnaires in 1997, 2002, 2007 and 2012. Statistical analyses were conducted by chi-square statistics, Cochrans Q and logistic regression. ResultsIn total, 15.7% and 74.0% reported incident (tooth loss only in 2012) and prevalent tooth loss (tooth loss in 1992 and 2012). Significant differences occurred between the 1992 and 2012 prevalence of using toothpicks (from 48.3% to 69.1%), smoking (from 26.9% to 10.1%) and alcohol consumption (from 41.5% to 50.5%), 29% and 15.6% increased use of toothpicks and alcohol consumption, whereas 15.5% stopped daily smoking. Increased use of fluoridated tooth paste, smoking cessation and failure to increase use of toothpicks was associated with prevalent tooth loss between age 50 and 70. ConclusionThis study revealed positive and negative trends in oral health behaviours over a 20-year period in persons aged 50 at baseline. Mixed support was obtained for the assumption that oral health promoting lifestyle transitions follow experience with tooth loss. Older people with tooth loss experience could benefit from targeted counselling aimed at coping with oral diseases.

  • 3.
    Bengtsson, Martin
    et al.
    Univ Hosp Skane, Sweden.
    Wall, Gert
    Univ Hosp Skane, Sweden.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care. Malmo Univ, Sweden.
    Becktor, Jonas P.
    Malmo Univ, Sweden.
    Rasmusson, Lars
    Gothenburg Univ, Sweden.
    Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2-or 3-dimensional planning: A randomized double-blind active-controlled clinical trial2018In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 153, no 6, p. 786-796Article in journal (Refereed)
    Abstract [en]

    Introduction: Thorough treatment planning is essential for a good clinical outcome in orthognathic treatment. The planning is often digital. Both 2-dimensional (2D) and 3-dimensional (3D) software options are available. The aim of this randomized 2-arm parallel double-blinded active-controlled clinical trial was to comprae the outcomes of computer-based 2D and 3D planning techniques according to patient-reported health related quality of life. The hypothesis was that a 3D technique would give a better treatment outcome compared with a 2D technique. Methods: Orthognathic treatment for 62 subjects, aged 18 to 28 years, with severe Class III malocclusion was planned with both 2D and 3D techniques. After treatment planning but before surgery, the patients were randomly allocated via blind collection of 1 enveloped card for each subject in a 1:1 ratio to the test (3D) or the control (2D) group. Thus, the intervention was according to which planning technique was used. The primary outcome was patient-reported outcome measures. The secondary outcome was relationship between patient-reported outcome measures and cephalometric accuracy. Questionnaires on the patients health-related quality of life (HRQoL) were distributed preoperatively and 12 months after surgical treatment. The questionnaires were coded, meaning blinding throughout the analysis. Differences between groups were tested with the Fisher permutation test. The HRQoL was also compared with measurements of cephalometric accuracy for the 2 groups. Reslts: Three subjects were lost to clinical follow-up leaving 57 included. Of these, 55 subjects completed the questionnaires, 28 in the 2D and 27 in the 3D groups. No statistically significant difference regarding HRQoL was found between the studied planning techniques: the Oral Health Impact Profile total showed -3.69 (95% confidence interval, -19.68 to 12.30). Consistent results on HRQoL and cephalometric accuracy showed a difference between pretreatment and postreatment that increased in both groups but to a higher level in the 3D group. A difference between pretreatment and posttreatment HRQoL was shown for both groups, indicating increased quality of life after treatment. This supports recent findings comparing 3D and 2D planning techniques. No serious harm was observed during the study. Conclusions: Improvemens of HRQoL were shown after treatment independent of which planning technique, 2D or 3D, was used. No statisticaly significant difference was found between the planning techniqes. Registration: This trial was not registered. Protocol: The protocol was not published before trial commencement.

  • 4.
    Bågesund, Mats
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Public Dental Health Care. Linköping University, Faculty of Medicine and Health Sciences. TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Shafiee, Z.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Drivdal, M.
    Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway.
    Berden, J.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Storhaug, K.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Dental care and oral health in Aagenaes syndrome/lymphedema cholestasis syndrome 12015In: Special Care in Dentistry, ISSN 0275-1879, Vol. 35, no 2, p. 83-89Article in journal (Refereed)
    Abstract [en]

    Aagenaes syndrome/lymphedema cholestasis syndrome 1 (LCS1) is a rare genetic disorder characterized by neonatal cholestasis and lymphedema. The aim was to assess dental care and oral health in adults with LCS1. Fifteen (9M, 6F) individuals diagnosed with LCS1, aged 19-59 years participated. The study evaluated salivary secretion rate, dental radiographs, intraoral photos and included a questionnaire. Eight (53%) had regular dental checkups. Three had received subsidized dental care. Seven (47%) had two or more subjective symptoms of xerostomia. Three (20%) had a decreased stimulated salivary secretion rate below 0.7 mL/minute. Seven (47%) had dentin caries. Marginal periodontitis was found in all six patients above 35 years of age, but not before that age. Thirteen (87%) had tooth discoloration, which was extensive in three (20%). Conclusion. Several patients with LCS1 have problems with periodontitis and tooth discoloration. Frequent dental checkups are therefore recommended. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  • 5.
    Dawson, Andreas
    et al.
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden; Karolinska Institute, Sweden; Malmö University, Sweden; Aarhus University, Denmark.
    Stensson, Niclas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ghafouri, Bijar
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    List, Thomas
    Malmö University, Sweden; Skåne University Hospital, Sweden; Karolinska Institute, Sweden; Malmö University, Sweden; Aarhus University, Denmark.
    Svensson, Peter
    Aarhus University, Denmark; Aarhus University Hospital, Denmark; Karolinska Institute, Sweden; Karolinska Institute, Sweden; Malmö University, Sweden; Aarhus University, Denmark.
    Ernberg, Malin
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Malmö University, Sweden; Aarhus University, Denmark.
    Dopamine in plasma - a biomarker for myofascial TMD pain?2016In: Journal of Headache and Pain, ISSN 1129-2369, E-ISSN 1129-2377, Vol. 17, no 65Article in journal (Refereed)
    Abstract [en]

    Background: Dopaminergic pathways could be involved in the pathophysiology of myofascial temporomandibular disorders (M-TMD). This study investigated plasma levels of dopamine and serotonin (5-HT) in patients with M-TMD and in healthy subjects. Methods: Fifteen patients with M-TMD and 15 age-and sex-matched healthy subjects participated. The patients had received an M-TMD diagnosis according to the Research Diagnostic Criteria for TMD. Perceived mental stress, pain intensity (0-100-mm visual analogue scale), and pressure pain thresholds (PPT, kPa) over the masseter muscles were assessed; a venous blood sample was taken. Results: Dopamine in plasma differed significantly between patients with M-TMD (4.98 +/- 2.55 nM) and healthy controls (2.73 +/- 1.24 nM; P amp;lt; 0.01). No significant difference in plasma 5-HT was observed between the groups (P = 0.75). Patients reported significantly higher pain intensities (P amp;lt; 0.001) and had lower PPTs (P amp;lt; 0.01) compared with the healthy controls. Importantly, dopamine in plasma correlated significantly with present pain intensity (r = 0.53, n = 14, P amp;lt; 0.05) and perceived mental stress (r = 0.34, n = 28, P amp;lt; 0.05). Conclusions: The results suggest that peripheral dopamine might be involved in modulating peripheral pain. This finding, in addition to reports in other studies, suggests that dopaminergic pathways could be implicated in the pathophysiology of M-TMD but also in other chronic pain conditions. More research is warranted to elucidate the role of peripheral dopamine in the pathophysiology of chronic pain.

  • 6.
    Ekback, Gunnar
    et al.
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden.
    Does different wording of a global oral health question provide different results?2015In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 73, no 4, p. 250-257Article in journal (Refereed)
    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, Orebro (T) and Ostergotland (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.

  • 7.
    Ekback, Gunnar
    et al.
    Regional Örebro County, Sweden; Örebro University, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden.
    Self-perceived taste disturbance: a 20-year prospective study of a Swedish 1942 birth cohort2017In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 34, no 2, p. 180-186Article in journal (Refereed)
    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.

  • 8.
    Ekbäck, Gunnar
    et al.
    Örebro County Council, Sweden; University of Örebro, Sweden; Örebro University Hospital, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden.
    Palmetun-Ekbäck, Maria
    Örebro University Hospital, Sweden; Örebro County Council, Sweden.
    Ekbäck, Gustav
    Örebro County Council, Sweden; University of Örebro, Sweden; Örebro University Hospital, Sweden.
    Unell, Lennart
    Malmö University, Sweden; Örebro County Council, Sweden.
    Johansson, Ann-Katrin
    University of Bergen, Norway.
    Reporting dental caries disease in longitudinal studies - a suggestion2016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 2, p. 173-179Article in journal (Refereed)
    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.

  • 9.
    Gulcan, Ferda
    et al.
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Dental Commissioning Unit, Östergötland County Council, Linköping University, Sweden .
    Atle Lie, Stein
    University of Bergen, Norway.
    Nordrehaug Astrom, Anne
    University of Bergen, Norway.
    Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, no 20Article in journal (Refereed)
    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.

  • 10.
    Gulcan, Ferda
    et al.
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Atle Lie, Stein
    University of Bergen, Norway.
    Nordrehaug Astrom, Anne
    University of Bergen, Norway.
    Social predictors of less frequent dental attendance over time among older people: population-averaged and person-specific estimates2016In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 44, no 3, p. 263-273Article in journal (Refereed)
    Abstract [en]

    ObjectivesLongitudinal 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. MethodsIn 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). ResultsLess 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. ConclusionsThe 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.

  • 11.
    Gulcan, Ferda
    et al.
    Univ Bergen, Norway.
    Ekback, Gunnar
    Örebro Cty Council, Sweden; Örebro Univ, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Klock, Kristin S.
    Univ Bergen, Norway.
    Lie, Stein Atle
    Univ Bergen, Norway.
    Astrom, Anne Nordrehaug
    Univ Bergen, Norway.
    Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) - a prospective study of ageing people in Norway and Sweden2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 1, p. 21-29Article in journal (Refereed)
    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 Andersens 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.

  • 12.
    Gulcan, Ferda
    et al.
    University of Bergen, Norway.
    Nasir, Elwalid
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Nordrehaug Astrom, Anne
    University of Bergen, Norway.
    Correction: 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)2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, no 58Article in journal (Other academic)
    Abstract [en]

    n/a

  • 13.
    Hongxing, L.
    et al.
    Department of Clinical Dentistry - Prosthodontics, University of Bergen, Bergen, Norway.
    Astrøm, A. N.
    Department of Clinical Dentistry - Community Dentistry, University of Bergen, Bergen, Norway.
    List, T.
    Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
    Nilsson, Ing-Marie
    Region Östergötland, Public Dental Health Care.
    Johansson, A.
    Department of Clinical Dentistry - Prosthodontics, University of Bergen, Bergen, Norway.
    Prevalence of temporomandibular disorder pain in Chinese adolescents compared to an age-matched Swedish population.2016In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, no 4, p. 241-8Article in journal (Refereed)
    Abstract [en]

    This study aimed to (i) assess the prevalence and perceived need for treatment of TMD pain, and its association with socio-economic factors and gender, in adolescents in Xi᾽an, Shaanxi Province, China, and (ii) compare the prevalence and association with gender of TMD pain in Xi᾽an to an age-matched Swedish population. We surveyed Chinese adolescents aged 15 to 19 years in Xi'an, China (n = 5524), using a questionnaire with two-stage stratified sampling and the school as the sampling unit. The study included second-year students at selected high schools. It also included an age-matched Swedish population (n = 17,015) surveyed using the same diagnostic criteria for TMD pain as that used in the Chinese sample. The survey found TMD pain in 14·8% (n = 817) of the Chinese sample and 5·1% (n = 871) of the Swedish sample (P < 0·0001). Girls had significantly more TMD pain than boys in both the Chinese (P < 0·05) and Swedish (P < 0·001) samples. TMD pain increased with age in the Chinese population. Of the Chinese adolescents with TMD pain, 47% reported that they felt a need for treatment. Rural schools, low paternal education levels, poverty, living outside the home, poor general and oral health, and dissatisfaction with teeth all showed significant positive correlations with TMD pain. Prevalence of TMD pain in Chinese adolescents was significantly higher than in the Swedish sample.

  • 14.
    Ingemansson Hultquist, Ann
    et al.
    Västervik Public Dental Service, Kalmar County Council, Sweden.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Dentin caries risk indicators in 1-year-olds. A two year follow-up study2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 8, p. 613-619Article in journal (Refereed)
    Abstract [en]

    Background: Early childhood caries (ECC) risk factors are suspected to vary between regions with different caries prevalence.Aim: Identify ECC risk factors for 1-year-olds predicting dentin caries at 3 years of age in a region with low caries prevalence.Design: Caries risk was assessed by dental hygienist or dental assistant in 779 one-year-olds. The oral mutans streptococci (MS) score was performed from a tooth surface or (in pre-dentate children) from oral mucosa. A parental questionnaire with questions regarding family factors (siblings with or without caries), general health, food habits (night meals, breastfeeding, other beverage than water), oral hygiene habits and emerged teeth were answered by parents of the 1-year-olds. Dentin caries was assessed when the children were 3-year-olds. Simple and multiple logistic regression analyses were used for identification of caries-associated factors.Results: An increased caries risk was assessed in 4.4% of the 1-year-olds. Dentin caries was found in 2.6% of the 3-year-olds. Caries risk at 1 year was associated with caries at 3 years (OR=6.5, p=.002). Multiple regression analysis found the variables Beverages other than water (OR=7.1, pamp;lt;0.001), Caries in sibling (OR=4.8, p=.002), High level of MS (score 2-3) (OR=3.4, p=.03) and Night meal (OR=3.0, p=.03) to be associated with caries. The single variables Beverage other than water between meals and Caries in sibling were more reliable than Caries risk assessed performed by dental personnel.Conclusions: Behavioural, family and microbial factors are important when assessing caries risk among 1-year-olds in a region with low caries experience.

  • 15.
    John, M. T.
    et al.
    Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA.
    Rener-Sitar, K.
    Department of Prosthodontics, University of Ljubljana, Ljubljana, Slovenia.
    Baba, K.
    Department of Prosthodontics, Showa University, Tokyo, Japan.
    Čelebić, A.
    Department of Prosthodontics, University of Zagreb, Zagreb, Croatia.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care.
    Szabo, G.
    Department of Prosthodontics, University of Pécs, Pécs, Hungary.
    Norton, W. E.
    epartment of Health Behavior, University of Alabama, Birmingham, AL, USA.
    Reissmann, D. R.
    Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Patterns of impaired oral health-related quality of life dimensions.2016In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 43, no 7, p. 519-27Article in journal (Refereed)
    Abstract [en]

    How dental patients are affected by oral conditions can be described with the concept of oral health-related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional, and Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions influence the individual. By determining which patterns of impact on OHRQoL dimensions exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions' functional, painful, aesthetical and psychosocial impact occurs. Data came from the Dimensions of OHRQoL Project with Oral Health Impact Profile (OHIP)-49 data from 6349 general population subjects and 2999 prosthodontic patients in the Learning Sample (N = 5173) and the Validation Sample (N = 5022). We hypothesised that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. In a four-dimensional OHRQoL model consisting Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact, oral conditions' impact can occur in any combination of the OHRQoL dimensions.

  • 16.
    John, Mike T.
    et al.
    Department of Diagnostic and Biological Sciences, University of Minnesota, 7-536 Moos Tower 515 Delaware Street SE, Minneapolis, MN 55455, USA.
    Reissmann, Daniel R.
    Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Čelebić, Asja
    Department of Prosthodontics, University of Zagreb, and School of Dental Medicine and Clinical Hospital Centre, Zagreb, Croatia.
    Baba, Kazuyoshi
    Department of Prosthodontics, Showa University, Tokyo, Japan.
    Kende, Dóra
    Department of Prosthodontics, University of Pécs, Pécs, Hungary.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care.
    Rener-Sitar, Ksenija
    Department of Prosthodontics, University of Ljubljana, Ljubljana, Slovenia; Department of Prosthodontics, University Dental Clinics, University Medical Center Ljubljana, Ljubljana, Slovenia.
    Integration of oral health-related quality of life instruments.2016In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 53, p. 38-43Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To integrate items from two widely used oral health-related quality of life (OHRQoL) questionnaires, the General Oral Health Assessment Index (GOHAI) and the Oral Impacts on Daily Performances (OIDP), as well as culturally-specific items of the Oral Health Impact Profile (OHIP) into a four-dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact.

    METHODS: Subjects came from an ancillary study of the Dimensions of Oral Health-Related Quality of Life Project (N=267 patients, mean age±SD: 54.0±17.2years, 58% women.) Patients filled in the original 49 items of OHIP and 22 additional OHRQoL items in a cross-sectional study. These additional items consisted of 7 culturally specific OHIP items and 15 GOHAI or OIDP items with unique content not covered in OHIP-49. Before data collection, three experts hypothesized to which of the four OHRQoL dimensions these items belong. Hypotheses were tested in correlation analyses between the 22 items and the four dimension scores that were derived from OHIP-49.

    RESULTS: Five of the 22 items did not provide sufficient information to which dimension they belong. In 16 of the remaining 17 items, the pattern of correlation coefficients fitted experts' a priori hypotheses. Acceptance of 16 of the 17 hypotheses was interpreted as evidence that additional (not in OHIP-49 contained) OHRQoL items can be assigned to Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact.

    CONCLUSION: Items of three OHRQoL instruments can be integrated into a dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact.

    CLINICAL SIGNIFICANCE: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can serve as a simple and clinically appealing set of oral health-related quality of life (OHRQoL) dimensions and therefore provide an opportunity for simpler, but psychometrically improved OHRQoL measurement in the future.

  • 17.
    Lundqvist, Martina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Davidson, Thomas
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Sjöstrom, O.
    Oral Care AB, Sweden.
    Zimmerman, M.
    Oral Care AB, Sweden.
    Sjogren, P.
    Oral Care AB, Sweden.
    Health economic analyses of domiciliary dental care and care at fixed clinics for elderly nursing home residents in Sweden2015In: Community Dental Health, ISSN 0265-539X, Vol. 32, no 1, p. 39-43Article in journal (Refereed)
    Abstract [en]

    Objectives: Dental care for elderly nursing home residents is traditionally provided at fixed dental clinics, but domiciliary dental care is an emerging alternative. Longer life expectancy accompanied with increased morbidity, and hospitalisation or dependence on the care of others will contribute to a risk for rapid deterioration of oral health so alternative methods for delivering oral health care to vulnerable individuals for whom access to fixed dental clinics is an obstacle should be considered. The aim was to analyse health economic consequences of domiciliary dental care for elderly nursing home residents in Sweden, compared to dentistry at a fixed clinic. Methods: A review of relevant literature was undertaken complemented by interviews with nursing home staff, officials at county councils, and academic experts in geriatric dentistry. Domiciliary dental care and fixed clinic care were compared in cost analyses and cost-effectiveness analyses. Results: The mean societal cost of domiciliary dental care for elderly nursing home residents was lower than dental care at a fixed clinic, and it was also considered cost-effective. Lower cost of dental care at a fixed dental clinic was only achieved in a scenario where dental care could not be completed in a domiciliary setting. Conclusions: Domiciliary dental care for elderly nursing home residents has a lower societal cost and is cost-effective compared to dental care at fixed clinics. To meet current and predicted need for oral health care in the ageing population alternative methods to deliver dental care should be available.

  • 18.
    Nafi Salih, Firas
    et al.
    Public Dent Health Serv, Sweden.
    Lindsten, Rune
    Institute Postgrad Dent Educ, Sweden.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care. Public Dent Health Serv, Sweden.
    Perception of orthodontic treatment need among Swedish children, adolescents and young adults2017In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 75, no 6, p. 407-412Article in journal (Refereed)
    Abstract [en]

    Objective: Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19. Materials and methods: A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo. Results: The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.21.5), than among subjects, age 15 (3.6 +/- 1.2) (p = .0009), and subjects, age 19 (3.5 +/- 1.2) (p = .00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p = .002 and .001, respectively) and (ii) previous orthodontic treatment (p = .005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p = .002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p = .047) than Swedes, age 19. Conclusions: The lower limit for orthodontic treatment need among subjects, age 10, was higher - compared to subjects, ages 15 and 19 - and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.

  • 19.
    Nakka, Sravya Sowdamini
    et al.
    PEAS Institut AB, Linköping, Sweden, Örebro University, Örebro, Sweden.
    Lönn, Johanna
    PEAS Institut AB, Linköping, Sweden, Örebro University, Örebro, Sweden.
    Starkhammar Johansson, Carin
    Region Östergötland, Public Dental Health Care.
    Bengtsson, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Örebro University, Örebro, Sweden.
    Nayeri, Fariba
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases. Linköping University, Faculty of Medicine and Health Sciences.
    Antibodies produced in vitro in the detection of periodontal bacteria by using surface plasmon resonance analysis2015In: Clinical and Experimental Dental Research, ISSN 2057-4347Article in journal (Refereed)
    Abstract [en]

    Porphyromonas gingivalis (P. gingivalis) is a major etiological agent associated withperiodontitis. This study aims to develop antibodies to P. gingivalis in vitro for real-time detection of bacteria in clinical samples. Lymphocytes were isolated from wholeblood of patient treated for periodontitis and were stimulated with P. gingivalis ATCC33277. B-cell maturation to long-living antibody secreting-plasma cells was studiedusing flow cytometry and immunofluorescence staining. The antibodies developedin vitro were immobilized onto a CM-5 sensor chip of a biosensor to detect the pres-ence of P. gingivalis in the gingival crevicular fluid of patients with periodontitis com-pared to periodontally healthy controls (n = 30). Surface plasmon resonance (SPR)analysis was performed to evaluate specific interactions of bacteria in samples withthe immobilized antibodies. The results of SPR analysis were compared to the detec-tion of P. gingivalis in the samples using DNA–DNA checkerboard hybridizationtechnique. A clear and distinct change in lymphocyte morphology upon stimulationwith P. gingivalis was observed. Anti-P. gingivalis antibodies secreted by CD38+plasma cells showed the presence of all the four IgG subclasses. The results ofDNA–DNA checkerboard analysis were in agreement with that of SPR analysis forthe detection of P. gingivalis in patient samples. Furthermore, incubation with anti-P. gingivalis attenuated the bacterial response in SPR. The in vitro method for antibodyproduction developed during this study could be used for an efficient real-time detec-tion of periodontitis, and the attenuating effects of in vitro antibodies suggest their rolein passive immunization to prevent periodontitis and their associated risk factors.

  • 20.
    Nilsson, Ing-Marie
    et al.
    Region Östergötland, Public Dental Health Care.
    Willman, Ania
    Malmö University, Sweden.
    Treatment Seeking and Self-Constructed Explanations of Pain and Pain Management Strategies Among Adolescents with Temporomandibular Disorder Pain2016In: Journal of Open Archaeology Data, ISSN 2333-0384, E-ISSN 1984-3046, Vol. 30, no 2, p. 127-133Article in journal (Refereed)
    Abstract [en]

    Aims: To explore adolescents explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatment seeking behavior.

    Methods: One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years who had TMD pain and followed a semi structured interview guide. Subjects were strategically selected from patients referred to an orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis.

    Results: Qualitative manifest content analysis revealed two categories: (1) self constructed explanations, with three subcategories (situation-based explanatory model, physical/biologic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain an explanation for their pain, and because their symptoms bother others.

    Conclusion: Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialogue with their adolescent patients about their own explanations of pain, the nature of pain, and in which situations the pain appears. Dentists can also explore adolescent patients pain management strategies and perhaps also suggest new treatment strategies at an earlier stage.

  • 21.
    Norderyd, Johanna
    et al.
    Institute Postgrad Dent Educ, Sweden; Jonköping University, Sweden.
    Graf, Jonas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Marcusson, Agneta
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology.
    Nilsson, Karolina
    Ryhov County Hospital, Sweden.
    Sjöstrand, Eva
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Habilitation.
    Steinwall, Gunilla
    Habilitation Centre, Ryhov County Hospital, Jönköping.
    Ärleskog, Elinor
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Maxillofacial Unit.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Sublingual administration of atropine eyedrops in children with excessive drooling - a pilot study2017In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 27, no 1, p. 22-29Article in journal (Refereed)
    Abstract [en]

    BackgroundDrooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable. AimTo analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities. DesignThe study had a prospective, single-system research design. The participants served as their own controls. The study period was 3 weeks without treatment, 4 weeks with atropine eyedrop solution 10 mg/mL one drop a day followed by 4 weeks of one drop twice a day. Parents rating of their childs drooling was assessed on a 100-mm VAS, and unstimulated salivary secretion rate measurement was performed together with notations about side effects and practicality. ResultsParents VAS assessment of drooling decreased from a median (range) of 74 (40-98) at baseline to 48 (18-88) (P = 0.05) and 32 (12-85) (P = 0.004) after 4 weeks of atropine once a day and another 4 weeks of atropine twice a day, respectively (n = 11). Unstimulated salivary secretion rates decreased from baseline to end of study (P = 0.032). Several parents complained about difficult administration. No irreversible side effects were noted. ConclusionsSublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.

  • 22.
    Nordrehaug Åström, Anne Nordrehaug
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Gulcan, Ferda
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Changes in oral health-related quality of life (OHRQoL) related to long-term utilization of dental care among older people2018In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 76, no 8, p. 559-566Article in journal (Refereed)
    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.

  • 23.
    Oghli, Ibrahim
    et al.
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral Basic Sciences, Taibah University, Medina, Saudi Arabia; Scandinavian Centre for Orofacial Neurosciences, Malmö, Sweden.
    List, T.
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden; Scandinavian Centre for Orofacial Neurosciences, Malmö, Sweden; Department of Rehabilitation Medicine, Skane University Hospital, Lund, Sweden.
    John, M.
    Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, MN, USA.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care, Center for Oral Rehabilitation Norrköping. Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmo University, Malmo, Sweden; Scandinavian Centre for Orofacial Neurosciences, Malmö, Sweden.
    Prevalence and oral health-related quality of life of self-reported orofacial conditions in Sweden2017In: Oral Diseases, ISSN 1354-523X, E-ISSN 1601-0825, Vol. 23, no 2, p. 233-240Article in journal (Refereed)
    Abstract [en]

    Objectives

    To (i) determine the prevalences of self‐report in a Swedish adult population, of temporomandibular disorders, burning mouth syndrome, dry mouth, and bad breath and (ii) determine oral health‐related quality‐of‐life impairment in subjects reporting these conditions.

    Subjects and methods

    A cross‐sectional, randomized sample of the adult Swedish population (response rate: 46%, N = 1309 subjects) self‐reported their condition from the preceding month to assess prevalences of self‐report for the studied conditions together with comorbidity group of subjects who reported more than one condition. The 49‐item Oral Health Impact Profile (OHIP) used to assess oral health‐related quality of life.

    Results

    The most prevalent condition was bad breath (39%), followed by dry mouth (22%), temporomandibular disorders (18%) and burning mouth syndrome (4%). High comorbidity of conditions occurred in 27% of the population. Quality‐of‐life impairment increased with the number of comorbid conditions. Among individual conditions, burning mouth syndrome and temporomandibular disorders (57% and 40% OHIP points) presented higher impairment than dry mouth and bad breath (32% and 26% OHIP points).

    Conclusions

    Orofacial conditions were common and often coexist. The comorbidity group experienced the highest impact on oral health‐related quality of life: the more the comorbid conditions, the greater the negative impact.

  • 24.
    Svanberg, Christina
    et al.
    Region Östergötland, Public Dental Health Care. County Council Jamtland, Sweden.
    Norevall, Lars-Inge
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ekman, Bertil
    Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Wahlberg Topp, Jeanette
    Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Cephalometric analysis of adults with Turner syndrome2016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Turner syndrome (TS) is a genetic disorder of females with a prevalence of 1/2000-3000 live female births. The aim of this study was to compare cephalometric variables from adult women diagnosed with TS to a standardized reference group of 31-year old healthy women, and to evaluate the possible effects of human growth hormone (hGH) therapy in women with TS. Registered TS subjects in the Southeast region of Sweden were invited to take part in the study. Twenty-one women aged 36 +/- 13(18-57) years accepted participation. Lateral radiographs of the head were analyzed using standard cephalometric methods (Hasund analysis) and with the commercially available soft-ware program FACAD. Comparisons were made with roentgen-cephalometric standards from a reference group of nineteen 31-year old Swedish women. Analysis of the cephalometric radiographs from the TS subjects showed a more retrognathic maxilla (SNA 80.3 +/- 5.4) (p=0.0460) and mandible (SNB 77.0 +/- 5.2) (p=0.0014), and a correspondingly backward position of the chin (SN/Pg 78.9 +/- 5.5) (p=0.0046) as compared to the reference values of 31-year old women (SNA 83.2 +/- 3.0, SNB 81.5 +/- 2.3 and SNPg 83.0 +/- 2.3, respectively). In addition there was an increased posterior inclination of the maxilla (SN/NL 8.6 +/- 4.1), as compared to the reference values (SN/NL 5,3 +/- 2.7) (p=0.0048). There were no significant differences regarding sagittal or vertical jaw relations, mandibular inclination or cranial base angle between the TS-group and the 31-year olds with the reference values. No significant difference was seen in jaw relationship, as measured by the ANB value, however the Wits(index) (3.3 +/- 3.5) was higher (p=0.0001) than the reference values (-0.1 +/- 1.8). Subjects with or without previous hGH administration did not show any significant differences in cephalometric values. In conclusion, women with TS had a significantly more retrognathic maxilla (SNA) and mandible (SNB) and a correspondingly significantly posterior position of the chin (SN/Pg), a significantly increased posterior inclination of the maxilla (SN/NL) and a significantly increased Witsindex as compared to the reference group of 31-year old women. No craniofacial variables differed significantly between previously hGH-treated and not hGH-treated women with TS.

  • 25.
    Unell, L.
    et al.
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Johansson, A.
    University of Bergen, Norway.
    Ekback, G.
    University of Örebro, Sweden; Örebro County Council, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care. Malmö University, Sweden.
    Carlsson, G. E.
    University of Gothenburg, Sweden.
    Dental status and self-assessed chewing ability in 70-and 80-year-old subjects in Sweden2015In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 42, no 9, p. 693-700Article in journal (Refereed)
    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.

  • 26.
    Waller, Niels
    et al.
    Department of Psychology, University of Minnesota, N657 Elliott Hall, 75 East River Road, Minneapolis, MN, 55455, USA.
    John, Mike T.
    Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
    Feuerstahler, Leah
    Department of Psychology, University of Minnesota, N657 Elliott Hall, 75 East River Road, Minneapolis, MN, 55455, USA.
    Baba, Kazuyoshi
    Department of Prosthodontics, Showa University, Tokyo, Japan.
    Larsson, Pernilla
    Region Östergötland, Public Dental Health Care.
    Peršić, Sanja
    Department of Prosthodontics, School of Dentistry, University of Zagreb, Zagreb, Croatia.
    Kende, Dóra
    Department of Prosthodontics, University of Pécs, Pécs, Hungary.
    Reißmann, Daniel R.
    Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany..
    Rener-Sitar, Ksenija
    Department of Prosthodontics, Dental Division, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Prosthodontics, University Dental Clinics, University Medical Center of Ljubljan, Ljubljan, Slovenia.
    A 7-day recall period for a clinical application of the oral health impact profile questionnaire.2016In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 20, no 1, p. 91-99Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Aims were to investigate and compare the validity and reliability of Oral Health Impact Profile (OHIP) scores referencing 7-day and 1-month recall periods in international prosthodontic patients.

    MATERIAL AND METHODS: A sample of 267 patients (mean age = 54.0 years, SD = 17.2 years, 58 % women) with stable oral health-related quality of life was recruited from prosthodontic treatment centers in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden. These patients completed the OHIP on two occasions using a new 7-day recall period and the traditional 1-month recall period. OHIP score validity and reliability were investigated with structural equation models (SEMs) that included OHIP(past 7 days) and OHIP(1 month) latent factors and single indicator measures of global oral health status. The SEMs assessed measurement invariance and the relative validities of the two OHIP latent factors (representing the two recall periods).

    RESULTS: The SEMs provided cogent evidence for recall period measurement invariance for the two OHIP forms and equal validities (r = .48) with external measures of global oral health status.

    CONCLUSION: When assessed in international prosthodontic patients, OHIP scores using the new 7-day recall period were as reliable and valid as the scores using the 1-month recall period.

    CLINICAL RELEVANCE: Conceptual advantages make a 7-day recall period a preferred frame of reference in clinical applications of the OHIP questionnaire.

  • 27.
    Åstrom, Anne N.
    et al.
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Lie, Stein A.
    University of Bergen, Norway.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    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 65yr of age to 70yr 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 70yr 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.

  • 28.
    Åström, Anne N.
    et al.
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; Örebro University, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Lie, Stein A.
    University of Bergen, Norway.
    Gulcan, Ferda
    University of 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 Andersens 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. Cochrans 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 Andersens 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.

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