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André Kramer, Ann-Catrin
Alternative names
Publications (4 of 4) Show all publications
André Kramer, A.-C. A., Pivodic, A., Hakeberg, M. & Östberg, A.-L. (2019). Multilevel analysis of dental caries in Swedish children and adolescents in relation to socioeconomic status. Caries Research, 53(1), 96-106
Open this publication in new window or tab >>Multilevel analysis of dental caries in Swedish children and adolescents in relation to socioeconomic status
2019 (English)In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 53, no 1, p. 96-106Article in journal (Refereed) Published
Abstract [en]

The objective was to investigate the variability in dental caries experience in Swedish children and adolescents, at two different area levels: dental clinics and SAMS (small areas for market statistics), with respect to multiple individual socioeconomic factors (SES). Records of manifest caries using the DMFT indices (decayed, missing, filled teeth, dependent variables) were collected from electronic dental records for 300,988 individuals aged 3-19 years (97.3% coverage) from the Region Västra Götaland, Sweden. SES data were obtained from official registers and covered ethnicity, wealth, parental education, and employment. The SES variables were used as an independent aggregated variable - an in dex - categorized in deciles. Age and gender were independently included in the multilevel models. Two-level logistic regression analyses explored the probability of a dental caries experience and the variability (intracluster correlation) within dental clinic areas and SAMS, respectively. The most deprived (10th decile, SAMS level) 3- to 6-year-old children had an OR of 5.00 (95% CI 4.61-5.43) for dental caries experience (deft), compared with children in the 1st to 5th deciles. For older children and adolescents (≥7 years), the corresponding OR (DFT) was 2.25 (95% CI 2.15-2.35). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics. SES was more strongly related to the risk of dental caries experience than age and gender. In conclusion, the associations between SES and dental caries experience in Swedish children and adolescents were strong in the study and strongest in young children at a low level.

Keywords
Epidemiology, Neighborhood, Small area analyses, Social class
National Category
Dentistry
Research subject
Dental Hygiene
Identifiers
urn:nbn:se:kau:diva-74713 (URN)10.1159/000489570 (DOI)000456038700012 ()30001533 (PubMedID)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2019-09-11Bibliographically approved
André Kramer, A.-C., Petzold, M., Hakeberg, M. & Östberg, A.-L. (2018). Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.. Caries Research, 52(1-2), 42-50
Open this publication in new window or tab >>Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.
2018 (English)In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 52, no 1-2, p. 42-50Article in journal (Refereed) Published
Abstract [en]

The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.

Keywords
DMF indices, Decayed, missing, and filled teeth, Epidemiology, Parents, Preschool children, Socioeconomic status
National Category
Dentistry
Research subject
Dental Hygiene
Identifiers
urn:nbn:se:kau:diva-74710 (URN)10.1159/000481411 (DOI)000426035300007 ()29237152 (PubMedID)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2019-09-11Bibliographically approved
André Kramer, A.-C. A., Hakeberg, M., Petzold, M. & Östberg, A.-L. (2016). Demographic factors and dental health of Swedish children and adolescents. Acta Odontologica Scandinavica, 74(3), 178-85
Open this publication in new window or tab >>Demographic factors and dental health of Swedish children and adolescents
2016 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 3, p. 178-85Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence.

MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used.

RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts.

CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.

Keywords
Age distribution, dental caries, epidemiology, residence characteristics, sex
National Category
Dentistry
Research subject
Dental Hygiene
Identifiers
urn:nbn:se:kau:diva-74712 (URN)10.3109/00016357.2015.1063160 (DOI)000369294700003 ()26133545 (PubMedID)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2019-09-11Bibliographically approved
André Kramer, A.-C., Skeie, M. S., Skaare, A. B., Espelid, I. & Ostberg, A.-L. (2014). Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study in Swedish children.. European Archives of Paediatric Dentistry, 15(3), 167-73
Open this publication in new window or tab >>Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study in Swedish children.
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2014 (English)In: European Archives of Paediatric Dentistry, ISSN 1818-6300, E-ISSN 1996-9805, Vol. 15, no 3, p. 167-73Article in journal (Refereed) Published
Abstract [en]

AIM: To longitudinally follow and analyse caries prevalence and development in primary dentition in Swedish preschool children from 3 to 6 years of age.

STUDY DESIGN: A longitudinal clinical study.

METHODS: Three hundred 3-year-old children in the Public Dental Service were consecutively included. The children underwent annual clinical examinations at 3, 4, 5 and 6 years of age, performed by four calibrated dentists in clinical settings. Initial (d1-2) and manifest (d3-5) lesions were registered at surface and tooth level. Radiographs were taken when indicated and possible.

STATISTICS: Chi-squared test was used for group comparisons. Friedman's test, Wilcoxon non-parametric test and logistic regression analyses explored caries development over the years.

RESULTS: The parents of 271 children agreed to their children participating in the study (total dropout rate at 6 years, 10.3%). At baseline, 27.3% of the children had carious lesions (d1-5 mean 0.98, SD ± 2.44), and only 50.6% of the children were totally caries-free at 6 years (d1-5 mean 1.88, SD ± 2.81). Initial carious lesions made up the greater share at all ages. The greater part of the caries increment occurred between 3 and 4 years of age (p < 0.001). Having initial and/or manifest carious lesions at 3 years of age was a significant explanatory factor for new lesions at 6 years of age (OR 2.29; 95% CI 1.58-3.31).

CONCLUSION: Children with an early caries experience had a high risk of further disease progression. Oral health promotion and prevention programmes should target small children and their carers.

National Category
Dentistry
Research subject
Dental Hygiene
Identifiers
urn:nbn:se:kau:diva-74709 (URN)10.1007/s40368-013-0079-7 (DOI)24008371 (PubMedID)
Available from: 2019-09-11 Created: 2019-09-11 Last updated: 2019-09-11Bibliographically approved

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