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  • 1.
    Ahlman, Helena
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Tandvårdspersonals engagemang i kliniskt arbete med hemlösa: En kvalitativ studie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Hemlösa har ett stort tandvårdsbehov och behöver engagerad tandvårdspersonal som är beredda att arbeta kliniskt med denna grupp. Syfte: Syftet är att studera vad som engagerar tandvårdspersonal till att arbeta med hemlösa. Metod: En kvalitativ studie och kvalitativ innehållsanalys har använts. Urval: Studien baseras på intervjuer med en tandläkare och en tandsköterska. Resultat: Resultatet presenteras i två domäner. Domänen Fängslande speglar vad informanterna upplever spännande i kliniskt arbete med hemlösa. Tre kategorier finns under denna, Intresse, Ovillighet bland kollegor och Team-work. Under domänen Medkänsla finns två kategorier Nytta och Välvilja. Där speglas känslor som informanterna upplevde i arbetet med denna grupp. Kategorierna visar vad som engagerar informanterna i deras kliniska arbete med hemlösa. Konklusion: Känslorna som tandvårdspersonalen erhåller vid det kliniska arbetet med hemlösa utgör en grund för det engagemang som personalen känner för arbetet. Dock är det flera faktorer som samverkar till detta engagemang.

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    Studentuppsats Hemlösa
  • 2.
    Ahonen, H.
    et al.
    JJönköping University.
    Broström, A.
    Jönköping University; University Hospital Linköping.
    Fransson, E. I.
    Jönköping University.
    Neher, M.
    Jönköping University.
    Lindmark, Ulrika
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Jönköping University.
    Oral health-related situations among patients with experience of continuous positive airway pressure treatment- a critical incident analysis of experiences and actions2022In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 31, no Suppl 1, p. 92-93, article id P085Article in journal (Other academic)
  • 3.
    Ahonen, Hanna
    et al.
    Högskolan i Jönköping, HHJ. ADULT.
    Kvarnvik, Christine
    Folktandvården Region Jönköpings län.
    Broström, Anders
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Fransson, Eleonor I.
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Nygårdh, Annette
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Stensson, Malin
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Lindmark, Ulrika
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Oral hälsa och obstruktiv sömnapné- protokoll för en longitudinell studie2019Conference paper (Refereed)
  • 4.
    Ahonen, Hanna
    et al.
    Högskolan i Jönköping, HHJ. ADULT.
    Kvarnvik, Christine
    Broström, Anders
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Fransson, Eleonor I.
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Nygårdh, Annette
    Högskolan i Jönköping, HHJ, Avd. för omvårdnad.
    Stensson, Malin
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Norderyd, Ola
    Ulander, Martin
    Sunnergren, Ola
    Jansson, Henrik
    Sayardoust, Shariel
    Lindmark, Ulrika
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    “No one seems to know”: Studieprotokoll för utvärdering av ett teoretiskt ramverk för oral hälsa avseende reliabilitet och validitet i en obstruktiv sömnapné population2019Conference paper (Other academic)
  • 5.
    Ahonen, Hanna
    et al.
    Jönköping University.
    Kvarnvik, Christine
    Jönköping University; Jönköping City Council.
    Norderyd, Ola
    Jönköping University; Jönköping City Council; Malmö University.
    Brostrom, Anders
    Jönköping University; University Hospital Linköping.
    Fransson, Eleonor, I
    Jönköping University.
    Lindmark, Ulrika
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Jönköping University.
    Clinical and self-reported measurements to be included in the core elements of the World Dental Federation's theoretical framework of oral health2021In: International Dental Journal, ISSN 0020-6539, E-ISSN 1875-595X, Vol. 71, no 1, p. 53-62Article in journal (Refereed)
    Abstract [en]

    Introduction Oral health is part of general health, and oral diseases share risk factors with several non-communicable diseases. The World Dental Federation (FDI) has published a theoretical framework illustrating the complex interactions between the core elements of oral health (CEOHs): driving determinants, moderating factors, and general health and well-being. However, the framework does not specify which self-reported or clinical measurements to be included in the CEOHs. Objectives To explore oral health measurements relevant for a general adult population to be included in the CEOHs in the FDI's theoretical framework of oral health. Materials and methods A psychometric study was performed, using cross-sectional data from Sweden (N = 630, 54% women, mean age 49.7 years). The data set initially consisted of 186 self-reported and clinical measurements. To identify suitable measurements, the selection was discussed in different settings, including both experts and patients. Principal component analyses (PCAs) were performed to explore, reduce and evaluate measurements to be included in the three CEOHs. Internal consistency was estimated by Cronbach's Alpha. Results The validation process yielded 13 measurements (four clinical, nine self-reported) in concordance with the CEOHs. PCAs confirmed robust validity regarding the construction, predicting 60.85% of variance, representing psychosocial function (number of measurements = 5), disease and condition status (number of measurements = 4), and physiological function (number of measurements = 4). Cronbach's Alpha indicated good to sufficient internal consistency for each component in the constructs (alpha = 0.88, 0.68, 0.61, respectively). Conclusion In a Swedish general adult population, 13 self-reported and clinical measurements can be relevant to include to operationalise CEOHs in the FDI's theoretical framework.

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  • 6.
    Ahonen, Hanna
    et al.
    Jönköping University, Sweden.
    Neher, Margit
    Jönköping University, Sweden.
    Fransson, Eleonor I.
    Jönköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden; University Hospital Linköping, Sweden.
    Lindmark, Ulrika
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Jönköping University, Sweden.
    Views on oral health determinants as described by persons with continuous positive airway pressure‑treated obstructive sleep apnoea: a qualitative study2023In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 23, no 1, article id 407Article in journal (Refereed)
    Abstract [en]

    Background Oral diseases have been associated with cardiovascular diseases, and persons with continuous positiveairway pressure [CPAP]-treated obstructive sleep apnoea [OSA] have an increased risk for negative consequences forboth oral and general health. CPAP treatment is often life-long and adherence to treatment is essential. Xerostomiais a common side-effect which can lead to treatment abandonment. Oral health is a changeable part of our generalhealth and well-being and exploring the views of oral health determinants from persons with experience of CPAP-treatment is important to prevent adverse oral health outcomes. The purpose of this study was to explore whatpersons with experience of CPAP-treated OSA view as determinants for their oral health. Methods Eighteen persons with long-term experience of CPAP-treated OSA were purposively selected. Data werecollected by semi-structured individual interviews. A code book based on the World Dental Federation’s [FDI] theo-retical framework for oral health was developed and used to analyse the data using directed content analysis. Thedomains in the framework’s component driving determinants were used as pre-determined categories. Using thedescription of driving determinants as a guide, meaning units were extracted from the interview transcripts throughan inductive approach. Then, by employing a deductive approach the code book was used to categorise the meaningunits into the pre-determined categories. Findings The views on oral health determinants described by the informants were compatible with the five domainsin the component driving determinants in the FDI’s theoretical framework. Ageing, heredity, and salivation (biologicaland genetic factors), influences from family and the wider society (social environment), location and re-localisation(physical environment), oral hygiene habits, motivation, willingness to change, professional support (health behav-iours), and availability, control, finances, and trust (access to care) were viewed as important oral health determinantsby the informants. Conclusion The study points to a variety of individual oral health-related experiences that oral healthcare profession-als could consider when designing interventions to reduce xerostomia and prevent adverse oral health outcomes forpersons undergoing long-term CPAP-treatment.

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  • 7.
    Alubusi, Sara
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Munhygienvanor och kunskap om oral hälsa hos vuxna individer med utländsk bakgrund: En enkätstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En stor invandring innebär en ökad påfrestning på tandvården från individer med utländsk bakgrund. Hos individerna med utländsk bakgrund har man funnit en nedsatt oral hälsa. Att undersöka vad individer med utländsk bakgrund vet om orala sjukdomar samt vilka munhygiensvanor de har kan hjälpa till att hitta eventuella riskfaktorer till nedsatt oral hälsa. Detta hjälper tandvården att se inom vilket område man bör informera. och stärka denna grupp för att vid behålla deras orala hälsa. Syfte: Att undersöka munhygiensvanor och kunskaper kring oral hälsa hos vuxna individer med utländsk bakgrund. Frågeställning: Finns det någon skillnad mellan hur ofta män och kvinnor med borstar? Metod: Kvantitativ studie. Empirisk enkätstudie. Enkäten omfattar frågor om munhygienvanor, kunskap om karies och kunskap om parodontit. Urvalet bestod av vuxna män och kvinnor som har en utländsk bakgrund och är över 18 års ålder. Med utländsk bakgrund menas att individerna är födda utomlands och har utländska föräldrar. Studiedeltagarna befann sig på en SFI skola i Mellansverige. Resultat: Antal studiedeltagare som deltog i studien var 78, (n=36 män), (n=29 kvinnor), (n=13 som inte angav kön). Majoriteten av studiedeltagarna visade sig ha goda vanor med antalet gånger de borstar tänderna per dag, hur ofta de använder fluor och användning av orala munhygiensprodukter utöver tandborste. Studien visar även att en mindre del av studiedeltagarna känner de största riskfaktorerna för att få orala sjukdomar. Konklusion: Individer med utländsk bakgrund har goda munhygiensvanor men saknar till viss del kunskap kring orsaken till varför orala sjukdomar som karies och parodontit uppstår.

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  • 8.
    Alvenfors, Adam
    et al.
    Sahlgrenska Academy, University of Gothenburg, Sweden; Public Dental Service in Region Västra Götaland, Skövde, Sweden.
    Velic, Mersiha
    Public Dental Service in Region Västra Götaland, Folktandvården Sylte, Trollhättan, Sweden.
    Marklund, Bertil
    Sahlgrenska Academy, University of Gothenburg, Sweden; Research, Education, Development & Innovation, Primary Health Care in Region Västra Götaland, Vänersborg, Sweden.
    Kylén, Sven
    Research, Education, Development & Innovation, Primary Health Care in Region Västra Götaland, Vänersborg, Sweden.
    Lingström, Peter
    Sahlgrenska Academy, University of Gothenburg, Sweden.
    Bernson, Jenny
    Sahlgrenska Academy, University of Gothenburg, Sweden.
    “Difficult” dental patients: a grounded theory study of dental staff’s experiences2022In: BDJ Open, E-ISSN 2056-807X, Vol. 8, no 1, article id 24Article in journal (Refereed)
    Abstract [en]

    Introduction

    The “difficult” patient is a well-known and potentially negative character in various care contexts.

    Objectives

    This study aimed to generate a conceptual framework explaining the main concerns about “difficult” dental patients, and obtain a deeper understanding of their characteristics, how they affect the dental staff and how the staff think and act in order to manage these patients.

    Methods

    Ten interviews were conducted with professional dental caregivers, including dentists, dental hygienists, and dental nurses. The audio-recorded interviews were transcribed and analyzed in accordance with the principles of grounded theory.

    Results

    The main concern regarding “difficult” dental patients generated a framework of seven descriptive interrelated lower-level categories grounded in the data, subsumed in the core category “balancing subjective difficulties”. The informants perceived the possession of “showing interaction difficulties” and “having bio-psycho-social complexity”, as characteristic features of “difficult” patients, who could further adversely affect the dental staff by “evoking negative emotions and behaviors”, “hampering self-esteem and job satisfaction”, and “impairing life and health in general”. To manage the dental care of these patients, the staff used strategies aimed at “activating internal and external resources” and “creating adaptive treatment relations” with patients.

    Conclusions

    The dental staff’s meaning of the phenomenon of “difficult” dental patients points to specific characteristics, effects, and handling strategies. The core category captures the contradictory dynamics of characteristics and affects as these concepts seem interrelated to the caregivers’ handling capacity. The dental staff’s possibility of handling the main concern through balancing subjective difficulties depends on contextual conditions regarding time, to bring the patient and/or oneself at the center of attention. This indicates a need for further research regarding dental interactions and studies generalizing the outlook on “difficult” dental patients.

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  • 9.
    Andersson, Annica
    et al.
    Karlstad University, Division for Health and Caring Sciences.
    Karlsson, Malin
    Karlstad University, Division for Health and Caring Sciences.
    Arbetstillfredsställelse inom tandhygienistprofessionen2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Tandhygienisters arbetstillfredsställelse och vad som påverkar denna är hittills relativt lite studerat. Det finns således ett stort behov av att undersöka detta område närmare. Syftet med studien var att undersöka vilka faktorer som påverkar arbetstillfredsställelse inom

    tandhygienistprofessionen, samt hur vanligt förekommande det är att yrkesverksamma tandhygienister upplever arbetstillfredsställelse. Metoden som användes var en systematisk litteraturstudie. Resultatet visade att flera faktorer av olika karaktär är av betydelse för

    tandhygienisters upplevelse av arbetstillfredsställelse. De huvudsakliga faktorerna innefattar fysisk arbetsmiljö, psykosociala faktorer samt olika bakgrundsfaktorer. Den fysiska arbetsmiljö som förekommer inom tandhygienistprofessionen innehåller flera moment som

    kan orsaka muskuloskeletala problem, vilket kan påverka upplevelsen av

    arbetstillfredsställelse. Faktorer av psykosocial karaktär såsom stress och arbetsorganisatoriska faktorer samt samarbete och kommunikation över yrkesgränserna framstår i studien ha en stor betydelse för upplevd tillfredsställelse i arbetet. Studien visade

    också att verksamma tandhygienister upplever arbetstillfredsställelse trots att flera av de inverkande faktorerna har en negativ karaktär. Konklusionen är att arbetstillfredsställelse inom tandhygienistyrket påverkas av såväl fysiska som psykosociala förhållanden med

    tonvikt på det senare.

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    FULLTEXT01
  • 10.
    Andersson, Ida
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Berger, Susanne
    Karlstad University, Faculty of Social and Life Sciences.
    Tandblekningens påverkan på tandsubstansen och den omkringliggande vävnaden: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 11.
    Andersson, Maria
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Persenius Wentzel, Mona
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Good in Providing Oral Care, but we Could be Better-Nursing Staff Identification of Improvement Areas in Oral Care2021In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 7, article id 23779608211045258Article in journal (Refereed)
    Abstract [en]

    Introduction: Oral care to older people in short-term care units is a complex and challenging everyday practice for nursing staff. Oral care research and knowledge about prerequisites and obstacles is extensive. However, there is a lack of knowledge about how nursing staff in short-term care units describe their satisfaction about provided oral care in order to maintain older people's oral health. Objective: The purpose of this study was to describe how nursing staff perceive their satisfaction of oral care provided for older people in short-term care units and to identify oral care improvements. Methods: This study reports on the results of two open-ended questions that were part of a larger study. Informants (n = 54) were nursing staff working in the involved short-term care units in municipalities from both densely and sparsely populated regions in central and northern Sweden. The answers to the open-ended questions were analyzed using content analysis. Results: The analysis yielded one main category; "Working together to improve satisfaction with older people's oral care" and four subcategories: "Older people's oral health," " Consideration and respect for the older person's autonomy," "Having access to adequate products," and "Working together in the same direction." Conclusion: Identification of older people's oral health problems together with adequate nursing intervention will increase older people's health outcomes and quality of life. However, regardless of work role, the nursing staff might have difficulty changing their behavior or transforming intentions into actions. Oral care is a complicated and proactive practice that requires nursing staff's attention as well as both educational and organizational initiatives. Working in a supportive and collaborative relationship provides prerequisites for optimal oral care in short-term care units.

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  • 12.
    Andersson, Pia
    et al.
    Högskolan Kristianstad.
    Bjurbrant Birgersson, Ann-Marie
    Högskolan Kristianstad.
    Wårdh, Inger
    Karolinska Institutet.
    Kvalitetsindikatorer för munhälsa2007In: Kvalitetsindikatorer inom omvårdnad / [ed] Idvall, E, Stockholm: Gothia Förlag AB, 2007, p. 45-56Chapter in book (Other academic)
  • 13.
    André Kramer, Ann-Catrin André
    et al.
    Public Dental Service, Region Västra Götaland.
    Hakeberg, Magnus
    Petzold, Max
    Östberg, Anna-Lena
    Demographic factors and dental health of Swedish children and adolescents2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 3, p. 178-85Article in journal (Refereed)
    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.

  • 14.
    André Kramer, Ann-Catrin André
    et al.
    epartment of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg.
    Pivodic, Aldina
    Hakeberg, Magnus
    Östberg, Anna-Lena
    Multilevel analysis of dental caries in Swedish children and adolescents in relation to socioeconomic status2019In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 53, no 1, p. 96-106Article in journal (Refereed)
    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.

  • 15.
    André Kramer, Ann-Catrin
    et al.
    Department of Behavioral and Community Dentistry, Institute of Odontology, Göteborg.
    Petzold, Max
    Hakeberg, Magnus
    Östberg, Anna-Lena
    Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents.2018In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 52, no 1-2, p. 42-50Article in journal (Refereed)
    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.

  • 16.
    André Kramer, Ann-Catrin
    et al.
    Public Dental Service, Region Västra Götaland.
    Skeie, M S
    Skaare, A B
    Espelid, I
    Ostberg, A-L
    Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study in Swedish children.2014In: European Archives of Paediatric Dentistry, ISSN 1818-6300, E-ISSN 1996-9805, Vol. 15, no 3, p. 167-73Article in journal (Refereed)
    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.

  • 17.
    Arvidsson Persson, Berit
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Larsson, Emma
    Karlstad University, Faculty of Social and Life Sciences.
    Kliniskt prövade behandlingsmetoder för att hjälpa tandvårdsrädda individer att klara tandvårdsbehandling2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Introduktion: Tandvårdsrädsla är ett problem som inte verkar avta trots modernare behandlingsmetoder. Mellan 4-20% av världens befolkning lider av tandvårdsrädsla. Tandvårdsrädslan har en multifaktoriell bakgrund, vanligast anges smärtsamma minnen från barndomen och traumatiska tandvårdsupplevelser senare i livet. Hur de tandvårdsrädda hanterar sin situation beror på ett antal psykosociala faktorer i samverkan. Syfte: Att beskriva vilka kliniskt prövade metoder som finns för att få patienter med tandvårdsrädsla att acceptera och fullfölja tandvårdsbehandling. Frågeställningar: 1) Vilka olika behandlingsmetoder förekommer för att underlätta behandling av tandvårdsrädda patienter inom tandvården? 2) Hur skiljer sig behandlingsmetoderna för tandvårdsrädda barn respektive vuxna? Metod: Systematisk litteraturstudie. Resultat: De granskade artiklarna visar att de flesta barn som fick beteendevetenskaplig terapi klarade att genomgå tandvårdsbehandling. Den vanligaste behandlingsstrategin var "tell-show-do". Även hos vuxna fungerade beteendevetenskapliga metoder bäst. Kognitiv terapi gav bra resultat på sikt. Sedering eller behandling under narkos är vanligt vid tandvårdsrädsla hos barn. Även för vuxna kan sedering användas i exempelvis akuttandvård. Enbart sedering med farmaka ger dock ingen bestående förbättring av tandvårdsrädsla, varken hos barn eller vuxna. Slutsats: De psykologiska metoderna ensamma eller i kombination med sedering ger på sikt den bästa effekten när det gäller att minska tandvårdsrädslan.

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  • 18. Axelsson, P.
    et al.
    Rolandsson, Margot
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Bjerner, B.
    How Swedish dental hygienists apply their training program in the field1993In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 21, no 5, p. 297-302Article in journal (Refereed)
  • 19.
    Axelsson, Per AT
    Karlstad University. Göteborgs universitet.
    Periodontitis Is Preventable2014In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 85, no 10, p. 1303-1307Article in journal (Other academic)
  • 20.
    Berggren, Kristina
    et al.
    Jönkoping, University.
    Brostrom, Anders
    Jönkoping, University;Linköping University Hospital.
    Firestone, Allen
    Ohio State University, USA.
    Wright, Bridget
    Ohio State University, USA.
    Josefsson, Eva
    Jönkoping, University.
    Lindmark, Ulrika
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Jönkoping, University;Ohio State University, USA .
    Oral health problems linked to obstructive sleep apnea are not always recognized within dental care-As described by dental professionals2022In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 1, p. 84-95Article in journal (Refereed)
    Abstract [en]

    Objectives Obstructive sleep apnea (OSA) has an impact on an individual's quality of life and general health, and can also affect their oral health. The patient's experiences, together with intraoral signs and symptoms could indicate the presence of OSA. Knowledge that the patient has, or is at high risk for having OSA can help the dental healthcare provider maintain the oral health and general health for these patients. The purpose was to explore dentists and dental hygienists' experiences when encountering adult patients with potential, untreated and treated OSA. Methods A qualitative inductive approach was used. Experienced dentists and dental hygienists working within Swedish Public Dental Service were strategically selected. Semi-structured face-to-face interviews were performed followed by qualitative content analysis. Results Interviews from 13 participants, seven dental hygienist and six dentists, led to three areas describing varied experience: Importance of the patient encounter and identifying intraoral signs both of which describe experiences related to the importance of the initial unstructured conversation and focused clinical assessments, and strategies for nurturing care which point to interest about care, treatment, and collaborations with medical health care providers. Conclusions Dental professionals are not able to consistently recognize patients who have, or are at high risk for OSA. During the patient encounter, is it important to determine if a patient is at risk for, or has oral signs of OSA.

  • 21.
    Björnson, Emma
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Pettersson, Erica
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Kunskaper och inställning till motiverande samtal hos en grupp tandhygienister: En tvärsnittsstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 22.
    Boman, Linda-Mari
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Karlsson, Minna
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Dental karies, dental fluoros och munvårdsvanor hos barn i Tanzania: Litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: I Tanzania lever mer än var femte innevånare i fattigdom och endast hälften har tillgång till rent vatten. Den orala hälsan tas sällan om hand på rätt sätt och behovet av orala hälsoprogram är stort. Landet har också problem med höga fluorhalter i grundvattnen vilket har förödande konsekvenser för tänderna.  Syfte: Att studera förekomsten av dental karies och dental fluoros samt vilka munvårdsvanor barn 6-18 år har i Tanzania Frågeställningar: Vilken är förekomsten av dental karies bland barn 6-18 år i Tanzania? Vilken är förekomsten av dental fluoros bland barn 6-18 år i Tanzania? Vilka munvårdsvanor har barn 6-18 år i Tanzania? Metod: En litteraturstudie Resultat: Studierna visade att kariesförekomsten i de studerade åldersgrupperna var låg. Vanligast med karies i det permanenta bettet är i djupa fissurer och andra molaren i underkäken. En ökad risk för dental fluoros genom intag av magadi och ökad fluorhalt i dricksvattnet. Dental fluoros ökar risken för ett nedsatt välbefinnande. En studie (2010) visar även på att tandborstningsfrekvensen och användning av tandkräm är mer frekvent än förr (1994, 1998). Besök hos tandläkaren sker inte kontinuerligt. Konklusion: Litteraturstudien visade på ett omfattande behov av munhälsoprogram i Tanzania samt olika åtgärder mot dental fluoros.

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  • 23.
    Borén, Lisa
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Claesson, Ekaterina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Livskvalitet hos personer med kronisk parodontit - litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Gingivit förekommer hos en större del av befolkningen och kronisk parodontit förekommer hos upptill 40 % av alla vuxna i Sverige. Kunskapen om parodontala sjukdomar och vad de kan leda till är begränsad hos den svenska befolkningen. Den parodontala behandlingen delas in i icke-kirurgisk och kirurgisk infektionskontroll. Mätinstrumenten OHIP-14 och -49 är de mätinstrument som används oftast för att mäta livskvalité.

    Syfte: Att beskriva livskvalitén hos individer med kronisk parodontit.

    Frågeställningar: Hur upplever individer med kronisk parodontit sin livskvalité?

    Metod: En litteraturstudie.

    Resultat: I resultatet framkommer det att livskvaliteten hos personer med parodontit påverkas påtagligt. Faktorer som påverkar är bland andra psykologisk och fysiologisk diskomfort/ dysfunktion, tuggfunktionen, dålig andedräkt och att mat fastnar mellan tänderna. Det har även påvisats att icke-kirurgisk parodontal behandling påverkar livskvalitén positivt.

    Konklusion: Livskvalitén hos individer med kronisk parodontit påverkas.

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  • 24.
    Boström, Anita
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Carlson, Christina
    Munhälsa2019In: Hälsan i Värmland: Resultat från undersökningen Liv och Hälsa 2017 / [ed] Laura Kobyletzski, Karlstads universitet och Landstinget i Värmland , 2019Chapter in book (Other academic)
  • 25.
    Boström, Charlotte
    Karlstad University. Karlstad University, Division for Health and Caring Sciences.
    Metoder att behandla vuxnas tandvårdsrädsla: En systematisk litteraturstudie2009Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
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  • 26.
    Bylund, Helena
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Olsson, Paula
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Implementering av Nationella Riktlinjer för vuxentandvård avseende karies och parodontit: En longitudinell interventionsstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: För att tandvården skall kunna styras med systematiska prioriteringar tog Socialstyrelsen fram Nationella Riktlinjer ( NR ) för vuxentandvård som ett stöd. Dessa grundas på tidigare forskning och bygger på evidens.

    Syfte: Syftet var att undersöka i vilken utsträckning tandhygienister kände till och tillämpade socialstyrelsens Nationella Riktlinjer för vuxentandvård avseende preventions- och behandlingsåtgärder för karies och parodontal sjukdom samt periimplantit  före respektive efter en implementeringsintervention.

    Frågeställningar:

    Var har tandhygienisterna funnit information gällande NR?

    Vilka karies-, parodontit-, och periimplantitpreventiva åtgärder enligt NR anser tandhygienisterna är de bäst lämpade för patienter med dessa sjukdomar samt vilken/vilka skillnader föreligger i val av åtgärder efter jämfört med före implementeringen?

    Metod: Trettioåtta tandhygienister fick utbildning med stöd av förändringsagenter samt genomgick ett interventionsprogram avseende NR i fyra steg.

    Resultat: Före implementeringen rekommenderade 52,6 % av tandhygienisterna tandtråd i kombination med fluorpreparat vid tillståndet ”Initial kronkaries” jämfört med 0 % efter. Av deltagarna valde 57,9 % Rökstopp + annan åtgärd före för att efter reduceras ned till 31,6 % , värdena avsedde ”Kronisk parodontit”.

    Konklusion: Implementeringen av NR visade att tandhygienister efter intervention med utbildning och stöd av förändringsagenter använde mer evidensbaserad prevention vid karies, parodontit och periimplantit än tidigare. Uppföljande utvärdering av evidensbaserad prevention inom tandvården rekommenderas, då ett mindre antal icke evidensbaserade preventiva åtgärder kvarstod.

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  • 27. Daarstad, Eva
    et al.
    Johansson, Ann-Christine
    Munvård till äldre: En enkätstudie till vårdpersonal på särskilt boende2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Antalet äldre ökar i Sverige. Åldrandet medför ökad risk att drabbas av sjukdomar vilket kan påverka munhälsan negativt. Äldre med stort vård- och omsorgsbehov flyttar ofta till särskilt boende. Många av dem behöver hjälp med munhygienen. Munvården till äldre i särskilt boende är ofta bristfällig med dålig munhälsa som följd. Syftet var att beskriva vårdpersonalens attityder och beteenden avseende den egna samt de äldres munhälsa och munvård, samt undersöka om munvårdsutbildning kan relateras till munvårdsinsatser på särskilt boende. En tvärsnittsstudie med kvantitativ ansats genomfördes och datainsamlingen gjordes med hjälp av ett frågeformulär. Resultatet visade att de flesta respondenterna ansåg munhälsan som viktig. Majoriteten tyckte att de boende bör få hjälp med munvård två gånger per dag men få hjälpte de äldre med munvård så ofta. Munhygienen ansågs vara den svåraste delen i omvårdnadsarbetet. Flertalet hade fått munvårdsutbildning och få önskade mer kunskaper. Munvården upplevdes fungera bra på avdelningarna och sågs som en del av god omvårdnad. Flera faktorer, som att de äldre gjorde motstånd och tidsbrist, uppgavs som svårigheter. Konklusionen var att attityden till munvård var positiv, men hindrande faktorer som motstånd från de äldre och tidsbrist bidrog till att den prioriterades lågt. Endast en liten del av vårdpersonalen önskade mer munvårdsutbildning.

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  • 28.
    Daarstad, Eva
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Johansson, Ann-Christine
    Karlstad University, Faculty of Social and Life Sciences.
    Munvård till äldre: En enkätstudie till vårdpersonal på särskilt boende2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Antalet äldre ökar i Sverige. Åldrandet medför ökad risk att drabbas av sjukdomar vilket kan påverka munhälsan negativt. Äldre med stort vård- och omsorgsbehov flyttar ofta till särskilt boende. Många av dem behöver hjälp med munhygienen. Munvården till äldre i särskilt boende är ofta bristfällig med dålig munhälsa som följd. Syftet var att beskriva vårdpersonalens attityder och beteenden avseende den egna samt de äldres munhälsa och munvård, samt undersöka om munvårdsutbildning kan relateras till munvårdsinsatser på särskilt boende. En tvärsnittsstudie med kvantitativ ansats genomfördes och datainsamlingen gjordes med hjälp av ett frågeformulär. Resultatet visade att de flesta respondenterna ansåg munhälsan som viktig. Majoriteten tyckte att de boende bör få hjälp med munvård två gånger per dag men få hjälpte de äldre med munvård så ofta. Munhygienen ansågs vara den svåraste delen i omvårdnadsarbetet. Flertalet hade fått munvårdsutbildning och få önskade mer kunskaper. Munvården upplevdes fungera bra på avdelningarna och sågs som en del av god omvårdnad. Flera faktorer, som att de äldre gjorde motstånd och tidsbrist, uppgavs som svårigheter. Konklusionen var att attityden till munvård var positiv, men hindrande faktorer som motstånd från de äldre och tidsbrist bidrog till att den prioriterades lågt. Endast en liten del av vårdpersonalen önskade mer munvårdsutbildning.

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  • 29.
    Edman, K.
    et al.
    Uppsala University ; Center for Public Dental Services, Falun ; .
    Wårdh, Inger
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska institutet.
    Oral health care beliefs among care personnel working with older people: follow-up of oral care education provided by dental hygienists2022In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 20, no 2, p. 241-248Article in journal (Refereed)
    Abstract [en]

    Objectives: The proportion of older people in the population is increasing rapidly. Along with this comes an increase in the number of people requiring assistance in daily living, including oral care. Swedish law stipulates that care personnel who work with older people should be offered oral health education every year. The aim of this study was to investigate oral health care beliefs among such personnel. Methods: A questionnaire study was conducted among 2167 personnel providing care to older people at special accommodation sites and in home care. Data were collected using the Nursing Dental Coping Beliefs Scale. Descriptive statistics were calculated and logistic regression analysis was performed. Results: Personnel working in home care had lower odds of having an internal locus of control than those working in special accommodation, and personnel with less than 10 years of working experience had lower odds than their more experienced counterparts. Men had higher odds of having an external locus of control than women. Conclusions: It seems important to ensure that home care personnel and less experienced personnel attend oral care educational sessions, and to encourage male staff to focus on oral care work.

  • 30.
    Ehrén, Zara
    et al.
    Tandhygienistprogrammet.
    Karlsson, Åsa
    Tandhygienistprogrammet.
    Munhälsopromotion bland barn: Tandhygienisters hälsofrämjande arbete på individnivå2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Tandhygienisten har en stor roll när det gäller att introducera barnet till tandvården och att arbeta med pedagogik och empowerment, en process där patienten lär sig ta större kontroll över beslut och handlingar, som påverkar barnets orala hälsa.

    Syftet var att beskriva hur legitimerade tandhygienister arbetade kliniskt med munhälsopromotion till barn, hur pedagogiska strategier användes och vilka teorier strategierna grundades på.

    Metoden var en kvalitativ intervjustudie, som genomfördes som pilotstudie vilket innebar att studien utfördes i liten skala för att testa en intervjuguide.

    Resultatet visade att tandhygienisten använde ett salutogent perspektiv och tvåvägskommunikation med barnet och föräldern för att kunna få fram viktig information. Motiverande samtal, ”tell-show-do”-metoden och positiv förstärkning var pedagogiska strategier, som respondenterna tog upp.

    Konklusionen är att samtliga respondenter använder pedagogiska strategier, men de visste inte vilken teori som låg till grund för de pedagogiska strategierna. Utifrån svaren konstaterades att den humanistiska traditionen låg till grund för respondenternas arbetssätt. Tandhygienistens kunskap om pedagogiska strategier och teorier är begränsad. Detta indikerar att pedagogik, som ett obligatoriskt ämne i tandhygienistutbildningen, är betydelsefullt.

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  • 31.
    Ek, Maria
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Grederup, Sofie
    Karlstad University, Faculty of Social and Life Sciences.
    Hygienåtgärder för tandimplantat2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Introduktion: Tandimplantat är en allt vanligare ersättning för förlorade eller saknade tänder. Av patienten krävs en god egenvård för att bibehålla frisk vävnad runt implantatet samt stödjande behandling i form av klinisk vård. Bristande rengöring kan resultera i utveckling av mucosit eller peri-implantit.

    Syfte: Att beskriva olika hygienåtgärder och deras effekter i vården av tandimplantat.

    Frågeställningar:

    - Vilka hygienåtgärder finns för tandimplantat i den kliniska vården och vilka effekter har dessa?

    - Vilka hygienåtgärder inom egenvård finns för tandimplantat och vilka effekter har dessa?

    Metod: Systematisk litteraturstudie

    Resultat: Kliniska behandlingsmetoder som visat positiva resultat är ultraljud och air-powder abrasive system. Curetter, Vectorsystemet och laser gav sämre resultat. Tilläggsbehandling med antibiotika har visat varierande resultat beroende på antibiotikatyp och behandlingstid. Eltandborstens rengöringseffekt var bättre än den konventionella tandborstens. Klorhexidin påverkar inte befintligt plack men förhindrar nya bakteriers kolonisation på en ren implantatyta.

    Konklusion: Litteraturstudien kan fungera som en vägledande hjälp vid val av terapimetod för mucosit och peri-implantit inom ramarna för tandhygienistens kompetens.

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  • 32.
    Ericson, Dan
    et al.
    Malmö University, Sweden.
    Carlsson, Peter
    Malmö University, Sweden.
    Gabre, Pia
    The Sahlgrenska Academy of Gothenburg, Sweden.
    Wårdh, Inger
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska institutet, Sweden.
    Zimmerman, Mikael
    Ad Modum AB.
    Sjögren, Petteri
    Oral Care AB.
    Effect of a single application of silver diamine fluoride on root caries after 12 months in institutionalised older adults: A randomised clinical trial2023In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 40, no 3, p. 390-397Article in journal (Refereed)
    Abstract [en]

    Objective: Silver diamine fluoride (SDF) has been shown to be highly effective against caries, in particular for arresting root surface caries and for dentine caries in primary teeth. SDF may complement fluoride varnish routines for treatment of root caries in nursing home residents. The aim of this randomised, single-blinded, placebo-controlled trial was to evaluate the additive effect of a single annual application of SDF for prevention and treatment of incipient root caries in older adult nursing home residents. Method: Four hundred older adult nursing home residents (≥70 years old) with at least one exposed root surface (on teeth 15, 14, 13, 23, 24, or 25) were identified during routine dental examination visits in the domiciliary dental care setting. Eligible patients, who were able to understand the implication of consenting to the study, were invited to participate. Their cleaned root surfaces were randomly allocated to treatment with SDF (Advantage Arrest Silver Diamine Fluoride 38%, Advantage Arrest, LLC, Redmond, OR 97756, USA, Lot 16 152) or with placebo (tap water), each for 1 minute. Results: Of the 400 eligible individuals, 42 declined to participate and two forms were destroyed. The remaining 356 participants (89.0%; mean age 87.7 years) were randomly allocated, with 174 going to the SDF group and 182 to the placebo group. At 1 year, 273 participants (76.7%) were available for assessment: 135 in the SDF group and 138 in the placebo group. By that time, 109 individuals (39.9%) demonstrated root caries progression or regression. Among those 118 (16.7%) of the 708 included root surfaces had developed caries There were no statistically significant differences in the primary outcome related to treatment with SDF or placebo, at either patient or root surface level. Conclusion: Based on the finding of this clinical trial, it is concluded that a single SDF application to complement a risk-based preventive programme including fluoride varnish applications did not have a statistically significant additional preventive effect on root caries development in a group of older adult nursing home residents with limited caries activity and cognitive capacity to cooperate in oral care activities. 

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  • 33.
    Ericson, Dan
    et al.
    Malmö University, Sweden.
    Carlsson, Peter
    Malmö University, Sweden.
    Gabre, Pia
    The Sahlgrenska Academy of Gothenburg, Sweden.
    Wårdh, Inger
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska institutet, Sweden.
    Zimmerman, Mikael
    Ad Modum AB.
    Sjögren, Petteri
    Oral Care AB.
    Response to professor Milgrom2023In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 40, no 3, p. 407-407Article in journal (Refereed)
  • 34.
    Eriksson, Camilla
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Nygren Härdig, Josefine
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Sociala faktorer och barns orala hälsa: En litteraturstudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 35.
    Feki Larsson, Selma
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Forssten, Anna-Ida
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Behandlingsmetoder för att lindra tandvårdsrädsla: En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Tandvårdsrädsla innebär ett psykiskt och fysiskt lidande för individen. Rädslan för tandvården grundas i olika företeelser: tidigare upplevelser från tandvården och påverkan från förälder. Tandvården har en betydande roll till att kunna lindra rädslan.

     

    Syfte: Att kartlägga vilka behandlingsmetoder som beskrivs i litteraturen för att lindra tandvårdsrädsla.

     

    Frågeställningar: Vilka behandlingsmetoder används för att lindra tandvårdsrädsla?

     

    Metod: Litteraturstudie

     

    Resultat: Kognitiv beteendeterapi (KBT) är en lyckad metod för att behandla tandvårdsrädsla då KBT går till botten med vad som ligger bakom rädslan. Många av deltagarnas rädsla för tandvården minskade med KBT. Lokalanestesi var många gånger inte tillräckligt för att lindra smärtan. För många deltagare hjälpte inplanerad behandling med sedering att minska ångesten dagarna före besöket. Att medicineras med Midazolam och Alprazolam visade att deltagarna var mer samarbetsvilliga och kände mindre ångest i tandvårdssituationen. Lavendel och handdockor som komplement i tandvårdsbesöket lindrade inte rädslan till tandvården.

     

    Konklusion: Författarna har tittat på vilka behandlingsmetoder som kan lindra tandvårdsrädsla. Det finns studier som visar att medicinering bidrar till minskad ångest men få studier som visar att medicinering bidar till minskad tandvårdsrädsla. Därför skulle ett förslag till vidare forskning vara om medicinering bidrar till minskad tandvårdsrädsla.

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    Behandlingsmetoder för att lindra tandvårdsrädsla - En litteraturstudie
  • 36.
    Friman, Göran
    Karolinska institutet.
    Medical screening in dental settings2017Doctoral thesis, comprehensive summary (Other academic)
  • 37.
    Friman, Göran
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences. Karolinska institutet.
    Golestani, G
    The Swedish Dental Service Organizations , Stockholm County A.
    Kalkali, A
    The Swedish Dental Service Organizations Västra Götaland.
    Wårdh, Inger
    Karolinska institutet.
    Hultin, M
    Karolinska institutet.
    Patient Experiences of Medical Screening Performed by the Dental Services: A Qualitative Study2013In: Open Journal of Stomatology, ISSN 2160-8709, E-ISSN 2160-8717, no 3, p. 497-503Article in journal (Refereed)
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  • 38.
    Friman, Göran
    et al.
    Karolinska Institutet.
    Hultin, M
    Nilsson, GH
    Wårdh, Inger
    Karolinska institutet.
    Long-term follow-up ofopportunistic medical screening for hypertension and diabetes within dentistry: A descriptive study.Manuscript (preprint) (Other academic)
  • 39.
    Friman, Göran
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska institutet.
    Hultin, Margareta
    Karolinska Institutet.
    Nilsson, Gunnar H.
    Karolinska Institutet.
    Wårdh, Inger
    Karolinska Institutet.
    Medical screening in dental settings: A qualitative study of the views of authorities and organizations Health Services Research2015In: BMC Research Notes, E-ISSN 1756-0500, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    Background: The practice of identifying individuals with undiagnosed diabetes mellitus type II or undiagnosed hypertension by medical screening in dental settings has been received positively by both patients and dentistry professionals. This identification has also shown to be cost-effective by achieving savings and health benefits, but no investigation has been made of the attitudes of authorities and organizations. The aim of this study was to describe the views of authorities and organizations. Results: Thirteen authorities and organizations were interviewed of the sample of 20 requested. Seven approached authorities and organizations did not believe it was relevant to participate in the study. The manifest analysis resulted in four categories: medical screening ought to be established in the society; dentistry must have relevant competence to perform medical screening; medical screening requires cooperation between dentistry and health care; and dentistry is not the only context where medical screening could be performed. The latent analysis resulted in an emerging theme: positive to, but uncertain about, the concept of medical screening in dental settings. The spokespersons for the approached authorities and organizations had a positive view of medical screening but the respondents experienced a lack of facts concerning the scientific communities’ position, guidelines and procedures in the topic. Conclusions and implications: Approached authorities and organizations generally had a positive view of medical screening in dental settings but were uncertain about the concept. Further scientific knowledge and guidelines concerning the topic are needed before it can be commonly introduced and additional research on implementation strategies and long-term follow-up of medical screening are needed.

  • 40.
    Friman, Göran
    et al.
    Karolinska institutet.
    Hultin, Margareta
    Karolinska institutet.
    Nilsson, Gunnar H
    Karolinska institutet.
    Wårdh, Inger
    Karolinska institutet.
    Seven-Year Follow-Up of Screening for Hypertension and Diabetes at a Dental Clinic2019In: Journal of Dentistry and Oral Sciences, ISSN 2582-3736, no 2, p. 1-12Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the distribution of risk, diagnosis and pharmacological treatments for diabetes and hypertension after seven years among patients provided with opportunistic medical screening in a dental setting.Material and Methods: The initial screening’s 170 participants were asked to take part in a seven-year follow-up study. Data were collected through self-reported information in a written health declaration. Outcome measures:• Number of study participants who had passed away• Prescription of antidiabetics or antihypertensives• Changes in weight and height to calculate body mass index (BMI)Results: The follow-up study consisted of 151 participants. Twenty had passed away. The risk needs for medicating with antihypertensive drugs after seven years for those not receiving pharmacological treatment at the initial screening was 3.7 times greater (p=0.025 CI 1.2-11.3) for participants with a diastolic blood pressure (BP) ≥ 90 mm Hg (85 for diabetics) than for the others. The risk was 3.9 times greater (p=0.020 CI 1.2-12.6) for those with a systolic BP of 140-159 mm Hg and 54.2 times greater (p<0.0001 CI 9.8-300.3) for those with a systolic BP ≥ 160 mm Hg than for those with a systolic BP 140 mm Hg. There were no changes in BMI.Conclusion: At least one in ten cases of incorrect medication or undiagnosed hypertension may be identifiable through opportunistic medical screening.

  • 41.
    Friman, Göran
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Samband munhälsa och allmän hälsa2019In: Hälsan i Värmland: Resultat från undersökningen Liv och Hälsa 2017 / [ed] Laura Kobyletzki, Karlstads universitet och Landstinget i Värmland , 2019Chapter in book (Other academic)
  • 42.
    Friman, Göran
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Wårdh, Inger
    Karolinska Institutet.
    Nilsson, Gunnar
    Karolinska Institutet.
    Hultin, Margareta
    Karolinska Institutet.
    Identifying patients in dental settings at risk of cardiovascular disease and diabetes2013In: Cardiovascular system, ISSN 2052-4358, Vol. 1, no 5Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of our study was to identify patients in a dental setting at risk of already having or developing high blood pressure or high plasma glucose, investigate possible associations between these conditions and periodontal status and explore the correlation between screening results and follow-up assessments concerning the need for medical treatment and/or lifestyle changes performed by medical staff.

    Methods: A total of 170 dental patients were consecutively included at their regular yearly check-up visit. Data on age, weight, height, amount and use of tobacco and medication for cardiovascular disease and diabetes mellitus were collected, as well as data about systolic and diastolic blood pressure, in addition to pulse and plasma glucose. Clinical and radiographic examinations revealed data about periodontal status by probing periodontal pockets and measuring marginal alveolar bone loss by means of x-rays. Patients who exceeded normal diastolic blood pressure and plasma glucose values were referred for diagnosis and care.

    Results: Thirty-nine patients exhibiting high values were provided referrals and 24 or 14.1% of the 170 participants required additional care. The correlation between oral and medical health care concerning blood pressure recorded was 64.5% (p<0.001), while the correlation was 40.0% (p<0.001) concerning plasma glucose. Among middle aged men and elderly subjects, the data revealed/showed a significant correlation between marginal alveolar bone loss and high systolic blood pressure (p=0.001).

    Conclusions: The correlation between oral health care and medical health care registrations based on blood pressure and plasma glucose indicates that it may be appropriate for dental professionals to perform opportunistic medical screening and refer risk patients to the medical care system before complications occur. In order to identify medical risk patients in dental settings on the basis of high blood pressure, a suggestion may be to examine middle-aged men and elderly patients of both sexes who exhibit radiographic markers for marginal alveolar bone loss.

  • 43.
    Fägerstad, Anida
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Lundgren, Jesper
    University of Gothenburg.
    Arnrup, Kristina
    Örebro universitet.
    Dental fear among children and adolescents in a multicultural population: a cross-sectional study2015In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, p. 109-120Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore dental fear in a multicultural population of child and adolescent dental patients, with background, gender, age, and socioeconomic status taken into account. A specific aim was to investigate whether the level of DF differed between patients with a non- Swedish background and patients with a Swedish background.

    In conjunction with a routine visit to the dental clinic, 301 patients (8-19 years old) assessed their dental fear on the Children's Fear Survey Schedule - Dental Subscale, using self-ratings. Following an interview protocol, patients' and their parents' country of birth, and parents' education and occupation/employment were registered. An interpreter was present when needed.

    Self-rated dental fear was almost equal among patients coming from a non-Swedish background and patients with a Swedish background. Girls scored higher than boys and younger children scored slightly higher compared to older children, but the pattern of dental fear variation was inconsistent. Socioeconomic status differed between the groups with a non- Swedish vs. a Swedish background, but no impact on dental fear was revealed. When children and adolescents with a non-Swedish vs. a Swedish background were modelled separately, female gender and younger age had an impact on dental fear only in the group with a Swedish background.

    No differences in dental fear were found between children and adolescents from non-Swedish vs. Swedish backgrounds. Dental fear variations according to gender and age were more pronounced in the group with a Swedish background compared to the group with a non-Swedish background. No impact of socioeconomic status could be revealed.

  • 44.
    Fägerstad, Anida
    et al.
    Örebro universitet.
    Lundgren, Jesper
    University of Gothenburg.
    Arnrup, Kristina
    Örebro universitet.
    Carlsson, Eva
    Örebro universitet.
    Barriers and facilitators for adolescent girls to take on adult responsibility for dental care: a qualitative study2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1, article id 1678971Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aims to explore and describe experiences of the dental care system among adolescent dental patients with a recent history of missed dental appointments at public dental clinics (PDCs) in a Swedish county.

    Methods: Twelve adolescent girls participated in the study. Data were collected by individual, semi-structured, open-ended interviews and analysed with qualitative content analysis.

    Results: The study findings could be summed into the theme ?Triggers for adolescent girls to take on or not take on adult responsibility for dental care?. The experience of free dental care could be summarized in five main categories: Pain and discomfort; Attractive and healthy teeth; Feeling safe and secure; Taking on the responsibility; and Free of charge. These five categories consisted of 15 subcategories.

    Conclusions: The results of this study should increase the knowledge on how to meet and treat adolescent girls in dental care. Knowing what will happen during the dental visit was highlighted by the participants as decisive to whether or not they would attend their dental appointments. Therefore, we should as far as possible ensure that our patients feel safe at their dental visits and by trying to avoid painful treatments.

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  • 45.
    Fägerstad, Anida
    et al.
    Örebro universitet.
    Lundgren, Jesper
    University of Gothenburg.
    Windahl, Jenny
    Örebro universitet.
    Arnrup, Kristina
    Örebro universitet.
    Dental avoidance among adolescents: a retrospective case–control study based on dental records in the public dental service in a Swedish county2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to investigate the occurrence of missed dental appointments among 16–19-year-old adolescents in a Swedish county. A second aim was to explore associations between background and concomitant factors and missed appointments and to investigate if these associations differed between areas with different sociodemographic profiles.

    Materials and methods: A list of booked, and missed, appointments for 10,158 individuals during 2012 was used for assessments. Based on the total sample, 522 cases with, and 522 matched controls without, dental avoidance behavior in 2012 were identified. Data on previous missed and cancelled appointments, oral health status, dental treatment, fear or behavior problems, and medical, and, where available, psychosocial or lifestyle factors were extracted from the dental records using a preset protocol covering the period 2009–2012.

    Results: In 2012, 13.1% of 23,522 booked appointments were missed, with a higher proportion of missed appointments among boys than girls. Cases with avoidance behavior more often had a record of sociodemographic load and dental fear or behavior management problems. They also had more oral health problems, more invasive dental treatments, and, in the past, more missed and canceled appointments.

    Conclusion: To enable good oral health and continued regular dental care, we need to pay more attention to adolescents’ individual situation and be observant of early signs of avoidance.

  • 46.
    Fägerstad, Anida
    et al.
    Örebro universitet.
    Windahl, Jenny
    Örebro universitet.
    Arnrup, Kristina
    Örebro universitet.
    Understanding avoidance and non-attendance among adolescents in dental care: an integrative review2016In: Community Dental Health, ISSN 0265-539X, Vol. 33, no 3, p. 195-207Article in journal (Refereed)
    Abstract [en]

    Objective: To review articles exploring manifestations of avoidance of or non-attendance to dental care, to identify background and concomitant factors specifically associated with dental avoidance among adolescents.

    Methods: PubMed, CINAHL and PsychINFO were searched using MeSH terms and keywords covering dental avoidance, non-attendance and non-utilization. Searches were limited to peer-reviewed studies in English, published in 1994– 2014. Twenty-one research articles were included. Data were extracted, ordered, coded, categorized, and summarized according to the integrative review method.

    Results: The identified factors formed three common major themes: Environmental, Individual and Situational factors. Only seven studies, all from Sweden or Norway, investigated factors associated with dental avoidance. The remaining 14 studies were geographically widespread. Regarding avoidance, the main focus was found to be on individual and situational factors, while environmental factors were more often investigated for the outcome non-attendance.

    Conclusions: Although a wide variety of environmental, individual and situational factors could be summarized in this review, factors specifically associated with dental avoidance in a context of free dental care still need to be investigated. The possible impacts of cultural background, of tobacco, alcohol or drug use and of psycho-social circumstances deserve further research. Clinical implications of today’s knowledge may be to pay attention to the adolescents’ individual background and everyday life situation, to offer agreed and individualized treatment, taking fears and attitudes into consideration, to avoid painful treatments, and to be alert for early signs of avoidance.

  • 47.
    Fälth Källehult, Ida
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Kariesprevalens hos barn med övervikt och fetma: En litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Övervikt och fetma är ett ökande hälsoproblem i världen. Karies är en väl utbredd sjukdom globalt. Både karies, övervikt och fetma är multifaktoriella sjukdomar som har kostvanor och socioekonomi som gemensamma riskfaktorer. Världshälsoorganisationen (WHO) har därför tagit fram strategier i försök att förebygga och kontrollera karies och viktökning bland barn. Syfte: Att beskriva kariesprevalensen hos barn i åldrarna 2-12 år med övervikt och fetma. Frågeställningar: Vilken är kariesprevalensen hos barn med övervikt och fetma jämfört med normalviktiga? Metod: Litteraturstudien bygger på insamlad data från vetenskaplig litteratur publicerad 2007- 2014. Resultat: Nio av 16 studier visade att barn med övervikt och fetma hade högre kariesprevalens än normalviktiga barn, medan sju artiklar inte kunde påvisa någon statistiskt signifikant association. Några studier visade att socioekonomiska faktorer och fermenterbara kolhydrater var signifikant associerat till ökad kariesprevalens. En artikel visade att konsumtion av fettrik mat var vanligt förekommande bland barn med övervikt eller fetma. Konklusion: Trots att flera av studierna visade en association mellan karies, övervikt och fetma är slutsatsen av denna litteraturstudiestudie att det föreligger en tvetydig association mellan karies, övervikt och fetma bland barn. Några studier som visade en association antydde att sockerkonsumtion var en gemensam riskfaktor. Studier som inte visade någon association hänvisade till att karies, övervikt och fetma inte hade identisk etiologi. Vidare forskning behövs som inkluderar korrelerande faktorer till både karies samt övervikt och fetma för att studera området närmare.

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  • 48.
    Gohari, Homayon
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Haddad, Kamran
    Karlstad University, Faculty of Social and Life Sciences.
    Oral hälsa hos vuxna diabetiker2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes är en kronisk sjukdom och mer än 150 miljoner i världen har sjukdomen. Diabetessjukdomen försämrar både den allmänna och den orala hälsan. Diabetikernas kunskaper om sjukdomens negativa effekter på munhälsan är bristfällig. Syfte: var att beskriva hur vuxna individers orala hälsa påverkas av diabetes och vad tandhygienister ska beakta vid en tandvårdsbehandling. Frågeställningar: Vilka är de orala komplikationerna hos vuxna individer med diabetes? Kan parodontitbehandling hos diabetiker ha positiva effekter på diabetessjukdomen? Vad bör tandhygienister särskilt ta hänsyn till vid behandling av diabetiker? Metod: Studien har genomförts som en systematisk litteraturstudie. Resultat: Parodontala sjukdomar är den dominerande orala komplikationen hos diabetiker. Diabetiker som är rökare har svårare parodontala sjukdomar än de som inte röker. Liksom parodontit förekommer karies hos diabetiker men är inte lika omfattande studerad som de parodontala sjukdomarna. Diabetiker med bättre metabolismkontroll har bättre oral hälsa. Många diabetiker har dåliga kunskaper om att diabetessjukdomen kan ha negativ effekt på deras orala hälsa. Konklusion: Diabetiker har behov av både parodontala behandlingar och hälsofrämjande och förebyggande insatser. Ett samarbete mellan tandvård och sjukvård är nödvändig.

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  • 49.
    Gohari, Homayon
    et al.
    Karlstad University.
    Haddad, Kamran
    Oral hälsa hos vuxna diabetiker2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes är en kronisk sjukdom och mer än 150 miljoner i världen har sjukdomen. Diabetessjukdomen försämrar både den allmänna och den orala hälsan. Diabetikernas kunskaper om sjukdomens negativa effekter på munhälsan är bristfällig. Syfte: var att beskriva hur vuxna individers orala hälsa påverkas av diabetes och vad tandhygienister ska beakta vid en tandvårdsbehandling. Frågeställningar: Vilka är de orala komplikationerna hos vuxna individer med diabetes? Kan parodontitbehandling hos diabetiker ha positiva effekter på diabetessjukdomen? Vad bör tandhygienister särskilt ta hänsyn till vid behandling av diabetiker? Metod: Studien har genomförts som en systematisk litteraturstudie. Resultat: Parodontala sjukdomar är den dominerande orala komplikationen hos diabetiker. Diabetiker som är rökare har svårare parodontala sjukdomar än de som inte röker. Liksom parodontit förekommer karies hos diabetiker men är inte lika omfattande studerad som de parodontala sjukdomarna. Diabetiker med bättre metabolismkontroll har bättre oral hälsa. Många diabetiker har dåliga kunskaper om att diabetessjukdomen kan ha negativ effekt på deras orala hälsa. Konklusion: Diabetiker har behov av både parodontala behandlingar och hälsofrämjande och förebyggande insatser. Ett samarbete mellan tandvård och sjukvård är nödvändig.   

  • 50.
    Grönvalls, Cecilia
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Anna, Linder
    Karlstad University, Faculty of Social and Life Sciences.
    Oral hälsa hos vuxna och äldre med hyposalivation: En systematisk litteraturstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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