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  • 1.
    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.

  • 2.
    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.

  • 3.
    Hugoson, Anders
    et al.
    Center for Oral Health, School of Health Sciences, University of Jönköping Read More: http://informahealthcare.com/doi/abs/10.3109/00016357.2011.654247.
    Hellqvist, Lena
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Rolandsson, Margot
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Birkhed, Dowen
    Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg.
    Dental caries in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983–2003)2012In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, no 4, p. 289-296Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this study was to evaluate some intra-oral caries-associated variables and tobacco use on dental caries. Materials and methods. The participants were randomly recruited from three cross-sectional studies in Jönköping, Sweden, in 1983, 1993 and 2003. Each study consisted of 130 individuals in each of the 20, 30, 40, 50, 60 and 70-year age groups. Of these, 550, 552 and 523 dentate individuals attended respective year of examination. They were all examined both clinically and radiographically. A questionnaire was completed in conjunction with the examination. In the studies, 345 were smokers, 104 snus users and 1142 non-tobacco users, in total 1591 individuals. Results. In 1983 and 1993, there were no significant differences in mean DFS between non-users and smokers, but a statistically significantly higher mean DFS in comparison with snus users. In 2003, there was no statistically significant difference in mean DFS between the groups. Multiple regressions showed that, after adjusting for age, gender and socio-demographic variables, there was a statistically significant association between DFS and smoking in 1983 (smoking excluded in favour of lactobacilli when further analysed) and DFS and plaqueindex (PLI) in 1993. In 2003, there was no association, apart from buffer capacity (Power rising) between DFS and the examined intra-oral caries-associated variables and tobacco use. Conclusions. The results of these epidemiological studies, performed in 1993 and 2003, indicate that daily smoking or snus use does not increase the risk of dental caries.

  • 4.
    Höglund, Markus
    et al.
    Centre for Orofacial Medicine, Public Dental Service Östergötland, Linköping; Karolinska Institutet.
    Wårdh, Inger
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska Institutet.
    Shahnavaz, Shervin
    Karolinska Institutet; Region Stockholm.
    Berterö, Carina
    Linköping University.
    Dental clinicians recognizing signs of dental anxiety: a grounded theory study2023In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 5, p. 340-348Article in journal (Refereed)
    Abstract [en]

    Introduction and Objective

    There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.

    Materials and Methods

    Eleven semi-structured interviews were conducted with dental clinicians from the public dental service of ostergotland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis.

    Results

    The core category was identified as; 'the clinical eye', clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: Sympathetic activation, Patient-reported anxiety, Controlling behaviours, Avoidance and Accomplishment. Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patient's normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor.

    Conclusions

    Clinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor.

  • 5.
    Lindmark, Ulrika
    et al.
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Hakeberg, Magnus
    Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg.
    Hugoson, Anders
    Högskolan i Jönköping, HHJ. Oral hälsa.
    Sense of coherence and oral health status in an adult Swedish population2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, p. 12-20Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate sense of coherence in relation to oral health status in an adult Swedish population in order to better understand the determinants of positive oral health-promoting behavior and differences in oral health.

    Material and methods. A stratified random sample of 910 individuals from Jönköping, Sweden aged 20, 30, 40, 50, 60, 70 and 80 years was obtained. The investigation used the Swedish short version of the Sense of Coherence (SOC) questionnaire comprising 13 items and a self-report questionnaire to elicit demographic information. In addition, a clinical and radiographic oral examination was performed.

    Results. A total of 525 individuals, 261 men and 264 women, consented to participate in the study. Bivariate analysis revealed that higher mean SOC scores were statistically significantly associated with more decayed and filled surfaces (DFS) and filled surfaces (FS), fewer decayed surfaces (DS), fewer teeth with calculus and periodontal health. Multivariate analysis showed that higher SOC scores represented a predictor of fewer occurrences of a periodontal probing pocket depth of ‡4 mm and a lower risk of plaque in different regression models.

    Conclusions. Higher SOC scores may be a protective determinant of plaque and periodontal disease, indicating an association between SOC and oral health.

  • 6.
    Rolander, Bo
    et al.
    Högskolan i Jönköping.
    Lindmark, Ulrika
    Högskolan i Jönköping.
    Johnston, Venerina
    The University of Queensland, Australia.
    Wagman, Petra
    Högskolan i Jönköping.
    Wåhlin, Charlotte
    Linköpings universitet.
    Organizational types in relation to exposure at work and sickness: a repeated cross-sectional study within public dentistry2020In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 78, no 2, p. 132-140Article in journal (Refereed)
    Abstract [en]

    Objective: Organizations and state agencies that provide dental care continuously face various and novel demands related to the need for dental care. However, rearrangements of work tasks by reducing the number of tasks performed by dental personnel might make the work more monotonous, repetitive, and static within an organization. The aim of this study is to compare how two dental work organizations, with different staffing and clinic size, are perceived by dental personnel focusing on physical and psychosocial conditions, leadership, work ability and presenteeism in 2012 and 2014.

    Material and Methods: This repeated cross-sectional study included personnel from the Public Dental Service in Sweden. There were 282 dentists, dental hygienists, and dental nurses who answered a questionnaire 2012 and 299 in 2014.

    Results and conclusion: In 2012, nine per cent of medium clinics reported poor leadership compared with 27% in 2014. For large clinics, 17% perceived poor leadership in 2012 compared with 31% in 2014. A higher proportion of the employees reported presenteeism due to high physical load (43%) and high psychosocial load (21%) in 2014 compared with 31% and 13% in 2012. These results indicate the need for work place interventions promoting health among dental employees.

  • 7.
    Rolander, Bo
    et al.
    Högskolan i Jönköping, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd).
    Wåhlin, Charlotte
    Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden.
    Johnston, Venerina
    Intervention and Implementation Research Unit, Karolinska Institutet, Stockholm, Sweden.
    Wagman, Petra
    Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Lindmark, Ulrika
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Changes in division of labour and tasks within public dentistry: relationship to employees work demands, health and work ability2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 6, p. 471-479Article in journal (Refereed)
    Abstract [en]

    Objective: By 2023, fewer dentists are expected in Sweden, at the same time as the demand for dental care is expected to increase. Older people, in particular, are expected to require more dental health than previous generations. To meet this demand, the public sector dentistry in Sweden is moving towards changes in division of labour among dental professionals, including dentists, dental hygienists and dental nurses. However, the impact of this reallocation on the physical and psychosocial wellbeing of employees is unknown. The aim of this study was to compare workplaces with an equal or larger proportion of dental hygienists than dentists (HDH) with workplaces with a larger proportion of dentists than dental hygienists (HD) on the physical and psychosocial work load, musculoskeletal and psychosomatic disorders and sickness presence.

    Material: A total of 298 persons employed in the Public Dental Service in a Swedish County Council participated in this study.

    Conclusion: The medium large clinics HDH reported 85% of employee’s with considerably more high psychosocial demands compared to employees in medium HD (53%) and large HD (57%). Employees in medium large clinics HDH also reported sleep problems due to work (25%) compared with employees in medium large clinics HD (6%), large clinics HD (11%) and small clinics HDH (3%). Clinic size does not seem to influence the outcome of the HD and HD clinics to any great extent. Of all employees, about 94–100% reported high precision demands and 78–91% poor work postures.

  • 8.
    Wårdh, Inger
    et al.
    Göteborg University.
    Berggren, Ulf
    Andersson, Lars
    Sörensen, Stefan
    Assessments of oral health care in dependent older persons in nursing facilities.2002In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 60, no 6, p. 330-6Article in journal (Refereed)
  • 9.
    Östberg, Anna-Lena
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Adolescents' views of oral health education: A qualitative study2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 2, p. 300-307Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate adolescents perceptions and desires with respect to oral health education. Aseries of focus group sessions was conducted with adolescents in schools. The groups comprised an average of 6 individuals,with a total of 34 participants. The main themes of the discussions were the informants perceptions of the oral healtheducation in different settings and under varying circumstances. The discussions were transcribed verbatim and analyzedaccording to the basic principles of Grounded Theory. One of the most important issues appeared to be the dental personnelconsidering the individual as a subject and not as an object. The adolescents in the study were uncertain about their knowledgeof oral health. Often, the participants expressed a wish to be taught more at the dental visit. Information in schools was sparse.The support of parents was acknowledged but little discussed. The methods used in advertisements to describe dentalproducts were met with skepticism. These should not be imitated in oral health education as this might undermine thecredibility of the dental services. Girls were perceived to be more interested in health than boys were. Two core categorieslabeled credibility and confidence, which interacted continually, emerged from the data in the analysis. The resultsindicate that the credibility of the intermediary of the health messages is essential, as is their ability to create confidence. Thus,oral health education among adolescents is more likely to be successful when credibility and confidence are perceived

  • 10.
    Östberg, Anna-Lena
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, P
    Hakeberg, M
    Oral impacts on daily performances: associations with self-reported health and medication2009In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 67, no 6, p. 370-376Article in journal (Refereed)
  • 11.
    Östberg, Anna-Lena
    et al.
    Högskolan i Skövde.
    Eriksson, B
    Högskolan i Skövde.
    Lindblad, U
    Högskolan i Skövde.
    Halling, A
    Malmö Högskola.
    Epidemiological dental indices and self-perceived oral health in adolescents: ecological aspects2003In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 61, no 1, p. 19-24Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the correlations between epidemiological indices (objective) and self-perceived oral health (subjective) in adolescents at the school level, and to study gender differences in epidemiological indices and in self-perceived oral health.The study comprised two sets of data from Skaraborg County, Sweden; 1. Self-reported questionnaires were answered by adolescents at all senior level schools (n=9 559, 1315 years). 2. Epidemiological indices based on clinical registrations of oral health in 13-15-year-old adolescents were collected in all 17 municipalities (n= 7 899). Simple and partial Pearson correlation coefficients were used to study correlations between subjective and objective oral health in the adolescents at the school level. Gender differences in adolescents subjective and objective oral health were estimated using a logistic regression model. The correlations between epidemiological index registrations and self-perceived oral health were weak. The strongest correlations were found between epidemiological indices and self-perceived gingival bleeding: 0.416 between the DS (decayed surfaces) index and self-perceived bleeding. Girls more seldom than boys were satisfied with the appearance of their teeth; in municipalities with clinical good oral health OR 0.76 (95% CI 0.59-0.98) and with poor clinical oral health OR 0.74 (CI 0.57-0.94). No gender differences were found in the epidemiological index registrations. The currently used epidemiological indices did not reflect adolescents own perceptions of their oral health at the school level and they could not recognize or identify gender differences. Surveillance of oral health in young people should include information on self-perceived oral health.

  • 12.
    Östberg, Anna-Lena
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Halling, A
    Lindblad, U
    Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents1999In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 57, no 4, p. 231-236Article in journal (Refereed)
    Abstract [en]

    A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior, and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR)= 5.8[3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR=1.7[1.4-2.1) and the older (OR=2.4[1.9-3.1]) adolescents. Conclusion: Most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys

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