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  • 1.
    Hellovist, Lena
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Cariol, Gothenburg, Sweden..
    Rolandsson, Margot
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hugoson, Anders
    Högskolan i Jönköping.
    Lingstrom, Peter
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Cariol, Gothenburg, Sweden..
    Birkhed, Dowen
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Cariol, Gothenburg, Sweden..
    Dental caries and associated factors in a group of Swedish snus users2015In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 1, 47-54 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n=102), all habitual snus users for >= 10 years. The control group (n=101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for >= 10 years. A clinical and radiographic examination and a questionnaire were completed.The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p=0.005). There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p=0.000). Furthermore, snus users had a mean gingival index (+/- SD) for the whole dentition of 20.4 +/- 18.2, while the index for non-users was14.4 +/- 13.9 (p=0.009); the corresponding values for teeth 13-23 were 14.9 +/- 20.6 and 7.7 +/- 11.9 respectively (p=0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different cariesassociated factors.

  • 2.
    Hellqvist, Lena
    Göteborgs universitet, Institutionen för odontologi.
    Smoking, snuffing and oral health with special reference to dental caries2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background and aims: This thesis describes oral health and the use of tobacco with the emphasis on dental caries and Swedish snuff (snus). There appears to be a general opinion in Sweden that snus protects against caries, but there are no scientific studies that support these speculations. More research is therefore needed and the aims of the present investigations were accordingly: 1) to describe the use of tobacco and changes over time (1983-2003) in randomly selected individuals between 15 and 70 years of age, in relation to socioeconomic conditions and dental care habits, 2) to study the relationship between various intraoral caries-associated variables and the effect of smoking and of using snus on dental caries, 3) to study caries-related factors and the pH fall in dental plaque in a group of Swedish snus users and 4) to investigate pH changes in plaque in vivo when using different snus products, both with and without nicotine, and to analyse their carbohydrate content. Methods: Three previous epidemiological cross-sectional studies carried out in 1983, 1993 and 2003 were the platform for Studies I & II (n=2015 and 1591 respectively). The participants were between 15 and 70 years of age. Study III was a clinical study with middle-aged adults (26-62 years old), who had been using snus for ≥10 years (n=102) and a control group (n=101) consisting of non-tobacco users. Study IV, in which plaque pH was measured in situ, comprised 10 snus users. Results: Study I showed that there was a statistically significant reduction from 34% tobacco users in 1983 to 28% in 2003. The decrease was most obvious among smokers, while the number of snus users increased somewhat. More tobacco users than non-users did not visit a dentist regularly. In 1983 and 1993 (Study II), there were no significant differences in mean DFS between smokers and non-users, but there was a statistically significantly higher mean DFS in comparison with snus users. Study III, which was carried out in 2009-2011, showed that the salivary secretion rate was higher (p<0.001) in snus users than in non-users (2.50 vs. 2.16 ml/min). Regarding gingival inflammation, non-users showed a mean of 14.4 ± 13.9 and snus users 20.4 ± 18.2 (p<0.009). No statistically significant differences between these two groups were found regarding plaque index, primary and secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci and lactobacilli. The pH fall after a sucrose rinse was more pronounced among the controls than in the snus users (NS). Snus users had fewer snacks between meals compared with non-users (p<0.001). The intraoral pH measurements in Study IV showed that all four nicotine-containing products increased the plaque pH, in contrast to three of the six nicotine-free products, which lowered the pH. The carbohydrate analyses showed only traces of glucose, fructose and sucrose (0.5-1%) and starch (≈1.5%) in the various nicotine-containing snus products. Some of the nicotine-free products, on the other hand, contained up to 6.5% low-molecular-weight carbohydrates and 26.0% starch. Conclusions: 1) During the 20-year period (1983-2003), there was a reduction in the number of smokers and an increase in the number of snus users. Tobacco users had less frequent dental visits and poorer oral hygiene habits than non-tobacco users. 2) The results of the cross-sectional epidemiological studies, performed in 1993 and 2003, indicate that daily smoking and the use of Swedish snus do not appear to increase the risk of dental caries. 3) The clinical study carried out in 2009-2011 showed only minor or no differences in caries and related factors between daily snus users and non-users. 4) All the tested nicotine-containing snus products increased the plaque pH, in contrast to three of the six nicotine-free products, which lowered the pH.

  • 3.
    Hellqvist, Lena
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Boström, Anita
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Lingström, Peter
    Odontologi, avd för Cariologi, Sahlgrenska akademin, Göteborgs universitet.
    Hugoson, Anders
    Rolandsson, Margot
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Birkhed, Dowen
    Odontologi, avd för Cariologi, Sahlgrenska akademin, Göteborgs universitet.
    Effect of nicotine-free and nicotine-containing snus on plaque pH in vivo2012In: Swedish Dental Journal, ISSN 0347-9994, Vol. 36, no 4, 187-194 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate pH changes in plaque in vivo during the use of nicotine-free and nicotine-containing snus. The carbohydrate content of the products was also analysed. Ten subjects, all regular snus users, participated in an experimental cross-over study, on eleven occasions with an interval of one week. Six nicotine-free and four nicotine-containing products, which are sold on the Swedish market, were included and a sucrose solution was used as a control. The subjects did not brush their teeth for three days before coming to the laboratory, without eating, drinking or using snus/smoking for two hours prior to the test. pH was measured at three approximal sites up to 45 min with the test product placed under the upper lip. The carbohydrate analysis showed that the nicotine-containing products contained only traces of glucose, fructose and sucrose (0.5-1%) and starch (approximate to 1.5%). Some of the nicotine-free products contained up to 6.5% low-molecular-weight carbohydrates and 26.0% starch. The intraoral pH measurements showed that four nicotine-containing products increased the plaque pH, in contrast to three of the six nicotine-free products, which lowered the pH. These pH changes may have an effect on the caries risk, both positively and negatively, depending on which product is used.

  • 4.
    Hellqvist, Lena
    et al.
    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
    Odontologi, avd för Cariologi, Sahlgrenska akademin, Göteborgs universitet.
    Hugoson, Anders
    School of Health Sciences, Jönköping.
    Tobacco use in relation tosocioeconomic factors anddental care habits amongSwedish individuals 15–70 yearsof age, 1983–20032009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 1, 62-70 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe the use of tobacco and changes in its use over time among individuals living in Jo¨nko¨ping, Sweden, and to analyse tobacco habits in relation to socioeconomic conditions, personality aspects and dental care habits. Methods: This study comprised three epidemiological cross-sectional studies, involving a random selection of individuals aged between 15 and 70 years, and was conducted in 1983, 1993 and 2003. The participants were asked to complete a questionnaire. Results: The results revealed a statistically significant reduction from 34% tobacco users in 1983 to 27% in 1993 and 28% in 2003. The main decrease was seen among smokers. At the same time, the number of users of snuff increased in all the age groups between 20 and 60 years of age. The use of tobacco was therefore largely unchanged in 1993 and 2003. In 2003, there was a statistically significant difference between users and nontobacco users when it came to the frequency of dental visits; more tobacco users than non-tobacco users did not visit a dentist at all or did not visit a dentist regularly. In 1993, nontobacco users brushed their teeth more frequently than tobacco users and this difference was statistically significant. Conclusions: During the 20-year study, there was a reduction in the number of smokers and an increase in the number of snuff users. There was a difference between tobacco users and non-tobacco users when it came to the frequency of dental visits and oral hygiene habits.

     

     

  • 5.
    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, 289-296 p.Article 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.

  • 6.
    Rolandsson, Margot
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hellqvist, Lena
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Birkhed, D
    Hugoson, A
    Tobacco use in relation to socioeconomic factors and dental care habits among Swedish individuals 15-70 years of age, 1983-20032009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 1, 62-70 p.Article in journal (Refereed)
    Abstract

    Abstract: Objectives: The aim of this study was to describe

    the use of tobacco and changes in its use over time among

    individuals living in Jo¨nko¨ping, Sweden, and to analyse

    tobacco habits in relation to socioeconomic conditions,

    personality aspects and dental care habits. Methods: This

    study comprised three epidemiological cross-sectional

    studies, involving a random selection of individuals aged

    between 15 and 70 years, and was conducted in 1983, 1993

    and 2003. The participants were asked to complete a

    questionnaire. Results: The results revealed a statistically

    significant reduction from 34% tobacco users in 1983 to 27%

    in 1993 and 28% in 2003. The main decrease was seen

    among smokers. At the same time, the number of users of

    snuff increased in all the age groups between 20 and

    60 years of age. The use of tobacco was therefore largely

    unchanged in 1993 and 2003. In 2003, there was a

    statistically significant difference between users and nontobacco

    users when it came to the frequency of dental visits;

    more tobacco users than non-tobacco users did not visit a

    dentist at all or did not visit a dentist regularly. In 1993, nontobacco

    users brushed their teeth more frequently than

    tobacco users and this difference was statistically

    significant. Conclusions: During the 20-year study, there was

    a reduction in the number of smokers and an increase in the

    number of snuff users. There was a difference between

    tobacco users and non-tobacco users when it came to the

    frequency of dental visits and oral hygiene habits

1 - 6 of 6
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