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Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013): II. Review of clinical and radiographic findings
The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden;Malmö University, Faculty of Odontology, Malmö, Sweden. (Jönköpingsstudien 2013)
The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden. (Jönköpingsstudien 2013)
The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden. (Jönköpingsstudien 2013)
The Institute for Postgraduate Dental Education, Region Jönköping County, Jönköping, Sweden. (Jönköpingsstudien 2013)
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2015 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 39, no 2, 69-86 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973–2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80 years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden.

The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.

The frequency of edentulous individuals aged 40–70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30–80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003.

The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10–20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5–60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40- year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 40 and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.

In age groups 10–30-year-olds a major reduction from about 30% to 15% in mean plaque score was seen between 1973–2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003–2013. The percentage of tooth sites with gingivitis was for 20 years and older about 40% in 1973. In 2013, the percentage was about 15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years, 1973–1993.

The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003–2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.

The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.

Abstract [sv]

Syftet med denna epidemiologiska studie utförd 2013 var att analysera kliniska och röntgenologiska data om oral hälsa och jämföra resultaten med fyra tvärsnittsstudier utförda 1973 till 2003. Ettusen, 1104, 1078, 987 och 1010 slumpvis utvalda individer undersöktes under respektive år1973, 1983, 1993, 2003 och 2013. Individerna var jämnt fördelade i åldersgrupperna 3, 5, 10, 15, 20, 30, 40, 50, 70 och 80 år. 1973 var inga 80-åringar med. Alla studiedeltagare bodde i Jönköpings stad.

Vid den kliniska och röntgenologiska undersökningen registrerades tandlöshet, avtagbar protetik, dentala implantat, antal tänder, karies, fyllningar, munhygien, tandsten, parodontalt status, utförd endodontisk behandling och apikalstatus.

Frekvensen av tandlösa individer 40-70 år var 16 %, 12 %, 8 %, 1 % och 0,3 % under respektive år 1973, 1983, 1993, 2003 och 2013. Det fanns inga helt tandlösa protesbärare yngre än 80 år 2013.

Under hela 40-årsperioden från 1973 ökade antalet tänder i åldersgrupperna 30-80 år. 2013 hade 60-åringar nästan kompletta dentitioner. Implantat fanns i alla åldersgrupper från 30 år och uppåt. Trettiosex individer hade implantat 2013. Detta var signifikant fler än vid de tidigare undersökningarna med fyra 1993 och arton 2003.

Antalet karies- och fyllningsfria barn och vuxna ökade under hela 40-årsperioden. Kariesfria 3- och 5-åringar ökade till 79 % respektive 69 % 2013. I åldersgruppen 10-20 år ökade antalet kariesfria individer mellan 2003 och 2013. Antalet karies- och fyllningsfria 15-åringar 2013 var 43 % jämfört med 20% 2003. I alla åldersgrupper 5-60 år var DFS lägre 2013 jämfört med tidigare undersökningar, medan DFS i åldersgrupperna 70 och 80 år var oförändrad. Den mest uttalade förändringen var minskningen i antalet fyllda ytor, FS. Bland 15-åringarna registrerades 17,8 FS 1973 jämfört med 0,9 2013. Bland 40-åringarna var motsvarande siffror för FS 50,8 respektive 13,1.

Avseende andelen kronförsedda tänder var den mest uppenbara förändringen den procentuella minskningen i åldersgruppen 50 år från 24 % till 4 %. Andelen rotfyllda tänder minskade mellan 1973 och 2013 i alla åldersgrupper.

I åldersgrupperna 10-30 år sågs en stor reduktion av medelvärdet av plack 1973 – 2003. Endast en mindre förändring sågs den senaste 10-årsperioden. För åldersgrupperna 40 år och äldre observerades en minskning av tandytor med plack mellan 2003 och 2013.

Frekvensen av gingivit var generellt lägre 2013 jämfört med undersökningsåren 1973-1993. Ingen förändring i gingivitmedelvärde noterades mellan 2003-2013 förutom en mindre ökning bland 20-åringarna.

Procenten individer med tandköttsfickor > 4 mm ökade med ålder. Mellan 2003 och 2013 sågs en tydlig minskning i alla åldersgrupper med fickdjup 4 mm eller mer. Bland 50-åringar var andelen individer med tandköttsfickor > 4 mm 76 % 2003 och 38 % 2013. Över hela 40-årsperioden minskade antal individer med måttlig marginal benförlust och antalet individer utan marginal benförlust ökade.

En jämförelse av de fem studierna visar på en stor generell förbättring i oral hälsa över 40 år. Detta kommer innebära betydande förändringar för tandvården.

Place, publisher, year, edition, pages
2015. Vol. 39, no 2, 69-86 p.
Keyword [en]
Epidemiology, oral health, dental caries, periodontal disease, endodontics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-27703Scopus ID: 2-s2.0-84937928052Local ID: HHJADULTIS, HHJOralISOAI: oai:DiVA.org:hj-27703DiVA: diva2:845867
Funder
Medical Research Council of Southeast Sweden (FORSS)
Available from: 2015-08-13 Created: 2015-08-13 Last updated: 2015-10-28Bibliographically approved

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