The aim was to evaluate and test the psychometric properties of the Dental Hygienist Beliefs Survey (DHBS) in a Swedish sample of different patient groups and students. It was hypothesized that negative dental hygienist beliefs would discriminate between fearful and non-fearful study groups. The DHBS was distributed together with the revised Dental Beliefs Survey (DBS-R) and the Dental Anxiety Scale (DAS). The study sample included 394 subjects (130 students, 144 general dental patients, 90 periodontal patients and 30 patients on a waiting list for dental fear treatment). The results verified that the DHBS discriminates well between dentally fearful and non-fearful study groups. The DHBS had high internal consistency (Cronbach's alpha = 0.96-0.98) in all the groups. The correlation between the DHBS and the DBS-R was high (rho = 0.82, P < 0.001). Furthermore, the DHBS correlated significantly with the DAS, as well as with a low but significant correlation to age (more negative attitudes in younger age groups) and gender (more negative attitudes amongst women). Regression analysis showed that gender and the DHBS items: 23, 16 and 28, i.e. items related to feeling helpless, worries/fears not being taken seriously and fear about 'bad news' possibly preventing treatment, were the most important predictors of dental fear. The results suggest that the DHBS may be a valid and reliable scale to use in order to assess patient's specific attitudes to dental hygienists. However, the psychometric properties including test-retest analysis and the underlying factor structure of the DHBS need to be further explored.

The aim of this study was to evaluate and to test the psychometric properties of a Swedish version of the revised Dental Beliefs Survey (DBS-R) in different patient groups and in a non-clinical sample of students. It was hypothesized that negative dental beliefs, assessed using the DBS-R, would discriminate between fearful and non-fearful study groups. The questionnaire was distributed together with the Dental Anxiety Scale (DAS). The sample included 550 adults who responded to the questionnaires (206 students, 177 general dental patients, 105 periodontal patients and 62 patients at a waiting list for dental-fear treatment). The internal drop-out rate was low. The results confirmed that the DBS-R discriminates well between fearful patients and the other study groups. The DBS-R had a high internal consistency in all the study groups. Furthermore, the DBS-R correlated significantly with age (higher values in younger age groups) and the DAS. Regression analyses showed that the DBS-R subdimensions of 'communication' and 'control'/or 'trust', respectively, were significant predictors for dental fear. The results suggest that the DBS-R is a reliable and valid instrument for use in different Swedish patient- and non-clinical population groups in order to assess attitudes to dentists. However, the underlying factor structure of the DBS-R needs to be further explored and established.

INTRODUCTION: In this study, we investigated prolonged pain reactions in teenage orthodontic patients during a common orthodontic treatment. The aim was to examine factors predicting pain at the end of a follow-up week after placement of elastic separators. METHODS: Fifty-five patients (ages, 12-18 years) were included. Baseline assessments were made of perceived intensity of general and dental pain experiences, motivation for treatment, dental anxiety, and personality factors (self-esteem and temperament). Pain intensity was assessed on a visual analog scale, and pain medications were recorded. The patients were separated into pain and no-pain groups according to pain experiences at day 7. RESULTS: The pain group (mainly girls) had significantly higher ratings of treatment pain than in the non-pain group at all times measured except for the treatment day. Bivariate and multiple logistic regressions showed significant predictive power from motivation, dental anxiety, activity temperament, and vaccination pain. CONCLUSIONS: In this adolescent patient sample, low motivation for orthodontic treatment, high ratings of vaccination pain, elevated dental anxiety level, and low activity temperament characterized patients reporting pain 1 week after the elastic separators were placed.

OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.

Objective. The aim of this study was to reveal possible socio-economic risk indicators for apical periodontitis.

Material and Methods. In 1992–93 a representative sample of women in Göteborg, Sweden, aged 38–84 years, participated in a medical and dental survey (n=981) which included dental and medical examinations and dental radiographic examination (OP). The dependent variable was apical periodontitis (AP = 0, AP > 0). The independent variables were age, number of teeth, number of restored teeth, number of root-filled teeth, number of teeth with carious lesions, satisfactory masticatory function, and dental esthetics as crude measures of self-reported dental health, dental anxiety, time elapsed since last visit to a dental office, regular dental visiting habits, smoking, alcohol habits, and marital status. A subjective evaluation of economy, health and life situation (acceptable or poor) was accounted for as socio-economic variables. The oldest age group, women born 1908, and edentulous individuals were omitted, leaving 844 subjects for analysis. Statistical analysis included multivariate logistic regression, chi-squared test, and independent t-test for comparison of group characteristics (AP = 0 vs AP > 0).

Results. For socio-economic variables there was a significant association between acceptable health and apical periodontitis (OR = 1.72 (CI = 1.09–2.70)). For oral-related variables, root-filled teeth (OR = 1.17 (CI = 1.10–1.23)) and teeth with carious lesions (OR = 1.48 (CI = 1.19–1.85)) were predictive of apical periodontitis.

Conclusions. In the present study, socio-economic variables and dental visiting habits did not appear to have obvious implications for periapical health, whereas root-filled teeth and carious lesions were associated with apical periodontitis.

This cross-sectional study was designed to explore a possible association between endodontic disease variables and coronary heart disease (CHD). Dental infections are hypothesized to be linked to atherosclerosis and could be a cause of vascular changes crucial for the development of CHD. Most studies have focused on periodontal disease. To our knowledge, no one has specifically studied endodontic variables as risk factors for the development of CHD. In 1992-93, a representative sample (n = 1056) of women in Göteborg, Sweden, aged between 38 and 84 years, took part in a combined dental and medical survey. The dependent variable was CHD, i.e. subjects with angina pectoris and/or a history of myocardial infarction (n = 106). The independent variables were number of root-filled teeth (RF), number of teeth with periapical radiolucencies (PA), tooth loss (TL), age, life situation, marital status, smoking, alcohol habits, body mass index, waist-hip ratio, serum cholesterol and triglyceride concentrations, hypertension and diabetes. The multivariate logistic regression analysis did not prove the endodontic variables to be predictive of CHD. Only age and tooth loss were significantly associated with CHD, with OR = 1.07 (CI = 1.03-1.12) and OR = 2.70 (CI = 1.49-4.87), respectively. The bivariate logistic regression analysis showed a positive significant association between subjects with RF = 2 and CHD, but for PA the bivariate analysis did not support an association with CHD. This cross-sectional study did not reveal a significant association between endodontically treated teeth and CHD nor between teeth with periapical disease and CHD.

Aim

To study changes in technical quality of root fillings and periapical status in root filled teeth in random samples of 20 to 70 year-olds between 1973 and 2003.

Methodology

Data from dentate subjects aged 20–70 years from examinations conducted in 1973 (n = 498), 1983 (n = 530), 1993 (n = 547) and 2003 (n = 491) were used for the analysis. Length of root fillings were measured on radiographs to the nearest 0.1 mm. Adequate seal was defined as a root filling without lateral and/or apical voids. Periapical status was assessed according to the periapical index. All observations were made by one calibrated observer registered from full mouth radiographic examinations. Teeth with root fillings ending within the canal without lateral or apical voids were considered adequate. The association between root filling quality and periapical status was analysed by means of the Chi-squared test and a multilevel logistic regression analysis.

Results

Adequately root filled teeth had a significantly lower frequency of apical periodontitis than inadequately root filled teeth (11.8% vs. 22.8%). The frequency of technically adequate root fillings increased statistically significant from 1973 (23.7%) to 2003 (36.4%) without a concomitant improvement of the periapical status in root filled teeth over time (24.5% vs. 24.6%).

Conclusions

This study reports on an improving technical quality of root fillings over time, without a concomitant improvement of the periapical status in root filled teeth. A larger proportion of treated molars over time may be of importance for the result.

OBJECTIVE: To evaluate different groups of patients' self-reported assessments of dental anxiety and pain related to various routine dental hygienist treatment procedures, and to investigate the relationship between anxiety concerning dental and dental hygienist treatment. MATERIAL AND METHODS: A consecutive sample of 393 patients participated in the study (59.7% F, age range 20 to 85 years, mean 47.6 years). Periodontology (PC), oral medicine (OM), student and general practice (GP) clinics were included. Each patient was asked to answer a questionnaire which included different demographic information, self-reported levels of dental anxiety, and experience of pain in relation to different dental hygienist treatments. RESULTS: Higher dental anxiety was found in relation to gender (women), dentist treatment, and PC and OM patients. Experiences of high or extreme pain were reported by between 7.1% and 9.7% of participants for all dental hygienist procedures except polishing (0.8%). There were significant correlations between dental hygienist fear levels and reported extreme pain experiences among all five treatment procedures. Patients treated at the PC clinic scored significantly higher on pain compared with patients at the other clinics, with the exception of the OM clinic. CONCLUSIONS: Patients reported higher dental anxiety levels for dentist treatment as compared with dental hygienist treatment. Moreover, dental anxiety was significantly associated with perceived pain related to different dental hygienist treatment procedures.

The aim of this study was to investigate the Swedish version of an oral health-related quality of life (OHRQL) instrument, the short form of the Oral Health Impact Profile (OHIP-14), and to assess OHRQL among patients in general dental care and specialist clinics (periodontics, TMD and implant dentistry) in Göteborg, Sweden. Consecutively selected patients were asked to answer the OHIP-14, the General Oral Health Assessment Index (GOHAI) and a questionnaire including socio-demographic, general health and oral health questions. 153 patients (50-89 years old) out of 237 (65%) returned the questionnaires. Cronbach's Alpha among the OHIP items was high (0.93) and the corrected item-scale correlation varied between 0.51 and 0.79. The correlation between the OHIP-14 score and the GOHAI was high (-0.83) indicating good criterion validity. The mean additive OHIP-14 score was 22.6 (SD = 10.5). Implant patients scored significantly higher than other patient groups with respect to missing teeth, dentures and mobile teeth. High scores were also associated with perceived poor general health and dissatisfaction with life-situation. The test-retest reliability was assessed in a separate sample (n = 47) and the correlation coefficient was 0.85. The Swedish version of OHIP-14 demonstrated good reliability and validity. The poorer OHRQL reported by the implant patients reflects the strong association found between OHIP score and dentures and missing teeth, while OHIP-14 did not show similar sensitivity to other impacts of oral disorders.

Objectives The Sense of coherence (SOC) questionnaire estimate an individual’s degree of an inside strength leading to a health promoting behaviour. The aim was to investigate sense of coherence in relation to oral health status. Method A stratified random sample of 910 individuals from Jönköping, Sweden, aged 20,30,40,50,60,70 and 80 years old, was used. The investigation contained the Swedish short version of  the SOC questionnaire with 13-items and a self-reported questionnaire about demographic information, oral health related behaviour and attitudes to oral health. In addition a clinical and radiographical examination was performed. Results A total of 525 individuals participated in the study, 261 men and 264 women. Socioeconomic factors such as age, marital status, income and education had a statistical significant association to SOC.  Bivariate analyse showed that higher mean SOC scores had a statistically significant relationships with more decayed filled surfaces (DFS) and filled surfaces (FS), less caries severity, less teeth with calculus and a better periodontal health. Logistic regression analysis showed that Individuals with high SOC score were predictive of high DFS (OR=3.3, CI 1.14-9.36) and FS  (OR=2.1, CI 0.98-4.31) but low gingivitis scores (OR=0.54, CI 0.30-0.95). After controlling for age, high SOC scores showed a protective effect for gingivitis (OR=0.52,  CI 0.29-0.94) and plaque (OR=0.61, CI 0.36-1.04). Conclusions Socioeconomic factors had an association with SOC. Statistical associations were found between SOC scores and oral health status with regard to several  important oral clinical variables and high SOC scores may indicate a protective determinant for gingivitis and plaque.