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  • 101.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Stenström, Ulf
    Växjö Universitet.
    Wärnberg Gerdin, Elisabet
    Linköpings Universitet.
    Hugoson, Anders
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    The distribution of 'sense of coherence' among Swedish adults: A quantitative cross-sectional population study2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Background:

    Antonovsky’s concept of ‘‘sense of coherence’’ (SOC) has been shown to be related to health. The aim of this study was to describe the distribution of SOC scores and their components in an adult Swedish population aged 20–80 years.

    Methods:

    A random sample of 910 individuals from Jönköping, Sweden, aged 20, 30, 40, 50, 60, 70 and 80 years, of which589 agreed to participate in an oral health examination. The participants answered Antonovsky’s 13-item version of ‘‘the lifeorientation questionnaire scale’’. The response to the items and the distribution of the three components ofcomprehensibility, manageability and meaningfulness were analyzed for different age groups and genders using meanvalues and standard deviations, Student’s t-test and ANOVA.

    Results:

    A total of 526 individuals, 263 men and 263 women,answered all 13 questions and constituted the final material for the study (response rate 89%). The individual SOC scoreincreased with age. The 20 year olds had a statistically significantly lower SOC score compared with the other age groups and55% of them had a low SOC (≤66 points) compared with 17% of the 80 year olds. Men in the 60 and 70 year age groups hada statistically significantly higher SOC score compared with women of the same age.

    Conclusions:

    The individualdistribution of SOC varied with age and gender. Twenty year olds had a significantly lower SOC score comparedwith elderly age groups. Elderly men had a statistically significantly higher SOC score compared with women ofthe same age.

  • 102.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Wåhlin, Charlotte
    Intervention and Implementation Research Unit, Karolinska Institutet, Linköping, Sweden.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Futurum, Academy for Health and Care, Jönköping County Council, Jöonköping, Sweden.
    Workplace health in dental care – a salutogenic approach2018In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 16, no 1, p. 103-113Article in journal (Refereed)
    Abstract [en]

    Objective

    The purpose was to explore self-reported psychosocial health and work environments among different dental occupations and workplaces from a salutogenic perspective. A further purpose was to analyse possible associations between three salutogenic measurements: The Sense of Coherence questionnaire (SOC), the Salutogenic Health Indicator Scale (SHIS) and the Work Experience Measurement Scale (WEMS).

    Methods

    Employees in the Public Dental Service in a Swedish county council (n = 486) were invited to respond to a self-reported web survey including demographics, work-related factors, the SOC, the SHIS and the WEMS.

    Results

    This study showed positive associations between employee characteristics and self-reported overall psychosocial health as well as experienced work environment. Autonomy was reported more among men than women (P < 0.000) and to a higher degree by dentists and dental hygienists than dental nurses (P < 0.000). Meaningfulness, happiness, job satisfaction, autonomy and positive to reorganization were reported by personnels aged less than 40 years (P ≤ 0.047). Clinical coordinators reported significant better health (SOC, SHIS) and experienced more autonomy, better management and more positive to reorganization than other dental professions. Dental hygienists and nurses experienced less time pressure than dentists (P ≤ 0.007). Better health and positive work experiences were also seen in smaller clinics (P ≤ 0.29).

    Conclusion

    Dental professionals reported a high degree of overall psychosocial health as well as a positive work experience. Some variations could be seen between employee characteristics such as gender, years in dental care, professionals, managing position and workplace size. Identify resources and processes at each workplace are important and should be included in the employee's/employers dialogue.

  • 103.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Wärnberg Gerdin, Elisabeth
    Centrum för folkhälsovetenskap, Linköping.
    Johansson, Ingegerd
    Avdelning för odontologi, Umeå universtitet.
    Stegmayr, Birgitta
    Avdelning för folkhälsovetenskap och klinisk medicin, Umeå universitet.
    Sense of Coherence and Food Selection in Adults2004In: Oral health and prevention during the different stages of life: Conference of International Federation of Dental hygienists 2004; Madrid, 2004, p. 1-Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Background:  “Sense of coherence” (SOC) influences the individual´s capacity to handle events associated with health (Antonovsky, 1987). Peoples selection of eating habits may be regarded as a “life choice” (Johansson et al, 2001; Lännernäs et al, 1997; Palojoki, 1997) as it is made against the knowledge that dietary habits influence endemic diseases (Falkenberg, 2001; Wolfram, 2003).

    Aim: The aim of the study was to examine if SOC is associated with food selection.

    Method: The study population were 3,072 woman and 2,920 men, from the 1999 year WHO MONICA project in northern Sweden. Data were collected by the Antonovsky short SOC questionnaire (13 items)(Antonovsky,1987), and a semi-quantitative food questionnaire (84 items) (Johansson et al, 2001).

    Results: Both men and woman with the lowest SOC scores consumed less healthy food like vegetables and fruits but more fat and sucrose containing products than individuals with high SOC scores (t-test, ANOVA, post hoc-test).

    Conclusion: It is concluded that individuals with a low SOC score have less favorable dietary habits.

  • 104. Machtei, E E
    et al.
    Cho, M I
    Dunford, R
    Norderyd, J
    Zambon, J J
    Genco, R J
    Clinical, microbiological, and histological factors which influence the success of regenerative periodontal therapy.1994In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 65, no 2Article in journal (Refereed)
    Abstract [en]

    The primary objectives of this double-blind, controlled clinical trial were to assess factor(s) which affect the success of guided tissue regeneration (GTR) procedures in mandibular Class II buccal furcation defects. Thirty subjects, with mandibular Class II furcation defects, were randomly assigned to one of two treatment groups; patients in Group A received oral hygiene instructions with scaling and root planing, while subjects in Group B received similar treatment but without subgingival scaling and root planing at the affected site. After initial oral hygiene instructions and scaling and root planing, GTR surgery was performed using ePTFE barrier membranes. Membranes were retrieved at 6 weeks and subjected to histological examination. Twelve months after regenerative therapy, clinical measurements and re-entry surgical measurements were repeated. Probing reduction (2.61 mm), horizontal probing attachment gain (2.59 mm), and vertical probing attachment gain (0.95 mm) were all significantly better compared to baseline. Likewise, significant improvements in furcation volume (8.0 microliters) and in bone measurements were observed at re-entry. There was no discernible difference between subjects for whom complete anti-infective therapy was deferred to the time of the surgery (Group B) compared to subjects in whom complete anti-infective therapy was performed as part of the hygienic phase of therapy (Group A). Pre-operative pocket depth was directly correlated with the magnitude of attachment gain as well as the amount of new bone formation in the furcation area. Subjects who maintained good oral hygiene and who had minimal gingival inflammation throughout the study demonstrated consistently better regenerative response.(ABSTRACT TRUNCATED AT 250 WORDS)

  • 105. Machtei, E E
    et al.
    Dunford, R
    Hausmann, E
    Grossi, S
    Norderyd, J
    Genco, R J
    A stepwise approach to determine periodontal attachment loss in longitudinal studies.1993In: Journal of Periodontal Research, ISSN 0022-3484, E-ISSN 1600-0765, Vol. 28, no 6 Pt 2Article in journal (Refereed)
  • 106. Machtei, E E
    et al.
    Norderyd, J
    Koch, G
    Dunford, R
    Grossi, S
    Genco, R J
    The rate of periodontal attachment loss in subjects with established periodontitis.1993In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 64, no 8Article in journal (Refereed)
    Abstract [en]

    A stepwise approach to determine attachment level changes was utilized to assess the nature of progression of periodontal disease. Following initial screening, 51 subjects with established periodontitis were monitored quarterly for 9 more months. Probing depth (PD) and relative attachment level (RAL) were recorded using an automated, pressure sensitive probe system. To establish intra-examiner error, repeated measurements were performed for all sites at the final visit. An overall standard deviation (SD) for RAL repeated measurements was initially calculated (0.76 mm) using all 6,935 double measurements. Sites were sorted by factors which contribute to the error of attachment level measurements; i.e., pocket depth (shallow, moderate, deep), tooth type (molar, non-molar) and location (buccal, lingual). Data were sorted by the above 12 groups, and SD for repeated measurements was calculated separately for them. The ratio between these SD and the overall SD served as the corrective factor. Each patient's initial threshold (2 SD) was multiplied by these corrective factors thus resulting in 12 thresholds for each subject. Next, linear, exponential and logarithmic regression models were tested for each site, and the regression model showing the highest R value was chosen for that site. AL changes were tested against the patient's threshold for that site. Sites with attachment loss exceeding the threshold were deemed active. Five hundred eighty-one sites (8.3%) exhibited attachment loss exceeding the various thresholds. Of these, linear progression occurred in 195, logarithmic in 224, and exponential in 162 sites. Individual patient's attachment loss ranged from 0.6 to 19.4% of all sites.

  • 107. Magnusson, C
    et al.
    Nilsson, M
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Degenerative changes in human temporomandibular joints in relation to occlusal support.2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, p. 305-311Article in journal (Refereed)
  • 108. Magnusson, Cecilia
    et al.
    Ernberg, Malin
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    A description of a contemporary human skull material in respect of age, gender, temporomandibular joint changes, and some dental variables2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 2, p. 69-81Article in journal (Refereed)
    Abstract [en]

    Controversy exists concerning the etiological factors behind degenerative changes in the temporomandibularjoints (TMJs). Occlusal factors, ageing, gender and genetics are some factors that have been discussed.The aim of the present study was to examine a contemporary human skull material in respect of gender, age, occlusal variables and form and surface changes in the temporomandibular joints.The material consisted of 259 human skulls, 170 males and 89 females, with an age range of 18-100 years.The over all dental status was poor, and 22% were edentulous. Both medio-lateral and antero-posterior dimensions as well as anterior and superior shape of the condyles were in good agreement with previous results. Form and surface changes of both the condyles and the temporal components were, however, more common in the present material compared to most previous studies. Men had on average more degenerative changes in the TMJs compared to women. In agreement with many previous studies, there was an increase of such changes with increasing age. Severe tooth attrition was a common finding, especially in men, but no correlation was found between this variable and the severity of degenerative changes in the TMJs. Abfractions were found in only 3 cases. Considering the common finding of severe tooth attrition,the rare occurrence of abfractions does not lend support to the hypothesis that abfractions are mainly caused by occlusal loading. In conclusion: Condylar dimensions and shape of the condyles were in good agreement with previously presented results. Severe tooth attrition and pronounced degenerative changes in the TMJs were common findings but no statistically significant association was found between these two variables.

  • 109. Magnusson, Cecilia
    et al.
    Nilsson, Mats
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ. Oral health.
    Degenerative changes in the human temporomandibular joints in relationt to occlusal support2010Conference paper (Other academic)
  • 110.
    Magnusson, T
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Enbom, L
    Occlusal index: a comparative study1984In: Tandläkartidningen, ISSN 0039-6982, Vol. 76, no 6, p. 306-11Article in journal (Refereed)
  • 111.
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Orofacial smärta och huvudvärk ur ett odontologiskt perspektiv1995In: Tandläkartidningen, ISSN 0039-6982, Vol. 87, no 11/12, p. 742-750Article in journal (Refereed)
  • 112.
    Magnusson, Tomas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Karlsson, Christina
    Clinical impact of radiological examinations of patients with suspected temporomandibular disorders2002In: Swedish Dental Journal, ISSN 0347-9994, Vol. 26, no 2, p. 67-74Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the proportion and diagnostic value of different imaging techniques when investigating patients with suspected temporomandibular disorders (TMD). Out of 396 patients referred to a specialist clinic of stomatognathic physiology, information from radiological examinations was available in 285 patients (72%) at first examination or obtained during the course of treatment. The most common radiographic examination was panoramic radiography. Radiological findings with some clinical importance were made in one-fourth of the 285 patients. In another 11% of these patients, additional radiological findings not judged to be associated with the TMD but in need of therapeutic measures, were made. In 72 patients information from more extensive examinations such as transcranial projections of the TMJs, conventional tomography of the TMJs, CT images and MRT images were performed during the course of treatment. In 63% of these patients, the extended examinations revealed findings of clinical significance for the TMD diagnosis and/or treatment. It is concluded that panoramic radiography has a diagnostic value when investigating patients with suspected TMD. Because of this, and since the effective radiation dose is small for this exposure, and since also no findings on the panoramic radiographs can be an important information, extended use of this examination can be recommended in patients referred to a specialist clinic because of suspected TMD. The need for more extended radiological examinations in TMD patients is limited and should always be based on individual information from the patient's history and/or clinical findings.

  • 113. Murati, Selvinaze
    et al.
    Elias, Karolina
    Kunskap om barns orala hälsa hos förskollärarstudenter2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Background: In 2016, there were over half a million children enrolled in preschools in Sweden. Preschool staff are role models concerning diet and attitudes about oral hygiene, for children. Because children spend a lot of time in preschool it is important to highlight the knowledge of preschool students. The aim of this study was to investigate preschool students’ knowledge of oral health in children. Method: The study was a quantitative cross-sectional study with a survey as a measuring instrument. The survey consisted of 20 questions where knowledge and attitudes about children’s oral health and dietary habits were measured. The selection was based on all students from term six at the preschool teacher program at Jönköping University spring term 2018, a total of 82 students. The data collected was analyzed using computer programs SPSS and Excel. Result: A total of 55 students participated in the study. The majority of participants showed high knowledge and good attitudes regarding children’s oral health and dietary habits. However, only 18 % of the participants responded correctly on the question about what age children needed adult care when tooth brushing. Conclusion: The study found that preschool students had high knowledge regarding children’s oral health and dietary habits, but this knowledge did not come from the education.

  • 114.
    Norderyd, Johanna
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    A biopsychosocial approach to functioning, oral health and specialist dental health care in children with disabilities – Swedish and international perspectives2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Maintaining good oral health may be more important for children with disabilities than others, since problems with oral health may increase the impact of a disability, or the medical condition may increase the risk for poor oral health. In addition, the risk for oral health problems may be influenced by the functioning of the child. Functioning can also affect the child’s ability to cooperate in the dental setting, and how dental treatment is performed. A medical diagnosis alone does not provide enough information about a child’s functioning, nor oral health. Thus, there is a need for a holistic perspective of oral health and dental health care in children with disabilities. The International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) enables a structured assessment of the biopsychosocial consequences of a health condition.

    Aim: The overall aim of this thesis was to investigate how biopsychosocial factors relate to oral health and specialist dental health care in children with disabilities in a Swedish, and an international context, with special focus on the experience of dental treatment under general anaesthesia (DGA).

    Material and methods: The research was conducted using a quantitative, cross-sectional, comparative and descriptive design. An ICF-CY Checklist for Oral Health was completed with data from a structured interview with children 0-16 years old, referred for specialist dental health care, and their parents/carers. Additional information was retrieved from dental and medical records. Three groups were included in data analyses: one large international group of 218 children from Argentina, France, Ireland and Sweden; one large Swedish group with 99 children with complex disabilities; and one international group of children with disabilities and manifest dental caries from Argentina, France and Sweden.

    Results: The ICF-CY Checklist for Oral Health identified both common and varying functional, social and environmental aspects relevant for oral health and oral health care in children who had been referred to specialist dental clinics in four countries. Swedish children with caries experience had been referred to a paediatric dental specialist clinic at a significantly older age than caries-free children. The medical diagnoses were not significantly related to dental caries or child functioning in the large Swedish group with complex disabilities and low caries prevalence, nor was there a significant relationship between dental caries and child functioning. Collinearity between dental caries and problems in the functioning factor ’Interpersonal interactions andrelationships’ was observed in the international group of children with disabilities and manifest dental caries. DGA sessions with combined medical and dental treatment were common in the large Swedish study group. Children with experience of DGA had more severe problems in intellectual functions than those without experience of DGA. Problems in interpersonal interactions and relationships increased, while problems with mobility decreased, the likelihood for children having had experience of DGA. On international group level, dmft/DMFT was significantly higher in children with the experience of DGA than in those without DGA experience, but looking at Argentina, France and Sweden separately, this was not true for the Swedish children. There were significant, international differences between the prevalence of dmft/DMFT, DGA and environmental barriers.

    Conclusion: The biopsychosocial perspective, operationalised by the ICF-CY, contributes a holistic view on oral health and specialist dental health care in children with disabilities. In addition to certain differences, children with different health status from different countries share many functional and environmental aspects, important for oral health and dental health care. Early referral to a paediatric specialist dental clinic seemed favourable for oral health. The medical diagnosis was not related to child functioning or dental caries. Child functioning had a significant impact on DGA, and in children with disabilities and manifest dental caries, child functioning also had a correlation with caries. The dental caries burden was a stronger factor than functioning for the experience of DGA, however, dental health organisation and country context seemed to matter the most. Combining dental and medical procedures during the same GA session is good use of resources for both the individual and the society. To ensure children with complex disabilities to have the possibility of achieving equivalent good oral health as other children, DGA is one important factor.

  • 115.
    Norderyd, Johanna
    et al.
    Odontologiska Institutionen i Jönköping.
    Aronsson, Johan
    Ryhov County Hospital, Jönköping, Sweden.
    Hypoplastic root cementum and premature loss of primary teeth in Coffin–Lowry syndrome: a case report2012In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 22, no 2, p. 154-156Article in journal (Refereed)
    Abstract [en]

    Background.  Coffin–Lowry syndrome (CLS) is a rare genetic disorder. The syndrome presents with psychomotor retardation, short stature, skeletal deformations, digit abnormalities, and distinctive facial features. Oral and dental findings in CLS are common and they include thick prominent lips, high palate, midline lingual furrow, hypodontia, microdontia, delayed eruption, and early tooth loss. Only one earlier case suggesting hypoplastic root cementum as cause for primary loss of teeth in CLS has been published.

    Case Report.  This case describes a 3-year-old boy with premature loss of primary incisors without preceding root resorption. In addition to the dental findings, the boy had several general signs and symptoms and the dental findings together with the other characteristics led to the clinical diagnosis of CLS, which later was genetically verified. Histological analysis of an extracted primary incisor showed hypoplastic root cementum.

    Conclusion.  Hypoplastic root cementum may explain early tooth loss in CLS. As early loss of primary teeth is rare, especially when there is no previous root resorption, the individual is likely to seek dental care. Thus, the dentist may play an important role in assisting in the diagnosing of CLS.

  • 116.
    Norderyd, Johanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Faulks, D.
    Molina, G.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Klingberg, G.
    What determines dental caries treatment under general anaesthesia in children with disabilities: number of cavities, child functioning or dental organisation?Manuscript (preprint) (Other academic)
  • 117.
    Norderyd, Johanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Faulks, Denise
    CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France.
    Molina, Gustavo
    Facultad de Odontología, Universidad Nacional de Córdoba, Cordoba, Argentina.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work.
    Klingberg, Gunilla
    Departement of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Which factors most influence referral for restorative dental treatment under sedation and general anaesthesia in children with complex disabilities: Caries severity, child functioning or dental service organisation?2018In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 28, no 1, p. 71-82Article in journal (Refereed)
    Abstract [en]

    Background

    The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health – Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment.

    Aim

    To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY.

    Design

    Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records.

    Results

    Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors.

    Conclusions

    Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities.

  • 118.
    Norderyd, Johanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Graf, Jonas
    Department of Otorhinolaryngology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Marcusson, Agneta
    Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University, Linköping, Sweden.
    Nilsson, Karolina
    Habilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
    Sjöstrand, Eva
    Department for Child and Youth Habilitation, County Council of Östergötland, Linköping, Sweden.
    Steinwall, Gunilla
    Habilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
    Ärleskog, Elinor
    Department of Oral & Maxillofacial Surgery, Linköping University Hospital, Linköping, Sweden.
    Bågesund, Mats
    Centre for Orthodontics and Paediatric Dentistry and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Sublingual administration of atropine eyedrops in children with excessive drooling - a pilot study2017In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 27, no 1, p. 22-29Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Drooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable.

    AIM: To analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities.

    DESIGN: The study had a prospective, single-system research design. The participants served as their own controls. The study period was 3 weeks without treatment, 4 weeks with atropine eyedrop solution 10 mg/mL one drop a day followed by 4 weeks of one drop twice a day. Parents' rating of their child's drooling was assessed on a 100-mm VAS, and unstimulated salivary secretion rate measurement was performed together with notations about side effects and practicality.

    RESULTS: Parents' VAS assessment of drooling decreased from a median (range) of 74 (40-98) at baseline to 48 (18-88) (P = 0.05) and 32 (12-85) (P = 0.004) after 4 weeks of atropine once a day and another 4 weeks of atropine twice a day, respectively (n = 11). Unstimulated salivary secretion rates decreased from baseline to end of study (P = 0.032). Several parents complained about difficult administration. No irreversible side effects were noted.

    CONCLUSIONS: Sublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.

  • 119.
    Norderyd, Johanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Klingberg, Gunilla
    Departement of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Faulks, Denise
    CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work.
    Specialised dental care for children with complex disabilities focusing on child's functioning and need for general anaesthesia2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 24, p. 2484-2491Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe and analyse dental care and treatment modalities for children with complex disabilities from a biopsychosocial perspective, with special focus on dental treatment under general anaesthesia (GA) and its relationship to child's functioning.

    METHOD: An ICF-CY Checklist for Oral Health was completed using structured interview, direct observations, and dental records for patients attending a specialist paediatric dentistry clinic. Descriptive and comparative data analysis was performed. Performance qualifiers from the ICF-CY component Activities and participation were used to calculate functional factors.

    RESULTS: Median referral age was 1.5 years and the majority were referred by their paediatrician. Almost all visited a dental hygienist regularly. Dental treatment under GA was common and was combined in 78% of sessions with medical treatment. Children with limitations in their interpersonal interactions and relationships were most likely to have dental GA.

    CONCLUSION: Children without caries experience had been referred for specialist dental care at an earlier age than children with caries experience. GA was a common treatment modality and dental and medical treatments were coordinated under the same GA for a majority of children. By using the ICF-CY, it was possible to identify functional limitations characterising children with disabilities that require dental treatment under GA. Implications for Rehabilitation Early referral to a specialist in paediatric dentistry is valuable for oral disease prevention in children with disabilities. Availability of dental treatment under general anaesthesia (GA) is also important. Combining dental and medical interventions during the same GA session optimises resources both for the individual and for the health organisation. Children with limitations in interpersonal interactions and relationships are more likely to need dental treatment under GA than other children.

  • 120.
    Norderyd, Johanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Lillvist, Anne
    Mälardalens högskola.
    Klingberg, Gunilla
    Tandvårdshögskolan, Malmö högskola.
    Faulks, Denise
    Clermont Université, Université d’Auvergne, EA3847, Centre de Recherche en Odontologie Clinique, Clermont-Ferrand, France.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Oral health, medical diagnoses, and functioning profiles in children with disabilities receiving paediatric specialist dental care – a study using the ICF-CY2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 16, p. 1431-1438Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe 0–16-year-old children with disabilities receiving paediatric specialist dental care from a biopsychosocial perspective, with focus on relationship between oral health, medical diagnosis, and functioning. Method: A questionnaire with an International Classification of Functioning, Disability and Health – Children and Youth version (ICF-CY) Checklist for Oral Health was completed using structured interview, direct observation, and information from dental records. Descriptive data analysis was performed together with principle component analysis to calculate factors of functioning used in cluster analysis in order to present functioning profiles. Results: Ninety-nine children with at least one major medical diagnosis were included. Twenty had previous caries experience. Two factors of functioning were calculated, labelled “Physical ability” and “Intellectual ability, communication, and behaviour”. Based on functioning profiles three clusters were determined. There were no statistically significant differences in caries experience between medical diagnoses or clusters. Conclusion: It was possible to identify profiles of functioning in children with disabilities receiving specialist dental care. Despite complex disabilities, the children had good oral health. Neither medical diagnosis nor functioning was found to have a clear relationship with oral health. To understand the environmental context leading to high-quality oral health, further studies of dental management in relation to medical and oral diagnoses and child functioning are needed.

    Implications for Rehabilitation

    • Child Oral Health

    • The use of ICF-CY makes it possible for paediatric dentists to assess children’s functioning, disability, and health from a biopsychosocial perspective, showing that the medical diagnosis alone is not enough to assess functions relevant for oral health in the individual.

    • In order to adequately organize, plan, and improve dental care for this heterogenic group of young patients with disabilities a biopsychosocial approach is valuable, aiding a holistic perspective on oral health.

    • Despite complex medical and functional disabilities that may challenge oral health and dental care, this study finds oral health to be good in a group of children with disabilities attending a specialist dental clinic.

  • 121.
    Odersjö, M. L.
    et al.
    Clinic of Pediatric Dentistry, Public Dental Service, Borås, Region Västra Götaland, Sweden.
    Robertson, A.
    Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Koch, G.
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Pediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Incidence of dental traumatic injuries in children 0-4 years of age: a prospective study based on parental reporting2018In: European Archives of Paediatric Dentistry, ISSN 1818-6300, E-ISSN 1996-9805, Vol. 19, no 2, p. 107-111Article in journal (Refereed)
    Abstract [en]

    AIM: To collect prospective information reported by parents regarding dental traumas occurring in children 6 months to 4 years of age, furthermore, to collect data on complications from the dental records.

    METHODS: The staff from the child health services distributed a questionnaire at the regular health check-up reviews for a number of age groups, i.e., 6, 12, 18, 24, 30, 36, and 42 months of age. The parents were to observe and register factors around dental trauma for the following 6-month period. The questionnaires (138) were returned, irrespective of any trauma having occurred or not. If a child was seeing a dentist (emergency visit), the diagnosis of trauma and later complications were collected from the dental records.

    RESULTS: There were 35 of 138 children experienced trauma (6-47 months of age). The half-year incidence of trauma in children 6 months to 4.0 years of age was between 12 and 48%. A total of 41 traumatic dental injuries (TDIs) were reported. Of these 24 occurred indoors. The most common reason for trauma was falling accidents. In 24 out of the 41 reported TDIs the children were not seen by a dentist in connection with the trauma. The reason was that the parents thought the trauma did not matter.

    CONCLUSIONS: The high incidence of TDIs reported in toddlers in this study indicates that there is an under-reporting of TDIs in previously reported studies. The research design used in the present study has an advantage and should be tested in further studies.

  • 122.
    Odqvist, Stephanie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Vu, Helen
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Tandvårdsrädsla hos sexuellt utnyttjade personer: - En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dental fear may originate from both incidents within or outside of the dentistry.  The majority of the population experience some form of dental fear in varying degrees. It has been shown that dental fear has a negative impact of the oral health. Due to sexual abuse, people may suffer from several harmful consequences, which can be observed during a clinical examination. Aim: The aim of this review was to explore eventual relationship between dental fear and sexual abuse. Method: The method used was a literature review. An article search with keyword combinations was carried out in different databases. The selected articles went through several steps of selections and one quality assessment. Result:  The studies showed a divided result, but most studies could demonstrate a statistically significant relationship between dental fear and sexual abuse. Several factors in dentistry may evoke flashbacks and contribute to a negative perception of dentistry. Victims of oral sexual abuse presented higher levels of dental fear. Conclusion: There is a confirmed relationship between dental fear and sexual abuse. Certain elements within the dentistry can have a negative impact on the dental care experience.  

  • 123. Ohrn, K
    et al.
    Hakeberg, Magnus
    Jönköping University, School of Health Science, HHJ. Oral health. Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Abrahamsson, K H
    Dental beliefs, patients' specific attitudes towards dentists and dental hygienists: a comparative study.2008In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 6, no 3, p. 205-213Article in journal (Refereed)
    Abstract [en]

    Interpersonal relationships are important for communication, oral health education and patients' satisfaction with dental care. To assess patients' attitudes towards dental caregivers, a Swedish version of the revised Dental Belief Survey (DBS-R) and a comparable and partly new instrument the Dental Hygienist Belief Survey (DHBS) have been evaluated. The aim of the present study was to investigate if patients' attitudes towards dental hygienists (DH) and dentists (D) differ with regard to the separate items in DBS-R and DHBS. The study was a comparative cross-sectional study with 364 patients (students, general patients and patients with periodontal disease). All patients completed the DBS-R and DHBS surveys. The overall pattern in the results showed that participants in general had a less negative attitude towards DH when compared with that towards D. This was most pronounced among students and least pronounced among patients with periodontal disease. No statistically significant difference could be found in items with regard to feelings of shame and guilt in dental care situations, indicating that these items were rated on a more negative level also for DH. The conclusion is that participants had a less negative attitude towards DH with the exception of situations which may give rise to feelings of shame and guilt, an important finding for future dental hygiene care.

  • 124. Ostberg, AL
    et al.
    Andersson, P
    Hakeberg, Magnus
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Cross-cultural adaptation and validation of the oral impacts on daily performances (OIDP) in Swedish2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 4, p. 187-195Article in journal (Refereed)
  • 125.
    Pakpour, Amir H.
    et al.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Kumar, Santhosh
    Population Social Health Research Program, Griffith Health Institute, School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.
    Scheerman, Janneke F. M.
    Academic Centre of Dentistry Amsterdam, Department of Preventive Dentistry, ACTA University, Amsterdam, Netherlands.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Oral health-related quality of life in Iranian patients with spinal cord injury: A case-control study2016In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 47, no 6, p. 1345-1352Article in journal (Refereed)
    Abstract [en]

    Introduction: The study aimed to compare the oral health variables, general, and oral health-related quality of life (QoL), depression, and anxiety between spinal cord injury (SCI) patients and healthy controls and also to determine the key factors related to the oral health-related quality of life (OHRQoL) in the SCI patients.

    Methods: A total of 203 SCI patients and 203 healthy controls were enrolled. Patients and healthy adults were invited to attend a dental clinic to complete the study measures and undergo oral clinical examinations. OHRQoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14), and the general health-related quality of life (GHRQoL) was evaluated by SF-36. In SCI patients, depression and anxiety were recorded using the Hospital Anxiety and Depression Scale (HADS), while Functional Assessment Measure (FAM) was used to assess dependence and disability. All the subjects were examined for caries which was quantified using the decayed, missing, and filled Teeth (DMFT) index, gingival bleeding index (GI), plaque index, and periodontal status by community periodontal index (CPI).

    Results: The analysis of covariance (ANCOVA) revealed significant differences between the two groups in terms of oral health expressed in DMFT, oral hygiene, and periodontal status, controlled for age, gender, family income, and occupational status (p < 0.001). Using the hierarchical linear regression analyses, in the final model, which accounted for 18% of the total variance (F(126.7), p < 0.01), significant predictors of OHRQoL were irregular tooth brushing (β = 1.23; 95% CI = 1.06; 1.41), smoking (β = 0.82; 95% CI = 0.66; 0.97), dry mouth (β = 0.37; 95% CI = -0.65 to 0.10) functional and motor functioning (β = 0.32; 95% CI = -0.45 to 0.17), DMFT (β = 0.06; 95% CI = 0.02; 0.09), CPI (β = 0.22; 95% CI = 0.04; 0.04), physical component measure of GHRQoL (β = -0.275; 95% CI = -0.42 to 0.13), lesion level at the lumbar-sacral (β = -0.18; 95% CI = -0.29 to -0.06) and thoracic level (β = -0.09; 95% CI = -0.11 to -0.06).

    Conclusion: SCI patients had poor oral hygiene practices, greater levels of plaque, gingival bleeding, and caries experience than the healthy controls. In addition, more number of SCI patients had periodontal pockets and dry mouth than the comparative group. SCI patients experienced more depression and anxiety, poor GHRQoL, and OHRQoL than the healthy control group. The factors that influenced OHRQoL in SCI patients were age, toothbrushing frequency, smoking, oral clinical status, depression, physical component of GHRQoL, and level of lesion.

  • 126.
    Pakpour, Amir H.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Kumar, Santhosh
    Griffith Health Institute, School of Dentistry and Oral Health, Gold Coast, QLD, Australia.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.2018In: Journal of Investigative and Clinical Dentistry, ISSN 2041-1618, E-ISSN 2041-1626, Vol. 9, no 1, article id e12264Article in journal (Refereed)
    Abstract [en]

    AIM: In the present study, we evaluated the direct and mediating (indirect) effects of clinical oral conditions, dental anxiety, sense of coherence (SOC), and socioeconomic variables on oral health-related quality of life (OHRQoL) and general health-related quality of life (GHRQoL) in Iranian adolescents.

    METHODS: A longitudinal design was used with a sample of 1052 (694 males, mean age=15.05 years) schoolchildren from Qazvin, Iran. Each participant completed a background information sheet and the following scales at baseline: Modified Dental Anxiety Scale, SOC, PedsQL 4.0 Generic Core Scale, and PedsQL Oral Health Scale. The PedsQL 4.0 Generic Core and Oral Health scales were recompleted at the 18-mo follow up.

    RESULTS: Father's education, monthly family income, dental anxiety, Community Periodontal Index (CPI), decayed, missing, and filled teeth (DMFT), and SOC significantly and directly predicted OHRQoL at 18 mo. Father's education had indirect effects on OHRQoL through CPI and DMFT, family income had indirect effects through DMFT, and dental anxiety had indirect effects through CPI. OHRQoL at 18 mo (β=0.499) and SOC (β=0.084) had significant and direct and mediating effects through OHRQoL on GHRQoL, while father's education, monthly family income, dental anxiety, CPI, and DMFT only showed mediating effects.

    CONCLUSIONS: Clinical oral indicators had direct effects on OHRQoL, but mediated the effects of dental anxiety and socioeconomic status on both OHRQoL and GHRQoL.

  • 127.
    Persson, Viktoria
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Enroth, Anna-Maria
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Kunskap och tillämpning av Functional food i det kariespreventiva arbetet inom tandvården: En enkätstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: An adequate nutrition is essential for the promotion and maintenance of the general and oral health. Dental caries is a multifactorial disease in which diet is a important factor. Functional foods are defined as "foods that provide health benefits beyond basic nutrition" and "foods that has one or more additives, modified to contribute to a healthy diet". Aim: The aim of the study was to identify the level of knowledge and application regarding information to patients about Functional food in caries prevention work in Public dental services, County Council of Kronoberg. Method: The survey included 106 participants consisted of dentists, dental hygienists and dental nurses from 17 different Public dental services. The survey consisted of 24 questions. The results were presented descriptive, with tables and charts, as well as statistically analyzes using chi-square tests. Results: The majority of participants were categorized into the groups: low level of knowledge and medium or low application level of Functional food in the caries prevention work. Most of the participants had a great interest in obtaining additional knowledge. Conclusion: Dental professionals would like to get more knowledge about Functional food for an increased application in patient care, provided that scientific evidence is obtained.

  • 128.
    Pola, Forat
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Följsamhet av vårdhygienrutiner och kunskap om blodburna smittor hos tandvårdsstudenter vid Sefako Makgatho Health Sciences University, Sydafrika: En kvantitativ tvärsnittsstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Blood-borne infections are common problem in healthcare. Informations about the prevalence in dental care are limitet. Healthcare professionals in South Africa are particularly vulnerable to blood-borne infections. The best way to minimize blood-borne infections is to increase compliance to infection control. Objective: To describe and compare compliance to infection control routines and knowledge of blood-borne infections among  different groups of dental students at a university in Ga-Rankuwa, South Africa. Materials and method: A quantitative cross-section web-based survey. The participants were dental students who were registered in 2019, dental hygienist, dental therapist students, 3ed year and dental students 4th year. Non Parametric – Chi - Square and Fisher's test was used to analyze data. Result: Majority of the students had  compliance regarding the use of gloves and mask during patient treatment, changing gloves and disinfection of  unit between patients. Compliance was less at other parts where approximately half (49%) had the correct answer concerning: gloves, using of  gloves, clinical uniform and using of mobile and accessories. Correct answers to the knowledge of blood-borne infections för all dental students was 67%. Conclusions: The participants had better results on knowledge of blood-borne infections than on compliance to infection kontrol. No significant difference was found among the student dental groups

  • 129. Poulsen, Sven
    et al.
    Koch, Göran
    Wendt, Lill-Kari
    Jönköping University, School of Health Science, HHJ. Oral health.
    Fissurförsegling år 20062006In: Odontologi 2006, Köpenhamn : Munksgaards , 2006, p. 131-141Chapter in book (Other academic)
  • 130. Rahmati, Raihanna
    et al.
    Calina, Alexandru
    Samband mellan motiverande samtal och parodontala sjukdomar och karies: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: MI is a method for counseling and for helping individuals find and maintain motivation for change of behavior. In later years the method has also seen some use in dental care.

     

    Aim: To study the effect of MI on parodontal diseases and caries in children, adolescents and adults.

     

    Method: The study design was a literature review where scientific articles were gathered by searching through databases like for example PUBMED, DOSS, Medline, Psychinfo and CINAHL and then scrutinized and summarized. Seventeen articles were selected according to existing inclusion-/exclusion criteria. The included studies were reviewed with a modified review template to present studies of strong/moderate value.  

     

    Result: The selected articles were from Canada, China, France, Germany, Iran, India, Serbia, Spain, Sweden and USA. About 50% of the articles indicated a positive result for patients who undertook MI-sessions in combination with regular treatment, compared to control groups. The other half could see no such results.

     

    Conclusion: The method seems to have effect in some instances but not in others. A factor that showed no alteration of MI effectiveness was the patients’ age. Further research is required to determine what factors might influence the outcome of using MI in dental care.

  • 131.
    Rantzow, Veronica
    et al.
    Higher Vocational Education, Helsingborg.
    Andersson, Pia
    Kristianstad University.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Occurrence of oral health problems and planned measures in dependent older people in nursing care2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 23-24, p. 4381-4389Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE:

    To describe oral health problems and planned measures in older people receiving nursing care.

    BACKGROUND:

    Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities.

    METHODS:

    Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014-June 2015 were included. The Revised Oral Assessment Guide-the Jönköping (ROAG-J) was used routinely by nursing staff in nursing care facilities to measure oral health status.

    RESULTS:

    Oral assessments were made on 2,567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%).

    CONCLUSION:

    Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care.

    RELEVANCE TO CLINICAL PRACTICE:

    The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.

  • 132.
    Rolander, Bo
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johnston, V.
    School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Wåhlin, C.
    Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden.
    Organizational types in relation to exposure at work and sickness - a repeated cross-sectional study within public dentistry2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850Article 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.

  • 133.
    Rolander, Bo
    et al.
    Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Futurum, Academy for Health and Care, Jönköping County Council, Sweden.
    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
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    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.

  • 134.
    Rolander, Bo
    et al.
    Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Wåhlin, Charlotte
    Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Task reorganization within the public dental professions impacts on the health and workability of employeesIn: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850Article in journal (Refereed)
  • 135.
    Roos-Jansåker, Ann-Marie
    et al.
    Department of Periodontology, Public Dental Health Service, Kristianstad.
    Almhöjd, Ulrica S.
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Treatment of peri-implantitis: Clinical outcome of chloramine as an adjunctive to non-surgical therapy: a randomized clinical trial2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 1, p. 43-48Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate the adjunctive clinical effects of a chloramine to non-surgical treatment of peri-implantitis.

    Material and methods: Eighteen individuals diagnosed with peri-implantitis (clinical signs of inflammation and progressive bone loss) on at least two implants were included. Clinical variables; plaque accumulation (Pl), probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP), were recorded at baseline and at 3-month follow-up. Primary clinical efficacy variable was the change in the number of sites with BoP. The implants were randomized into two different treatment groups: test and control. Both implants received supra- and submucosal debridement by ultrasonic instrumentation supplemented with hand instruments. The implants assigned to the test group first received local applications of a chloramine gel (PerisolvTM; RLS Global AB, Gothenburg, Sweden) followed by mechanical instrumentation. The oral hygiene was checked at 6 weeks.

    Results: After 3 months, implants of both groups showed statistically significant reduction (P < 0.001) in the number of BoP-positive sites compared with baseline. The reduction of BoP-positive sites in the test group changed from 0.97 (SD 0.12) to 0.38 (SD 0.46), and in the control group from 0.97 (SD 0.12) to 0.31 (SD 0.42). Between-group comparisons revealed no statistically significant differences at baseline and after 3 months, for BoP or any of the other variables.

    Conclusion: In the present randomized clinical trial of peri-implantitis therapy; non-surgical mechanical debridement with adjunctive use of a chloramine is equally effective in the reduction of mucosal inflammation as conventional non-surgical mechanical debridement up to 3 months.

  • 136.
    Roshandel, Zahra
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Legitimerad tandvårdspersonals uppfattning och erfarenhet kring kariesriskbedömning- En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 137.
    Safi, Morid Ahmad
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Nasrallah, Rowaid
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Knowledge and attitude of oral health among caregivers in nursing homes for elderly in Ga-Rankuwa, South Africa.: A Cross-sectional study2017Independent thesis Basic level (degree of Bachelor of Fine Arts), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Elderly today have an increased life expectancy and retaining their teeth longer than before, it is important that healthcare-professionals have knowledge about oral health and how to prevent oral diseases. Objective: To study knowledge and attitude of oral health among caregivers at nursing homes in Ga-Rankuwa, Pretoria, South Africa. Method: The study was a quantitative cross-sectional study. Data was collected by a questionnaire representing four dimensions; Internal Locus of Control, External Locus of Control, Self-Efficacy and Oral Health Care Beliefs (OHCB), consisting questions about oral health and oral hygiene. The population consisted of 130 caregivers. Result: A total of 50 out of 61 caregivers participated in the study, out of which 43 were females and 7 were males. The age-interval was between 20-75 years. Generally, no statistical significant differences in knowledge and attitudes between the two nursing homes and between the caregivers´ professional statuses was noticed. T-test showed a statistical significant difference (P=0.011) between the caregivers for OHCB-dimension, and (P=0.044) between nursing home “A” and “B” for OHCB dimension. Conclusion: The general level of knowledge and attitude among the caregivers was satisfactory but low. Monitored health intervention studies should be given to promote oral health care knowledge and beliefs. 

  • 138.
    Sayardoust, Shariel
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Ekström, Jörgen
    University of Gothenburg, Gothenburg, Sweden.
    Isoprenaline- and VIP-induced nitric-oxide-clepenclent in vitro release of rat parotid amylase2003In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 82, no B, p. B398-B398, article id 3108Article in journal (Refereed)
  • 139.
    Sayardoust, Shariel
    et al.
    Department of Pharmacology, Sahlgrenska Academy Göteborg University, Göteborg, Sweden.
    Ekström, Jörgen
    Department of Pharmacology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Parasympathetic nerve-evoked protein synthesis, mitotic activity and salivary secretion in the rat parotid gland and the dependence on NO-generation2006In: Archives of Oral Biology, ISSN 0003-9969, E-ISSN 1879-1506, Vol. 51, no 3, p. 189-197Article in journal (Refereed)
    Abstract [en]

    Incorporation of radiolabelled leucine and thymidine into trichloroacetic acid-insoluble material of the parotid gland was used as indices of protein synthesis and mitotic activity, respectively, following electrical stimulation of the parasympathetic auriculo-temporal nerve for 30 min in pentobarbitone-anaesthetized rats under adrenoceptor blockade (phentolamine and propranolol, 2 mg/kg intravenous of each) in the absence or presence of atropine (2 mg/kg intravenous) and without or with nitric oxide synthase inhibitors. In atropinized rats, the parasympathetic non-adrenergic, non-cholinergic (NANC) nerve-evoked mean increases in protein synthesis at a frequency of 10 Hz (142%) and 40 Hz (200%) were not affected in a statistically significant way (124 and 275%, respectively) by the neuronal type NO-synthase inhibitor Nwpropyl-l-arginine (N-PLA) (30 mg/kg intravenous). Neither were the increase (175%) in protein synthesis at 10 Hz in non-atropinized animals affected by N-PLA (180%). The increase (65%) in mitotic activity, 19 h after the end of stimulation at 40 Hz, in the presence of atropine, was not affected by N-PLA (55%). Neither were the increase (95%) in gland content of amylase at this point of observation statistically significant affected by N-PLA (144%). The secretion of fluid and output of amylase from the parotid gland upon nerve stimulation was not affected by N-PLA. When examining the non-selective NO-synthase inhibitor L-NAME (30 mg/kg intravenous) in atropinized rats subjected to stimulation at 10 Hz, neither the increase in protein synthesis nor the evoked fluid response or amylase outputs were affected. Hence, in contrast to an NO-dependent sympathetic-induced protein synthesis and mitosis in the parotid gland, involving the activity of the neuronal type NO-synthase, no support for a parasympathetic-induced protein synthesis (and gain in gland amylase) and mitosis, depending on NO-generation, was found. Likewise, the present findings provide no evidence for a role of NO in the parasym pathetic nerve-evoked fluid secretion and amylase output. 

  • 140.
    Sayardoust, Shariel
    et al.
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden, and Department of Pharmacology, Sahlgrenska Academy Göteborg University, Göteborg, Sweden.
    Gröndahl, Kerstin
    Department of Oral and Maxillofacial Radiology, Institute for Postgraduate Dental Education, Sweden.
    Johansson, Eva
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Thomsen, Peter
    Department of Biomaterials, Institute for Clinical Sciences, Gothenburg University, Göteborg, Sweden.
    Slotte, Christer
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Implant survival and marginal bone loss at turned and oxidized implants in periodontitis-susceptible smokers and never-smokers: A retrospective, clinical, radiographic case-control study2013In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 84, no 12, p. 1775-1782Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about the long-term outcome of oxidized surface oral implants, especially in periodontitis-susceptible smokers. The aim of this study is to determine implant survival and marginal bone loss at turned and oxidized implants in smokers and never-smokers with periodontitis.

    Methods: Forty smokers and 40 never-smokers with experience of advanced periodontal disease, treated with implants 5 years previously, are included in this study. Groups were matched for sex, oral hygiene, and implant distribution, and patients were subgrouped by implant surface type (turned or oxidized).

    Results: The overall implant survival rate was 96.9% in never-smokers and 89.6% in smokers. Compared with oxidized implants, turned implants failed more frequently in smokers. In smokers, mean (standard error of the mean) marginal bone loss at 5 years was 1.54 (0.21) mm at turned and 1.16 (0.24) mm at oxidized implants. In never-smokers, significantly greater bone loss was found at oxidized implants, 1.26 (0.15) mm, than at turned implants, 0.84 (0.14) mm. Oxidized implants demonstrated similar bone loss for both groups. Turned implants lost significantly more bone in smokers. Compared with never-smokers, the smokers' likelihood ratio for implant failure was 4.68, 6.40 for turned and 0.00 for oxidized implants.

    Conclusions: The results of the study underscore the need for prevention and cessation of smoking. Turned implants failed more frequently and lost more marginal bone in smokers. In contrast, oxidized implants showed similar failure rates and bone loss in smokers and never-smokers. Turned implants displayed less bone loss than oxidized implants in never-smokers. Oxidized surface implants are more suitable for patients susceptible to periodontitis who smoke.

  • 141.
    Sayardoust, Shariel
    et al.
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden, and Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Omar, Omar
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Norderyd, Ola
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden, and Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Thomsen, Peter
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden.
    Clinical, radiological, and gene expression analyses in smokers and non-smokers, Part 2: RCT on the late healing phase of osseointegration2017In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 19, no 5, p. 901-915Article in journal (Refereed)
    Abstract [en]

    Background: The mechanisms behind the impact of smoking on osseointegration are not fully understood.

    Purpose: To investigate the initial clinical and molecular course of osseointegration of different implants in smokers and non-smokers in a randomized controlled trial (RCT).

    Materials and Methods: Smoking (n = 16) and non-smoking (n = 16) patients received 3 implant types: machined, oxidized, and laser-modified surfaces. Baseline bone biopsies were retrieved from the implant sites. After 60 and 90 days, the pain score, implant stability quotient (ISQ), and peri-implant crevicular fluid (PICF) gene expression were analyzed. Furthermore, radiological and clinical assessments were made at 90 days.

    Results: At 90 days, no pain was reported, irrespective of smoking habit. A higher ISQ was found in smokers compared with non-smokers. Marginal bone loss (MBL) was greater in smokers than in non-smokers. The comparison of implant surfaces revealed greater MBL exclusively at the machined implants in smokers. At 90 days in smokers, the PICF around machined implants revealed a higher expression of the proinflammatory cytokine, interleukin-6 (IL-6), and a lower expression of the osteogenic gene, osteocalcin (OC), compared with the PICF around modified implants. Furthermore, OC expression was lower at machined implants in smokers compared with machined implants in non-smokers. After adjustment for age and implant location (maxilla/mandible), multivariate regression revealed the following predictors of MBL: smoking, bleeding on probing at 90 days, hypoxia-inducible factor 1 alpha (HIF-1α) expression at baseline and IL-6 expression in PICF at 90 days.

    Conclusions: During the early phase of osseointegration, non-smokers and smokers present a similar, high implant survival. In contrast, smokers present a greater MBL, particularly at machined implants. HIF-1α baseline expression in the recipient bone and IL-6 expression in PICF cells are important molecular determinants for MBL after 90 days. It is concluded that smoking has an early effect on osseointegration, which is dependent on the implant surface properties and the local host response. 

  • 142.
    Sayardoust, Shariel
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Omar, Omar
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Norderyd, Ola
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Thomsen, Peter
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Implant-associated gene expression in the jaw bone of smokers and nonsmokers: A human study using quantitative qPCR2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 9, p. 937-953Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study aimed to compare the molecular events in implant-adherent cells and in peri-implant bone during the osseointegration of machined and oxidized titanium implants in smokers and nonsmokers.

    MATERIALS AND METHODS: Twenty-four smokers and 24 nonsmokers each received machined and anodically oxidized mini-implants. The mini-implants and the surrounding bone were retrieved after 1, 7, and 28 days, for gene expression analysis of selected factors using quantitative polymerase chain reaction (qPCR).

    RESULTS: Differences between machined and oxidized implants were more evident in the implant-adherent cells than the peri-implant bone. The machined implants revealed higher expression of proinflammatory cytokines, interleukin-8 (IL-8) (in nonsmokers), and tumor necrosis factor-alpha (in nonsmokers and smokers), compared with the oxidized implants. Conversely, the expression of bone formation genes, alkaline phosphatase and osteocalcin, was generally higher at the oxidized implants. In smokers, the temporal pattern revealed the delayed and initial inhibition of osteoblastic and osteoclastic gene expression, respectively, mainly at the machined implants. In contrast, oxidized implants revealed higher expression of bone remodeling, cathepsin K (CatK) and calcitonin receptor, and coupling, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin, genes after 7 day in smokers.

    CONCLUSIONS: The implant-adherent cells are more sensitive to surface properties and smoking conditions than the cells in the peri-implant bone. Smoking imposes inhibitory effects on the initial molecular events of osseointegration in the human bone-implant interface. The surface properties of oxidized implants appear to have a beneficial effect on osseointegration by mitigating the smoking-induced negative effects.

  • 143.
    Sayardoust, Shariel
    et al.
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden, and Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Omar, Omar
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden.
    Thomsen, Peter
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden.
    Gene expression in peri-implant crevicular fluid of smokers and nonsmokers. 1. The early phase of osseointegration2017In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 19, no 4, p. 681-693Article in journal (Refereed)
    Abstract [en]

    Background: Smoking is a risk factor for dental implants. The mechanisms behind the impact of smoking on osseointegration are not fully understood.

    Purpose: To investigate the initial molecular and clinical course of osseointegration of different titanium implants in smokers and nonsmokers.

    Materials and Methods: Smoker (n = 16) and nonsmoker (n = 16) patients were included. Each patient received three implant types: machined, oxidized and laser-modified surfaces. After 1, 7, 14, and 28 days, the peri-implant crevicular fluid (PICF) was sampled for gene expression analysis of selected factors involved in early processes of osseointegration. Furthermore, pain-score (VAS), resonance frequency analysis (RFA) and baseline clinical assessments were performed.

    Results: Early failure of osseointegration, associated with a high and sustained perception of pain, was encountered in 3/32 patients. In general, high pain scores were reported during the first days after implantation, irrespective to smoking habit, which correlated to high levels of pro-inflammatory cytokines during the first days after implantation. Higher ISQ values were found in smokers compared to nonsmokers. In smokers exclusively, ISQ values correlated to harder and less atrophic bone quality and quantity, respectively. Smokers displayed a higher expression of osteocalcin (OC), but later peak and lower expression of bone morphogenetic protein (BMP-2) (at 7 days) compared to nonsmokers. In comparison to machined implants, surface-modified implants were associated with higher expression of alkaline phosphatase (ALP) and cathepsin K (CatK) at 28 days in nonsmokers.

    Conclusions: During the early phase of osseointegration, postoperative pain is linked to the inflammatory cell response and, may tentatively serve as an indicator of biological complication and implant loss. The present study suggests that smokers have an altered bone composition and (ultra)structure based on the observations that ISQ values are higher and correlate to recipient bone quality and quantity in smokers.

  • 144.
    Scheerman, Janneke F M
    et al.
    Academic Centre for Dentistry Amsterdam (ACTA), Department of Preventive Dentistry, Amsterdam, Netherlands.
    van Meijel, Berno
    Inholland University of Applied Sciences, Department of Health, Sports and Welfare/Cluster Nursing, Amsterdam, Netherlands.
    van Empelen, Pepijn
    Netherlands Organization for Applied Scientific Research (TNO), Department of Child Health, Leiden, Netherlands.
    Kramer, Gem J C
    Academic Centre of Dentistry Amsterdam, Department of Orthodontics, Amsterdam, Netherlands.
    Verrips, Gijsbert H W
    Netherlands Organization for Applied Scientific Research (TNO), Department of Child Health, Leiden, Netherlands.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Oral health. Qazvin University of Medical Sciences, Department of Social Determinants of Health, Research Centre (SHD), Qazvin, Iran.
    Van den Braak, Matheus C T
    Academic Centre for Dentistry Amsterdam (ACTA), Department of Preventive Dentistry, Amsterdam, Netherlands.
    van Loveren, Cor
    Academic Centre for Dentistry Amsterdam (ACTA), Department of Preventive Dentistry, Amsterdam, Netherlands.
    Study protocol of a randomized controlled trial to test the effect of a smartphone application on oral-health behavior and oral hygiene in adolescents with fixed orthodontic appliances2018In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 18, no 1, article id 19Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12-16 with fixed orthodontic appliances.

    METHODS/DESIGN: The RCT has two conditions: an experimental group that will receive the WhiteTeeth app in addition to care as usual, and a control group that will only receive care as usual. Care as usual will include routine oral-health education and instruction at orthodontic check-ups. In the western part of the Netherlands 146 participants will be recruited from four orthodontic clinics. Data will be collected during three orthodontic check-ups: baseline (T0), 6 weeks of follow-up (T1) and 12 weeks of follow-up (T2). The primary study outcomes are the presence of dental plaque (measured with a modified Silness and Loë Plaque Index); and gingival bleeding (measured with the Bleeding on Marginal Probing Index). Secondary outcomes include changes in self-reported oral-health behaviors and its psychosocial factors identified by the HAPA theory, such as outcome expectancies, intention, action self-efficacy, coping planning and action control.

    DISCUSSION: Since the intervention was designed to target psychosocial factors in the motivational and volitional components of the behavior-change process, we hypothesize that the app will cause greater improvements in oral-health behavior and oral hygiene more than traditional oral-health-promotion programs (i.e., care as usual).

    TRIAL REGISTRATION: The trial has been registered with the Dutch Trial Register ( NTR6206 : 20 February 2017).

  • 145.
    Scheerman, Janneke F. M.
    et al.
    Inholland University of Applied Sciences, Amsterdam, Netherlands.
    van Meijel, Berno
    Inholland University of Applied Sciences, Amsterdam, Netherlands.
    van Empelen, Pepijn
    TNO Research Group, Leiden, Netherlands.
    Verrips, Gijsbert H. W.
    TNO Research Group, Leiden, Netherlands.
    van Loveren, Cor
    Academic Center for Dentistry Amsterdam, Amsterdam, Netherlands.
    Twisk, Jos W. R.
    VU Medical Center Amsterdam, Amsterdam, Netherlands.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    van den Braak, Matheus C. T.
    Academic Center for Dentistry Amsterdam, Amsterdam, Netherlands.
    Kramer, Gem J. C.
    Academic Center for Dentistry Amsterdam, Amsterdam, Netherlands.
    The effect of using a mobile application (“WhiteTeeth”) on improving oral hygiene: A randomized controlled trial2019In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effectiveness of the WhiteTeeth mobile app, a theory-based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients.

    Methods: In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check-ups: at baseline (T0), at 6-week follow-up (T1) and at 12-week follow-up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n = 67). The control group received usual care only (n = 65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al-Anezi and Harradine plaque index), and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behaviour and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed-model analyses to determine the intervention effects.

    Results: At 6-week follow-up, the intervention led to a significant decrease in gingival bleeding (B = −3.74; 95% CI −6.84 to −0.65) and an increase in the use of fluoride mouth rinse (B = 1.93; 95% CI 0.36 to 3.50). At 12-week follow-up, dental plaque accumulation (B = −11.32; 95% CI −20.57 to −2.07) and the number of sites covered with plaque (B = −6.77; 95% CI −11.67 to −1.87) had been reduced significantly more in the intervention group than in the control group.

    Conclusions: The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.

  • 146.
    Scheerman, Janneke Francisca Maria
    et al.
    Department Oral Hygiene, Inholland University of Applied Sciences, Cluster Health, Sport and Welfare, Amsterdam, The Netherlands.
    Hamilton, Kyra
    School of Applied Psychology, Griffith University, Brisbane, Australia.
    Sharif, Mohammad Owaise
    Eastman Dental Institute, University College London, London, England.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    A theory-based intervention delivered by an online social media platform to promote oral health among Iranian adolescents: a cluster randomized controlled trial2019In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Article in journal (Refereed)
    Abstract [en]

    Objective: Based on the Health Action Process Approach, we tested the efficacy of a theory-based program using an online social media platform (Telegram) to promote good oral hygiene behaviour among Iranian adolescents.

    Design: A three-arm randomized-controlled trial design was used, consisting of an adolescent only intervention group (A group; n = 253), an adolescent and mother intervention group (A + M group; n = 260), and a control group (n = 278).

    Main outcome measures: Psychosocial variables, toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index.

    Results: Increases in adolescent toothbrushing at the one- and six-month follow-ups in both intervention groups compared to the control group were observed. Adolescents in the A + M group showed significant greater improvements in their toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index scores than adolescents in the A group. Improvements to toothbrushing social cognitions were also observed.

    Conclusions: Current results support the use of the theory-based program delivered by Telegram in improving good oral hygiene behaviour and oral health outcomes among Iranian adolescents. Involving mothers in an intervention can confer additional benefits for adolescent oral health.

  • 147.
    Shah, Furqan A.
    et al.
    Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sayardoust, Shariel
    Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Thomsen, Peter
    Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Palmquist, Anders
    Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Extracellular matrix composition during bone regeneration in the human dental alveolar socket2019In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 127, p. 244-249Article in journal (Refereed)
    Abstract [en]

    Within the dental alveolar socket, the sequence of events following tooth extraction involves deposition of a provisional connective tissue matrix that is later replaced by woven bone and eventually by lamellar bone. Bone regeneration within the dental alveolar socket is unique since the space occupied by the root(s) of a tooth does not originally contain any bone. However, extracellular matrix composition of the healing alveolar socket has not previously been investigated. Here, alveolar bone biopsies representing early (7–46 months, < 4y) and late (48–60 months; 4–5y) healing periods were investigated using Raman spectroscopy, X-ray micro-computed tomography and backscattered electron scanning electron microscopy. Partially or completely edentulous individuals and those with a smoking habit were not excluded. Between < 4y and 4–5y, mineral crystallinity and bone mineral density increase, phenylalanine, proline/hydroxyproline, and bone surface-to-volume ratio decrease, while the carbonate-to-phosphate ratio, the mineral-to-matrix ratio, and the collagen crosslink ratio remain relatively unchanged. Observed exclusively at 4–5y, hypermineralised osteocyte lacunae contain spherical and rhomboidal mineral nodules. Spearman correlation analysis reveals several significant, high (ρ = 0.7–0.9; p ≤ 0.01) and moderate (ρ = 0.5–0.7; p ≤ 0.01) correlations. Mineral crystallinity and proline/hydroxyproline, the carbonate-to-phosphate ratio and phenylalanine, mineral crystallinity and bone surface-to-volume ratio, the carbonate-to-phosphate ratio and bone surface-to-volume ratio, proline/hydroxyproline and bone mineral density, and bone mineral density and bone surface-to-volume ratio are negatively correlated. Mineral crystallinity and bone mineral density, and proline/hydroxyproline and bone surface-to-volume ratio are positively correlated. Although bone regeneration in the dental alveolar socket follows typical bone healing patterns, the compositional and microstructural patterns reveal mature bone at < 4y with indications of better mechanical competence at 4–5y. 

  • 148.
    Slåtterlid Skeie, Marit
    et al.
    Faculty of Medicine and Dentistry.
    Wendt, Lill-Kari
    Jönköping University, School of Health Science, HHJ. Oral health.
    Poulsen, Sven
    Department of Pediatric Dentristy .
    Dental caries in children and adolescents2009In: Pediatric Dentistry: A Clinical Approach / [ed] Göran Koch, Sven Poulsen, Oxford, England: Blackwell , 2009, 2, p. 61-70Chapter in book (Other academic)
  • 149. Sondell, Katarin
    et al.
    Söderfeldt, Björn
    Hugoson, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Dental care utilization in a Swedish county in 1993 and 20032010In: Swedish Dental Journal, ISSN 0347-9994, Vol. 34, no 4, p. 217-Article in journal (Refereed)
  • 150.
    Stange, Karolina Mikkelä
    et al.
    Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden .
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden.
    Bjerklin, Krister
    Department of Orthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden.
    Autotransplantation of premolars to the maxillary incisor region: A long-term follow-up of 12-22 years2016In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 38, no 5, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the long-term outcome of treatment of missing maxillary incisor teeth by transplantation of premolars, with special reference to aesthetics and patient satisfaction.

    Subjects and Methods: Twenty subjects who had undergone transplantation of premolars to the maxillary incisor area were recalled for follow-up varying between 12 and 22 years post-surgery. Twelve subjects presented for examination, including radiography and three subjects participated only by answering questions. Three reference groups-general practitioners, orthodontists, and lay people-evaluated the aesthetic results from photographs. Patient satisfaction was evaluated by interviews and OHIP-14.

    Results: The mean age at transplantation was 12.3 years: 1 subject had been 20 years old and 11 were in the range of 9-14 years. Twelve to 22 years after autotransplantation, 5 subjects could not be reached: of the 15 who could be contacted, the survival rate was 15 out of 15. In the 12 subjects who presented for clinical examination, 11 out of the 12 transplants were assessed as successful. Nine transplants were restored with crowns and five had been recontoured with composite build-ups. In one patient, no restorative treatment had been undertaken. The subjects were satisfied with the aesthetic result.

    Conclusion: Autotransplantation of premolars is an appropriate method for treatment of missing maxillary anterior teeth. Subjects with a transplanted tooth to the maxillary anterior region perceive their oral health as good long term.

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