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  • 51.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Koch, Göran
    Göthberg, Catharina
    Helkimo, Anna Nydell
    Lundin, Sven-Ake
    Norderyd, Ola
    Sjödin, Bengt
    Sondell, Katarina
    Oral health of individuals aged 3-80 years in Jönköping, Sweden during 30 years (1973-2003): I. Review of findings on dental care habits and knowledge of oral health2005In: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, no 4, p. 125-138Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to compare data on dental care habits and knowledge of oral health in four cross-sectional epidemiological studies carried out in 1973,1983,1993, and 2003. The 1973 study constituted a random sample of 1,000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993 and 2003 studies, which comprised 1,104, 1,078, and 987 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used in connection with a clinical and radiographic examination. The same questions were used in all the four studies. An addition to the 1993 and 2003 investigations were questions concerning ethnic background. In 2003 approximately 90-95 per cent of all individuals were visiting the dentist on a regular basis every or every second year. The 30- and 40-yea r-olds, however, did not visit a dentist as regularly in 2003 as in 1993. In these age groups 21-24 per cent of the individuals, respectively, reported that they had not visited a dentist in the last 2 years. Almost all children 3-15 years old received their dental care within the Public Dental Service (PDS). During the period 1973-2003 an increase in percentage of individuals aged 20-50 years treated by the PDS was seen compared to private practice, while among 60-80 year-olds there were only minor changes. Most so-year-olds and older received their dental care by private practitioners. About 70-80 per cent of all adults in 2003 were enrolled in a recall system on the dentist's initiative while in 1973 most appointments were based on the patient's own initiative. The number of individuals who were frightened, 5-17 per cent, or felt discomfort at the prospect of an appointment with the dentist was more or less the same during the whole period. The knowledge of the etiology of dental diseases did not changed much between 1973 and 2003. The frequency of toothbrushing increased since 1973 and in 2003 more than 90 per cent of all individuals brushed their teeth twice or once a day. The use of dental floss and toothpicks decreased in 2003 compared to 1983 and 1993. Almost all individuals in 2003 used fluoride toothpaste. It was obvious that the dental team constituted the main source of dental health information. For the age groups 20 and 30 years information from friends and relatives was also important. In the age groups 3-20 years up to 45 per cent of the individuals were consuming soft drinks every day or several times a week.

  • 52.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Koch, Göran
    Helkimo, Anna Nydell
    Lundin, Sven-Ake
    Caries prevalence and distribution in individuals aged 3-20 years in Jönköping, Sweden, over a 30-year period (1973-2003)2008In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 18, no 1, p. 18-26Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Oral health status of individuals aged 3-80 years in the city of Jönköping, Sweden, has been assessed in a series of epidemiological studies over a 30-year period. AIM: To analyse the changes in caries prevalence and caries distribution in child population sample groups, based on studies performed in 1973, 1978, 1983, 1993, and 2003. DESIGN: Each time point included 500 randomly sampled individuals, divided into age groups of 3, 5, 10, 15, and 20 years. Results. Thirty-five per cent of 3-year-olds were caries free in 1973, compared with 69% 30 years later. Decayed and filled primary (dfs) and permanent surfaces (DFS) were reduced by 50-80% between 1973 and 2003. Adolescents aged 10 and 15 years exhibited the most pronounced reduction in DFS on the occlusal surfaces. By 2003, 90% of the proximal carious lesions in 15-year-olds were initial carious lesions. In 2003, about 60% of 15-year-olds had a DFS of < or = 5, while about 7% exhibited a DFS of > or = 26. CONCLUSIONS: Despite the dramatic decline in the prevalence of caries, caries remains a health problem among children, particularly those of preschool age. Continuous epidemiological studies are recommended to evaluate preventive measures.

  • 53.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Laurell, L
    Lundgren, D
    Frequency distribution of individuals aged 20-70 years according to severity of periodontal disease experience in 1973 and 1983.1992In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 19, no 4, p. 227-32Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare changes in periodontal status of a Swedish population over a 10-year period expressed as frequency distributions of individuals according to severity of periodontal disease experience. The study involved 600 randomly selected individuals evenly distributed into age groups 20, 30, 40, 50, 60 and 70 years, examined in 1973 and another randomly selected group of 597 individuals similarly age distributed and examined in 1983. Based on clinical data and full mouth intraoral radiographs all individuals were classified into 5 groups according to severity of periodontal disease experience. In 1983, 23% of the individuals were classified as having healthy periodontal tissues, group 1, compared to 8% in 1973. The changes were most pronounced in the age groups 20 and 30 years, among whom 58% and 35%, respectively, were registered as having healthy periodontium in 1983. The prevalence of individuals with gingivitis without signs of lowered periodontal bone level, group 2, was 22% in 1983 compared to 41% in 1973. In all, 49% of the dentate population in 1973 and 45% in 1983 showed no marginal alveolar bone loss. Moderate periodontal bone loss, group 3, was found in 41% of the population in 1983 compared to 47% in 1973. Among 30-, 40-, and 50-year-olds, there were more, and among 60- and 70-year-olds, fewer individuals in this group in 1983 compared to 1973. 96% of the dentate population were classified as belonging to groups 1, 2 or 3 in 1973 compared to 86% in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

  • 54.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Norderyd, Ola
    Has the prevalence of periodontitis changed during the last 30 years?2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 8 Suppl, p. 338-345Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reviews global trends in the change in prevalence of periodontitis over the last 30 years. MATERIAL AND METHODS: The epidemiology of periodontal disease is briefly reviewed together with the current classification system and the clinical and radiographic diagnostic methodology in periodontal disease. RESULTS: This review identifies the very limited number of studies that provide prevalence data over time, and this data is discussed in comparison with those stemming from a few corresponding studies from countries outside Europe. CONCLUSIONS: The data indicate a possible trend of a lower prevalence of periodontitis in recent years.

  • 55.
    Hugoson, Anders
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Sjödin, Bengt
    Norderyd, Ola
    Trends over 30 years, 1973-2003, in the prevalence and severity of periodontal disease.2008In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 35, no 5, p. 405-414Article in journal (Refereed)
    Abstract [en]

    AIM: The present investigation presents findings of the prevalence and distribution of gingivitis and periodontitis in a Swedish population over the 30 years 1973-2003. MATERIAL AND METHODS: Four cross-sectional epidemiological studies in 1973, 1983, 1993, and 2003 were performed in Jönköping, Sweden. Random samples of individuals aged 20, 30, 40, 50, 60, 70, and 80 years were examined clinically and radiographically. Diagnostic criteria were edentulousness, number of teeth, plaque, gingival status, probing pocket depth, gingival recession, alveolar bone level, and classification according to periodontal disease status. RESULTS: In all age groups, the number of edentulous individuals decreased dramatically and the number of teeth increased. Oral hygiene improved considerably. Over the 30 years, the proportion of periodontally healthy individuals increased from 8% in 1973 to 44% in 2003 and the proportion of individuals with gingivitis and moderate periodontitis decreased. There was a non-significant trend for the proportion of individuals with severe periodontal disease experience (Group 4) to decrease, while the proportion of individuals with advanced periodontitis (Group 5) remained unchanged. CONCLUSION: Oral hygiene and periodontal health improved significantly in the 20-80-year age groups over the 30 years 1973-2003.

  • 56.
    Isaksson, H.
    et al.
    Department of Paediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping.
    Alm, A.
    Department of Paediatric Dentistry, Kärnsjukhuset, Skövde.
    Koch, G.
    Department of Paediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping.
    Birkhed, D.
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Caries prevalence in Swedish 20-year-olds in relation to their previous caries experience2013In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 47, no 3, p. 234-242Article in journal (Refereed)
    Abstract [en]

    Background/Aim: There are few studies of caries development and caries-related factors from early age to young adulthood. The aim of the present study is to analyse caries prevalence in 20-year-olds in relation to their previous caries experience. Method: Oral health from 3 to 20 years of age was followed longitudinally in a cohort of 499 individuals. The clinical and radiographic incidence of caries and restorations in 494 20-year-olds was related to caries data at 3, 6 and 15 years of age. Results: Twenty-six per cent of the 20-year-olds were caries-free. The mean number of initial and manifest lesions and restorations (Di + mFS) was 5.8. Initial lesions comprised 40% of the Di + mFS. Of the occlusal surfaces of molars and premolars, 12 and 4%, respectively, had manifest caries or restorations. Compared with individuals who had been caries-free during childhood (primary dentition) and adolescence, those with a history of caries activity while growing up had statistically significantly more approximal lesions at the age of 20 (DmFSa 0.6 vs. DmFSa 4.6, respectively). Those with manifest caries during childhood but caries-free at 15 years had a low caries prevalence at 20 years of age (DmFSa 1.3). Few new lesions developed after age 15. However, 50% of initial lesions at this age had progressed to manifest lesions at age 20. Conclusion: There is a relationship between caries prevalence at age 20 and early caries experience.

  • 57.
    Isaksson, Helén
    et al.
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Birkhed, Dowen
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Alm, Anita
    Department of Paediatric Dentistry, Kärnsjukhuset, Skövde, Sweden.
    Nilsson, Mats
    Futurum – The Academy of Healthcare, County Hospital, Jönköping, Sweden.
    Koch, Göran
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Prevalence of dental erosion and association with lifestyle factors in Swedish 20-year olds2014In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 72, no 6, p. 448-457Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate the prevalence, distribution and severity of dental erosion and its association with lifestyle, oral and general health in young adults. Materials and methods. Four hundred and ninety-four individuals, 20-years of age, participated. Dental erosion in molars and maxillary incisors was evaluated. Caries, plaque and gingivitis were registered. Saliva samples were taken and the subjects were interviewed about behavioural and dietary habits and oral and general health. Body mass index (BMI) was calculated. The individuals were sub-divided into two groups according to the presence and absence of dental erosion: within the group with erosion was a sub-group of individuals with extensive erosion. Results. Of the individuals 25% had no erosion, 75% had erosion and 18% had extensive erosion. Erosion was found in molars in 74% of the individuals and on buccal and palatal surfaces in maxillary incisors in 4% and 7%, respectively. Cupping was seen in 65% of individuals and severe erosion in molars in 1.6%. Compared to subjects with no erosion, those with extensive erosion had a higher consumption of soft drinks (p = 0.05), caries prevalence (p < 0.01), prevalence of mutans Streptococci (p < 0.01) and BMI (p < 0.05). Furthermore, subjects with erosion had higher caries prevalence (p < 0.01) and BMI (p < 0.01) than those with no erosion. Conclusions. Swedish young adults have a high prevalence of dental erosion, but the level of severe erosion is low. The study disclosed a relationship between dental erosion and behavioural factors, oral health and BMI.

  • 58.
    Isaksson, Helén
    et al.
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Koch, Göran
    Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Alm, Anita
    Department of Preventive and Community Dentistry, Public Dental Health Service, Västra Götaland Region, Göteborg, Sweden.
    Nilsson, Mats
    Futurum, Academy of Health and Care, Region Jönköping County, Jönköping.
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Birkhed, Dowen
    Malmö University Faculty of Odontology, Department of Oral Diagnostics, Malmö, Sweden.
    Parental factors in early childhood are associated with approximal caries experience in young adults - A longitudinal study2019In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 47, no 1, p. 49-57Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To test the hypothesis that parental factors in early childhood influence approximal caries experience in young adults.

    METHODS: A cohort of 494 individuals was followed longitudinally from 1 to 20 years of age. Data were retrieved from parental interviews and questionnaires when the child was 1 and 3 years of age. At age 20, the participants underwent bitewing radiographic examination. Based on the number of approximal caries lesions (Da), stratified into initial (Di ) or manifest caries (Dm ) and approximal fillings (Fa), the participants were divided into two main groups: those with: (a) 0 Dim Fa (n = 244) and (b) >0 Dim Fa (n = 250). A subgroup was also created (≥8 Dim Fa; n = 33).

    RESULTS: Toothbrushing with fluoride toothpaste at 3 years of age less than twice a day (OR 1.6, 95% CI 1.0-2.6) and the participants' mothers' self-estimation of their oral health care as "less than optimal" were important risk factors for developing caries (>0 Dim Fa OR 2.0, 95% CI 1.3-3.1). An interaction effect between toothbrushing at 3 years of age less than twice a day and consumption of caries risk products > 3 times a day further increased the caries experience in young adults (≥8 Dim Fa OR 8.3, 95% CI 1.8-37.8) together with maternal anxiety about dental treatment (OR 7.4 95% CI 1.6-34.6).

    CONCLUSIONS: Parental factors in early childhood are associated with caries experience at 20 years of age.

  • 59.
    Jacobsson, Brittmarie
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Karies och kariesassocierade faktorer bland svenska 15-åringar med invandrarbakgrund2004Report (Other academic)
    Abstract [en]

    Objectives: The aim of the present study was to evaluate the prevalence of caries and caries associated variables in 15-year-olds with a foreign background in relation to Swedish 15-year-olds and to examine differences in the prevalence of caries in immigrant adolescents according to their length of residence in Sweden. Methods: All 15-year-old adolescents (n=143) at one public school in the city of Jönköping, Sweden, were asked to participate in the study. The adolescents were divided into two groups according to their background: immigrants and non-immigrants. The final study cohort comprised 117 adolescents: 51 immigrants and 66 non-immigrants. All participants were interviewed individually in a structed interview on background data, diet, oral hygiene habits and fluor exposure. Data on caries prevalence were extracted from the dental records of the examination made when the participants were 15 years old. Results: Immigrant adolescents had significantly more surfaces affected by enamel and dentine caries than non-immigrants, but the proportions of immigrants and non-immigrants who had symptoms of enamel or dentine caries were equal. Adolescents born in Sweden of immigrant parents or who had arrived before 1 year of age had caries prevalence similar to those of non-immigrant adolescents, whereas children who had immigrated to Sweden after seven years of age had a caries prevalence that was 2–3 times higher. Among immigrant adolescents, compared with non-immigrants, a lower proportion ate breakfast regularly and had a higher intake of snack products, and sucrose intake was positively correlated with caries prevalence among immigrants. There were no statistically significant differences in toothbrushing or flossing frequency or use of fluorides between immigrants and non-immigrants, but immigrant adolescents who brushed their teeth only once a day had more than twice as many proximal surfaces affected by caries as immigrants who brushed twice a day. Conclusion: Caries prevalence is higher in immigrant than in Swedish adolescents, especially in adolescents who immigrated to Sweden. After seven years of age. As caries was mainly restricted to the enamel. Immigrant adolescents had on average more caries associated factors than non-immigrants.

  • 60.
    Jacobsson, Brittmarie
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    On Oral Health in Young Individuals with a Focus on Sweden and Vietnam: A Cultural Perspective2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    AIM: The overall aim of this thesis was to study culture as an oral health determinant for dental caries and gingivitis in children living in Jönköping, Sweden, in relation to children living in Da Nang, Vietnam.

    MATERIALS AND METHODS: In 1993 and 2003, cross-sectional studies with clinical examinations and questionnaires were performed in Jönköping, Sweden, with a random sample of 130 children from each of four age groups; 3, 5, 10 and 15 years. The final study sample comprised 739 children, 154 (21%) with two foreign-born parents and 585 (79%) with two Swedish-born parents (Paper I). In 2000, all 15-year-olds (n=143) at one school in Jönköping, Sweden, were asked to participate in a questionnaire study connected to clinical data. The final sample comprised 117 individuals, 51 (44%) with foreign-born parents and 66 (56%) with Swedish-born parents (Paper II). In 2008, a cross-sectional study with clinical examinations and questionnaires was performed in Da Nang, Vietnam with 840 randomly selected children, 210 in each of four age groups; 3, 5, 10 and 15 years. The final sample comprised 745 individuals (Papers III and IV).

    RESULTS: In 2003, the mean number of decayed (initial and manifest) and filled tooth surfaces was significantly higher in all age groups in children with foreign-born parents compared with children with Swedish-born parents. The gap between children with foreign-born parents and Swedish-born parents increased over the ten-year period from 1993 to 2003. The odds ratio of dental caries development among 10- and 15-year-old children with foreign-born-parents was more than six times higher than for their counterparts with Swedish-born parents (Paper I). Fifteen-year-olds born in Sweden of foreignborn parents and those who had immigrated before one year of age had a caries prevalence similar to 15-year-olds with Swedish-born parents, whereas the caries prevalence in children who had immigrated to Sweden after 7 years of age was 2-3 times higher (Paper II). Among the 3- and 5-year-olds in Vietnam, 98% suffered from dental caries, compared with 91% of 10- and 15-year-olds (Paper IV). The distribution of the most frequent values of decayed and filled primary tooth surfaces (dfs) in 5-year-olds was 16–20, and of decayed and filled permanent tooth surfaces (DFS) in 15-year-olds was 1–5. The maximum dfs was 76–80, and significant numbers of children had dfs between 20 and 50. The percentage of tooth sites with plaque and gingivitis was higher for children in all age groups with foreign-born parents compared with children with Swedish-born parents, except among the 15-year-olds in 2003. In Vietnam, the prevalence of plaque and gingivitis was high in all age groups, especially in 10- and 15-year-olds. Fifteen-yearolds in Sweden with foreign-born parents had a higher intake of snack products between principal meals compared with 15-year-olds with Swedish-born parents (Paper II). In Sweden, most children in all age groups brushed their teeth themselves or with help from their parents twice or more than twice a day (Paper I). Among 3- and 5-year-olds in Vietnam, about half of the parents reported that their children brushed their teeth themselves or with help from parents twice or more than twice a day (Paper III). All 3-year-olds and 99% of 5-year-olds in Sweden brushed their teeth with fluoride toothpaste (Paper I). Among 15-year-olds in Sweden with foreign-born parents, 88% reported that they brushed their teeth with fluoride toothpaste at least twice a day compared with 98% of 15-year-olds with Swedish-born parents (Paper II). In Vietnam, 44–78% of the children used fluoride toothpaste for toothbrushing and 51% consumed sweets between principal meals at least once a day (Paper III). Sweetened milk was the most common source of this sugar intake for the 3- and 5-year-olds (Paper III).

    CONCLUSIONS: Culture is an important oral health determinant for dental caries and gingivitis in children. There is an urgent need to improve oral health care promotion and preventive programmes for children with foreign-born parents in Sweden, but also a great need for such programmes for children in Vietnam.

  • 61.
    Jacobsson, Brittmarie
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    On oral health in young individuals with foreign and Swedish backgrounds2011Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Sweden, children and adolescents with two foreign-born parents constitute 17% of all children in the Swedish population.

    AIMS: The aims of this thesiswere to collect knowledge of the prevalence of gingivitis, caries and caries associated variables, in the 3-, 5-, 10- and 15-year age groups with two foreign born parents compared with their counterparts with Swedish-born parents in a ten-year perspective (Study I). To investigate the prevalence of caries and caries-associated variables in 15-year-olds in relation to foreign backgrounds and to examine differences in the prevalence of caries in adolescents with foreign backgrounds according to their length of residence in Sweden (StudyII).

    MATERIAL AND METHODS: In 1993 and 2003, cross-sectional studies with random samples of individuals in the age groups of 3, 5, 10 and 15 years were performed in Jönköping, Sweden. The oral health status of all individuals was examined clinically and radiographically. The children or their parents also answered a questionnaire about their attitudes to, and knowledge of, teeth and oral health care habits. The final study sample comprised 739 children and adolescents, 154 with two foreign-born parents (F cohort) and 585 with two Swedish-born parents (S cohort) (Study I). In Study II, all 15-year-olds(n=143) at one school in the city of Jönköping were asked to participate in the study. The final sample comprised 117 individuals, 51 with foreign-born parents and 66 with Swedish-born parents. All the individuals were interviewed using a structured questionnaire with visualisation e.g. food packages, sweets and snacks. Information about DFS was collected from case records at the Public Dental Service.

    RESULTS: In both 1993 and 2003, more 3- and 5-yearolds in the S cohort were caries free compared with the F cohort. In 1993, dfs was higher among 3- and 5-year-olds in the F cohort (p<0.01) compared with the S cohort. In 2003, dfs/DFS was statistically significantly higher in all age groups among children and adolescents in the F cohort compared with the S cohort. In 2003, the odds ratio of being exposed to dental caries among 10- and 15-year-olds in the F cohort, adjusted for gender and age, was more than six times higher (OR=6.3, 95% CI:2.51-15.61; p<0.001) compared with the S cohort (Study I). Fifteen-year-olds born in Sweden with foreign-born parents, or who had arrived before one year of age, had a caries prevalence similar to that of adolescents with Swedish-born parents, whereas children who had immigrated to Sweden after seven years of age had a caries prevalence that was two to three times higher (p <0.06) (Study II). Both in 1993 and 2003, the mean of the percentage of tooth sites with plaque and gingivitis was numerically higher in all age groups in individuals with foreign backgrounds compared with Swedish background, except between the 15-year-olds (Study I).

    CONCLUSIONS: The decrease in caries prevalence, in a ten-year perspective, was less among children and adolescents with foreign-born parents compared with children and adolescents with Swedish-born parents. In 2003, there was statistically significantly more caries in all age groups among children and adolescents with foreign-born parents compared with children and adolescents with Swedish-born parents. Children who immigrated to Sweden at age seven or later had a two to three times higher caries prevalence compared with their Swedish counterparts. The odds ratio for being exposed to dental caries was almost six times higher for 10- and 15-year olds with foreign-born parents compared with their Swedish counterparts. The intake of carbohydrate-rich food was higher among 15-year olds with foreign backgrounds compared to those with Swedish background. There is an obvious need to improve the promotion of oral health care programmes among children and adolescents with foreign-born parents.

  • 62.
    Jacobsson, Brittmarie
    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.
    Ho, Thanh Thi
    Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    Chuong, Hoang Ngoc
    Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    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.
    Sociodemographic conditions, knowledge of dental diseases, dental care, and dietary habits2015In: Journal of Public Health Dentistry, ISSN 0022-4006, E-ISSN 1752-7325, Vol. 75, no 4, p. 308-316Article in journal (Refereed)
    Abstract [en]

    Objectives

    This study's aim was to present data on the sociodemographic conditions, knowledge of dental diseases, dental care, and dietary habits among children aged 3, 5, 10, and 15 years in Da Nang, Vietnam.

    Methods

    A cross-sectional epidemiological questionnaire study was conducted in a population of 840 children randomly selected by their year and month of birth (January to July), including 210 individuals in each age group. A self-reported questionnaire was completed by the parents of 3- and 5-year-olds, and a modified questionnaire was given to 10- and 15-year-olds to complete by themselves.

    Results

    Mass media constituted the main source of oral healthcare information. Parents assisted with tooth brushing in 86 percent of 3-year-olds and 71 percent of 5-year-olds. Fluoride toothpaste was used by 44-78 percent of children, with no clear age-related trend. Within the past year, 60 percent of 3- and 5-year-olds, 20 percent of 10-year-olds, and 49 percent of 15-year-olds reported they had not visited a dental professional. Sweets were consumed between principal meals by 70-80 percent of children. Milk with sugar was regularly consumed by 71 percent of 3-year-olds and 91 percent of 5-year-olds.

    Conclusions

    Children showed frequent sugar consumption and insufficient frequency of brushing their teeth with fluoride toothpaste. Food-based dietary guidelines should play a significant role in nutrition and oral health. It is especially important that oral health prevention programs reach preschool children before they establish unhealthy dietary habits. Parental education about oral health and access to oral healthcare services are also needed to improve children's oral health.

  • 63.
    Jacobsson, Brittmarie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Ho Thi, T
    Hoang Ngoc, C
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Oral Health of Children in Da Nang, Vietnam: Dental caries, caries associated factors and gingivitisManuscript (preprint) (Other academic)
  • 64.
    Jacobsson, Brittmarie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Ho Thi, T
    Hoang Ngoc, C
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Oral Health of Children in Da Nang, Vietnam: Sociodemographic conditions, knowledge of dental diseases, dental care and dietary habitsManuscript (preprint) (Other academic)
  • 65.
    Jacobsson, Brittmarie
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Koch, Göran
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Oral health and coherent determinants in children and adolescents with foreign background compared to Swedish youth2010In: Oral health - new concepts for the new millenium: Glasgow 1/3 July 2010 / [ed] Marjolijn Hovius, 2010Conference paper (Refereed)
    Abstract [en]

    Aim: The aim of this study was to investigate oral health status and coherent determinants in children and adolescents with foreign background compared to children with Swedish background. Methods: In 1993 and 2003 cross-sectional studies with random samples of individuals in the age groups 3-,5-,10- and 15-years were performed in Jönköping, Sweden. All individuals were personally invited to a clinical and radiographic examination of oral health status. They were also asked about their attitudes and knowledge about teeth and oral health care habits. The final study cohort comprised 739 children and adolescents, 154 with Foreign background (F-cohort) and 585 with Swedish background (S-cohort). Results: Both in 1993 and 2003 more 3- and 5-year-olds in the S-cohort were caries-free compared to the F-cohort. In 1993 dfs/DFS was higher among 3- and 5-year-olds in the F-cohort (p=0.01). In 2003 dfs/DFS was significantly higher in all age groups in the F-cohort compared to the S-cohort. The cumulative percentage of proximal caries-free, initial and manifest lesions and restorations among 10-year-olds in the F-cohort were in 1993 55%, 23%, 4% and 18%. The corresponding figures for the S-cohort were 69%, 20%, 6% and 5%, respectively. In 2003 figures in the F-cohort were 54%, 29%, 4% and 13% compared to 82%, 12%, 1% and 5% in the S-cohort (p=0.037). Among males with foreign background and lived in families with low education, the odds was four times higher (OR=4.0 +95%CI; 2.2-7.2) to be exposed to dental caries, then among their Swedish counterparts. Conclusions: There had been a decline in caries prevalence between 1993 and 2003 in all age-groups except among the 3-year-olds. However the improvement of dfs/DFS was stronger in the S-cohort in all age-groups and the gap between the F- and S-cohorts was considerable larger in 2003 compared to 10 years earlier.

  • 66.
    Jacobsson, Brittmarie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Thanh, Ho Thi
    Dental Department, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    Chuong, Hoang Ngoc
    Dental Department, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Oral health of children and adolescents in Da Nang2014In: Oral Hygiene & Health, ISSN 2332-0672, Vol. 2, no 4, p. 1-6Article in journal (Refereed)
    Abstract [en]

    This is a cross-sectional epidemiological study comprising 840 randomly selected children in the age groups of 3, 5, 10 and 15 year-olds. All children were clinically examined for number of teeth, dental caries, dental fillings, plaque, gingivitis and probing pocket depth. Dental care and dietary habits were collected using a self-reported questionnaire. Among 3 and 5 year olds, 98% suffered from dental caries, compared to 91% of 10 and 15 year olds. The mean (SD) of decayed (initial and manifest) and filled tooth surfaces (dfs/DFS) in the different age groups was: 18.2 (14.1), 23.0 (15.4), 5.1 (4.2) and 6.9 (6.0), respectively. There was an average of ~ 30% in all age groups with plaque and gingivitis. Consuming milk with sugar more than 2–3 times a week (3 and 5 year olds) and eating sweets between principal meals twice a day (in 10 and 15 year olds) were statistically significant with caries prevalence. It is concluded that dental caries and gingivitis are significant public health problems among children in Da Nang, Vietnam.

  • 67.
    Jacobsson, Brittmarie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Wendt, Lill-Kari
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Johansson, Ingegerd
    Dental caries and caries associated factors in Swedish 15-year-olds in relation to immigrant background.2005In: Swedish Dental Journal, ISSN 0347-9994, Vol. 29, no 2, p. 71-79Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to evaluate the prevalence of caries and caries associated variables in 15-year-olds in relation to foreign background and to examine differences in the prevalence of caries in immigrant adolescents according to their length of residence in Sweden. All 15-year-old adolescents (n=143) at one public school in the city of Jönköping, Sweden were asked to participate in the study. The adolescents were divided into two groups according to their background: immigrants and non-immigrants. Data on caries prevalence were extracted from the dental records of the examination made when the participants were 15 years old. The proportions of immigrants and non-immigrants free from carious lesions were equal. Immigrant adolescents, however, had on average more enamel carious lesions. Adolescents born in Sweden of immigrant parents or who had arrived before 1 year of age had a caries prevalence similar to those of non-immigrant adolescents, whereas children who had immigrated to Sweden after 7 years of age had a caries prevalence that was 2-3 times higher. As the caries carious lesions in immigrant adolescents is mainly restricted to the enamel, and possibly reversible, early introduction of preventive programmes seems essential.

  • 68.
    Johansson, Emma
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Classon, Lisa
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Förekomst av riskfaktorer för och attityder till dentala erosionsskador bland högskolestudenter2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The aim of this study was to examine occurrence of risk factors and attitudes to erosive tooth wear among university students. Method: This study was a prospective cross-sectional study where data were collected by a group survey through a cluster sampling of students at a university in southern Sweden. Results: Risk factors that the 99 students showed were fruit-, fruit juice consumption, time in front of computer/tv/tablet computer and exercise. A total of 24,2 % consumed fruit and 17,2 % consumed fruit juice more than three times/week. A statistically difference that woman ate more fruit then men could be demonstrated. It was a total of 23,5 % who spent time in front of the computer/tv/tablet more than five hours/day. It was a total of 25,5 % who exercised more than three times/week which men exercised statistically significantly more than woman. The participants were more doubtful to changes in their habits if they had risk to develop erosive tooth wear then when a trouble occurred like pain in form of tooth sensitivity. Participants in the older age group (22-42 years old) were statistically more doubtful to change a habit if the color of the teeth would be affected by erosive tooth wear.

  • 69.
    Johansson, Isabelle
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Dental- and nursing care collaborations in Sweden – A way to support nursing staff in oral hygiene care for older people2019Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Oral health is an integral part of the general health and quality of life. Yet oral health among older people requiring nursing care is often poor. Despite this group’s frequent contact with health care services, they tend to lose contact with dental care. In nursing care, nursing staff are tasked to assist with oral hygiene care, but this has become more demanding as many older people retain more teeth or have advanced prosthetic constructions. Previous research in the field emphasised the need of collaboration between dental- and nursing care to support the nursing staff in this task. However, there is a lack of evidence regarding the effects of these collaborations.

    Aim: The overall aim of the thesis is to examine two oral health programmes used within nursing care with different design regarding support from and collaboration with dental care.

    Methods: Quantitative research methods was used. The data in Study I comes from an oral health assessments guide (ROAG-J) performed by nursing staff in a national health register. Oral health, assessed at two occasions from older people with nursing care, were used. Study II was a controlled intervention study performed at a nursing home. The intervention involved individual coaching of nursing staff in oral hygiene care by dental hygienist for four hours per week at the ward for a period of three months. Oral assessments of older people were performed by dental hygienists and questionnaires to nursing home staff were used.

    Result: In Study I, 667 individuals aged 65 years or older, receiving nursing care services and assessed using ROAG-J between November 2011 and March 2014 were included. No statistically significant difference in any of the oral health variables was found between the first and subsequent assessments. At the first assessments, less than one third of participants had oral health problems. At the first assessment, status of the tongue differed in men and women (p < .01); at the subsequent assessment, gender differences were found in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006).

    In Study II, 33 nursing staff and 48 residents participated at the baseline measurement and 22 and 32 respectively at the 9-month follow-up. The nursing staff changed in knowledge and attitudes related to gum disease, approximal cleaning, usage of fluoride and the likelihood that older persons would express the need for oral health support. The most frequently reported oral health problems among the residents pertained to teeth and gums. The residents relatively high level of oral health was stable during the study period.

    Conclusions: The participants in the oral health programmes were able to maintain an acceptable level of oral health during the study periods although health was likely to decline. The nursing staff maintained a high level of knowledge and attitudes about oral health. However, there seems to be a discrepancy regarding the prevalence of oral health problems among older people. A collaboration between dental- and nursing care providers indicates a positive influence on providing oral hygiene care.

  • 70.
    Johansson, Isabelle
    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. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    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.
    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. ADULT. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Oral health status of older adults in Sweden receiving elder care: Findings from nursing assessments2016In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 65, no 3, p. 215-223Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life.

    OBJECTIVE: The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care.

    METHODS: Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care.

    RESULTS: Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed.

    DISCUSSION: Most participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.

  • 71.
    Johansson, Isabelle
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Torgé, Cristina Joy
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    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).
    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. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Effekt på munhälsa av samarbete mellan tandhygienist och personal i äldreomsorg2017Conference paper (Other academic)
  • 72.
    Johansson, Isabelle
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Torgé, Cristina Joy
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    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. ADULT.
    Is an oral health coaching programme a way to sustain oral health for elderly people in nursing homes: A feasibility studyManuscript (preprint) (Other academic)
  • 73.
    Josefsson, Eva
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Immigrant background and orthodontic treatment need: Quantitative and qualitative studies in Swedish adolescents2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    During the last three decades there has been an increased influx of refugees and immigrants into Scandinavia. The overall aim of this thesis was primarily to improve our knowledge of malocclusion and orthodontic treatment need, both normative and self-perceived, in adolescents of varying geographic origin. A further aim was to determine whether any differences with respect to perception of general appearance and psychosocial well-being were related to geographic origin.

    Papers I and II concerned self perceived and normative orthodontic treatment need. About 500 12-13 year-old subjects, stratified into different groups: A-Sweden, B-Eastern/Southeastern Europe, C-Asia and D-other countries, answered a questionnaire and underwent clinical examination by the author. In paper III the association between the two variables in papers I and II was investigated. Paper IV was a follow up study, at 18-19 years of age, of the relationship between geographic origin and prevalence of malocclusion, self-perceived treatment need, temporomandibular symptoms and psychosocial wellbeing. In Paper V a qualitative study of 19-20 year old subjects was conducted, to identify the strategies they had adopted to handle the issue of persisting poor dental aesthetics.

    The main findings were that at 12-13 years of age, immigrant subjects had a lower perceived orthodontic treatment need than subjects of Swedish background. Girls of Swedish background had the highest self perceived treatment need, whilst girls of non-Swedish background were most concerned that fixed appliance therapy would be painful. In a few of the clinical variables measured at 12-13 years of age, the Swedish group exhibited the greatest space deficiency and irregularity in both the maxillary and mandibular anterior segments and greater overjet, compared to the Eastern/Southeastern European and Asian groups. The clinical implications were negligible. The orthodontic treatment need according to “Index of Orthodontic Treatment Need - Dental HealthComponent” (IOTN-DHC) grades 4 and 5, ranged from 30 to 40 percent, without any inter-group differences. There were strong associations between subjects perceiving a need for orthodontic treatment and 6IOTN-DHC grades 4 and 5, anterior crossbite and avoiding smiling because they were self-conscious about their teeth. At the age of 18-19 years, the frequency of malocclusion was similar in all groups. Subjects of Asian origin had a higher self-perceived orthodontic treatment need than their Swedish counterparts and a higher frequency of headache than those of Eastern/Southeastern European origin. Psychological wellbeing was reduced in nearly one quarter of the sample, more frequently in girls than boys. No association was found between self-perceived orthodontic treatment need and psychological wellbeing.

    The theory “Being under the pressure of social norms” was generated in Paper V, and it can be applied to improve our understanding of young adults who have adjusted to living with poor dental aesthetics and also aid to identify those who are not as well-adjusted and would probably benefit from treatment. Undisclosed dental fear is an important barrier to acceptance of orthodontic treatment in early adolescence. Despite demographic changes due to immigration, no major change in the prevalence of malocclusion and normative orthodontic treatment need has been disclosed. This does not apply to adolescents and adults who immigrated at an older age.

  • 74.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Bjerklin, Krister
    Jönköping University, School of Health Science.
    Halling, A
    Self-perceived orthodontic treatment need and culturally related differences among adolescents in Sweden2005In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 27, no 2, p. 140-147Article in journal (Refereed)
  • 75.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Bjerklin, Krister
    Lindsten, Rune
    Factors determining perceived orthodontic treatment need in adolescents of Swedish and immigrant background2009In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 31, no 1, p. 95-102Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the association between self-perceived orthodontic treatment need and malocclusion in 12 to 13-year-old-adolescents of Swedish and immigrant background. The sample consisted of 379 students, stratified according to geographic background: both parents born in A/Sweden (n = 269), B/Eastern Europe (n = 56), and C/the Middle East (n = 54). Registrations were based on a questionnaire, a clinical examination, radiographs, and patient records. Treatment need was classified according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Logistic regression analysis was used for comparison of the results.

  • 76.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Bjerklin, Krister
    Lindsten, Rune
    Malocclusion frequency in Swedish and immigrant adolescents: influence of origin on orthodontic treatment need2007In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 29, no 1, p. 79-87Article in journal (Refereed)
    Abstract [en]

    Sweden has become increasingly multicultural, In the year 2000, almost 25 per cent of the child and adolescent population was of foreign origin. Such a major change in demographics may lead to altered orthodontic treatment need in the community, with implications for planning appropriate levels of orthodontic resources. The aim of this study was to compare the frequency of malocclusion and orthodontic treatment need in 12- and 13-year olds of Swedish and immigrant background. The subjects, n = 493, were stratified into four groups according to family origin: (A) subject and both parents born in Sweden, and subject or at least one parent born in (B) Eastern Europe, (C) Asia, or (D) other countries. Registrations were based on available radiographs, patient records, and a clinical examination. Normative treatment need was based on a number of variables. Treatment need was expressed according to the dental health component (DHC) and aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN).

    Group A exhibited the greatest space deficiencies and irregularities in the maxillary and mandibular anterior segments and also the greatest overjet. More primary molars had been extracted in groups B and C, with a positive correlation between early extraction of primary molars and retention of permanent successors. Self-assessed orthodontic treatment need, IOTN-AC, was highest in group A. For all four groups, the orthodontist's estimate of treatment need was significantly higher than the subjects' self-assessed need.

    This study confirms that, despite the change in demographics, variations in frequencies of malocclusion and treatment need among children of different cultural background are only minor and the overall orthodontic treatment need remains unchanged.

  • 77.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Bjerklin, Krister
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Self-perceived orthodontic treatment need and prevalence of malocclusion in 18- and 19-year-olds in Sweden with different geographic origin2010In: Swedish Dental Journal, ISSN 0347-9994, Vol. 34, no 2, p. 95-106Article in journal (Refereed)
    Abstract [en]

    Orthodontic treatment need and demand in 19-year-olds in Sweden has not previously been analysed in relation to geographic origin. The aim of this follow-up study was to examine the prevalence of self-perceived treatment need, malocclusion, earlier orthodontic treatment, self-perceived dental aesthetics and prevalence of symptoms indicative oftemporomandibular disorders in 18-19 year-olds and to analyze any differences between native born and immigrants. Body esteem and psychological wellbeing were also evaluated. The subjects, n=316, were grouped according to family origin: Group A: both parents born in Sweden (98 girls, 80 boys); Group B:the subject or at least one parent born in Eastern /South Eastern Europe (24 girls, 26 boys) and Group C: Asia (44 girls, 44 boys). Two hundered and sixty-eight participants presented for clinical examination and answered the full questionnaire, and 48 who rejected clinical examination,were interviewed by telephone using selected questions from a questionnaire. The results show that adolescents of Asian origin had a higher self-perceived treatment need than adolescents of Swedish origin. There were negligible inter-group differences with respect to frequency of malocclusion. Forty-four per cent of all participants had previously undergone orthodontic treatment, significantly more Swedish than Asian subjects. Dissatisfaction with dental aesthetics was attributed primarily to tooth colour (38 per cent) and irregular anterior teeth (34 per cent). Adolescents of Asian origin had a higher frequency of headache than those of Eastern/South Eastern European origin. Compared to boys, girls had a higher self-perceived treatment need, a higher frequency of headache and TMD and were more concerned about body appearance. Psychological wellbeing was reduced in nearly one quarter of the participants, predominantly girls: girls of Asian origin had the highest frequency. No association was found between self-perceived orthodontic treatment need and psychological wellbeing.

  • 78.
    Josefsson, Eva
    et al.
    Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Treatment of missing maxillary lateral incisors: a clinical and aesthetic evaluation2019In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 3, p. 273-278Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate whether implant therapy or orthodontic space closure was the best treatment option for patients with missing maxillary lateral incisors.

    Subjects and methods: The implant group (I group) consisted of 22 patients aged <26 years who had one or both maxillary lateral incisors substituted by a single implant-supported crown. The space-closure group (SC group) consisted of patients matched with I group patients based on diagnosis, gender, and number. Examinations were performed by one examiner and occurred at least 5 years after the prosthetic therapy or orthodontic treatment was finished. Clinical examination of the 44 patients involved assessing the aesthetics and gingival conditions of the implant-supported crown and the replacement canine, the occlusal morphology and the extraoral characteristics. Both the patient and examiner answered a question about their satisfaction with the aesthetic result.

    Results: Of the 12 variables analysed by the examiner, one variable was significantly improved in the I group and five variables were improved in the SC group. There were no significant differences between the treatment groups for the remaining six variables. Gingival colour and crown length were better in the SC group, and crown colour was better in the I group. There were no significant differences between the groups with regards to the patient's and examiner's overall aesthetic satisfaction of the maxillary anterior teeth or between the patient's and examiner's opinion.

    Conclusion: If both treatment alternatives are available, space closure is preferable.

  • 79.
    Josefsson, Eva
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Lindsten, Rune
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Hallberg, Lillemor R-M.
    Högskolan i Halmstad.
    A qualitative study of the influence of poor dental aesthetics on the lives of young adults2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 1, p. 19-26Article in journal (Refereed)
    Abstract [en]

    Objective: Although many countries offer some publicly funded orthodontic treatment for children, not all conditions receive treatment and some adolescents enter adulthood with persisting poor dental aesthetics or malocclusions. The aim of this study was to generate a theory highlighting the main concerns of young adults, either native-born or of immigrant background, with poor dental aesthetics and the measures they adopt to manage their condition in everyday life.

    Material and methods: A qualitative method, classic grounded theory, was applied in order to generate a substantive theory highlighting the main concerns and managing mechanisms of 13 strategically selected 19- and 20-year-olds with poor dental aesthetics. Open interviews were conducted with each participant, the topics covering different aspects of social and dental conditions.

    Results: A core category and three conceptual categories were generated. The core category was labelled "Being under the pressure of social norms" and was related to categories explaining three different ways in which these young adults handle their main concern: (1) avoiding showing their teeth; (2) minimizing the importance of appearance; and (3) seeking orthodontic treatment. The theory offers the potential for improved understanding of young adults who, despite poor dental aesthetics, are managing well with life, and also of those who have not adjusted well.

    Conclusions: In early adolescence it may be problematic to make decisions about orthodontic treatment. Undisclosed dental fear can be an important barrier. Some of the young adults in the present study would probably benefit from treatment.

  • 80.
    Karami, Shams
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Tandvårdsrädsla hos barn och ungdomar: En litteraturstudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To examine the factors which have causal relationship with dental fear among children and adolescents.

    Material and methods: This study is a literature review of published scientific articles that concerns the dental fear and its causes among children and adolescents. The searching and assessment of the relevant scientific articles have been made with the intention to find answers to the study's purpose. Quantitative studies were included in the study. Articles that were published before the 2000s were excluded.

    Results: Showed that child dental fear is associated with parental dental fear. Unpleasant experience at dental visits contribute to dental fear. Pain and irregular dental visits are associated with dental fear among children and adolescents.

    Conclusions: There are different causal relationship to dental fear among children and adolescents. Several studies noted that girls had a higher level of dental anxiety than boys. Most common factors which associates with dental fear among children and adolescents are distressing painful experience, previous experience of toothache, injection, drilling and the sound of drilling.

  • 81. Karlsson, Ewelina
    et al.
    Lymer, Ulla-Britt
    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.
    Periodontitis from the patient's perspective, a qualitative study2009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 1, p. 23-30Article in journal (Refereed)
  • 82.
    Karlsson, Frida
    et al.
    Public Dental Service, Region Kronoberg, Lammhult, Sweden..
    Stensson, Malin
    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.
    Jansson, Henrik
    Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden..
    Caries incidence and risk assessment during a five-year period in adolescents living in southeastern Sweden2019In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to examine the caries incidence in adolescents using the Public Dental Service (PDS) during a 5-year period in relation to their caries experience at baseline and risk classification.

    METHODS: A five-year retrospective cohort study based of the dental records from 17 PDS clinics in southeastern Sweden was conducted; 159 individuals born in 1997 were included, and their caries risk was classified at 12 and 17 years of age. Caries prevalence and documented risk groups were assessed at baseline and after five years.

    RESULTS: The increment of caries (both initial and manifest caries) was higher, to a statistically significant degree, after five years in adolescents who were recorded as caries-free at baseline compared to individuals with caries at baseline (p<0.001). In individuals with caries at baseline, the greatest increment of caries was found at approximal sites (p<0.001). At baseline, individuals were classified as low (94%), medium (6%) and high risk (0%). After five years, the figures were 74%, 20% and 6%, respectively. Although classified in a low-caries-risk group, 9% had ≥ 6 decayed or filled surfaces at baseline, and 23% did after five years. Approximately 62% of individuals were registered as caries-free at baseline, and 45% were after five years.

    CONCLUSIONS: There was an increase in caries over five years, especially among adolescents without caries experience at baseline. The majority of adolescents had the same risk classification after five years. Further research with a larger sample size is needed to evaluate risk assessment for caries.

  • 83.
    Klingberg, Gunilla
    et al.
    Odontologiska fakulteten, Malmö högskola, Sweden.
    Norderyd, Johanna
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Odontologiska institutionen, Jönköping, Sweden.
    Etik i børnetandplejen med særligt fokus på børn med funktionsnedsættelse eller langvarig sygdom2016In: Tandlaegebladet, ISSN 0039-9353, Vol. 120, no 9, p. 800-806Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Dental care for children with disabilities – ethical considerationsAll dental care demands an ethical approach, maybe even more so in child dental care. Today more children with disabilities or longterm illness come to the dentist. How these children should be met and cared for does not differ from other patients, but in dental care for children with disabilities and long-term illness it may be more likely for situations and ethical dilemmas to evolve, where the dentist must stop, reflect, and analyze before continuing with treatment. Autonomy, integrity, and informed consent are important concepts when meeting patients and parents. The dentist also has to be prepared to sometimes step in and substitute autonomy.

  • 84.
    Krivohlavek, Natalija
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Duric, Tina
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Diabetes typ 1. Dess påverkan på barn och ungdomars orala hälsa.2019Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of the literature overview was to study evidence for type 1 diabetes impact on children and adolescents oral health.

    Method: The study was a general literature study. The inclusion criteria were that they should have been published between 2008 until 2018, peer-reviewed and have an age range of children up to 18 years. After a quality review, 21 articles were used in this study. The articles that was used, have all studied diabetes type 1 and its impact on children and adolescents oral health.

    Result: The result showed that the disease type 1 diabetes has an effect on the oral health of children and adolescents. Gingivitis, caries, periodontitis, oral candidos, plaque and calculus are oral disorders that has been shown having a higher prevalence in children with diabetes in comparison to healthy children. The results in the studies varied to a certain extent due to different outcome measures and methods.

    Conclusion: Previous studies have shown a relationship between children and adolescents with type 1 diabetes and their impaired oral health, where plaque and gingivitis were most prevalent. More research is generally required on how diabetes type 1 affects the oral health of children and adolescents in general.

  • 85. Kvint, Sven
    et al.
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ. Oral health.
    Anmälningsärenden i anslutning till implantatstödd protetik2001In: Tandläkartidningen, ISSN 0039-6982, Vol. 93, no 6, p. 34-39Article in journal (Refereed)
  • 86.
    Landt, K.
    et al.
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Hagstam-Harrison, L.
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Kvist, T.
    Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Frisk, Fredrik
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Dawson, V. S.
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Bjørndal, L.
    Department of Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
    EndoReCo, (Group author)
    Fransson, H.
    Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Demographic factors in Swedish adults undergoing root filling and subsequent extraction of a maxillary first molar: a comparative study2018In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 51, no 9, p. 975-980Article in journal (Refereed)
    Abstract [en]

    Aim: To study the demographics of Swedish adults who had received a root filling, followed by extraction during the following 5–6 years in comparison with subjects who had undergone a corresponding root filling with an uneventful outcome.

    Methodology: The root filled maxillary first molar was chosen as the comparison model. The Swedish Social Insurance Agency provided data on all teeth reported as root filled in Sweden during 2009. A comparison group, equally large as the study group, was constructed by randomly selecting subjects with root filled maxillary first molars, which had not subsequently been extracted, that is, an uneventful outcome. Demographic data on the subjects were obtained from Statistics Sweden: country of birth, disposable income, educational level, age, civil status and gender. Chi-square, t-tests and logistic regression were used for statistical analyses.

    Results: In the year 2009, 36 139 maxillary first molar teeth were reported to have been root filled, 4362 (12.1%) of which were then recorded as extracted during the following 5–6 year period. Only minor intergroup differences were noted: 86.5% of the study group were Swedish-born, compared with 84.4% of the comparison group (P = 0.007). Women comprised 53.2% of the study group and 50.5% (P = 0.01) of the comparison group. There was an association between extractions and gender as well as age; men had a lower odds ratio (OR) for extraction OR, 0.87; confidence interval (CI), 0.80–0.95. For every additional year, the chance for extraction was higher OR, 1.01; CI, 1.01–1.01. No other significant differences were detected.

    Conclusions: There was only little or no demographic differences between the study group, comprising Swedish adults who had undergone root filling of one of their maxillary first molars in 2009 and subsequent extraction during the following 5–6 years, and the comparison group, with uneventful outcomes after a corresponding root filling. 

  • 87.
    Lindfors, Erik
    et al.
    Department of Stomatognathic Physiology, Public Dental Health Service, Uppsala, Sweden.
    Hedman, Eva
    Public dental health service, Uppsala, Sweden.
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Ernberg, Malin
    Department of Dental Medicine, Karolinska Institutet and Scandinavian, Center for Orofacial Neurosciences, (SCON), Huddinge, Sweden.
    Gabre, Pia
    Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Patient experiences of therapeutic jaw exercises in the treatment of masticatory myofascial pain: A qualitative study2017In: Journal of Oral and Facial Pain and Headache, ISSN 2333-0384, Vol. 31, no 1, p. 46-54Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate patients' experiences of therapeutic jaw exercises for treating masticatory myofascial pain.

    Methods: A total of 10 patients were selected for the interview study. All patients had received treatment with jaw exercises at a specialist clinic. Semi-structured interviews were conducted in a nonclinical environment according to an interview guide with 10 domains. The interviews were transcribed and translated into English. Systematic text condensation (STC) was used to arrange and analyze the text material.

    Results: In the systematic process of analyzing the qualitative data, four main themes were identified: "Patient Adherence," "Symptoms," "Treatment Effect," and "Participation." Most informants were initially skeptical of the jaw exercises due to their simplicity. Later on, the simplicity of the exercises and the fact that they did not need more advanced treatment were valued most by a majority of patients. Some informants suspected serious disease behind their symptoms. Treatment effects on pain and physical impairment were reported. To do the jaw exercises in conjunction with an already established routine seemed important to enhance adherence. Trust in the caregiver and being able to remedy their pain by themselves were also important to the informants.

    Conclusion: Jaw exercises are a useful treatment valued by patients due to their simplicity and effectiveness. However, before the treatment, patients should be informed about the cause of the symptoms, and any skepticism should be addressed. Results from this qualitative study cannot be generalized, but the study design and the selected population allow the results to be transferable to similar contexts. 

  • 88.
    Lindfors, Erik
    et al.
    Department of Stomatognathic Physiology, Public Dental Health Service, Uppsala, Sweden.
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Ernberg, Malin
    Department of Dental Medicine, Karolinska Institutet, Scandinavian Center for Orofacial Neurosciences, Huddinge, Sweden.
    Patients' experiences of therapeutic jaw exercises in the treatment of masticatory myofascial pain-A postal questionnaire study2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 46, no 9, p. 800-806Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The most common non-dental pain in the orofacial region is pain associated with temporomandibular disorders (TMD), and jaw exercises are a common treatment in these cases. Since masticatory myofascial pain has components of an affective and cognitive nature, knowledge about the patients' experiences of the condition and treatment is important.

    OBJECTIVE: The aim was to study the patients' experiences of jaw exercises in the treatment of masticatory myofascial pain.

    METHODS: A questionnaire, containing 24 statements that should be answered according to a five-item verbal Likert scale, was sent to 150 consecutive patients with masticatory myofascial pain according to the Research Diagnostic Criteria for TMD after they had been treated with jaw exercises for 3-12 months.

    RESULTS: The response rate was 73% (n = 109), and 79% of the responders were women. 71% of the patients reported that it was easier to remember the jaw exercises if they put them in conjunction with an already established routine. Before examination, 49% of the patients suspected serious disease behind their symptoms, but these concerns were greatly relieved by the information provided. As a result, 78% reported that information about the underlying cause of their symptoms made them more involved in the treatment. Finally, 72% of the respondents reported that the jaw exercises were effective in reducing their symptoms.

    CONCLUSIONS: Information about the cause of the symptoms and the treatment is important to reassure and make the patient involved in the treatment. Most patients report that jaw exercises are an effective treatment and they appreciated to have tools to tackle the problems themselves if the symptoms should return.

  • 89. Lindfors, Erik
    et al.
    Nilsson, Håkan
    Helkimo, Martti
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Treatment of temporomandibular disorders with a combination of hard acrylic stabilisation appliance and a soft appliance in the opposing jaw: A retro- and prospective study2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 1, p. 9-16Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the treatment effect of a combined treatment with a stabilisation appliance and a soft appliance in the opposing jaw in patients refractory to previous TMD treatment. During a 5-year-period, 2001-2005, a total of 98 patients received the combined treatment at the Department of Stomatognathic Physiology, the Institute for Postgraduate Dental Education, Jönköping, Sweden. Before the patients received the combined treatment, they had already been given several different TMD treatments during a long period of time, either before referral or at the specialist clinic, with only minor or no effect on their TMD symptoms. The patients were followed prospectively (n=10), or analysed retrospectively (n=88). The data registered were gender, age, main indication for TMD treatment, number of visits to the clinic before and after the introduction of the combined treatment, as well as according to a clinical (Di) and anamnestic (Ai) dysfunction index. The most common causes for treatment in the retrospective material were problems of muscular origin and problems of both muscular and TMJ origin. In the prospective material, most of the patients had mainly muscular symptoms. Both the clinical and anamnestic dysfunction index decreased statistically significantly in the retrospective material after the introduction of the combined treatment. There was a numerical improvement of both indices also in the prospective material. In conclusion, the present investigation showed that a combined treatment with a hard acrylic stabilisation appliance and a soft appliance in the opposing jaw seems to give a remarkable improvement of TMD signs and symptoms in apparently therapy resistant TMD patients. General conclusions should, however, be made with caution due to the fact that the study did not include any control group. There is an obvious need for randomized controlled studies concerning the efficacy and effectiveness of the combined treatment presented in this study.

  • 90.
    Lindfors, Erik
    et al.
    Department of Stomatognathic Physiology, Public Dental Health Service, Uppsala, Sweden.
    Tegelberg, Åke
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
    Magnusson, Tomas
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Ernberg, Malin
    Department of Dental Medicine, Karolinska Institutet, Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden.
    Treatment of temporomandibular disorders – knowledge, attitudes and clinical experience among general practising dentists in Sweden2016In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 6, p. 460-465Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to investigate the self-perceived level of knowledge, attitudes and clinical experience in treatment of temporomandibular disorders (TMD) among general practising dentists (GPDs).

    Material and methods: A web-based questionnaire was sent to all GPDs in the public dental health service in the County of Uppsala in 2010 (n = 128) and 2014 (n = 113). The GPDs were asked to answer questions in the following categories: Demographic information, Quality assurance, Clinical experience and treatment, Need for specialist resources in the field of TMD and Attitudes. Between the two questionnaires, the GPDs were offered TMD education and an examination template including three TMD questions was introduced in the computer case files. The results were also compared with a previous questionnaire from 2001.

    Results: The response rate was 71% (2010) and 73% (2014). The majority of the GPDs were women (70% in 2010 and 72% in 2014). The reported frequency of taking a case history of facial pain and headache increased between 2010 and 2014. In 2014, the GPDs were more secure and reported higher frequency of good clinical routines in treatment with jaw exercises and pharmacological intervention compared to 2001. Interocclusal appliance was the treatment with which most dentists felt confident and reported good clinical routines.

    Conclusions: The GPDs felt more insecure concerning TMD diagnostics, therapy decisions and treatment in children/adolescents compared to adults. There is a high need for orofacial pain/TMD specialists and a majority of the GPDs wants the specialists to offer continuing education in TMD.

  • 91.
    Lindmark, Ulrika
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Känsla av sammanhang, den orala hälsan, tandvårdsbeteende och attityder till tandvård2007In: Tandhygienisttidningen, ISSN 1102-6146, Vol. 27, no 5, p. 5-Article, review/survey (Other academic)
  • 92.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    What is an Oral Health Risk Assessment Tool, and can it be useful within nursing care? ROAG-J in the Swedish Quality Register Senior Alert2019Conference paper (Refereed)
  • 93.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hakeberg, Magnus
    Avdelning för Beteende och Samhällsodontologi, Institutionen för Odontologi, Sahlgrenska Akademin, Göteborgs Universitet.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Kan känsla av sammanhang ha betydelse för beteende, kunskap och attityder relaterat till oral hälsa?2010In: Tandhygienisttidningen, ISSN 1102-6146, Vol. 30, no 2, p. 55-Article in journal (Other academic)
    Abstract [sv]

    Abstrakt – Syfte: Att studera sambandet mellan känsla av sammanhang (KASAM), oralt hälsorelaterat beteende, kunskap om och attityd till oral hälsa i en vuxen svensk befolkning. Metod: En tvärsnittsstudie där ett stratifierat urval av 910 individer, i åldrarna 20, 30, 40, 50, 60, 70 och 80 år erbjöds att delta i studien. I undersökningen användes den svenska kortversionen (13 frågor) av Antonovsky’s livsfrågeformulär som mäter känslan av sammanhang samt ett frågeformulär gällande oralt hälsorelaterat beteende, kunskap om samt attityder till oral hälsa. Dessutom ingick frågor gällande sociodemografiska faktorer. Totalt var det 589 individer som samtyckte att delta i studien. Resultat: Totalt var det 525 individer, 261 men och 264 kvinnor, som besvarade alla 13 frågorna i SOC frågeformuläret, vilket utgjorde det slutliga materialet vid analyserna. Bivariata analyser visade på samband mellan högre KASAM medel poäng och beteende såsom färre söta drycker och färre antal mellanmål/ dag, jämfört med individer med lägre KASAM medel poäng. Individer med högre KASAM hade också en mer positive attityd såsom påståenden om att vara nöjd med tandvården, betydelsen av att ha egna tänder när man blir äldre, nöjd med egna tänder, anser sig ha bra tänder samt ingen känsla av obehag att uppsöka tandvården. Individer med högre KASAM poäng hade även ett signifikant samband med kunskap om karies. Dessa samband, förutom variabeln söta drycker, kvarstod efter kontrollering för alla sociodemografiska faktorerna (kön, ålder, civilstånd, inkomst, utbildning och yrkesnivå). Stark KASAM och god kunskap om karies var statistiskt signifikant, efter kontrollering för ålder och kön. Sammanfattning: KASAM hade ett statistiskt signifikant samband med oralt hälsoorelaterat beteende, attityder till oral hälsa samt kunskap om karies. I arbetet med oralt hälsofrämjande arbete, skulle KASAM kunna vara ett verktyg för att främja en större förståelse för individers beteende, attityder till och kunskap om oral hälsa och  möjliggöra för tandvårdspersonal att använda denna kunskap i kommunikation med individer och grupper.

  • 94.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hakeberg, Magnus
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Känslan av sammanhang (KASAM) och oralt status bland vuxna: en epidemiologisk tvärsnittsstudie2009In: Tandhygienisttidningen, ISSN 1102-6146, Vol. 29, no 2, p. 61-61Article, review/survey (Other academic)
    Abstract [sv]

    Känslan av sammanhang (KASAM) är ett frågeformulär som skattar förmågan till ett hälsofrämjande beteende. Syftet var att analysera sambandet mellan KASAM, sociodemografiska faktorer samt oralt status. Material och Metod: Populationen bestod av ett stratifierat slumpmässigt urval bestående av 910 individer från Jönköping, i åldrarna 20, 30, 40, 50, 60, 70 och 80 år. Instrument som användes var den korta versionen av KASAM (13 frågor) samt ett frågeformulär innehållande sociodemografiska frågor. En klinisk och röntgenologisk undersökning genomfördes i anslutning till utlämnandet av enkäterna. Resultat: Totalt deltog 525 individer, 261 men och 264 kvinnor. Sociodemografiska faktorer som ålder, civilstånd, inkomst och utbildning hade en statistisk signifikant association med KASAM. Bivariat analys visade att individer med högre KASAM medelvärde hade statistiskt signifikant fler karierade och fyllda ytor (DFS) och fyllda ytor (FS), färre karierade ytor, färre tänder med tandsten och bättre parodontal hälsa. Efter kontrollering för bakgrundsfaktorer såsom kön, civilstånd, inkomst, utbildning och yrkesnivå, visade det sig att individer med hög KASAM poäng hade en större risk för högre DFS och FS men mindre risk för gingivit. Efter justering för ålder, visades hög KASAM poäng ha en förklarande betydelse för gingivit och plack. Konklusion: Sociodemografiska faktorer hade ett samband med KASAM. Dessutom visade analyserna samband mellan KASAM och fler viktiga orala variabler. Ytterligare studier rekommenderas avseende sambanden mellan KASAM och oral hälsa, där bl a oralt hälsobeteende och attityder till tandvård studeras.

  • 95.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hakeberg, Magnus
    Hugoson, Anders
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Sense of coherence and its relationship with oral health-related behaviour and knowledge of and attitudes towards oral health2011In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 39, no 6, p. 542-553Article in journal (Refereed)
    Abstract [en]

    Objective:  To investigate the relationship between sense of coherence (SOC), oral health–related behaviour, knowledge of and attitudes towards oral health in an adult Swedish population.

    Methods:  A cross-sectional design with a stratified random sample of 910 individuals aged 20, 30, 40, 50, 60, 70 and 80 years were invited to the study, from Jönköping, Sweden. The investigation used the Swedish short version of the SOC questionnaire comprising 13 items and self-reported questions about oral health habits and knowledge of and attitudes towards oral health. In addition, a self-report questionnaire to elicit demographic information was included.

    Results:  A total of 525 individuals, 261 men and 264 women, answered all the 13-item SOC questions, which constituted the final number of the participants. After adjustment for all the sociodemographic factors included in the analysis, individuals with a stronger SOC had twice as high a chance of having healthier behaviour, including a lower frequency of snacks and drinks between meals, as well as a more positive attitude, such as the importance of having one’s own teeth as one gets older, satisfaction with their own teeth, perceiving their teeth as good and no feeling of dental fear, compared with individuals with a poorer SOC. Moreover, SOC and a good knowledge of caries were significantly associated after adjustment for age and gender.

    Conclusions:  SOC was significantly associated with several oral health–related behaviours, attitudes towards oral health and knowledge of dental caries. When working with oral health promotion, SOC could be a way for promoting a better understanding of the behaviour and attitudes of individuals and for enabling dental personals to use that knowledge for the guidance of the individual.

  • 96.
    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.
    Hakeberg, Magnus
    2Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg.
    Hugoson, Anders
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Sense of coherence and oral health status in an adult Swedish population2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, p. 12-20Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 97.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hakeberg, Magnus
    Jönköping University, School of Health Science, HHJ. Oral health.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ. Oral health.
    Sense of coherence (SOC), a determinant to oral health status among adults?: a cross sectional population study2008In: International Research Seminar on Salutogenesis and at the 1st Research Meeting of the IUHPE Thematic Working Group on Salutogenesis, 2008Conference paper (Other academic)
    Abstract [en]

    Aim To investigate sense of coherence in relation to oral health status. Method A stratified random sample of 910 individuals from Jönköping, Sweden, aged 20,30,40,50,60,70 and 80 years old, was used. The investigation contained the Swedish 13-items version of  the SOC questionnaire and a self-reported questionnaire about demographic information. In addition an oral clinical and radiographical examination was performed. Results A total of 525 individuals participated in the study, 261 men and 264 women. Socioeconomic factors such as age, marital status, income and education had a statistical significant association to SOC. Bivariate analyse showed that higher mean SOC scores had a statistically significant relationships with more decayed filled surfaces (DFS) and filled surfaces (FS), less caries severity, less teeth with calculus and a better periodontal health. Logistic regression analysis showed that Individuals with high SOC score were predictive of high DFS and FS  but low gingivitis scores. After controlling for age, high SOC scores showed a protective effect for gingivitis and dental plaque. Conclusions Socioeconomic factors had an association with SOC. Statistical associations were found between SOC scores and oral health status with regard to several important oral clinical variables and high SOC scores may indicate a protective determinant for gingivitis and plaque.

  • 98.
    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.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    "Sense of coherence" and oral health in an adult population: an epidemiological study2007In: 7th conference on advances in health care science research, 2007Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Objective: The aim was to investigate the individual distribution regarding ‘Sense of coherence’ (SOC) and oral health in an adult population. Method: A random sample of 589 individuals from Jönköping, Sweden, aged 20,30,40,50,60,70 and 80 years old, was used. Clinical and radiographical examinations were performed and a questionnaire measuring attitudes, knowledge of oral health and SOC (13-items) was included. Total SOC score and the three components; comprehensibility, manageability and meaningfulness which SOC is built upon was analyzed. Results: A total of 526 individuals participated in the study, 263 men and 263 women. The individual SOC score showed an increase with age, and the youngest group (20 years) had a significantly lower SOC score compared to the other age groups. Elderly men had a statistical significantly higher SOC compared to the elderly women (60 and 70 age groups). Analysing the three components, comprehensibility had statistical significantly higher mean SOC score, compared to manageability and meaningfulness. When dividing the participants into two subgroups, one with low (<66 points) and one with high (> 76 points) SOC score respectively, 55% among 20 years old had low SOC score compared to 18% for 80 years olds. The result described different personalities, depending on high and low SOC scores in comprehensibility, manageability and meaningfulness, according to Antonovsky´s model about the dynamic relations between the three components in SOC. Preliminary results showed that individuals with high SOC had statistical significant more number of decayed and filled surfaces (DFS) compared to individuals with low SOC. Conclusion: The distribution of SOC score differed regarding age and gender. Younger individuals had lower SOC scores compared to elderly individuals. A clear association was found between SOC scores and oral health measured by number of DFS.

  • 99.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. HHJ. Oral health.
    Hugoson, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. HHJ. Oral health.
    Stenström, Ulf
    Socialhögskolan, Växjö Universitet.
    Wärnberg Gerdin, Elisabeth
    Centrum för folkhälsovetenskap, Linköping.
    Oral hälsa och individens känsla av sammanhang, en epidemiologisk studie2005In: Odontologisk riksstämma, 2005Conference paper (Other (popular scientific, debate etc.))
  • 100.
    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. 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). Department of Periodontology, Centre of Oral Health Sciences, Malmö University, Malmö, Sweden.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Ryhov, Jönköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Oral health matters for the nutritional status of older persons: A population-based study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1143-1152Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the association between oral health and nutritional status in the context of daily care for older people.

    BACKGROUND: Oral problems often increase with age and affect a person's ability to chew and swallow. They might also influence the ability to maintain a satisfactory nutritional status. Oral health awareness is therefore of great importance in nursing care for older people.

    DESIGN: A retrospective cross-sectional study.

    METHODS: Data from the Swedish quality register, Senior Alert, were used, including structured assessments of both oral and nutritional status using the Revised Oral Assessment Guide-Jönköping and the Mini Nutritional Assessment. In total, 1,156 persons (mean age: 82.8 ± 7.9) had both oral and nutritional assessments registered by the nursing staff in daily care.

    RESULTS: Approximately 29% of participants had moderate oral health problems. Another 12% had severe problems. Over 60% of the persons were considered at risk of malnutrition or were malnourished. There was a weak correlation between poor nutritional status and poor oral health, and approximately one-third of the persons who were at risk or malnourished had simultaneous oral problems. A multivariate logistic regression revealed that when problems involving voice and swallowing were present, there was also a greater possibility of being assessed as at risk of malnourishment or being malnourished.

    CONCLUSION: There is a relationship between oral health problems and nutritional status, indicating the importance of evaluating oral health status in older persons with nutritional problems.

    RELEVANCE TO CLINICAL PRACTICE: Nursing staff involved in care for older people should be aware of the importance of including regular oral health check-ups in their work. There is also a need for nursing staff members and oral health professionals to exchange knowledge.

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