Swedish dental journal最新文献

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

The aim of this study was to explore the oral health in Swedish individuals with the diagnosis of homozygote cystathionine beta synthase-deficient homocystinuria (HC), a rare disorder of amino acid metabolism affecting connective tissue, in which the phenotypic abnormalities include dislocation of the optic lens, skeletal abnormalities, thromboembolic events, and sometimes mental retardation. Further aims were to evaluate the oral findings against previous oral observations in a medical case report, such as high narrow palate, mandibular prognathia, crowding and early eruption of teeth. Every hospital in Sweden was contacted, with the inquiry of patients with diagnosis of HC,which resulted in 14 individuals participating in oral clinical examination. The oral findings evaluated against previous medical case reports showed to be partly in accordance with previous observations. Dental health showed to be compromised in a majority of cases. Together with the fact that methionine restriction (low-protein diet) is involved in the treatment of the condition and might result in a diet high in sugars, this points out the role of regular dental checkups and preventive oral care for individuals suffering from HC. In addition, short dental roots were a finding not previously reported in the literature. All the studied cases had central maxillary incisors with short roots, when compared to reference values used.

The aim of the present study was to evaluate patient attitudes and expectations relative to dental implant treatment. A questionnaire was mailed to all 400 patients that had received dental implant treatment at a large multi-specialist clinic during 2008. The questionnaire included questions relative to the reasons for dental implant treatment, if the patient earlier had considered dental implants, expectations of the treatment, discomfort during and after surgery, and how the patient perceived the esthetic outcome. The response rate was 61% (114 men/130 women). The stated reason for tooth loss was in 50% of the patients periodontitis,19% caries, 8% accidents,13% other reasons, and 10% no stated reason. Almost all patients (96%) were satisfied with the esthetic appearance and also regarding the information of the treatment (94%). Regarding the time between surgery and completion of prosthetic work, 79% (n = 192) found it to be reasonable. 71% (n = 170) thought the cost was what they had expected. 47% of the patients experienced the implant surgery better than expected and 48% as expected. In conclusion, the present study revealed that almost all patients were satisfied with the function and esthetics of the dental implant reconstruction and most patients were also satisfied regarding the costs and treatment duration.

Mandatory reporting to the social services is required by dental professionals when suspicion of child abuse or neglect occurs. The objective of this study was to analyze the recommendations previously made by the Ombudsman for Children in Sweden. The aim was to study the association between having guidelines and the inclination to report to the social services and also the association between management of multiple missed appointmens and reports to the social service. A web-based questionnaire was sent to the clinical department heads (CDH) of all PDS in Sweden, distributed and authorized by The Ombudsman for Children in Sweden. The response frequency was 95% and all county councils of Sweden were represented. The results showed regional differences regarding management of suspected child abuse, neglect and dental neglect. Clinical department heads that had reported to the social services more often had guidelines on child abuse and neglect (p < 0.000). Management of repeated missed appointments varied between clinics. Those who never had made a report to the social services more often stated that the reason for missed appointments was parental negligence (p = 0.004) and less often thought it was an actual maltreatment (p = 0.003), and they more often rescheduled when a child repeatedly missed an appointment (p = 0.013). Sixty-four percent of the clinical department heads requested additional support in this matter. In conclusion, public dental service clinics in Sweden are significantly more likely to report to the social services if guidelines regarding child abuse and neglect are available.

Population-based health promotion with school-based fluoride varnish programmes is becoming more frequent, as these programmes have been implemented in many parts of Sweden during the last five years. The caries-prevention effect is well studied, but as yet there is no study aimed at adolescents'experiences of these programmes. The aim of this study was therefore to describe how a school-based fluoride varnish programme is experienced by participating adolescents. The study was performed as a qualitative study by conducting four focus-groups interviews. In all, 26 adolescents participated, all aged 15. All the participants had several years'experiences of a fluoride varnish programme at school. The participants were asked to describe their experience of participating in the programme.The analysis of the data from the interviews was carried out according to the principles of phenomenography.The three themes that emerged were"Conceptions in relation to the individual", "Conceptions in relation to the school dental nurse"and "Conceptions in relation to the group and school". The result showed that the adolescents experienced that it was positive to take part in a fluoride varnish programme at school and they regarded the school as an important health promotion arena. In spite of this, there were perceptions that were worth reflecting on for school dental nurses, such as feelings of exposure, peer pressure and a perceived lack of information. To further improve these programmes, and thereby increase population-based dental health promotion, it is important to highlight the role of dental personnel, as they are largely responsible for creating the atmosphere.

Severe dental fear/phobia (DF) is a problem for both dental care providers and for patients who often suffer from impaired oral health and from social and emotional distress.The aim of this paper was to present the Swedish model for DF treatment within the National Health Insurance System, and to describe the dental phobia treatment and its outcome at The Dental Fear Research and Treatment Clinic (DFRTC) in Gothenburg. A literature review was made of relevant policy documents on dental phobia treatment from the National Health Insurance System and for Västra Götaland region on published outcome studies from DFRTC. The treatment manual of DFRTC was also used. In Sweden, adult patients with severe DF are able to undergo behavioral treatment within the National Health Insurance System if the patient and caregivers fulfil defined criteria that must be approved for each individual case. At DFRTC dental phobia behavioral treatment is given by psychologists and dentists in an integrated model. The goal is to refer patients for general dental care outside the DFRTC after completing treatment. The DF treatment at DFRTC has shown positive effects on dental fear, attendance and acceptance of dental treatment for 80% of patients. Follow-up after 2 and 10 years confirmed these results and showed improved oral health. In addition, positive psychosomatic and psychosocial side-effects were reported, and benefits also for society were evident in terms of reduced sick-leave. In conlusion, in Sweden a model has been developed within the National Health Insurance System helping individuals with DF. Behavioral treatment conducted at DFRTC has proven successful in helping patients cope with dental care, leading to regular attendance and better oral health.

Cranio-maxillofacial malformations, as seen in Crouzon and Apert syndromes, may impose an immense distress on both function and aesthetics of the person affected. The aims of this study were to describe and compare the main facial and intraoral features of patients with Apert and Crouzon syndromes, the clinical manifestations that may be present, additionally to the main syndromic traits, as well as the cranio-maxillofacial surgical treatment protocols followed.Twenty-three patients with Apert syndrome (6 males, 17 females), and 28 patients with Crouzon syndrome (20 males, 8 females) were evaluated for general medical aspects, craniofacial characteristics, dentoalveolar traits before and after the final orthognathic surgery, and types and timing of cranio-maxillofacial operations. Mental retardation, associated additional malformations, cleft palate, and extensive lateral palatal soft tissue swellings were more common in children with Apert syndrome. In both syndromes, clinical findings included concave profile, negative overjet, posterior crossbites, anterior openbite, and dental midline deviation, which were corrected in almost all cases with the final orthognathic surgery, with the exception of the lateral crossbites, including more than one tooth pair, which were persisting in about half of the cases. Cranial vault decompression and/or reshaping, midfacial and orbital advancement procedures, often in conjunction with a mandibular setback, were the most frequent cranio-maxillofacial operations performed. In conclusion, Apert syndrome is more asymmetric in nature and a more severe clinical entity than Crouzon syndrome. The syndromic dentofacial features of both conditions could be significantly improved after a series of surgical procedures in almost all cases with the exception of the posterior crossbites, with haIf of them persisting post-surgically.

The purpose of this study was to investigate the degree to which patients have perceived that they got questions or advice about eating habits and smoking habits at their last visit at the dental clinic and if this information was differently distributed between different age groups. A further aim was to study whether there were differences in the proportions of questions and advice given to individuals who perceived problems regarding caries and gum bleeding compared to those that did not feel they had problems. The results are based on a postal questionnaire survey,"Life and Health 2008". The study was conducted in a population of women and men aged 18-84 years in 5 counties in Sweden. A total of 68,710 questionnaires were sent out and the response rate was 59.2%. Substantial differences in proportions existed between age groups regarding who received questions and advice related to dental caries and periodontal disease. The differences between age groups regarding information were statistically significant since it was less common that older people got questions and advice than younger.These differences also exist, but less pronounced, between those with disease related problems and those without.Three factors were statistically significantly associated with information. Age, education level and problems with caries or bleeding gums had statistical effect on the prevalence of questions and advice related to eating habits or smoking habits respectively. In conclusion, it is an urgent need of education in methods for dental staff if they want to contribute to changes in life style behaviors for their patients since most patients today don't perceive that they got important disease relevant information at the last dental visit.

Unlabelled: A large number of patients treated in the general dental health service in Western countries report dental fear to some degree. Dentists' views of treating these fearful patients are not well described in the literature.Therefore, the aims of the study were to explore dentists' attitudes towards, experience of, and feelings about treating fearful patients. The sample consisted of 1293 members of the Association of Public Health Dentists in Sweden who were asked to respond to a web survey concerning dental fear. The response rate was 69% (n = 889).The majority of the responding dentists stated that dental fear is a problem in routine dental care,treating patients with dental fear is a positive challenge and they felt they were making a contribution.They also reported that treating patients with dental fear is associated with hard work, poor revenues, and little appreciation by employers. Female dentists reported a greater proportion of patients with dental fear and greater self-efficacy regarding the treatment of these patients, compared with their male colleagues. Dentists trained in other EU countries reported stress more often and less perceived contribution when treating fearful patients, compared with colleagues trained in Sweden.

Conclusion: Dentists' views of treating fearful patients are mainly positive; however, it is problematic that dentists feel stress and that dentists who treat many fearful patients feel their employers do not appreciate their efforts.

The aim of the present work was to evaluate the long-term results of dental implants and the risk factors associated with implant survival and success rates. 108 patients were examined and the control consisted of medical history taking, clinical and radiographic examinations. The survival rate of dental implants was 96.0% and the success rate was 94.3%. Mucositis was found to be related to patients' age and the number of implant units placed. Peri-implantitis was often found in patients showing low standards of oral hygiene as well as in those who were not coming on regular dental visits. Mucositis was in every 5th implant site and was mostly seen in patients with prosthetic constructions consisting of 3 or more units as well as in older patients. Oral hygiene and dental control visits are important to maintain good oral health.