Swedish dental journal最新文献

Unlabelled: The aim of this in vitro study was to develop a replica technique aimed at reproducing an enamel surface exposed to erosive challenge. The replica technique was then used to compare the effect of treating enamel with different fluoride (F) solutions using an in vitro erosion model. Human molar teeth were split in two (total n=34 specimens), and half of each specimen was isolated with impression material. Part I: 10 specimens were exposed to either 0.18% or 1.8% citric acid, the impression material was removed and replicas were prepared. All specimens and replica models were analysed by profilometry and SEM. Part II: 24 specimens were treated with native 0.1 mol/L F-solutions (HF, SnF2, NaF and TiF4), the impression material was removed, and the specimens were then exposed to 1.8% citric acid. Replicas were prepared and analysed by profilometry and SEM. The median height difference between the F-treated areas and the non-treated areas for each F-solution was measured. SEM micrographs were analysed qualitatively blind bytwo of the authors.

Results: Part I--Replicas showed good topographical reproduction of the tooth specimens. Part II--HF had a significantly greater erosion-inhibiting effect than the other fluoride solutions at 0.1 mol/L F as shown by profilometry. SEM revealed a clearly defined border between F-treated and non-treated surfaces only for specimens treated with HF- and TiF solutions. In conclusion, the present replica technique was able to differentiate between the effect of treating enamel with different fluorides against dental erosion in vitro. The technique should be tested further for possible use in situ and in vivo.

The aim of the present study was to investigate persons having problems with dental filling materials in a Swedish population, their perceived oral health, and their reception from dental care personnel. The development over time (between 1992 and 2007) has also been studied concerning the presence of problems from dental filling materials. In two counties in Sweden, Orebro and Ostergötland, all persons born in 1942 have been surveyed by mail every fifth year since 1992. In the year 2007, all persons born in 1932 also received the same questionnaire. The total number of respondents in 2007 were 9813 persons (response rate 72.6%). Logistic regression models were constructed with those having had problems or not from dental filling materials as dependent variable. Multiple regression analysis was done with selfperceived oral health as dependent variable. There were about 10% (868) reporting problems from dental filling materials. There were clear differences between the two groups, having problems or not. The group reporting problems from dental filling materials perceived both their general and oral health as being worse compared with others. More frequently they had asked questions about adverse effects from dental filling materials, had changed dental fillings and crowns, and had amalgam present. They also felt less well treated by dental personnel and were not so pleased with dental care in general as others. In conclusion, there were many persons perceiving problems from dental filling materials. Forthose, both perceived general health and oral health was worse and they were less satisfied with dental care in general. No consistent common characteristic, neither as to socioeconomic nor lifestyle factors, could be shown for those having experienced problems from dental filling materials.

The aim of the study was to investigate orthodontic treatment need and the outcome of orthodontic treatment in 15-, and 20-year-olds in Jönköping, Sweden, with special reference to residual treatment need. An offer to participate in a clinical investigation was extended to random samples of 130 15-year-olds and 130 20-year-olds. Ninety-six of the 15-year-olds (73.3%; 45 boys and 51 girls) and 82 of the 20-year-olds (62.6%; 47 males and 35 females) accepted and presented for examination The participants filled in a questionnaire and impressions were taken for study models, which were graded according to the ICON index. In all, 39 (40.6%) of the 15-year-olds and 38 (46.3%) of the 20-year-olds had undergone or were currently undergoing orthodontic treatment. Ninety-one per cent of the 15-year-olds and 84% of the 20-year-olds considered that the orthodontic treatment goals had been fully or almost fully attained. Two of the 15-year-olds and two of the 20-year-olds currently wanted orthodontic treatment. This indicates a residual treatment demand of about 2%.

Unlabelled: The purpose of the study was to evaluate bed-partners' and patients' self-reports of general well-being, physical strength and mental energy after treatment for obstructive sleep apnoea (OSA) with a mandibular advancement oral appliance (OA). Patients (N = 134) referred from medical physicians diagnosed with true OSA, i.e. an apnoea-hypopnoea index of > 10, were treated with an OA for more than one year. The somnographic evaluations were undertaken in a patient's home before the start of, and six months after, treatment. An individually designed monobloc OA was manufactured by a dental technician for nightly use. After one year of treatment, a follow-up questionnaire was sent to patients whose sleep disorder was reduced > 50% from baseline values and to their bed partners. The questionnaire consisted of 15 questions or statements with multi-answer alternatives concerning well-being, physical strength, mental energy, sleep, day and night symptoms, and the Epworth Sleepiness Scale (ESS: eight questions). The questionnaire was answered by 82% (110/134) of the patients and 85 bed partners. Both patients and bed partners reported improvement in general well-being, physical strength and mental energy, between 70-80% for patients and 55-68% for bed partners sharing the same bed-room. Similar results were found for concentration ability, joyfulness and strength of effort in social intercourse, as well as decreased daytime sleepiness, improvement in the feeling of getting enough sleep and reduced nocturia.

Conclusions: In all dimensions, the treatment effect had a great influence, not only on patients but on bed partners as well.

The aim of the study was to investigate tobacco cessation interventions by Swedish dental hygienists and their perception of the importance of tobacco cessation to oral health. A questionnaire was mailed to 400 randomly selected dental hygienists (DH) in Sweden. The questions covered such topics as tobacco cessation interventions, perceived barriers, and their perception of the importance of tobacco cessation in relation to caries, gingivitis, periodontitis and dental implants. The response rate was 57%. Tobacco habits were routinely recorded by 94% of the respondents. 52% of the dental hygienists reported time constraints, 50% reported insufficient competence and 43% answered that they had lack of experience to work with tobacco cessation. All respondents perceived tobacco cessation to be an important determinant of treatment outcomes in patients with dental implants and periodontitis. Bivariate analysis showed an association between training courses in tobacco cessation and tobacco cessation interventions (OR 3.25, CI 95% 1.80-5.85). A logistic multivariate regression model disclosed two other factors significantly correlated with tobacco cessation interventions: competence (OR 2.4, 95% CI 1.16-4.85), and experience (OR 2.1, 95% CI 1.06-4.28). The analyses were adjusted for age, length of undergraduate training course, and dental care organization. The dental hygienists considered tobacco cessation to be very important in patients with periodontitis and in those with dental implants. Most of the DH in this study undertook some tobacco cessation interventions, though not extensive; the main barriers reported were lack of time, competence and experience.

The purpose of this study was to evaluate the use of mouthrinse products in a Swedish adult population and the factors that influence their use. A questionnaire, comprising semi-closed questions focusing on mouthrinses for oral health, was distributed to randomly selected 700 individuals aged 17-94 years (final response rate of 60%). The data revealed that 47% of the individuals use a mouthrinse product on a regular basis and that it does not differ significantly due to age. Women use such products to a greater extent than men. Individuals who brush their teeth and who use approximal cleaning aids frequently appear to use mouthrinse products to a greater degree. Rinsing is primarily performed once a day or more (45%), in the evening (57%) and after brushing (87%). Those individuals that have been recommended to use the products by dentists and dental hygienists use them to a greater degree (78%) than those who have not received any recommendations (27%). Apart from dental personnel, advertising also plays a significant role in product selection. Of the different products available on the market, pure fluoride products constitute 46%. To summarise, this study indicates that a Swedish adult population, especially women, uses mouthrinse products to a relatively large extent, mainly as a supplement to other oral hygiene procedures such as brushing with a fluoride toothpaste twice daily. To select the most suitable product, the dental personnell should play a more active role in recommendations to the patients who need or want to use mouthrinses.

Unlabelled: The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50, 65 and 75 answered a questionnaire and were also clinically and radiographically examined.The number of edentulous individuals decreased from 15% in 1983 to 3% in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15% in 1983 to 2% in 2008. Individuals with moderate periodontitis decreased from 45% in 1983 to 16% in 2008.

Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated.This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

Children born extremely preterm often suffer from medical complications that have been shown to affect their oral health as toddlers and school children.The aim of this study was to investigate oral health and possible risk indicators for poor oral health in adolescents born extremely preterm compared with a control group and relate the findings to medical diagnoses at the clinical examination. Also in the same groups, compare the frequency of mineralization disturbances and its relation to postnatal morbidity and treatments. The medical records postnatally,was noted in 45 extremely preterm infants with a gestational age (GA) of <29 weeks, at 12 - 16 years of age and in age and gender matched fullterm controls with 37-43 weeks GA. A dental clinical examination was performed including a salivary examination. Medical diagnoses were noted at the time of the survey. Data from the patient dental records at 3, 6, and 9 years of age was compiled. The findings were related to gestational age, birth weight, neonatal and postnatal medical diagnoses treatments and medical diagnoses at the clinical examination. The result showed that the prevalence of plaque, gingivitis and the occurrence of Streptococcus mutans were higher among adolescents born extremely preterm compared to matched controls, and the saliva secretion was lower in the extremely preterm infants. The frequency of caries did not differ between the groups. Mineralization disturbances were more frequent in the primary dentition and more severe in the permanent dentition among the children born extremely preterm. No association between dental pathology, neonatal and postnatal morbidity and treatments was found. In conclusion, adolescents born extremely preterm have an increased number of risk indicators for a poorer oral outcome compared with the controls and more severe mineralization disturbances. These findings may imply an increased vulnerability for poorer oral health later in life.

The aims of this study were to investigate what kind of interocclusal appliances that were chosen among Swedish dentists when treating temporomandibular disorders (TMD), the clinical rationale for the treatment, the diagnoses that warranted the appliance treatment, the use of adjunct TMD treatments and prognostic considerations, and possible differences in these respects between children/adolescents and adults with TMD, and, finally, possible differences between private practitioners and general practitioners in the public dental service. During the 12-months-period April 2009-March 2010 all general dental practitioners in the county of Jönköping, Sweden, were asked to fill in a questionnaire when performing a TMD treatment with an interocclusal appliance. A total of 394 questionnaires were filled in and returned, 216 (55%) from dentists in public dental service and 178 (45%) from private practitioners. It was found that in 40% of the cases, no pre-treatment recording of the functional status in the masticatory system had been made. The commonest reasons for the treatment were bruxism, headache, and replacement of a previous appliance. Less than half of the appliances made were hard acrylic appliances. Some kind of adjunct therapy had been made in 22% of the cases treated in public dental service. The corresponding figure for those treated by private practitioners was 25%. Therapeutic jaw exercises was the commonest adjunct therapy followed by selective occlusal adjustment. In the vast majority of cases, the dentists judged the prognosis of the treatment to be good. It is concluded that a large number of appliances made to treat TMD were soft appliances, especially in public dental service. This reflects a possible overuse of soft appliances at the expense of hard acrylic appliances. Furthermore, in a large number of cases, the treatment was performed without any pre-treatment registrations, and adjunct therapies were rarely used. In all these respects,there is an improvement potential for the treatment of TMD in general dental practice.

Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.