Acta Odontologica Scandinavica最新文献

Objective: To describe the oral health status of patients with obesity and to explore the socio-demographic characteristics, comorbidities, lifestyle habits (tobacco, alcohol, sweet/acidic diet), and saliva parameters most associated with the dental caries experience.  Material and methods: We conducted a cross-sectional analysis of 204 patients' data with obesity attending a therapeutic education programme. Caries experience (number of decayed, missing, and filled teeth [DMFT]), periodontal status, oral hygiene, occlusal tooth wear, masticatory inefficiency, and saliva parameters were recorded.

Results: Mean DMFT was 12 ± 7 and was independently associated with age (mean 47 ± 14 years; for 1 standard deviation (SD) increase: β = 0.22, 95% confidence interval [CI] = 0.16-0.29), female sex (72%; β = 3.76, 95% CI = 1.65-5.87), brushing <2 times/day (35%; β = 2.86, 95% CI = 0.81-4.90), salivary buffering capacity (low [46%] vs. normal [40%]: β = 2.02, 95% CI = 0.08-3.95; very low [10%] vs. normal: β = 3.34, 95% CI = 0.31-6.37), and salivary consistency (bubbly [30%] vs. clear [57%]: β = 2.45, 95% CI = 0.52-4.38).

Conclusions: Improving patients' competencies for oral care, such as teeth brushing twice daily, is necessary to limit the burden of dental caries in individuals with obesity. Acting on salivary composition may also be of interest, and further studies are required to explore the underlying mechanisms.

Objective: This study aimed to gain knowledge of general oral health preventive measures with a specific focus on root caries preventive measures for patients ≥65 years old, performed by Norwegian dental hygienists in public and private dental health services. A secondary aim was to investigate differences and challenges in prevention practices.  Materials and methods: An electronic survey was conducted among the sample in 2022. A total of 365 dental hygienists were included in the analyses. Chi-square tests were used to analyze differences between private and public dental hygienists regarding preventive measures and perceived challenges.  Results: The most frequently reported general oral health preventive measures were oral hygiene instruction, professional tooth cleaning and scaling. Oral hygiene instruction and application of fluoride varnish were the most performed root caries preventive measure, and reduced manual dexterity in patients was the most perceived challenge. Public dental hygienists perceived challenges to a greater extent than private dental hygienists, particularly related to reduced mobility and ergonomic difficulties in patients.  Conclusion: This study confirms dental hygienists' important role in oral health promotion and showed that Norwegian dental hygienists performed a wide range of preventive measures for patients ≥65 years old. However, a number of challenges were identified in the preventive work.

Objectives: The aim was to provide an in-depth characterization of patients hospitalized with severe odontogenic infections (SOI), especially in relation to the origin of the infection. Furthermore, the aim was to generate an overview of which kind of treatment the patients had received before hospitalization and to analyze risk factors for prolonged length of hospital stay.

Material and methods: The study was a retrospective cross-sectional study, which included patients hospitalized at the University Hospital of Copenhagen, Denmark, with SOI from November 2012 through 2019. Data were extracted from medical hospital records. Analysis was performed using the χ2 test, analysis of variance, multiple correspondence analysis (MCA), and logistic regression.

Results: A total of 384 eligible patients were included. The most frequent origin of infection was apical periodontitis (46.9%), infection after tooth extraction (25.8%), multiple infectious foci (8.6%), and pericoronitis (6.0%). Significant differences in concomitant diseases (p = 0.017) were found between the groups of origin of infection. The MCA model showed little to no ability to generate an in-depth characterization of the group of patients. Eleven patients (2.9%) were treated with incision and drainage before hospitalization, and 131 patients (34.3%) received no kind of antibiotic before hospitalization.

Conclusion: The results indicate that clusters of variables could not be related to the origin of infection. In general, patients received insufficient treatment before hospitalization. Future studies should define risk factors for developing SOI and examine dental records of dental treatment before hospitalization.

Clinical relevance: To improve prehospital treatment with patients with SOI, general dental practitioners should treat the origin of the infection, attempt drainage, and optimize the prescription of antibiotics.

Objective: To explore patients' experiences of dental staff recognising their dental anxiety.

Material and methods: Semi-structured interviews were conducted with 10 adults who identified themselves as dentally anxious. The sampling of study participants was purposive, and the audio-recorded interviews were transcribed verbatim. Classical grounded theory and constant comparative analysis were used to analyse the interview data inductively. Theoretical saturation was reached after eight interviews.

Results: Hope for 'Fingerspitzengefühl' from the dental staff emerged as the core category, which means having an intuitive instinct about a situation and knowing how to react to it. It also is tact or sensitivity that comes with experience. The foundation for this core was four categories: Dental anxiety causes involuntary signals, Strategies to minimise contact, Seen and respected by the staff, and Recognisable strategies. The interviewees hoped that the dental staff would notice their dental anxiety and understand their feelings of shame, and take relevant actions to alleviate their anxiety.

Conclusions: Dentally anxious patients often struggle to express their anxiety but hope to find a dentist with Fingerspitzengefühl. The result cannot be generalised but transferred to a similar population.

Objective: Third molar extraction is a common procedure with occasional complications. This study aimed to determine the incidence and types of complications in challenging lower third molar extractions and to identify complication risk factors in tertiary hospital patients.

Material and methods: A retrospective cohort study was conducted on 354 patients who underwent unilateral lower third molar extraction during a 2-year period in 2018-2019 at Helsinki University Hospital. The outcome was the presence of a complication, and patient-related and operation-related variables served as determinants. Statistical analyses included Mann-Whitney U and Chi-squared tests, and binary logistic regression.

Results: Complications occurred in 16.7% of patients. The most common complication was local infection (7.6%), followed by nerve injury (5.6%). The complication risk was 3.7-fold (95% confidence interval (CI) 1.97-6.77, p < 0.001) higher in extractions defined as demanding than in routine operative extraction. If the third molar was acutely infected, the complication risk increased 2.0-fold (95% CI 1.08-3.75, p = 0.027).

Conclusions: Due to the high rate of complications in challenging extractions, scheduling a follow-up visit is important, and risk factors must be considered properly, especially in demanding extractions and in acutely infected third molars.

Objective: Temporomandibular joint (TMJ) arthritis is a common finding in juvenile idiopathic arthritis (JIA) patients. TMJ arthritis can cause significant disturbances in TMJ function and growth without treatment. Our aim was to evaluate the effectiveness of medical treatments used to manage TMJ arthritis and how to evaluate the outcome of the treatment. Furthermore, this study aimed to ascertain the prevalence of TMJ arthritis in JIA patients and investigate the potential impact of specific factors.

Material and methods: Between 2015 and 2019, a total of 194 JIA patients who received treatment at the Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Finland were included in the study. We retrospectively screened the patient records and imaging studies to find out how many patients had TMJ arthritis and what medication was used to treat it.

Results: Maximal incisal mouth opening (MIO) increased significantly with patients whose TMJ arthritis was successfully treated with intra-articular corticosteroid injection (IACI). Almost all patients with TMJ arthritis were treated with an IACI at some point during their treatment. Overall, 99 patients (51%) had been diagnosed with TMJ arthritis. No statistical difference was found between the prevalence of TMJ arthritis and different JIA subtypes, JIA onset time, gender, or immunological factors.

Conclusion: MIO is an easy way to evaluate the treatment outcome and possible disease activation of TMJ arthritis. The prevalence of TMJ arthritis is high among JIA patients. In our study, we could not find any parameters that predict TMJ arthritis, and despite systemic medication, TMJ arthritis might occur.

Objectives: This study aims to explore the identification of older people in need of dental consultation, with a Simplified Oral Indicator (SOI) used by home care nurses (HCNs) and with the Geriatric Oral Health Assessment Index (GOHAI-NL) completed by older people themselves, compared with the Oral Health Assessment Tool (OHAT-NL), performed by dental hygienists.

Methods: The HCNs completed SOI based on their professional view, knowledge and experience; scores red/orange/green were given to older people for oral health and oral hygiene. Older people completed the GOHAI-NL and dental hygienists completed the OHAT-NL.

Results: Data from 141 older people were analysed. Sensitivity and specificity of SOI -OHAT-NL were low (0.45 and 0.64, respectively); SOI scored only few older people as 'red', while only 11 older people did not need a dental referral according to the OHAT-NL. OHAT-NL and GOHAI-NL correlation was significant, but low (r = -0.226, p = 0.012).

Conclusion: Simplified Oral Indicator is currently not sensitive enough to identify older people in need of dental consultation. Additional education to HCNs and/or adjusting SOI may be needed. The GOHAI-NL seems not useful in dental triage.

Introduction: The impact of dental anxiety is profound. At the same time, dental anxiety is sometimes difficult to detect. Therefore, a patient-reported outcome measure is needed. The Modified Dental Anxiety Scale (MDAS) is a short, internationally used self-assessment questionnaire for screening of dental anxiety.

Aim: To cross-culturally adapt the original English MDAS to Swedish (MDAS-S), and to validate it in a Swedish setting.

Materials and methods: The adaptation was conducted in accordance with recommended guidelines. Field testing was performed both among adults presenting for their regular dental check-ups and among adults diagnosed by a psychologist as dentally phobic.

Results: The MDAS-S was formed during the adaptation procedure. Field testing included 246 adults presenting for their regular dental check-ups and 7 adults diagnosed with dental phobia. The MDAS-S score was significantly higher (p < 0.001) in the dentally phobic group than in the regular dental check-up group. Reliability was good with Cronbach's Alpha values between 0.880 to 0.909. Test-retest of 37 individuals showed an excellent Intraclass Correlation Coefficient of 0.956. Confirmatory factor analysis (CFA) finds support for a two-factor model although with 78% shared variance between the factors.

Conclusions: The MDAS-S demonstrates good reliability and appears valid as a screening tool for dental anxiety among Swedish adults.

Aim: To analyse the risk factors contributing to the prevalence of periodontitis among clusters of patients with diabetes and to examine the clustering patterns of clinical blood biochemical indicators.

Materials and methods: Data regarding clinical blood biochemical indicators and periodontitis prevalence among 1804 patients with diabetes were sourced from the National Health and Nutrition Examination Survey (NHANES) database spanning 2009 to 2014. A clinical prediction model for periodontitis risk in patients with diabetes was constructed via the XGBoost machine learning method. Furthermore, the relationships between diabetes patient clusters and periodontitis prevalence were investigated through consistent consensus clustering analysis.

Results: Seventeen clinical blood biochemical indicators emerged as superior predictors of periodontitis in patients with diabetes. Patients with diabetes were subsequently categorized into two subtypes: Cluster A presented a slightly lower periodontitis prevalence (74.80%), whereas Cluster B presented a higher prevalence risk (83.68%). Differences between the two groups were considered statistically significant at a p value of ≤0.05. There was marked variability in the associations of different cluster characteristics with periodontitis prevalence.

Conclusions: Machine learning combined with consensus clustering analysis revealed a greater prevalence of periodontitis among patients with diabetes mellitus in Cluster B. This cluster was characterized by a smoking habit, a lower education level, a higher income-to-poverty ratio, and higher levels of albumin (ALB g/L) and alanine aminotransferase (ALT U/L).

Objective: The aims of this study were to assess the accuracy of Cameriere's and Demirjian's methods in Finnish children, and compare the findings with those of the Turkish children according to dental age.

Material and methods: Dental panoramic tomography (DPT) of children (482 Finnish, 423 Turkish) aged between 5 and 15 years were evaluated. Comparison of mean difference between estimated and chronological age was evaluated. The difference between two means was analysed using paired t-test at 95% confidence interval (CI). Pearson correlation coefficients were used to estimate the correlation between chronological and estimated ages.  Results: Demirjian's method resulted in overestimation in all age groups except for 8-year-old girls. Dental age, however, was found to be underestimated with Cameriere's method in all age groups but 6-year-old girls and boys. In Northern Finnish children, Demirjian's method was more suitable for boys while Cameriere's method led to better estimation in girls. When comparing Finnish and Turkish children, differences between dental ages and chronological ages differed significantly in 10-year-old boys and 8-year-old girls with both methods.  Conclusion: Dental age of Turkish children seems higher than that of Finnish children. There is a significant difference between chronological and dental ages in both populations assessed by both methods.