During the last 3 decades, large resources have been allocated through the organized dental care system for the improvement of dental health among children and teenagers in Sweden. The aim of this study was to describe attitudes related to dental health and dental care among 20 to 25-year-old Swedes. A random sample of 650 individuals was drawn from the database of the National Social Insurance Board of Sweden. A postal questionnaire comprising 70 questions was delivered to the subjects and the response rate was 78%. A high proportion of the respondents considered themselves to have a high need for dental care. They had a strong conception of being able to influence their own dental health. Quite a few were concerned about their dental health. A high proportion indicated that they were satisfied with their dental function, but fewer individuals were satisfied with the appearance of their teeth. The respondents also reported good reception by their dentists, although opinions differed between the sexes. Women reported a significantly higher degree of discomfort and unease than men. Most respondents had adopted good oral hygiene habits but dental floss was rarely used. The majority of subjects indicated that they attended dental examinations on an annual basis. There is a need for further investigation into patients' attitudes to dental health and dental care. It is important to understand the significance patients attach to different concepts in the dental treatment. This would enhance our understanding of how the concept of felt need is expressed and transformed into demand for care.
Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provided with implant-supported restorative therapy in 2003. Patient files of 2,765 patients (11,311 implants) were collected from more than 800 clinicians. Information on patients, treatment procedures, and outcomes related to the implant-supported restorative therapy was extracted from the files. In total, 596 of the 2,765 subjects, provided with 2,367 implants, attended a clinical examination 9 y after therapy. Implant loss that occurred prior to connection of the supraconstruction was scored as an early implant loss, while later occurring loss was considered late implant loss. Early implant loss occurred in 4.4% of patients (1.4% of implants), while 4.2% of the patients who were examined 9 y after therapy presented with late implant loss (2.0% of implants). Overall, 7.6% of the patients had lost at least 1 implant. Multilevel analysis revealed higher odds ratios for early implant loss among smokers and patients with an initial diagnosis of periodontitis. Implants shorter than 10 mm and representing certain brands also showed higher odds ratios for early implant loss. Implant brand also influenced late implant loss. Implant loss is not an uncommon event, and patient and implant characteristics influence outcomes (ClinicalTrials.gov NCT01825772).
Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with =4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned =1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772).
The purpose of this study was to analyse endodontic status and treatment suggested for Swedish citizens requiring substantial dental care. According to the Swedish dental insurance system, treatment plans including radiographs have to be submitted for approval if the estimated cost of treatment exceeds a certain level (USD 500 in 1977). A sample of 1094 treatment plans received during 1977 and 1978 was randomly selected. In the radiographs the number of remaining teeth was recorded, periapical condition was evaluated and the quantity and quality of previous endodontic treatment were estimated. In addition, treatment plans concerning the teeth with periapical lesions were studied. The results indicated that patients analysed in this study that needed expensive treatment had more missing teeth, more root-filled teeth and more teeth with periapical lesions than what has been reported in previous studies of samples supposed to accurately represent the Swedish population. However, the technical quality of the root fillings and the frequency of periapical lesions in root-filled teeth were the same as in previous studies, with high frequencies of inadequate root fillings and related unfavourable responses. Thus the patients in this study retained a significant need for endodontic treatment despite having already received a great deal of endodontic care. Further, it was found that nearly half of the observed periapical lesions would not be treated based on the submitted plans.
The purpose of this study was to examine changes in the endodontic status of selected teeth in a population over time, in order to get a long-term perspective of endodontically treated teeth. A random sample of the adult Swedish population was selected in 1974 and offered a clinical and radiographic examination. Eleven years later 351 of the selected persons attended a follow-up examination (1985). In radiographs, covering the mandibular premolar and molar regions, the status of 1974 was directly compared, tooth by tooth, with the status of 1985. The results showed that a number of endodontically treated teeth with an apical periodontitis healed during the observation period. During the same period, approximately the same number of endodontically treated teeth presented with a new apical periodontitis. This finding suggested that cross-sectional studies could provide reliable information on the long-term success rate of endodontic treatment at the population level. The periapical lesions that persisted or developed during the observation period were strongly related to incomplete root canal obturation, which is in agreement with observations in follow-up studies from teaching and specialist clinics.
A longitudinal study of the frequency of dental visits has been conducted on a sample of 1302 individuals aged 20-60 years. These individuals had previously been interviewed regarding their dental care habits. They had also (subsequent to the interview) been clinically examined by a dentist. The results presented are based on the official dental care consumption statistics in Sweden, and thus differ from the information obtained from the interviews. In all age groups, women had a higher frequency of dental visits than men. The average number of courses of treatment carried out over a 4-year period was 2.0. Only 23% of the individuals received treatment once a year or more often, whereas 79% received treatment at least once during a period of 4 years. These figures were lower than those reported in the interviews. Individuals with a higher number of courses of treatment had also had a higher frequency of dental visits before, had been called in by their dentist for check-ups, had a higher income and knew more about teeth and their care, used oral hygiene aids daily and were living in metropolitan areas. Younger people with many remaining teeth and those with many decayed teeth had had a higher frequency of courses of treatment.
The oral status of an adult population of 204 patients with rheumatoid arthritis (RA) was compared with that of an age and sex-matched random sample of non-rheumatic subjects. The percentage of edentulous subjects, number of existing teeth in dentate subjects, prevalence, and quality of fixed and removable prostheses and prevalence of disorders of the stomatognathic system was recorded. The percentage of edentulousness among RA-patients was 17% and among non-RA subjects 19%. Number of remaining teeth was equal. 75% of removable partial and 62% of complete dentures among RA-patients were considered unsatisfactory compared to 25% and 56% respectively among non-RA subjects. Disorders related to the TMJ occurred much more frequently among RA-patients than among non-RA subjects. It is suggested that thorough stomatognathic examination and TMJ-prophylaxis be included in the overall care of RA-patients.
OBJECTIVE: To examine the indications for prescribing antidepressants and the clinical outcome when they are prescribed for the treatment of depression, and compare tricyclic antidepressants (TCAs) and selective serotonin re-uptake inhibitors (SSRIs) in these respects. METHOD: A naturalistic study of a prospective prescription monitoring database and medical records. RESULTS: Depression was the indication for 23% of the tricyclic treatments and for 82% of the SSRI treatments. A successful treatment of the depression was found in 20% of the TCA cases and 41% of the SSRI cases (NS). CONCLUSION: This study provides evidence that the main use of SSRIs in 1995 is the treatment of depression. The study implies that SSRIs have a more favourable outcome in "real life" than TCAs.