The aim of this study was to produce positive life-style changes in patients with chronic renal disease through a residential education programme about the medical aspects of chronic renal failure and the various treatment options in order to increase their physical capacity, emotional stability and general well-being. The programme was available to all categories of patients with chronic renal disease irrespective of treatment modality. Comparison of data pre and post course demonstrated improvements in physical activity, mental well-being and nutritional awareness.
In 2003, 19 public dental clinics in Västra Götaland Region implemented a population-based programme with fluoride varnish applications at school every six months, for all 12 to 15 year olds. In 2008, the programme was extended to include all 112 clinics in the region.
To evaluate caries increment and to perform a cost analysis of the programme.
A retrospective design with caries data for two birth cohorts extracted from dental records. Three groups of adolescents were compared. For Group 1 (n = 3,132), born in 1993, the fluoride varnish programme started in 2003 and Group 2 (n = 13,490), also born in 1993, had no fluoride varnish programme at school. These groups were compared with Group 3 (n = 11,321), born in 1998, when the programme was implemented for all individuals. The total cost of the four-year programme was estimated at 400SEK (˜ 44€) per adolescent.
Caries prevalence and caries increment in 15 year olds were significantly lower after the implementation of the programme. Group 2, without a programme, had the highest caries increment. The cost analysis showed that it was a break-even between costs and gains due to prevented fillings at the age of 15.
This school-based fluoride varnish programme, implemented on a broad scale for all 12 to 15 year olds, contributed to a low caries increment at a low cost for the adolescents in the Västra Götaland Region in Sweden.
In 2014, the Public Dental Health Service in Södra Ryd, Skövde, started a collaboration at the local family centre with the aim of performing health-promoting activities. Personnel at the family centre can play an important role in promoting children's health, including oral health, by testing preventive guidance.
To describe the personnel's experience of collaboration.
Qualitative interviews with transcripts analysed using the phenomenographic approach.
Seven staff with experience of collaboration. All were female, aged 34-62 and were dental nurses, child health-care nurses, preschool teacher or family centre co-ordinators.
Three themes describing personnel's experience of collaboration at the family centre emerged: Collaboration produces an holistic approach, Co-location creates added value and Working methods result in development. Each theme was represented by three to four categories that represent different conceptions of collaboration at a family centre.
The staff had found that the way of working was positive, mainly because it gave an increased overall view and that the co-location created added value. It also created development through mutual learning and new methods. However, it took time to establish collaboration and required permissive leadership.
The aim was to analyse 27-year-olds' perceptions of their own dental arrangement and any orthodontic care they may have received as a child or adolescent. All of the individuals in a sample of young adults in Kronoberg County, Sweden, who had received orthodontic care during childhood or adolescence (n = 121) were selected to participate in the study. In addition, 76 orthodontically untreated individuals were randomly selected from the same sample. All participants, both those who had previously had orthodontic treatment and those who had not, were sent a questionnaire. Most of the respondents were satisfied with their earlier decision, whether to choose orthodontic treatment or not. Dental professionals were considered to have had the greatest influence on this decision. This means that the desire for treatment may be guided by the orthodontist. Three out of four individuals considered orthodontic treatment important, even when irregularities of the teeth were minor. A majority of the individuals thought that they would have been able to wear visible braces if needed, even in adulthood. Individuals treated by specialists were more contented than individuals treated by general practitioners. Individuals with malocclusions and treatment need, but who had refused offered treatment, were in general more discontented with their dental arrangement; more than half of them now regretted their decision. They also felt it more difficult to communicate questions, thoughts, and opinions on their own desire for treatment. An increased level of information, especially to these individuals, would have been desirable.
The purpose of this series of studies was to evaluate the outcome of orthodontic care in Sweden from the professional's and the patient's perspective. In addition, a model was devised for the priority-planning of orthodontic care and for evaluating the different factors influencing the decision for orthodontic treatment. The results may be summarized as follows: Treatment Decision. Treatment desire, followed by treatment need and treatment benefit were the most important factors to consider when deciding whether or not treatment should be carried out. Regardless of the differences in resources and the structure of the free public care, a substantial proportion of the untreated 19-year-olds had malocclusions with treatment need, but they had no desire for treatment. Most of the 27-year-old individuals were satisfied with their earlier treatment decision, regardless of whether they had undergone orthodontic treatment. Dental professionals were considered to have had the greatest influence on this decision, which means that desire for treatment may be guided by the orthodontist. Individuals with malocclusions and treatment need--but who had refused proposed orthodontic treatment--were in general more discontented with their dental arrangement than other respondents, and a majority of them regretted their decision. Greater information to these individuals would have been desirable. Resources and Treatments Provided by General Practitioners or by Specialists. The sparsity of specialist resources resulted in either a greater restriction on the number necessary treatments being initiated or a greater proportion of the treatment being provided by general practitioners. In the 3 counties analysed, the treatment standard correlated well with the available resources: the greater the number of orthodontic specialists and ability to supervise the work of general practitioners and taking care of patients in need of specialist treatment, the higher the standard of treatment. Individuals treated by specialists were more contented than individuals treated by general practitioners. The measures of treatment outcome in general yielded more favourable scores for specialist treatments than for treatments provided by general practitioners, despite the specialist treatments on the average being classified as more difficult than those provided by general practitioners. Perceived treatment difficulty. About one-fourth of all treatments were classified as easy, one-fourth as moderately difficult, and one-half as difficult. The perceived treatment difficulty was associated on a group basis with the pretreatment need. The treatment investment increased and the treatment outcome became less favourable with increasing perceived difficulty. The treatment outcome was least favourable in the group where no treatment was suggested. Almost every fourth treatment was successfully carried out by mere extraction therapy. Attitudes in 27-year-olds. Orthodontic treatment was considered important by three out of four individuals, even in cases where irregularities of the teeth were small. A majority of the individuals thought that they would have been able to wear visible braces if needed, even in adult age. Methodological aspects. Studies that have used different indices to evaluate treatment outcome can only be compared with great caution. Measures with wide bases for evaluation may be more valid than measures with narrow bases. To estimate treatment outcome in terms of decrease of treatment need, the Indication Index may be recommended.
Three counties in Sweden (A, G, and W) with free orthodontic care and different orthodontic resources and geographic structures were studied in 1987. Samples of totally 942 young adults (mean age 18.8 years, SD 0.44) were examined concerning malocclusions and all orthodontic treatment provided by general practitioners or by orthodontic specialists. The care in a rural area (county G) with abundant specialist resources was based on specialist treatments easy assessable to the patients and supplemented by treatments, mainly without appliances and provided by general practitioners. There was a generous attitude of consultation with specialists and of providing treatment. The sparsity of specialist resources had in an urban area (county A) resulted in a greater restriction on providing treatments. The treatments were performed in a higher age and were, to a greater extent, not completed by the age of 19, and a smaller percentage of individuals were treated than in the other two counties. The care in a large rural area (county W) with long distances to the only specialist clinic was based on treatments provided by general practitioners. In spite of the few specialist resources there was a generous attitude of providing treatments. Interceptive methods were used to a great extent, and later completed with appliance therapy. According to a treatment priority index 44% of the untreated individuals in the three counties had malocclusions and an objective treatment need, and there were no significant differences between the counties. Regardless of differences in specialist resources and structure of the free public orthodontic care, a substantial and equal proportion of the untreated individuals in the counties had malocclusions with treatment need, but they had no treatment desire.
OBJECTIVE: To compare the outcome of orthodontic treatment and the desire for further treatment in 19-year-old young adults treated by specialists in urban and rural areas and to study the influence of the level of education of their parents. DESIGN: The individuals were clinically and retrospectively examined with reference to malocclusions and orthodontic treatment received during childhood and adolescence. SETTING: Orthodontic department in Kronoberg County, Sweden. SUBJECTS: From a sample of 302 young adults, all individuals who had received orthodontic treatment by specialists (n = 60) were selected. OUTCOME MEASURES: The individuals were compared according to outcome of treatment and place of residence. The pre-treatment need, the residual treatment need, the treatment results, and the desire for further treatment were estimated as well as treatment duration, number of visits, percentages of discontinued treatments and parents' level of education. RESULTS: There was a higher frequency of individuals without previous treatment and a lower frequency of specialist-treated individuals in rural areas than in urban areas in the county. The treatments implied substantial improvements, with a higher reduction of treatment need and a higher degree of success in patients from urban areas than from rural areas (P