The aim of the present study was to describe the Norwegian adult population according to: 1. number of teeth present, 2. demand and utilization of dental services, 3. travel time from home to the dentist, 4. dental health behaviour, 5. fear for dental treatment. The analyses were performed on a set of national data collected in 1989, which was representative of the non-institutionalized Norwegian population 20 years and above. The sample size was 1260 individuals. About 75% of the people had 20 teeth or more present. Nine percent were edentulous. Seventy-seven percent who had demanded dental services during the last year. The average expenditure for dental treatment for those who had demanded the services during the last year was NOK 826. Fifty-three percent travelled 15 minutes or less from home to the dentist. Eighteen percent travelled 30 minutes or more. Almost everybody with their own teeth present brushed their teeth regularly once a day. Thirty-three percent of all dentate people used woodsticks regularly once a day, while 20% used toothfloss regularly. Seventy-five percent had no to mild fear of the dentist, while 7% had a strong fear. Fear of the dentist was higher among women than among men. Fear of the dentist decreased by increasing age. Few people, less than 4%, had cancelled a dental appointment because of dental anxiety. There has been an improvement in dental health and dental health behaviour in Norway during the 1970's and 1980's. These improvements are discussed with special attention paid to the findings from the present study.
The aim of this study was to examine the effect of family income on accessibility to dental services among adults in Norway. The analysis was performed on a set of national data collected in 1989, which was representative of the non-institutionalized Norwegian population aged 20 years and above. The sample size was 1200 individuals. The data were analyzed according to a two-part model. The first part determined the probability of whether the consumer had demanded the services or not during the last year according to family income. The second part estimated how the amount of services utilized depended on family income, for those with demand. The elasticity of the odds of having demanded the services with respect to family income was 0.48. Family income had no effect on the amount of services utilized. Additional analyses also showed that there was no effect of family income on the probability of having received a filling or a crown when visiting the dentist. In Norway, almost all costs for dental services are paid by the consumer. It is not possible from the data alone to say whether subsidized dental care is an effective way of reducing the inequalities in demand.
The purpose of the present work was to assess the adequacy and effectiveness of a public dental program for old-age pensioners. The dental care program offered free consultation and treatment at reduced prices to all pensioners (3072) in a municipality near Oslo in 1979. To study treatment need and access to dental care, a random sample of 430 pensioners was drawn from the total population of old-age pensioners; 371 persons were clinically examined. Of the 3072 old-age pensioners 23.7% responded positively and indicated that they were interested in the program, whereas 19.8% accepted, and 14.6% had the treatment carried out. The program adequacy was low and became lower when more restricted criteria for access to dental services were used. The program effectiveness was 18% or 16%, depending on which criteria were used for access. Acceptance of the program was highest among people who were aware of it, had natural teeth, had a dental problem, did not have their own dentist, had limited education, or were among the young pensioners.
BACKGROUND: A number of epidemiological studies have shown that smoking is a risk factor for periodontal disease. Little is known about the relationship between smoking duration and alveolar bone loss. The purpose of this research was to describe the prevalence of alveolar bone loss according to smoking status in Norway. A dose-response model for duration of tobacco smoking on alveolar bone loss was then developed and discussed. METHODS: The study population consisted of 812 individuals living in Norway aged 45 to 64 years old (248 current smokers, 245 former smokers and 319 non-smokers). Alveolar bone loss was measured on bite-wing radiographs. Simple descriptive statistics were used to describe the central tendency and variation in alveolar bone loss. Regression analyses were performed to study the relationship between smoking duration and alveolar bone loss. RESULTS: Mean alveolar bone loss varied between 1.51 mm and 2.64 mm depending on smoking status and age. Mean alveolar bone loss was lowest in non-smokers and highest in current smokers. Given identical smoking status, the mean alveolar bone loss increased with increasing age except for the 2 oldest age groups of current smokers. CONCLUSIONS: Our results generate the hypothesis that the relationship between smoking duration and alveolar bone loss was "S-shaped." Assuming that alveolar bone loss is irreversible after smoking cessation, it could be hypothesized that there is a threshold period for tobacco smoking after which the accumulated effect of smoking becomes clinically observable. After a certain number of years of smoking, the effect on alveolar bone loss seems to level out. To test this hypothesis, the relationship between smoking duration and alveolar bone loss should be studied in a prospective study design.
The purpose of the present paper was to establish and evaluate a causal model on the use of dental services in Norwegian old-age pensioners living at home. Data were derived from the Health Survey of 1975. The independent variables sex, age, education and dental status were dichotomized and arranged in this assumed temporal sequence. The dependent variable was also dichotomized into use versus non-use of dental services last year. The analysis started with the bivariate percentage table for sex and use, and then proceeded by adding one by one of the independent variables in the order of their time sequence. In this way the statistical relationship between an independent and the dependent variable was decomposed into direct, indirect and spurious effects. Dental status was the most influential determinant of use of services, having the greatest direct effect (0.40) and mediating indirect effect of the prior variables. Education came second with a direct effect of 0.18 and an indirect effect (0.11) by affecting dental status. There were only negligible differences in use rates between the age groups (less than 75 / greater than or equal to 75 years of age) when the other variables were held constant (0.05, P greater than 0.05). The greater part of the direct effect of sex (0.11) was limited to dentate persons aged 65-74 with low education. Both age and sex affected use of services indirectly through dental status (0.09 and --0.04, respectively).
The purpose of this paper is to describe the changes in the oral health of adults from Trøndelag, Norway, over two decades (1973-1983-1994), from both a quasi-longitudinal and a time-lag perspective. Study participants were selected by random sampling in 1973, 1983 and 1994 (n=1759, n=3195, n=2341). Data were collected by epidemiological registrations and questionnaires. Oral health was measured by the additive DMF index. The number of decayed teeth was low in all age groups in 1994. There was a reduction in the number of filled teeth from 1983 to 1994 in the time-lag perspective in the youngest age group and the urban middle-aged group. The rural middle-aged adults and the older adults showed more filled teeth in 1994 than in 1983. In a quasi-longitudinal perspective, no significant changes in the 1960 birth cohort and the 1939-48 urban birth cohort were shown from 1983 to 1994, while the 1930-38 birth cohort and 1939-48 rural birth cohort acquired more filled surfaces during this period. There are now at least two different oral health populations of adults. The younger with the potential to carry oral health benefits into old age, and an elderly population burdened with extensive treatment but keeping their natural teeth.
One of the objectives of organized school dental service is to create ability and willingness among young adults to maintain a preventive oral health care, e.g. regular dental visits. In order to investigate the decisions about and plans for dental care among school dental service leavers a questionnaire was sent to a probability sample of 258 young adults who had finished ninth grade eight months earlier. The participation rate of the Youth Dental Program (YDP) was approximately 90%. The drop-outs were made up of at least two rather distinct groups. One of them was dominated by subjects with a high social background and they chose to a great extent care in private practice. The other group was dominated by young men with a low social background. They finished school early and expressed pessimistic expectations to the life-time of their own teeth.
In order to assess the prevalence of untreated caries in two groups of Danish 7th grade (13- to 14-year-old) school children in a blind study, a radiographic investigation was carried out. Only half of the children (394) had received regular school dental care during their years of attendance of primary school; the other children (368) had not. A bitewing radiograph of the right side of the mouth of each child was taken, employing a standardized technique. The radiographs were read without the examiner knowing the group identity of the radiographs. The criteria for discarding poor radiographs, teeth, and tooth surfaces are described. Some of the radiographic results are compared with the clinical caries score of the same group. Most of the radiographs without untreated caries were found among those of the children who received school dental service. Uncertainty of method in connection with radiographic investigation is discussed.
The National Health Insurance covers a minor part of the expenditures for adults' dental care in Norway. This paper describes the present principles for charging patients for health care services. The paper has 3 aims, 1) to describe patient charges assessed as personal expenditures for dental treatment, 2) to relate patient charges for dental treatment to patient charges for other health services, and thirdly 3) to compare the level of spending for dental care to other household-consumption. Patient charges are higher for dental care than for other non-institutionalized health services. There is an upper limit to patient charges for health services (dental services are not included). The upper limit was approximately 90 in 1987. Above that limit health services are free. Altogether 137,000 persons reached that level of personal expenditures for health services in 1987. The price per unit of dental services is considered rather low in Norway. However, approximately 600,000 adults had expenditures for dental services which exceeded 90. The inconsistency in the present level of patient charges is discussed.