The aim of this study was to compare the estimation ability of a dental hygienist to that of a dentist when, independently, recording the oral health status and treatment need in a population of elderly, receiving home nursing. Seventy-three persons, enrolled in a home nursing long-time care programme, were recruited. For the oral examination a newly developed protocol with comparatively blunt measurement variables was used. The oral examination protocol was tested for construct validity and for internal consistency reliability. Statistical analyses were performed using Wilcoxon matched pairs signed rank sum test for testing differences, while inter-examiner agreement was estimated by calculating the kappa-values. Comparing the two examiners, good agreement was demonstrated for all mucosal recordings, colour, form, wounds, blisters, mucosal index, and for the palatal but not the lingual mucosa. For the latter, the dental hygienist recorded significantly more changes. The dental hygienist also recorded significantly higher plaque index values. Also regarding treatment intention and treatment need, the dental hygienist's estimation was somewhat higher. In conclusion, when comparing the dental hygienist's and the dentist's ability to estimate oral health status, treatment intention, and treatment need, some differences were observed, the dental hygienist tending to register "on the safe side", calling attention to the importance of inter-examiner calibration. However, for practical purpose the inter-examiner agreement was acceptable, constituting a promising basis for future out-reach activities.
OBJECTIVES: To evaluate the attitudes to retaining natural teeth in an adult Swedish population, and to correlate the attitude to retaining natural teeth with some presumed influencing background factors. DESIGN: Cross-sectional study using a newly developed questionnaire. SUBJECTS: From the national census register of four municipalities in the southern part of the province of Holland, Sweden, with a total population of 126,878 adult (> or = 20 years) inhabitants, 4,200 persons were selected at random. The sample was randomised by age and sex, and 300 men and 300 women from the age groups 20, 30, 40, 50, 60, 70, and 80 years were included. INTERVENTION AND MAIN OUTCOME MEASURES: The questionnaire aimed to evaluate the number of remaining natural teeth, the dental care habits, the self-estimated quality of natural teeth, and the attitude to retaining natural teeth in the studied population, and also to evaluate the possible correlation between those factors, in particular, the attitude to retaining natural teeth versus the other factors. RESULTS: It was found that the attitude to the importance of retaining natural teeth was strongly correlated with the number of remaining natural teeth, the dental care habits, and the self-estimated quality of natural teeth. Also sex had an influence on this attitude but not age. CONCLUSIONS: The attitude to the importance of retaining natural teeth in an adult Swedish population is correlated with the number of remaining natural teeth, the dental care habits, the self-estimated quality of natural teeth, and sex, but not with age.
In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel's knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the intervention, a statistically significant improvement was recorded for changes in oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.
The aim of the study was to evaluate the prevalence of subjective perception of dry mouth in an adult population and to determine the prevalence of pharmacotherapy in this population. An additional aim was to assess a possible co-morbidity between symptoms of dry mouth and continuing pharmacotherapy. Four-thousand-two-hundred persons were selected at random from the national census register of the adult population of the southern part of the province of Halland, Sweden. The sample was stratified according to age and sex, and 300 men and an equal number of women aged 20, 30, 40, 50, 60, 70 and 80, were included. A newly developed questionnaire was mailed to each individual. In addition to questions about subjective perception of dry mouth, the subjects were asked to report on present diseases and continuing pharmacotherapy. Three-thousand-three-hundred and thirteen (80.5%) evaluable questionnaires were returned. The estimated prevalence of xerostomia in the population was 21.3% and 27.3% for men and women, respectively. This difference between the sexes was statistically significant. In non-medicated subjects, women tended to report a higher prevalence of xerostomia compared with men, 18.8% vs. 14.6%, and also among medicated subjects the estimated prevalence of dry mouth was higher for women than for men, 32.5% vs. 28.4%. There was a strong association between xerostomia and increasing age and also between xerostomia and continuing pharmacotherapy. The average prevalence of dry mouth among medicated and non-medicated subjects was 32.1% and 16.9%, respectively, the difference being statistically significant. There was also a strong association between xerostomia and the number of medications. In a logistic regression, the probability of reporting mouth dryness was significantly greater in older subjects and in women, and the probability increased with the number of medications taken. In conclusion, this epidemiological survey of an adult population has demonstrated that women, independent of age, do report a higher prevalence of xerostomia than men and that the symptom of dry mouth is strongly associated with age and pharmacotherapy. It is, however, not possible to discriminate between disease and pharmacotherapy as causal factors.
OBJECTIVES: To investigate the recall of oral health knowledge and confidence by nursing personnel in special housing facilities for the elderly, three years after an education programme. DESIGN: A cross sectional design using a questionnaire. SAMPLE: All nursing personnel, a total of 2,901 subjects, in five municipalities in south-western Sweden; of whom 950 had attended the programme. The response rate was 67% (1930 subjects). INTERVENTION: An oral health education programme consisting of four one-hour lessons. RESULTS: The oral health education programme still had an effect on the participants' attitudes towards oral health three years later. When comparing the trained group (OHEP+) which attended the programme with those who did not have training (OHEP-), the perceived ability, opportunity and the knowledge of oral health were significantly better in the former group, p
The purpose of this study was to evaluate the use of a chair-side test involving a count of salivary mutans streptococci (the Strip mutans test) in the assessment of caries risk in a group of preschool children living in an area with a low caries prevalence. A group of 528 4-year-old children were randomly allocated to a study or a control group. In the study group, the baseline microbial data, together with clinical findings of past caries experience, were used for caries risk assessment and for planning subsequent preventive treatment. All children were examined at baseline and after 2 years. Caries experience was assessed according to WHO criteria. There was no difference in caries experience between the study group and the control group at baseline. Within the study group, caries increment was positively correlated (P or = 2 and/or > or = 1 dmfs) developed more new lesions than those considered as 'low risk' (mean dmfs 2.6 v 0.9; P
The main objective of this thesis was to estimate the prevalence of subjectively perceived dry mouth, xerostomia, in a representative general adult population, and the possible co-morbidity between xerostomia and on-going pharmacotherapy. Further, to evaluate the effects of beta-adrenoceptor antagonists on saliva flow rate and composition. The prevalence of xerostomia was evaluated by means of a questionnaire mailed to a random sample of 4.200 adult subjects living in the southern part of the province of Halland, Sweden. Three hundred men and equally many women aged 20, 30, 40, 50, 60, 70 and 80 years were selected from the national census register. From 3311 (81%) evaluable questionnaires was concluded that, in the studied population, 21.3% of the men and 27.3% of the women reported xerostomia. The difference between the sexes was statistically significant, women reporting higher prevalence of dry mouth than men. It was also found that xerostomia was significantly age-related. Further, it was demonstrated that there was a strong co-morbidity between reported prevalence of dry mouth and on-going pharmacotherapy. Generally, no specific drug or drug-group proved to be especially xerogenic, rather, polypharmacy was strongly correlated to reported symptoms of dry mouth, and it was also a significant correlation between increasing xerostomia and the number of medications taken. The effects of beta-adrenoceptor antagonists on saliva flow rate and composition were evaluated both in healthy volunteers and in hypertensive patients. The effects of one week of treatment with the non-selective (propranolol) and the beta 1-selective (atenolol) adrenoceptor antagonists were compared with that of placebo in three different clinical trials, including 38, 11 and 19 healthy volunteers, respectively. Two of these studies were focused on the effects on whole saliva secretion rate and composition and the third study on the secretions from the parotid and the submandibular-sublingual glands. Salivary composition but not saliva flow rates were affected by the beta-adrenoceptor antagonists, and the most pronounced effects were observed for total protein composition and amylase activity, both being significantly decreased during treatment with any of the antagonists, however, more accentuated during treatment with atenolol. Twelve hypertensive patients who were well-controlled in their blood-pressure by means of monotherapy with metoprolol, a beta 1-selective adrenoceptor antagonist, were observed during four weeks of withdrawal and after re-exposure to this antihypertensive treatment. The observed effects on salivary composition were essentially the same as those found in healthy volunteers. In the hypertensive group, however, whole saliva flow rates increased significantly on drug withdrawal and decreased again on re-exposure to metoprolol.