In dentistry comparative studies of diffusion of disease preventive innovations are rare and usually atheoretical. For these reasons the present study was designed 1) to determine whether or not normal distribution assumptions applied to decisions to adopt caries preventive fluoride programs in a public dental service; 2) to compare rates of adoption of two school-based and one clinic-based fluoride program, and 3) to look for evidence indicating which type of decision-making may have been involved. The programs studied were school-based fluoride brushing 4-5 times per year, fluoride mouthrinsing at least once a month, and professional topical fluoride applications at least once a year. Data were collected by postal questionnaires from public dental officers in Norway in 1972, 1977 and 1982. To determine the length of time which had elapsed from the time of innovation of the technologies to adoption, the dental literature was reviewed. The adoption curves for school-based fluoride brushing and rinsing, as well as for clinic-based topical fluoride application did not comply with the normal distribution assumption. The time lapse from innovation to adoption was in excess of 10 yr and the rates of adoption differed between programs. Decision-making would appear to have been primarily individual or collective. It was concluded that generalization beyond the innovations studied and the social and organizational setting of this particular investigation is inadmissible. Consequently, there is a need for more and larger scale comparative analytical studies to increase our understanding of diffusion and adoption of innovations in dentistry.
Since most studies of caries decline are descriptive time-trend analyses, the purpose of this article was to identify factors statistically associated with the caries decline among Norwegian adolescents after 1985. The DMFT scores for the age groups 12 and 18 years reported annually by 19 counties were analysed. The average caries-free proportions of 18-year-olds increased from 2% to 15% between 1985 and 2000, while the DMFT declined by 49%; 10.2 +/- 0.75 to 5.2 +/- 0.78. The decline for the 12-year-olds was 53%. The mean DT at the dentinal level remained at about 0.8 for 12-year-olds and 1.5 for 18-year-olds throughout the observation period. There was no significant difference in DMFT increment from age 12 to 18 between the birth cohorts 1973 (3.8 +/- 0.46) and 1982 (3.0 +/- 0.52) when controlling for counties. The variables migration and children per dentist were significantly associated with the DMFT decline in multivariate analyses. The caries decline for 18-year-olds was significantly steeper before than after 1990. The decline among the 18-year-olds may be attributed to fluoride and more restrictive criteria for placement of fillings in teenagers in the 1980s and fewer filled teeth before the age of 12 years in the 1990s.
An epidemiological study of child health and nutrition in a northern Swedish county. VII. A comparative study of general and dental health, food habits and socio-economic conditions in 4-year-old children.
A study of the general and dental health and the food habits of randomly selected 4-year-old Swedish urban children was performed. The results were compared with the findings of an investigation carried out four years earlier in the same area. In comparison with the earlier study no significant differences were found in haemoglobin values, packed red cell volume, microsedimentation rate and anthropometric measurements. The food habits had altered. A reduction in the frequency of between-meal consumption, particularly of sweets and soft drinks, as well as a reduction of the frequency of meat, fish and egg consumption was found. The children had an increased sandwich and milk consumption. The caries frequency was markedly reduced, which might be explained by the decreased between-meal consumption and an increased consumption of fluoride tablets. The food habits and the caries situation were generally influenced by the parents' socio-economic conditions, especially their educational level.
To evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat.
The design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs.
There were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5 years . The caries increment for Group 1 was 1.34 ± 2.99 (mean ± SD), 1.24 ± 2.84 for Group 2, 1.07 ± 2.66 for Group 3 and 1.25 ± 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group.
In an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.
The aim of this study was to investigate attitudes to and experiences of dental care in a population, born 1942. The following items were studied: opinions of general and oral health, attitudes to and experiences of dental care, dental care habits, experiences of latest visit to a dentist, tobacco habits and use of various dental hygiene articles. A cross-sectional mail questionnaire was sent in 1992 to all 50-year-olds in two Swedish counties, Orebro and Ostergotland, totally 8888 persons; the response rate was 71%. Of the population 89%, indicated good health. Satisfaction with dental care was high, 94%. 26% stated attendance to a dentist twice or more per year, and 64% at least once a year. As to expenses, 78% paid less than 1000 SEK the last year. Concerning the latest visit, 38% reported painless treatment, 37% no inconvenience, and 55% good care. The duration of the latest visit included on an average 27 min in travel time, 7 min in waiting time and 27 min in treatment time. Information about oral hygiene was given to 29% and about cost for treatment to 47% of the interviewed. There were 28% daily smokers. Snuff was daily used by 10% of the males. Toothbrushing twice a day with fluoride toothpaste seemed to be the standard oral hygiene procedure and was reported by 80% of the respondents.
365 2nd through 4th graders completed a 3-yr clinical trial on the caries-preventive effect of rinsings every second week during the school year with 10 ml of an 0.2% neutral solution of sodium fluoride. All children received regular dental examinations and treatment in clinics established by the municipality in which the study took place. The trial was performed under double-blind conditions. The caries increment on teeth erupted at baseline was 1.75 DMFS in the fluoride group and 1.83 DMFS in the placebo group (P greater than 0.05; 95% confidence limits for percentage caries reduction: -20.7% and 29.5%). The caries increment on teeth erupting during the trial was 0.73 DMFS in the fluoride group and 0.99 DMFS in the placebo group (P greater than 0.05; 95% confidence limits for percentage caries reduction: 1.0% and 51.6%).
PURPOSE: To analyse possible changes in the severity and distribution of dental caries within the dentition in five groups of 4-year-old children examined with the same methods and criteria between 1980 and 2002. MATERIALS AND METHODS: The material consisted of retrospective caries recordings from cross-sectional studies performed in 1980, 1987, 1992, 1997 and 2002 in Umeå, Sweden. The distribution of dmfs within the dentition was analysed in the whole groups and in one third of each group with the highest dmfs-values (mSiC-index). RESULTS: When comparing the whole groups, no statistically significant changes were found over the years concerning total dmfs, or dmfs in molars and canines or in occlusal surfaces (p > 0.05). There was a significant increase in dmfs-values in incisors observed between 1980 and 1987, while a similar reduction was observed between 1987 and 1992 (p 0.05). There was, however, a statistically significant increase in the dmfs-values for molars and canines between 1997 and 2002 (p