We assessed dental and periodontal health in adults aged =30 years living in southern and northern Finland as part of the Health 2000/2011 Surveys (BRIF8901).
Clinical findings in 2000 (n?=?2967) and 2011 (n?=?1496) included the presence of teeth and number of teeth with caries, fillings, fractures or periodontal pockets.
Edentulousness decreased in all age groups. The prevalence of those with no caries increased from 67% to 69% in men and from 80% to 85% in women, and of those with no periodontal pocketing from 26% to 30% in men and from 39% to 42% in women. In 2011, the mean number of decayed teeth was 0.8 in men and 0.3 in women, and the corresponding mean numbers of teeth with deepened periodontal pockets 5.6 and 3.7. The gender difference had levelled concerning edentulousness, number of teeth and DMF teeth, but still existed in the occurrence of caries and periodontal pocketing.
The findings were in line with other population-based reports in the 2000s. However, periodontal health in Finland seems not to be as good as in many European countries and in the USA.
To assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models.
This study analysed data from 7112 subjects, aged 30 years or over, who participated in the nationally representative Finnish Health 2000 Survey. Parental and own education levels were the childhood and adulthood socioeconomic measures, respectively. Oral health was indicated by edentulousness, perceived oral health and levels of dental caries and periodontal disease. Three conceptual lifecourse models, namely critical period, accumulation and social trajectories, were separately tested in regression models.
In line with the critical period model, parental and own education levels were independently associated with oral health after mutual adjustment. There was also a graded linear relationship between the number of periods of socioeconomic disadvantage and oral health, corresponding to the accumulation model. Gradual declines in oral health were evident between social trajectories from persistently high to upwardly mobile, downwardly mobile and persistently low groups.
There was similar support for the lifecourse models of critical period, accumulation and social trajectories. They collectively contribute to a better understanding of oral health inequalities.
To assess the role of adulthood socioeconomic status (SES) and sense of coherence (SOC) in the relationship between childhood SES and adult oral health-related behaviours.
This study analysed responses of 5318 dentate subjects aged 30 years and over who participated in the Finnish Health 2000 Survey. Participants provided information on their demographic characteristics (sex, age, marital status and urbanization), childhood SES (parental education), adulthood SES (years of education and household income), the SOC scale and four oral health-related behaviours (dental attendance, toothbrushing frequency, sugar intake frequency and daily smoking). Structural equation modelling was used to test a model including adult SES and SOC as mediating factors of the relationship between childhood SES and adult oral health-related behaviours. Multi-group comparison was conducted to test the model within each sex and age group.
Childhood SES was related to adult oral health-related behaviours (P
This study assessed the independent and interactive associations between sense of coherence (SOC) and socio-economic status (SES) with oral health-related behaviours. Data from 5,399 dentate adults regarding their demographic characteristics, years of education, SOC score, and oral health-related behaviours were analysed. Household income was obtained from tax authorities. Logistic regression was used to test the adjusted association of SOC with each behaviour and to test the statistical interaction between each SES indicator and the SOC score. Subjects were 1.20 [95% confidence interval (95% CI): 1.11-1.28] and 1.22 (95% CI: 1.12-1.32) times more likely to visit dentists regularly for check-ups and to brush their teeth twice daily or more often, respectively, and were 1.11 (95% CI: 1.03-1.20) and 1.21 (95% CI: 1.12-1.32) times less likely to be daily smokers and to consume sugar-added products on a daily basis, respectively, for every unit increase in SOC score. The findings provide strong support for an association between higher levels of SOC and more favourable oral health-related behaviours, independently of current SES and demographic characteristics of the participants and across the four behaviours assessed. By contrast, the findings give limited support for the moderating role of SOC on the relationship between SES and oral health-related behaviours.
The aim of this study was to determine the most appropriate set of weights with which to calculate the number of sound-equivalent teeth (T-Health index) against perceived oral health, which was used as a proxy of oral health status. This study used data from 5,057 dentate subjects, > or = 30 yr of age, who ere participating in the Finnish Health 2000 Survey. Subjects provided information on socio-demographic characteristics, behaviours and perceived oral health, and had a clinical examination. The T-Health index was calculated by assigning different weights to missing, decayed, filled, and sound teeth. Thirty-six alternative sets of weights were evaluated. The most appropriate set of weights was judged by the strength of the adjusted association between the T-Health index and levels of perceived oral health in ordinal logistic regression models and by the invariance of this association according to the extent of restorative treatment (non-significant statistical interaction). Among the 36 sets of weights used to calculate the T-Health index, assigning twice the weight of a decayed tooth to a filled tooth whilst keeping the weight for a filled tooth
During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011.
The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged?=?30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen's model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation.
No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector.
Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care.
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