The dental health of 35-year-old Oslo citizens was investigated in cross-sectional studies applying similar methods in 1973, 1984 and 1993. In the 1993 investigation, a clinical and radiographic examination of dental caries was performed on 121 randomly selected individuals (response rate 68 per cent). DMFT/S scores were used for recording caries experience. Carious surfaces (DS) were related to independent variables organised under the four main categories of health field concept; environment, behaviour, biology and health care. Mean DMFS based on 28 teeth was 40.9 in 1993, compared to 66.5 in 1984 and 68.2 in 1973. DS, MS, FS and DMF values were significantly lower in 1993 compared with those from the previous 1973 and 1984 studies, while only minor differences were detected from 1973 to 1984. High numbers of decayed surfaces (DS) were significantly associated with poor oral hygiene, unsatisfactory economic status and irregular dental visiting habits. The most influential independent variables explained 35 per cent of the variance in carious surfaces (DS).
DMF teeth and surfaces were recorded in a random sample of 35-yr-old Oslo citizens (born 1949). The index values were related to selected independent variables: sex, years at school, oral hygiene status (OHI-S), periodontal conditions (PI), use of interdental cleaning devices and dental visiting habits. Data from the present investigation were analysed together with data from a similar study on 35-yr-olds in 1973 in order to detect possible changes over time. The mean DMFS-score in the present investigation was 85, indicating a high caries experience, mainly due to a high F-component. A statistically significant increase in the number of decayed surfaces was demonstrated concomitant with an increase in PI- and OHI-S scores. There were more carious surfaces among irregular dental visitors than among the regular visitors. No statistically significant differences in DMF-scores from 1973 to 1984 were detected, but there was a statistically significant reduction in the prevalence of untreated caries during this period. Furthermore, an increase in the number of filled surfaces from 1973 to 1984 and a reduction in the number of missing surfaces were registered. This may indicate a tendency towards restoring instead of extracting carious teeth during the last decade.
The purpose of the present study was primarily to establish the oral health status of young adults in the area of Porto, Portugal. The assessment is based on a random sample of 30- to 39-year-olds with criteria identical to those of a Norwegian study of 35-year-olds. This makes it possible also to present a comparative analysis of the caries prevalence in Oslo, Norway, and Porto, Portugal. The results indicate lower DMF scores among the Portuguese (DMFS = 46.2) than the Norwegian (DMFS = 85.0) adults. The difference is primarily due to a greater number of filled surfaces among the Norwegians (FS = 59.7) than the Portuguese (FS = 4.4). However, carious surfaces are more prevalent among Portuguese than Norwegian adults (DS = 9.2 versus DS = 3.3). Both among Portuguese and Norwegian adults, oral hygiene and dental visits seem to play an important role with regard to the prevalence of decayed surfaces. Decayed surfaces were more prevalent among men than women, and a correlation between social status and prevalence of decayed surfaces was present in both societies.
Periodontal disease indicators were evaluated according to the periodontal treatment need system (PTNS) in random samples of 35-year-old citizens of Oslo in 1973 and 1984. The study indicated that although periodontal disease was a common finding in both samples, there was a significant reduction in score C (indicating need for complex periodontal treatment) in 1984 compared to 1973. Whereas 37.9% of the subjects showed inflamed pockets deeper than 5 mm (score C) in 1973, only 22.9% scored C in 1984 (non-Caucasians excluded). This reduction was most pronounced in females. The mean number of C-quadrants in subjects needing complex periodontal treatment was also reduced from 2.0 in 1973 to 1.7 in 1984. Further analyses of the 1984 sample showed that the mean number of C-quadrants was significantly lower in subjects with low OHI-S scores and in regular dental visitors, whereas sex, years at school, toothbrushing frequency, interdental cleaning habits, previous periodontal therapy, self-experienced need for treatment, health attitude or smoking habits, did not seem to influence the prevalence of score C.
A random sample of 35-year-old subjects from Oslo took part in a dental survey in 1973 and were re-examined in 1988. Eighty-one subjects (85%) attended the final examination. The need for periodontal treatment was assessed by the Periodontal Treatment Need System (PTNS), and the oral hygiene by the Simplified Oral Hygiene Index (OHI-S). The participants attended a structured interview and answered a questionnaire about general and dental health habits as well as psycho-social factors. Only small changes in the distribution of subjects in the different PTNS categories were found to have taken place during the 15 years. In 1973, 56.8% were in need of scaling (Class B) and 32.1% had one or more deep inflamed pockets (Class C), and in 1988 the scores were 54.3% and 30.1% respectively. A logistic regression model was used to study the associations between risk factors and increased treatment need, as expressed by increase in the number of C-quadrants. Increased number of C-quadrants was positively associated both with short duration of education and with no interdental cleaning. Using a socio-ecological model for periodontal diseases, variables describing the items "behaviour" and "environment" were found to be most closely associated with increased need for periodontal treatment.
The present epidemiologic dental caries study indicates a high number of decayed surfaces (mean, 13.5 +/- 11.8 (SD)) in a Portuguese population of 30- to 39-year-olds from Porto. The most influential determinants for variation in carious surfaces were oral hygiene, gender, salivary buffer capacity, and missing teeth. By entering the most influential independent variables in a final multiple classification analysis, the total explained variance in carious surfaces was 27%. A comparison with results from a similar Norwegian dental health study showed that the biologic factors of importance for number of carious surfaces were the same, whereas the sociocultural determinants differed.
The purpose of the present study was to design a socio-ecologic caries model based on a general health model and to test the fit of data collected from a random sample of 200 50-year-old Oslo citizens to this designed model. The intention was also to investigate the relative importance of the four items environmental, behavioral, human biology, and health care organization factors. The dependent variable, number of carious surfaces, was recorded clinically and radiologically. The mean number of carious surfaces was 3.0 (SD, 3.5), with a range from 0 to 17, and the four items explained 5%, 25%, 28%, and 13% of the variance in number of carious surfaces, respectively. The complete model explained 42%, whereas traditionally used variables on the basis of the Keyes triad explained only 22% of the variance. The findings from the present study indicate that dental caries is a multifactorial disease with both behavioral and biologic determinants, and the socio-ecologic caries model represents a relevant supplement to the Keyes triad.
Eighty-one 35-year-old Oslo citizens examined in 1973 were reexamined after 15 years, to monitor changes in their caries situation expressed as carious surfaces (DS + DFS). Factors considered to be of importance for a change in the number of carious surfaces over this 15-year period were arranged under four items: environment, behavior, human biology, and health care organization. The results showed a slight but not statistically significant increase in the overall caries experience expressed as DMFS. A statistically significant reduction in DS + DFS from the age of 35 to 50 years was demonstrated. Despite this reduction 23% of the 50-year-olds had more carious surfaces than at age 35. The results indicate that the improvement in the number of untreated carious surfaces reported from many Western societies is also valid for adult Norwegians. However, this improvement is not shared by all. Multivariate analyses showed that behavioral factors had the greatest impact on the observed changes in dental health.
The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians.