Denmark, Iceland, Norway, and Sweden have all had a similar decline in dental caries during the last 20 years, although the decline has come later in Iceland. The purpose of this study was to compare the caries-preventive methods used for children and adolescents in these four countries. Questionnaires were sent to random samples of dentists, dental hygienists, and dental nurses working with children during 1995 and 1996. The results showed that the use of preventive methods was generally consistent between the countries. Nevertheless there were differences between the countries concerning the choice of preventive strategy for risk patients and also in how prevention was implemented. Danish dental care providers chose oral hygiene education as the priority, which they put into practice. Apart from fluoride varnish for some patients, most of them did not use or recommend fluoride except fluoride toothpaste. The Norwegian and Icelandic dental care providers chose both oral hygiene education and the use of fluoride as priorities, while most Swedish dental care providers preferred to provide dietary advice and oral hygiene education, and additional fluoride for risk patients. The differences could not be explained by other variables than nationality, implying that there are differences between the dental cultures in the four countries. The informational basis of decisions on preventive strategies varied between the different dental professionals in each country as well as between the countries, indicating that national professional cultures are being shaped differently. Despite the differences in choice of preventive methods, the dental health of children varies little across the frontiers. This raises the question of the significance of the choice of preventive methods to the decline of dental caries and points towards an urgent need to develop evidence-based preventive strategies.
All workers (n = 59) at a Danish chocolate factory were given a questionnaire in order to study dental health behavior and self-assessment of dental health. Regular dental visits at least once a year was reported by 71% of the respondents. Toothbrushing at least twice a day was claimed by most of the workers, but only a few reported to brush their teeth daily at work. One fourth declared that they often consumed chocolate at their working place. Good dental and gingival conditions were only reported by 25% and in correspondence with this, nearly one third claimed to have had much or a great deal of trouble with their teeth. Mean DMFS increased from 22.7 in the age group 16-19 yr to 106.7 among persons 40 yr of age or more. In the age group 20-39 yr half of the teeth present had gingivitis and calculus and among the older individuals half of the teeth had gingivitis and pockets deeper than 5 mm. Chocolate workers were considered a high risk group.
The purpose of the present investigation was to describe dental health behaviour in an adult Danish population and to study whether oral hygiene habits and consumption of sweets were affected by living conditions. The study group comprised 749 persons in the age group 25-44 years (82% of the original sample) and data on general health behaviour and dental health behaviour were collected by interviews. Regular dental visits were reported by 86%, 83% declared that they brush their teeth at least twice a day and toothbrushing after breakfast was reported by 51%. Regular use of toothpicks was reported by 45%, while dental floss was used by 22%. Dental visits varied according to education, income, work in shifts, sex, and self-assessment of dental health, while toothbrushing habits were affected by urbanization, sex, education, number of children in family, and self-assessment of dental health. Daily consumption of cakes/pastry was reported by 10%, six per cent consumed chocolate/liquorice every day, while soft drinks were drunk every day by 10%. Consumption of sweets varied according to education, shift work, sex, strained life situations, and the number of children in family. Among the regular dental visitors, oral hygiene habits were also influenced by living conditions. Thus, the challenges to general dental practice as regards dental health education are great.
The purpose of the present study was to develop and evaluate a preventive dental program at two Danish chocolate factories. The program was undertaken within the setting of an occupational health service in order to control oral occupational diseases. Eighty-nine persons (80%), 19-61 yr of age, participated in a 2-yr follow-up study. Preventive care was offered to the workers by a dental hygienist. Clinical prophylaxis was given at four visits the first year and two visits the second year. Health education was based on active involvement of the participants and safety committee or safety group members in order to stimulate self-care activities at the factories. The outcome of the program was evaluated by clinical recordings of visible plaque index (VPI), gingival bleeding (GB), calculus index (CI), and DMFS. Data on dental conditions were recorded at baseline, after 12, and after 24 months. Questionnaires were completed by the workers each time in order to obtain data on dental knowledge, attitudes, dental health behavior, social network activities, and perceptions of the process. The results showed improvement in dental health in terms of stepwise reductions in VPI, GB, CI, and DS. For example, mean GB decreased from 36% of the teeth scored at baseline to 9% at 24 months and mean DS decreased from 2.3 to 0.7. Positive developments of dental health behavior were observed. The proportion of workers reporting daily toothbrushing at work increased from 6% to 24% during the program and the proportion of workers using dental floss regularly increased from 24% to 47%. However, the changes in dental knowledge and attitudes were rather diffuse.(ABSTRACT TRUNCATED AT 250 WORDS)
A high priority is given to improvements in the oral health of the elderly in Scandinavia. In 1987 a Danish municipality established a dental public health care program for old-age pensioners. All 67-year-old citizens were offered school-based preventive and curative care using guidelines and principles established by the Danish Municipal Dental Service for children. Care was provided free of charge. Citizens not wishing to obtain care through the public system could do so from private dental practitioners. Reimbursement for care obtained from the private system was provided by the National Health Insurance and the municipality. The purpose of this study was to evaluate the outcome of the program after three years of operation. A follow-up design was used and data were collected by interviews and clinical registrations. At baseline and follow-up 216 (71%) and 235 (77%) pensioners, respectively, were interviewed about their self-assessments of dental health, dental knowledge, attitudes, and behavior. Clinical data were collected only for the elderly who participated in the public program, and included 194 persons at baseline and 187 at follow-up. These data included information on tooth loss, dental caries, periodontal health, and presence and function of removable dentures. At the follow-up, 86 percent of all respondents had regular dental visits of at least once a year compared to 46 percent at baseline; 75 percent participated in the public program and 11 percent obtained care from private practitioners. At the end of the intervention period, fewer elderly reported symptoms of poor oral health or impaired function of dentures.(ABSTRACT TRUNCATED AT 250 WORDS)
Approximately 25% of children under the age of 18 in the Municipality of Copenhagen have a non-Danish ethnic background, and it is suspected that there may be major inequalities in oral health as a result. OBJECTIVES: The objectives of this study were to describe the occurrence of dental caries in different ethnic minorities, and to analyse whether the dental caries experience of the children may be affected by cultural and behavioural differences. MATERIALS AND METHODS: The study was conducted in Copenhagen as a cross-sectional investigation of 794 children, aged 3 and 5 years old (preschool), 7 years old (Grade 1) and 15 years old (Grade 9). Children of Danish, Turkish, Pakistani, Albanian, Somali and Arabian backgrounds were selected by convenience sampling. Epidemiological data were retrieved from the Danish Recording System for the Public Dental Health Services (SCOR) and sociological data were collected by postal questionnaires. RESULTS: Marked differences in dental caries prevalence were observed when different ethnic minorities were compared to Danish children. These were most prominent for the primary dentition. At age 7, 53% of the Danish and 84% of the Albanian children were affected by dental caries, the mean caries experience was 3.5 dmfs (decayed, missed and filled surfaces) and 13.8 dmfs, respectively. Caries in incisors and/or smooth surfaces was observed in 10% of the Danish children and 48% of the Albanian children. There were cultural differences in dental attendance and self-care practices of children and parents. These socio-behavioural factors may help to explain the differences in dental caries prevalence and severity. CONCLUSIONS: Development of appropriate oral health promotion strategies is urgently needed to improve oral health behaviour and attitudes of parents and children of ethnic minorities. Preventive programs should be organized at local community level in close collaboration with key persons of ethnic minority societies.
OBJECTIVE: To describe the current organization of health promoting and preventive activities within the Danish Municipal Dental Health Service and to assess how the service has chosen to comply with the directives as formulated by the National Board of Health. DESIGN: A cross-sectional survey of the municipal dental health services was carried out on a national scale. Postal questionnaires were used to collect information on active and passive preventive care activities and community-orientated health promotion. SETTING: The survey was conducted to aid the reorientation and adjustment of the Municipal Dental Health Services in Denmark. SUBJECTS: All municipal dental health services in Denmark were considered relevant for the survey and 141 services (71%) responded to the questionnaire. OUTCOME MEASURES: Quantitative methods were used to measure recall-intervals for children and adolescents, passive and active prevention, identification of and care for individuals at risk, and health education. Qualitative methods were applied to record the organization of community health activities. RESULTS AND CONCLUSIONS: The majority of dental services stated that preschool children are called at regular intervals (every 3, 6 or 8 months); school-children and adolescents are most often recalled according to individual needs. Chairside assistants, dentists or dental hygienists give oral hygiene instructions systematically to children of grades 0 through to 3. Fluoride is frequently administered through topical application by dentists; fluoride tables are not used. Permanent molars are sealed when this is indicated. Clinical and socio-behavioural criteria are used to identify children at risk. Half of the services reported school-based health education, and in one-quarter of the municipalities community health activities took place. Adjustment of the services should consider population-directed activities and greater use of ancillary personnel.
This survey provides a description of the living conditions, dental health self-assessment, dental health behavior, and knowledge and attitudes to dental care in a population of noninstitutionalized psychiatric patients. A total of 84 individuals (70% of the persons selected) were interviewed using a pretested structured questionnaire. One of five participants did not perform oral hygiene as a daily routine and 45% had no regular dental visit habits. A proportion of about 40% reported symptoms from teeth or gingiva within the previous year. Despite an acceptable level of general knowledge on caries and periodontal problems, only a small proportion were aware of the caries-inducing potential of psychotropic drugs. People with more than five admissions to the psychiatric ward more often reported symptoms from teeth and gingiva; irregular dental visit habits were also related to number of admissions and to manic-depression. The survey indicates poor oral health among psychiatric patients compared with the general population and the need for specific oral care programs leveled at noninstitutionalized psychiatric patients is stressed.
The purpose of this investigation was to describe smoking and alcohol habits of an adult Danish population and to study whether these habits are influenced by living conditions. Moreover, the purpose was to test the hypothesis of unidimensionality of health behavior. The study comprised 749 persons in the age group 25-44 yr (82% of original sample) and data on smoking, alcohol consumption, diet, and dental health behavior were collected by interviews. Fifty-one percent of the interviewed persons were current smokers, 58% among men and 44% among women. One-fifth of the males and about one-tenth of the females were classified as heavy smokers consuming more than 15 cigarettes per day. Fifty-eight percent reported to have alcoholic drinks weekly 71% of men and 47% of women. All in all, 65% of the study group had a weekly consumption of larger beer, 6% of strong beer, 52% of red or white wine, 12% of dessert wine, and 27% of spirits. Alcohol consumption as well as smoking was more frequent among workers than officials. Multivariate regression analyses showed that smoking and alcohol habits varied according to sex, urbanization, education, shift work, and number of children in family. Correlations between alcohol habits, smoking, and perceived dental health were observed. Furthermore, smoking and dental health behavior were negatively associated. In factor analysis of variables on diet, smoking, alcohol, and dental health behavior, two factors were isolated: 1) alcohol consumption, and 2) active dental care. Only a small proportion of the total variance was explained and, thus, the hypothesis of unidimensionality of health behavior was not confirmed. Because of the multidimensionality different strategies and methods in health education may be needed to modify or change the various types of negative health behavior.