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.
The age and maintenance of dentures, and denture-cleaning habits, were studied by an interview survey. The material represented nation-wide the Finnish population aged greater than or equal to 15 years old, and there were 957 interviewees, of whom 328 were denture wearers. In total, 45% of the upper and 40% of the lower dentures were over 10 years old. More than one-third of the dentures more than 5 years old had never been maintained during that time. Individuals whose dentures had been made and fitted by dental technicians visited dentists less frequently than individuals whose dentures had been made by dentists. Over 80% of the denture wearers reported cleaning their dentures by brushing at least once a day, and women cleaned them more frequently than men. The present findings suggest that denture wearers should be a special target group for dental health education, for the development of the latter, and for the development of dental health care services in the future.
To explore nursing home patients' oral hygiene and their nurses' assessments of barriers to improvement.
In nursing homes, nurses are responsible for patients' oral hygiene.
This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study.
More than 40% of patients had unacceptable oral hygiene. 'More than 10 teeth' gave OR = 2, 1 (p = 0.013) and 'resist being helped' OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients' teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning.
Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses' education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.
Smoking is a risk factor for oral diseases and tooth loss. Our aim was to analyze the association between smoking intensity and duration and tooth loss among middle-aged Finnish adults who have enjoyed access to subsidized dental care since childhood.
This study was based on the Northern Finland Birth Cohort 1966 (NFBC1966) Project, a representative sample of Finnish 46-year-olds. Altogether 1946 46-year-olds participated in a survey and comprehensive clinical oral examinations. We measured smoking exposure in pack-years (intensity) and years of smoking (duration) combined with recent smoking status (current, former, occasional or never). We used negative binomial regression models to estimate the unadjusted and adjusted relative risks (RR) with corresponding 95 % confidence intervals (CI) for tooth loss as an outcome. Gender, education, tooth brushing frequency, dental plaque, diabetes and alcohol use served as explanatory variables for the adjusted models.
Smoking intensity associated with tooth loss in an exposure-dependent manner: those with a high number of pack-years had a significantly greater probability of tooth loss than never smokers: 11-20 pack-years (RR?=?1.55, 95 % CI?=?1.15-2.08) and 21 or more pack-years (RR?=?1.78, 95 % CI?=?1.36-2.33). Smoking duration also associated with tooth loss: those who had smoked for several years had a significantly higher probability of tooth loss than never smokers: 21-30 years of smoking (RR?=?1.66, 95 % CI?=?1.29-2.12) and 31 or more years of smoking (RR?=?1.72, 95 % CI?=?1.20-2.45).
We found a clear intensity- and duration-dependent relation between smoking and tooth loss among adults with access to subsidized dental care and in good oral health.
Cites: Int J Dent Hyg. 2015 Nov;13(4):292-30026294114
The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents.
A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression.
Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer.
High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.
In 1999, a dental reform became law in Sweden that regulated both dental care to dependent individuals and training in oral health care for nursing home personnel. Substantial resources have been channelled into these efforts, but the outcome of these efforts has not been evaluated. The aim of this study was to explore attitudes to and knowledge about oral health care among nursing home personnel more than 5 years after the law was adopted, that being 2005.
A total of 454 individuals employed at nursing homes answered a questionnaire of 16 multiple-choice items concerning attitudes to and knowledge about oral health care.
Eighty-nine per cent considered oral health care to be an important part of good nursing. The answers indicated problems, however, when it came to its implementation and knowledge, and 35% stated that they had had no formal education in oral health care.
Despite generally positive oral health care attitudes, it is important that oral health care education is available to and made of interest for all nursing home personnel, especially in light of the increase in number of natural teeth and frequency of crowns and bridges among dependent elderly.