OBJECTIVE: The purpose of this study was to investigate the temporal development of the utilization of dental care, in relation to socio-economic factors and also considering perceived oral health, attitudes to dental care, dental anxiety, care organisation and changes in the way that dental care is paid for. A conflict model was used as a theoretical framework. METHODS: In 1992, a mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Orebro and Ostergotland, as part of a cross-sectional study. This study group numbered 8888 persons. In 1997, the same population was sent a new questionnaire. There were 5363 persons who completed the questionnaire in both 1992 and 1997. Changes in utilization of dental care were analysed. RESULTS: An increase in personal expenditure for care was obvious, 42% paid more in 1997 compared with 1992. In the study, 7% had prolonged their time since most recent visit and 12% had less frequent visits. In regression models, education, occupation, place of residence, country of birth, marital status, gender, dental anxiety, having poor perceived oral health and poor general health were associated with utilization. Care organisation factors showed there was a greater probability of having higher utilization and higher cost of care when private practitioners provided the care. CONCLUSION: Small changes in the utilization of dental care occurred during this study time. Inequality in utilization existed and socio-economic factors affected utilization as well as health perception and dental anxiety. Changes in the cost of care did not affect utilization appreciably, probably because of a selected population with high price elasticity. Having a private care provider compared with one in the public system affected the probability of having higher utilization and higher cost for care.
The aim of the present study was to investigate persons having problems with dental filling materials in a Swedish population, their perceived oral health, and their reception from dental care personnel. The development over time (between 1992 and 2007) has also been studied concerning the presence of problems from dental filling materials. In two counties in Sweden, Orebro and Ostergötland, all persons born in 1942 have been surveyed by mail every fifth year since 1992. In the year 2007, all persons born in 1932 also received the same questionnaire. The total number of respondents in 2007 were 9813 persons (response rate 72.6%). Logistic regression models were constructed with those having had problems or not from dental filling materials as dependent variable. Multiple regression analysis was done with selfperceived oral health as dependent variable. There were about 10% (868) reporting problems from dental filling materials. There were clear differences between the two groups, having problems or not. The group reporting problems from dental filling materials perceived both their general and oral health as being worse compared with others. More frequently they had asked questions about adverse effects from dental filling materials, had changed dental fillings and crowns, and had amalgam present. They also felt less well treated by dental personnel and were not so pleased with dental care in general as others. In conclusion, there were many persons perceiving problems from dental filling materials. Forthose, both perceived general health and oral health was worse and they were less satisfied with dental care in general. No consistent common characteristic, neither as to socioeconomic nor lifestyle factors, could be shown for those having experienced problems from dental filling materials.