Health-related quality of life and prospective caries development

Background: The present study was conducted to prospectively assess the association between health-related quality of life (HRQoL) and the development of dental caries in adults in northern Sweden. The SF-36 questionnaire was used to estimate HRQoL. Methods: Adults who had (i) participated in a population-based health screening in northern Sweden between 2003 and 2009 and had completed the SF-36 questionnaire, and (ii) received a dental check-up within 1 year (n = 15,615) were included in the study. Of these, 9,838 had a second caries examination 2-7 years after the baseline recording. Information regarding SF-36, lifestyle factors and medical conditions was retrieved by questionnaires, and anthropometric status and blood lipid levels were measured. The association between dental caries (outcome) and SF-36 scores (exposure) with the inclusion of potential confounders was analysed by linear and logistic regression. Results: Caries increment increased significantly with decreasing scores for both physical and mental dimensions of SF-36 in women, but no association was seen in men. However, lifelong caries experience (DMFS) increased linearly with decreasing physical HRQoL in both men and women; this was also observed for the single dimension of mental HRQoL. The crude odds ratio for being in the highest caries quintile compared to the lowest when having the poorest physical HRQoL compared with the best physical HRQoL was 1.88 (95 % CI: 1.54-2.3). Several factors were identified as potential confounders in the associations between DMFS and SF-36 scores, including education level, smoking, age, medications, higher levels of total cholesterol, triglycerides, systolic blood pressure, body mass index and sugar intake. Except for education level and smoking, the effect sizes for the association between gradually decreasing SF-36 scores and increasing caries were generally moderate. Conclusions: Increased development of caries was associated with low physical HRQoL and some aspects of mental HRQoL. The mechanisms underlying these associations, which are likely confounded by both biological and lifestyle factors, remain to be elucidated. The study implies that, when possible, subjects with poor HRQoL would benefit from caries prevention measures meeting the underlying situation

Oral health of individuals aged 3-80 years in Jonkoping, Sweden, during 40 years (1973-2013)

The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city ofionkoping, Sweden, in 1973,1983,1993, 2003, and 2o13.The 1973 study constituted a random sample of L000 individuals evenly distributed in the age groups 3, 5,10,15, 20, 30,40, 50, 6o, and 7o yea rs.The same age groups with addition of a group of 8o-year-olds were included in the 1983,1993, 2003, and 2013 studies, which comprised 1,104;1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-6o years were treated by the Public Dental Service amounting to about 5o%. Almost 7o% of the 70- and 80-year-olds were treated by private practitioners. In 2013,10-20% of the individuals in the age groups 30-40 years did not regularly visit neither Public Dental Service nor a private practitioner.The corresponding figures for the individuals 50-80 years old were 4-7%. Similar number of avoidance was reported in the previous studies. In the survey 2013, about 20-30% of the individuals in the age groups 20-50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist.These findings were in agreement with the results from the surveys 1973-2003. Among the younger age groups, 10-15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series. In 2013, the knowledge of the etiology of caries was known by about 6o% of the individuals which was similar to that reported 1973 zoo3.Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries.This percentage was equivalent during the period 1973-2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day.These frequencies have gradually increased during the 40-year period. Around 40% in the age groups 50-8o years used toothpicks regularly in 2013.This is a about 1/3-1/2 less compared to 2003. In the age groups 20-40 years 3-14% used toothpicks for proximal cleaning in 2013. In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3-20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 201