The role of psychosocial factors and treatment need in dental service use and oral health among adults in Norway

Objectives - This study aimed to explore whether population characteristics were associated with the use of dental services, individual's personal oral health practices, dental caries and oral health‐related impacts using the revised Andersen's behavioural model as the theoretical framework. Methods - This cross‐sectional study included participants from a Norwegian general population (N = 1840; 20‐79 years) included in the Tromstannen—Oral Health in Northern Norway (TOHNN) study. The variables included in the model were social structure (income, education, urbanization), sense of coherence (SOC), enabling resources (difficulties accessing the dentist, declined treatment, dental anxiety), treatment need, use of dental services, toothbrushing frequency, sugary soda drink consumption, decayed teeth and oral health‐related impacts (OHIP‐14). Structural equation modelling was used to test the direct and indirect effects within Andersen's behavioural model of access and health outcomes. Results - Andersen's behavioural model fit the data well and explained a large part of the variance in use of dental services (58%), oral health‐related impacts (48%) and, to a lesser extent, decayed teeth (12%). More social structures and a stronger SOC was associated with more enabling resources, which in turn, was associated with more use of dental services. Social structures were not directly associated with use of dental services or decayed teeth but were predictive of oral health‐related impacts. A stronger SOC was associated with more frequent toothbrushing, less soda drink consumptions, fewer decayed teeth and less oral health‐related impacts. Self‐perceived need did not predict dental attendance but was associated with decayed teeth. A less frequent use of dental services, less frequent toothbrushing and more frequent sugary soda drink consumption were associated with more decayed teeth. Decayed teeth were not associated with oral health‐related impacts. Conclusion - The findings suggests that, in addition to focusing on reducing socioeconomic inequalities in relation to oral health in the Norwegian population, it is also important to consider how people perceive their own resources (eg financial, psychological, social) as well as their access to dental care in order to support regular dental attendance and potentially, in turn, enhance oral health

To what extent does smoking affect gingival bleeding response to supragingival plaque? Site‐specific analyses in a population‐based study

Background and objective - The aim of this study was to investigate the influence of smoking on the site‐specific association between bleeding on gingival probing and supragingival plaque and to assess whether this differs in different regions of the dentition. Methods - Data from a representative sample of 1911 adults (20‐79 years old) in Northern Norway were analyzed. Periodontal examinations consisted of full‐mouth recordings of periodontal probing depth (PD), bleeding on probing (BOP), and presence of supragingival plaque. Smoking status and background characteristics were self‐reported by questionnaire. The association between plaque and BOP was assessed in several three‐level (subject, tooth, and site) random intercept logistic regression models adjusted for PD, smoking status, socioeconomic factors, and body mass index. In a further model, it was assessed whether the association between supragingival plaque and BOP differed in different parts of the dentition. Results - For plaque‐free sites, bleeding tendency was lower in smokers, the odds ratio (OR) was 0.773 with a 95% confidence interval of 0.678‐0.881 as compared to non‐smokers (OR: 1; ref., P 2(4)= 32.043, P Conclusions - Smoking considerably attenuates the site‐specific association between plaque and BOP with a dose‐dependent effect. The effect of smoking did not differ across tooth types

The educational gradient in dental caries experience in Northern- Norway: a cross-sectional study from the seventh survey of the Tromsø study

Background Although, studies from Norway indicate a reduction in dental caries experience, in Northern-Norway this non-communicable oral condition is still prevalent. There is conflicting evidence of presence of social inequalities in dental caries in an adult population. Therefore, the aim of this study was to assess an association between educational level and dental caries experience in adults in urban Tromsø municipality, Northern-Norway, using The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework of health determinants. Methods Data from 3752 participants having recorded dental caries status and educational level in the seventh survey of the Tromsø Study: Tromsø7 were included. Dental status was examined clinically as decayed-, missing-, filled-teeth (DMFT score). For statistical analyses DMFT score was grouped into lower (DMFT<19) and higher (DMFT≥20). Educational level was obtained from a questionnaire and categorized as primary/partly secondary education, upper secondary education, tertiary education, short and tertiary education, long. Data on social and intermediary determinants was also self-reported. Univariable and multivariable binary logistic regression analyses were applied. Result This study included 1939 (52%) women and the mean age of the participants was 57.11. The mean DMFT score was 18.03. The odds of having higher DMFT score followed a gradient based on educational level. Participants who reported lower than secondary education had 2.06 -fold increased odds of having higher DMFT score than those with tertiary education, long (OR: 2.06, 95% CI: 1.50–2.83). Those with upper secondary education had 60% higher odds of having higher DMFT score (OR: 1.60, 95% CI: 1.21–2.11), and those with tertiary education, short had 66% higher odds of having higher DMFT score (OR: 1.66, 95% CI: 1.24–2.22). Conclusion The current cross-sectional study suggested an educational gradient in dental caries experience in an adult population of Northern- Norway. Further studies validating our results and investigating mechanisms of educational inequalities in oral health are warranted

Relationship between periodontitis and risk of cardiovascular disease: Insights from the Tromsø Study

Background Few large-scale studies have investigated the association between periodontitis and cardiovascular risk estimated by risk assessment models; moreover, this association remains unexplored in never-smokers. We aimed to examine the relationship between periodontitis and cardiovascular risk in a Norwegian general population, with a focus on never-smokers and the impact of sex and age. Methods The present study included 2623 participants from the seventh survey of the Tromsø Study (Tromsø7, 2015–2016), aged 45–74 years, and without previous myocardial infarction or stroke. Periodontitis was defined according to the 2017 American Academy of Periodontology and the European Federation of Periodontology classification system. Participants were categorized by grade based on percentage bone loss/age as no periodontitis/Grade A (low progression rate) and Grade B/C (moderate-rapid progression rate). Low, medium, and high cardiovascular risk was defined based on the Norwegian risk model NORRISK 2. We used ordered logistic regression analysis to examine the association between periodontitis and cardiovascular risk, adjusting for education, toothbrushing frequency, body mass index, and diabetes. Subanalyses included stratification by sex and age (45‒54, 55‒64, 65‒74 years) and a separate analysis of never-smokers. Results Periodontitis Grade B/C was associated with higher cardiovascular risk than no periodontitis/Grade A (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.75‒2.61). This association was significant in both men and women, all age groups, and never-smokers. However, when never-smokers were stratified by age, the association remained significant only in those aged 65–74 years (OR, 3.00; 95% CI, 1.50‒5.99). Conclusion Periodontitis Grade B/C was associated with higher cardiovascular risk overall, and in never-smokers aged 65–74 years

Periodontitis is associated with decreased experimental pressure pain tolerance: The Tromsø Study 2015–2016

Aim - To assess the relationship between periodontitis and experimental pain tolerance. Materials and Methods - Participants from the population-based seventh survey of the Tromsø Study with data on periodontitis were included (n = 3666, 40–84 years old, 51.6% women). Pain tolerance was assessed through (i) pressure pain tolerance (PPT) test with a computerized cuff pressure algometry on the leg, and (ii) cold-pressor tolerance (CPT) test where one hand was placed in circulating 3°C water. Cox proportional hazard regression was used to assess the association between periodontitis and pain tolerance adjusted for age, sex, education, smoking and obesity. Results - In the fully adjusted model using the 2012 Centers for Disease Control/American Academy of Periodntology case definitions for surveillance of periodontitis, moderate (hazard ratio [HR] = 1.09; 95% confidence interval [CI]: 1.01, 1.18) and severe (HR = 1.25, 95% CI: 1.11, 1.42) periodontitis were associated with decreased PPT. Using the 2018 classification of periodontitis, having Stage II/III/IV periodontitis was significantly associated with decreased PPT (HR = 1.09; 95% CI: 1.01, 1.18) compared with having no or stage I periodontitis. There were no significant associations between periodontitis and CPT in fully adjusted models. Conclusions - Moderate and severe periodontitis was associated with experimental PPT

Празднование Дня единения народов в приграничных областях Беларуси и России

Материалы XI Международной научной конференции 23–24 мая 2019 г

Interaction Design Methods in Fashion Design Teaching

The expressiveness of use is of focal interest in fashion design, which makes the perspective of act design important in learning/teaching. The objective of the project presented here was to introduce interaction design methods in fashion design teaching to make act design explicit throughout the different stages of the design process in a systematic manner; to develop a general workshop curriculum in experimental fashion design focusing on the expressiveness of wearing and use. A series of test workshops were implemented to provide a foundation for reflection and critical discussions. The main results, motivated by workshop evaluations, consist of theoreticalmodels for a systematic development of workshop exercises in fashion design aesthetics

Oral health-related quality of life, impaired physical health and orofacial pain in children and adolescents with juvenile idiopathic arthritis – a prospective multicenter cohort study

Background - Knowledge on oral health-related quality of life (OHRQoL) in children and adolescents with juvenile idiopathic arthritis (JIA) is limited, and longitudinal studies are lacking. We aimed to describe OHRQoL in children and adolescents with JIA compared to controls, and to explore the validity and internal consistency of the Early Childhood Oral Health Impact Scale (ECOHIS) and the Child Oral Impact on Daily Performance (Child-OIDP). Furthermore, we wanted to investigate associations between OHRQoL and orofacial pain, physical health, disease activity, and temporomandibular joint (TMJ) involvement in JIA. Methods - The Norwegian prospective, multicenter cohort study recruited participants with JIA between 4 and 16 years of age and corresponding controls from three pediatric university hospital departments and public dental health services. In the present study, we analyzed OHRQoL in all children  Results - The same OHRQoL questionnaire was completed both at first visit and two-year follow-up in 101 children  0: JIA group 81% and 85%, p = 0.791; control group 65% and 69%, p = 0.815), while adolescents with JIA reported fewer impacts at the two-year follow-up (Child OIDP > 0: JIA group 27% and 15%, p = 0.004; control group 21% and 14%, p = 0.230). The internal consistency of the OHRQoL instruments was overall acceptable and the criterion validity indicated that the instruments were valid at both visits. Orofacial pain was more frequent in children and adolescents with JIA than in controls. We found associations between OHRQoL impacts and orofacial pain, impaired physical health, disease activity, and TMJ involvement. Conclusions - Children and adolescents with orofacial pain or impaired physical health were more likely to report impacts on daily life activities than those without. Pediatric rheumatologists and dentists should be aware of impaired OHRQoL in individuals with JIA with active disease or temporomandibular joint involvement

Return to work after a workplace-oriented intervention for patients on sick-leave for burnout - a prospective controlled study

<p>Abstract</p> <p>Background</p> <p>In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.</p> <p>Methods</p> <p>In a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.</p> <p>Results</p> <p>There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.</p> <p>Conclusions</p> <p>We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.</p> <p>Trial registration</p> <p>Current Controlled Trials NCT01039168.</p