Scandinavian systems monitoring the oral health in children and adolescents; an evaluation of their quality and utility in the light of modern perspectives of caries management

Background: Recording reliable oral health data is a challenge. The aims were a) to outline different Scandinavian systems of oral health monitoring, b) to evaluate the quality and utility of the collected data in the light of modern concepts of disease management and to suggest improvements. Material and methods: The information for in this study was related to (a) children and adolescents, (b) oral health data and (c) routines for monitoring such data. This meant information available in the official web sites of the “KOSTRA-data” (Municipality-State-Report) in Norway, the Swedish National Board of Health and Welfare (“Socialstyrelsen”) and Oral Health Register (the SCOR system, National Board of Health) in Denmark. Results: A potential for increasing the reliability and validity of the data existed. Routines for monitoring other oral diseases than caries were limited. Compared with the other Scandinavian countries, the data collection system in Denmark appeared more functional and had adopted more modern concepts of disease management than other systems. In the light of modern concepts of caries management, data collected elsewhere had limited utility. Conclusions: The Scandinavian systems of health reporting had much in common, but some essential differences existed. If the quality of epidemiological data were enhanced, it would be possible to use the data for planning oral health care. Routines and procedures should be improved and updated in accordance with the modern ideas about caries prevention and therapy. For appropriate oral health planning in an organised dental service, reporting of enamel caries is essential.publishedVersio

Dental caries prevention strategies among children and adolescents with immigrant-or low socioeconomic backgrounds-do they work? A systematic review

Background: This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds. Methods: According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed. Results: Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective. Conclusion: On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds.publishedVersio

Traumatic dental injuries and experiences along the life course - a study among 16-yr-old pupils in western Norway

The study assessed risk factors for traumatic dental injuries (TDI) using experiences along the life course. A retrospective longitudinal study, including historical clinical data, was conducted on 16‐yr‐old pupils in western Norway. All first‐grade pupils born in 1997 and attending public high schools were invited to participate (n = 5,184). Participants responded to an electronically administered closed‐ended questionnaire (39.6%, n = 2,055). Information on the occurrence of TDI and events during the life course (categorized as socio‐economic, biological, psychosocial, and behavioural indicators) was collected. Variables with a significant bivariate association with three different dependent variables (TDI, severity of TDI, and multiple episodes of TDI) were tested in a hierarchical logistic regression analysis. Traumatic dental injuries were more frequent among boys, adolescents of higher socio‐economic status, and adolescents with adverse psychosocial and behavioural scores. Moderate and severe TDIs were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in the sport of wrestling. Multiple episodes of TDI were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in sports activities. Incorporation of different life‐course indicators is important in evaluating TDI severity and repeated incidents.publishedVersio

Terveydenhuolto hammaslääketieteen opetuksessa Pohjoismaissa

Tutkimuksen tavoitteena oli selvit­tää, miten terveydenhuoltoa opetetaan pohjoismaisissa hammas-lääketieteen tutkinto-ohjelmissa ja miten tämä opetus vertautuu eurooppalaiseen standardiin.Tutkimus toteutettiin poikittais­tutkimuksena keväällä 2020, ja siinä hyödynnettiin European Association for Dental Public Health (EADPH) -järjestön erityistyöryhmän laatimaa kyselyä. Nimettömät kyselyt lähetettiin sähköisesti Islannissa, Norjassa, Ruotsissa, Suomessa ja Tanskassa toimivien hammaslääketieteen laitostendekaaneille tai laitosjohtajille. Tarvittaessa lähetettiin muistutus. Tuloksia verrattiin vastaaviineurooppalaisiin tuloksiin.Yhteensä 86 % (12/14) laitok­sista vastasi kyselyyn. Suurin osa (9/12) vastaajista raportoi, että laitoksella on erityinen osasto tai yksikkö suun terveydenhuollon opetusta varten. Tämän opetuksen laajuus vaihteli 3 ja25 ECTS- pisteen välillä; keskiarvo oli 10 pistettä. Opetettavista teemoista ‘terveydenhuollontasa-arvoisuus’ (92 % vs. 68 %) sekä ‘korvaus- ja maksujärjestelmät’ (92 % vs. 62 %) oliPohjoismaissa hyvin huomioitu verrattuna eurooppalaiseen keskitasoon, toisin kuin ‘kansanterveydellinen toiminta ja taidot’ (58 % vs. 89 %).Voidaan todeta, että Pohjoismaissa terveydenhuollon opetus on yleisesti ottaen eurooppalaisella tasolla, joskaan ei kaikkien opetusteemojen osalta. Maiden ja oppilaitosten välillä esiintyy suurta vaihtelua.</p

Toxic and essential trace elements in human primary teeth: A baseline study within The MoBaTooth Biobank and The Norwegian Mother, Father and Child Cohort Study (MoBa)

The Norwegian Mother, Father and Child Cohort Study (MoBa) includes a nation-wide collection of deciduous teeth located in the MoBaTooth biobank. The aim of the present study is to create a baseline for early-life metal exposure using dentine biomarkers. Deciduous teeth were collected in the MoBaTooth biobank, a sub-study of the MoBa-study. This study uses 94 primary teeth from children with no known medical conditions at the age of 6 months, a normal birth weight (2500-4500g) and an equal number of teeth shed between 2008-2013 and 2014-2019. A total of 48 girls and 46 boys are included to create a baseline to characterise retrospective exposure to toxicants during multiple early-life developmental periods. Estimates of weekly prenatal and postnatal exposure to 18 metals by measuring dentine concentrations have been made using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Temporal trends in dentine levels differed from metal to metal. Girls had higher postnatal dentine levels of Mn and Zn, compared to boys (p = 0.020 for postnatal Mn-levels, and p = 0.011 for postnatal Zn-levels). Deciduous teeth provide retrospective information on the intensity and timing of early-life metal exposure at weekly temporal resolution. Creating a baseline, future studies can use outcomes of conditions and illness in children in case-control-studies aiming at prevention. Using deciduous teeth, a novel noninvasive biomarker, characterising early-life exposure to 18 metals in approximately weekly increments during sensitive developmental periods extending from the second trimester to 4 months postnatally has been performed.publishedVersio

Dental caries prevention strategies among children and adolescents with immigrant-or low socioeconomic backgrounds-do they work? A systematic review

Background: This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds. Methods: According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed. Results: Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective. Conclusion: On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds

Self-perceived oral health among 19-year-olds in two Swedish counties

The primary purpose of the present study, which focused on a census of 19-yearolds (2006) attending dental clinics in two Swedish counties, was to describe the frequency distribution of clinically- and self-perceived oral health indicators in terms of DSa (Decayed Surfaces approximal), four global dimensions of oral health and one ‘all-embracing’ oral health measure, according to county of residence and gender. A second purpose was to examine to what extent the clinical indicator of oral health and the global dimensions of self-perceived oral health contribute to the explainable variance of the global single-item indicator. Finally, the study examined whether or not the association of clinically- and self-perceived oral health indicators with the single global oral health indicator varied as a function of gender and place of residence. The study base was 46.5% (n=3658) of all children attending for dental checks (n=7866). The questionnaire included thirteen questions, divided into four global dimensions. These were Knowledge, Quality of life, Social and Function. There was also one ‘all-embracing’ oral health question, one question about gender and finally information about clinically-registered disease. The findings of this study were that females reported more serious problems than males in the Social and Quality of life dimensions and there were differences between counties in knowledge about oral diseases. The group with poor self-reported oral health in the ‘all-embracing’ oral health question had significantly more problems with all global dimensions, especially Quality of life and Social dimensions. Statistically-significant two-way interactions occurred between county and Knowledge and between county and Quality of life. This study supports the idea of one or several questions concerning self-perceived oral health to be used as a complement to the traditional epidemiological clinical registration of oral diseases

A biobank of primary teeth within the Norwegian mother and child cohort study (MoBa) per 2014: A resource for the future

The Norwegian Mother and Child Cohort Study (MoBa) is a prospective population-based cohort study including more than 100,000 pregnancies and following the children through childhood, using questionnaires and collecting biological samples. The aim of MoBa is to test specific aetiological hypotheses by estimating the association between exposure and disease, aiming at prevention. A biobank for exfoliated primary teeth collected from the children participating in MoBa has been established (MoBaTooth Biobank). Samples of tooth tissues from the primary dentition can give information about exposure to toxic and essential elements through foetal life and early infancy. Prenatally and postnatally formed tooth tissues permanently document early exposures unlike other biomarkers, as teeth form incrementally at a known rate. Results from tooth analyses will be coupled to corresponding information in the multiple questionnaires and data from analysis of other biological samples collected by MoBa. Invitations to donate one or more teeth are sent to all mothers/children in the period 2008-2016, when the child is 6¾ years old. By November 2014 21,748 participants had been recorded into the MoBaTooth database donating altogether 28,272 teeth (1.3 teeth per child). The response rate was 24%, but there is a lag of more than one year in the response. Data from the tooth biobank can supply MoBa with important additional information on the uptake of trace elements during foetal life and early infancy. This information can illuminate causal factors of health and disease in the future

Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review

Abstract Background This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds. Methods According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed. Results Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective. Conclusion On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds

Dental students’ professional communication skills: Using a student response system and peer discussion to raise awareness of the importance of good professional communication skills in practice periods

In large lectures in education of dentists there is often less dialogue and communication between students and the instructors, and several studies have found that traditional lecturing in such lectures is ineffective in promoting student learning. This Design Based Research (DBR) and case presentation focus on how the use of Student Response Technology (SRS) and feedback can improve communication in large lectures in dentist education. The case presentation is based on lecturer’s experiences and student responses from ten annual large lectures from the period 2010-2019 in the course “Practice Study” (3 ECTS) at University of Bergen where dentist students and their supervisors were gathered for an annual one-day seminar. The case presentation shows the importance of recognizing the factors that affect dentist students’ nervousness and tension for the practice periods and where the use of SRS seems to contribute to raise the awareness among supervisors and students about such issues. This, and a focus on good communications skills among dentist students and their supervisors seems to be crucial to focus on before their practice period in The Public Dental Health Care. There are also a number of limitations in this case presentation, which will be handled in the further development of this DBR-project