The types and management of dental trauma during military service in Finland

Abstract Background/Aims: All Finnish males must attend compulsory military service that lasts from 6 months to 1 year. About 25 000 males (approximately 80% of each age cohort) and 400 volunteer females complete the service annually. The aim of the study was to investigate the types of dental trauma occurring among Finnish conscripts during their military service. The article also focused on how dental trauma is treated in the Finnish Defence Forces. Material and Methods: All dental records in the Defence Forces’ patient register concerning dental trauma during the years 2011 and 2012 were analysed by tooth number, treatment procedures and number of visits. Results: According to the patient register, 361 conscripts suffered an oral trauma during their military service; thus, the average annual incidence was 7.2 trauma per 1000 conscripts. A total of 483 teeth were traumatized in the 2‐year period. The most frequently traumatized teeth were the maxillary central incisors (61%), and the most common findings were enamel or enamel‐dentin fractures (63% of all findings). Severe trauma was not common, and the most severe ones occurred during off‐duty hours. The most common treatment was direct filling (n = 189 patients). Only 53 patients had soft tissue injuries (bruises, wounds). Among patients with dental trauma, the mean number of visits to the Defence Forces’ dental clinic was 1.9. Great variation exists in recording findings concerning dental and oral trauma. Conclusion: Minor trauma is common. In all cases, recording trauma and treatments should be performed carefully

Adaptation and validation of a Nepali version of the Child-Oral Impacts on Daily Performances Index (C-OIDP)

Abstract The need for culturally validated measures of Oral Health-Related Quality of Life (OHRQoL) has been increasing in recent years. Objectives: To adapt the Child-Oral Impacts on Daily Performances (C-OIDP) index into the Nepali language and to validate it, to assess and compare the outcomes of self-reported oral problems, and to validate a structured questionnaire on general hygiene practices, oral hygiene practices, dietary habits, and use of tobacco. Basic research design: A school-based cross-sectional study on pilot and national samples. Participants: Nepalese schoolchildren representing WHO index age groups (5–6-year-olds, 12-year-olds, and 15-year-olds). The study was conducted on a pilot sample (n=128) selected conveniently and a national sample (n=1,052), selected from 18 sampling sites on the basis of the stratified random sampling method Main outcome measures: Adapted and validated Nepali C-OIDP Results: The Nepali C-OIDP showed excellent validation and reliability tests in both studies. The Cronbach’s alpha coefficients were 0.82 and 0.71 respectively in the pilot and national study. The most common self-reported oral problem was toothache, which was statistically significantly higher in the national sample. Conclusions: The Nepali C-OIDP index is valid and reliable for measuring oral impacts on daily performance among schoolchildren of Nepal

National reference centiles of anthropometric indices and BMI cut-off values in a child population in Nepal

Abstract Background: There is a need for national- or ethnicity-specific growth reference values in developing countries like Nepal, where rapid urbanisation and consequential nutritional transition is taking place. Aim: To establish national growth reference percentiles for anthropometric indices and to propose body mass index (BMI) cut-off values for Nepalese schoolchildren. Methods: This study comprised 1135 Nepalese schoolchildren of four World Health Organization (WHO) indexed age groups (5-, 6-, 12- and 15-year-olds). The age- and gender-specific smoothed percentile curves for anthropometric indices (height, weight, BMI, waist circumference, waist-to-hip-ratio and waist-to-height-ratio) were constructed using LMS method and the corresponding Z-scores were computed. The Receiver Operating Characteristic analysis was used to determine BMI cut-off values based on the International Obesity Taskforce (IOTF) and the WHO growth references. Results: The age- and gender-specified smoothed percentile values of anthropometric indices at 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were computed. The BMI cut-off values for thinness (−1.2 SDS/12th percentile), overweight (+1.2 SDS/88th percentile) and obesity (+2.1 SDS/98th percentile) had high discriminating power, and high sensitivity and specificity. Conclusion: The Nepali anthropometric cut-off values proposed here can be recommended to be applied into research, and to identify public health risks in Nepal among these age groups

Different risk factors for erosive tooth wear in rural and urban Nepal:a national study

Abstract Background: Erosive tooth wear (ETW) is of growing concern, but data on ETW among Nepalese children are scarce. The main aim of the study was to investigate the prevalence and severity of ETW among Nepalese schoolchildren. We also aimed to analyse the risk indicators for ETW according to location (rural/urban) and the role of obesity in the risk for ETW. Methods: This national study was conducted among 5–15-year-old Nepalese schoolchildren from different regions. Altogether, 1137 out of 1151 schoolchildren participated in both a clinical examination and a survey. ETW was recorded using the Basic Erosive Wear Examination. Results: The prevalence of ETW was 65%. One-fifth of the examined subjects were in need of preventive or restorative treatment. Living in an urban area and studying in a private school were protective factors for ETW, whereas consuming fruits frequently and using charcoal for tooth cleaning increased the odds for ETW. Central obesity was the strongest risk indicator for ETW among urban residents. Conclusions: ETW of low severity is common among Nepalese children and adolescents. Socio-demographic factors influence the prevalence of ETW in Nepal and there seems to be different factors that play a role in the ETW process according to location of residence

Burden of suspected epileptic seizures on emergency services:a population-based study

Abstract Background and purpose: Patients with acute epileptic seizures form a large patient group in emergency neurology. This study aims to determine the burden caused by suspected epileptic seizures at different steps in emergency care. Methods: A retrospective, cross-sectional, population-based (>1,000,000 inhabitants), 4-year (2015–2018) study was conducted in an urban setting with a single dispatch centre, a university hospital-affiliated emergency medical service (EMS), and five emergency departments (EDs). The study covered all adult (≥16 years old) emergency neurology patients receiving medical attention due to suspected epileptic seizures from the EMS and EDs and during hospital admissions in the Helsinki metropolitan area. Results: Epileptic seizures were suspected in 14,364 EMS calls, corresponding to 3.3% of all EMS calls during the study period. 9,112 (63.4%) cases were transported to hospital due to suspected epileptic seizures, and 3368 (23.4%) were discharged on the scene. 6969 individual patients had 11,493 seizure-related ED visits, accounting for 3.1% of neurology- and internal medicine-related ED visits and 4607 hospital admissions were needed with 3 days’ median length of stay (IQR=4, Range 1-138). Male predominance was noticeable at all stages (EMS 64.7%, EDs 60.1%, hospital admissions 56.2%). The overall incidence was 333/100,000 inhabitants/year for seizure-related EMS calls, 266/100,000 inhabitants/year for ED visits and 107/100,000 inhabitants/year for hospital admissions. Total estimated costs were 6.8 million €/year, corresponding to 0.5% of all specialized healthcare costs in the study area. Conclusions: Patients with suspected epileptic seizures cause a significant burden on the health care system. Present-day epidemiological data are paramount when planning resource allocation in emergency services

General- and oral-health-related predisposing factors for interrupting military service in the Finnish defence forces

Abstract Introduction: Finland’s security policy relies heavily on its own independent national defense, which is based on conscription. In 2011, 26,492 conscripts started their military service in Finland. Of these, 1,706 interrupted their military service and 191 changed to civilian service. Conscripts who interrupt their service seem to have an increased tendency to smoking, alcohol consumption, and taking snuff, which previous studies suggest to have strong associations with the need for restorative dental treatment and with lower socioeconomic status. The aim of this study was to compare the general and oral health habits between Finnish conscripts who interrupt their service and those who completed their military service and to find out what general- and oral-health-related factors could be used in predicting interruption of service. Methods: The study population consisted of 13,819 conscripts taking an oral examination during the service. Of these, 8,449 answered a computer-based anamnestic questionnaire and 264 interrupted their service. Predisposing factors on the anamnestic questionnaire for interrupting military service were evaluated by using a binary logistic regression model. The statistically significant factors were selected to form a sum variable which finally consisted of seven predisposing questions. Odds ratio (OR) values and 95% confidence intervals were calculated for each question and for the sum variable. Predictive accuracy was assessed by area under the receiver-operating curve. Results: The most obvious predisposing factor among those who interrupted their service compared to the reference group was lack of weekly physical exercise (OR = 5.80). The risk for interruption of military service was 68.6 times higher in cases where a subject exhibited six predisposing factors out of seven compared to those who had none. Conclusion: As a conclusion, a set of statistically chosen anamnestic questions could help identify conscripts who have an increased risk of interruption of military service in addition to a risk of dental problems

Association of dental fear with caries status and self-reported dentition-related well-being in Finnish conscripts

Abstract The main aim of this cross-sectional study was to examine the prevalence of dental fear among Finnish conscripts. Other aims were to study the association between dental fear and cariological status as well as their self-reported, dentition-related well-being. The study material consisted of 13,564 men and 255 women conscripts who underwent oral examinations. Of those, 8713 responded to a computer-based questionnaire. The mean number of decayed teeth (DT) was used in analyses for cariological status. Self-reported dental fear, dentition-related well-being and regular check-ups were analysed. Data were analysed with cross tables, Pearson Chi-Square tests, Fisher’s exact test and binary logistic regressive analysis. High dental fear or finding dental visits very scary was associated with DT > 2 both among women (14.6%, when DT = 0; 33.3%, when DT > 2) and men conscripts (2.3% and 10.8%, respectively). In addition, those reporting that dental health had a negative impact on their well-being and had no regular check-ups were more likely to need cariological treatment than the rest. A high education level, both one’s own and parental, was a protective factor for restorative treatment need in male conscripts. The findings of this study support the concept of a vicious cycle of dental fear and dental caries. A preventive, interactive way of work by dental teams would most likely be beneficial for dental health, avoiding the development of dental fear, and dentition-related well-being

Profiling of smokers and snuffers among young Finnish men:cross-sectional epidemiological study

Abstract Objective: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. Material and methods: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. Results: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. Conclusions: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing

Caries experience and erosive tooth wear in finnish men conscripts 2021:a cross-sectional study

Abstract Background: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. Methods: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. Results: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.6%) had BEWE (basic erosive wear examination) of 0–2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3–13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14–18). Conclusions: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts

Unmanned aircraft system (UAS) structure-from-motion (SfM) for monitoring the changed flow paths and wetness in minerotrophic peatland restoration

Abstract Peatland restoration aims to achieve pristine water pathway conditions to recover dispersed wetness, water quality, biodiversity and carbon sequestration. Restoration monitoring needs new methods for understanding the spatial effects of restoration in peatlands. We introduce an approach using high-resolution data produced with an unmanned aircraft system (UAS) and supported by the available light detection and ranging (LiDAR) data to reveal the hydrological impacts of elevation changes in peatlands due to restoration. The impacts were assessed by analyzing flow accumulation and the SAGA Wetness Index (SWI). UAS campaigns were implemented at two boreal minerotrophic peatland sites in degraded and restored states. Simultaneously, the control campaigns mapped pristine sites to reveal the method sensitivity of external factors. The results revealed that the data accuracy is sufficient for describing the primary elevation changes caused by excavation. The cell-wise root mean square error in elevation was on average 48 mm when two pristine UAS campaigns were compared with each other, and 98 mm when each UAS campaign was compared with the LiDAR data. Furthermore, spatial patterns of more subtle peat swelling and subsidence were found. The restorations were assessed as successful, as dispersing the flows increased the mean wetness by 2.9–6.9%, while the absolute changes at the pristine sites were 0.4–2.4%. The wetness also became more evenly distributed as the standard deviation decreased by 13–15% (a 3.1–3.6% change for pristine). The total length of the main flow routes increased by 25–37% (a 3.1–8.1% change for pristine), representing the increased dispersion and convolution of flow. The validity of the method was supported by the field-determined soil water content (SWC), which showed a statistically significant correlation (R² = 0.26–0.42) for the restoration sites but not for the control sites, possibly due to their upslope catchment areas being too small. Despite the uncertainties related to the heterogenic soil properties and complex groundwater interactions, we conclude the method to have potential for estimating changed flow paths and wetness following peatland restoration