Factors related to persons with health problems attributed to dental filling materials : part one in a triangular study on 65 and 75 years old Swedes

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

Satisfaction with dental care and life-course predictors : A 20-year prospective study of a Swedish 1942 birth cohort?

Objectives: The aim was to assess the impact of care experience, health factors and socioeconomic factors on satisfaction with dental care across time and to assess the stability or change in levels of self-reported satisfaction with dental care in individuals as they progress from middle age to early old age.Materials and methods: The present work is based on five separate data collections from a cohort study with 3585 individuals responding in all years of the survey. Data collection was conducted in 1992 when the subjects were 50 years of age and again 5, 10, 15 and 20 years later. Absolute stability in satisfaction with dental care was assessed by calculating the proportion of individuals who maintained their position in the same category from one survey period to another. Changes across time were tested using Cochran's Q test. Satisfaction with dental care across the 20-year survey period was modeled using the generalized estimating equation (GEE).Results and conclusion: The result showed that 85% of women and 83% of men remained satisfied with dental care. Binomial GEE revealed no statistical significant change in satisfaction with dental care between 1992-2012. In sum, this study has shown that this age group, born in 1942, was stably satisfied with dental care between age 50 and age 70, despite all changes during this time period. Females are more satisfied than men and the most important factors are the experience of attention during the last visit, satisfaction with dental appearance and good chewing capability

Self-perceived oral health among 65 and 75 year olds in two Swedish counties

The aim of this study was to investigate self-perceived oral health in two elderly populations, age's 65 and 75 years, and its relation to background factors, socioeconomic, individual, and dental health service system factors. Another purpose was to investigate if there were any differences in these respects, between the two age groups, born in 1932 or 1942. 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 were also surveyed using the same questionnaire. Those born in 1932 consisted of 3735 persons and those born in 1942 6078 persons. From an outline of a general model of inequalities in oral health data were analyzed with descriptive statistics and contingency tables with chi2 analysis. Multivariable analysis was performed by using multiple regression analysis. Factors related to self-perceived oral health were age group, social network, ethnicity, education, general health,tobacco habits, oral hygiene routines, dental visit habits and cost for care. The self-perceived oral health was overall rather high, especially in view of the studied ages, although it was worse for those of age 75. Socio-economic factors, dental health service system as well as individual lifestyle factors affected self-perceived oral health. To have a satisfying dental appearance, in the aspect of howyou are judged by other people, was important for these age groups. This presents a challenge for dental health planners especially since the proportion of older age groups are growing

Perceived oral health : changes over 5 years in one Swedish age-cohort

Objectives: The purpose of this study was to investigate if a change in the social gradients in perceived oral health occurred over a 5-year period, 1992-97, using a cohort population from two Swedish counties. Methods: In 1992, a cross-sectional mail questionnaire was sent to all 50-year-old persons in two counties in Sweden, Örebro and Östergotland, and altogether there were 8888 persons. In 1997, the same population was sent a new questionnaire. The cohort, comprising the same respondents from 1992 and 1997, was of 5363 persons. An index of perceived oral health was constructed out of three questionnaire variables: satisfaction with teeth, chewing ability and the number of remaining teeth. This index value was set as a dependent variable in a regression model. Reports of toothache were investigated in a separate logistic regression model. Results: There were obvious social gradients in the perceived oral health index both in 1992 and in 1997. Marital status, foreign birth, education and occupation were all substantially related to the perceived oral health. The change in perceived oral health was analyzed. Almost half of the cohort (47.4%) showed no change at all. Those with increased and those with decreased health were rather evenly distributed on both sides, with 22.0% with better health in 1997 and 30.6% with worse health. Gender and education were related to toothache experience. Conclusion: Changes have been moderate in the perceived oral health in this cohort, despite the rather drastic changes in the remuneration of dental care during this study time. On the other hand, this also means that the social differences remain, despite the official goals of increased equity

Patient satisfaction with dental care in one Swedish age cohort. Part II - What affects satisfaction

The aim of this study was to investigate satisfaction with dental care in relation to dental care factors, recent dental care experiences, past dental care experiences, general health factors, oral health factors and socio-economic factors and all over time. All persons born in 1942 in two counties in Sweden, Örebro and Östergötland, were surveyed by post in 1992 at the age of 50, and resurveyed at the age 55. There were 5363 persons responding at both times, constituting the study group. A conceptual theoretical model was constructed to be used as a framework in the analysis. Multiple regression analysis and contingency tables were used. Factors related to satisfaction with dental care were: care organisation, cost for care, visit to dental specialist, time spent in waiting room, regular attendance, reception at dental clinic, feelings of anxiety, taking part of school dentistry, smoking, oral health factors, dental appearance and being dissatisfied 5 years previously. Change between the two study years was affected by perceived oral health, experiences from the most recent dental visit and care organisation. Oral health related factors and dental care factors like cost for care and care organisation were related to satisfaction with dental care. Likewise were experiences from the most recent dental visit and to some extent past care experiences like school dentistry. Almost no correlation was seen between socio-economic factors and satisfaction

Older people's experiences of oral health and assisted daily oral care in short-term facilities.

BACKGROUND: Older people's oral health has improved, and many retain their natural teeth throughout their life. However, their daily oral care can be more difficult because of compromised general health and the reduced capacity for self-care that often comes with old age. More knowledge is needed about how older people view their oral health and oral care. The aim of this study was to describe how older people in short-term care experience their oral health and daily oral care. METHOD: A descriptive, qualitative study was performed through interviews with 14 older people (74-95 years) recruited from short-term care units in two Swedish regions. Data were analysed using inductive content analysis. RESULTS: The findings are described in one main category, three categories and nine sub-categories. The main category was Adapting to a changed oral condition while striving to retain independence. The first category, Wanting to manage daily oral care independently, contained three subcategories: Having always brushed my teeth without help, Being satisfied with my mouth and teeth, and Having to accept help if necessary. The second category, Acceptance of changes in oral condition, had three subcategories: Difficulty in chewing and swallowing, Difficulty with tooth brushing, and Not considering a dentist visit to be worth the cost. The third category, Barriers to receiving assistance from staff, had three subcategories: Staff lacking the time to help, Not wanting to be a burden, and Lack of confidence in staff's knowledge. CONCLUSIONS: The participants were generally satisfied with their oral health despite an expressed need for dental treatment. Daily oral care was something they wanted to manage themselves, and they had a strong desire to stay independent for as long as possible. Closer collaboration between dental and health care staff is necessary in order to implement clinical practice guidelines for oral health care and increase nursing staff's attention towards older peoples' oral health

Patient satisfaction with dental care in one Swedish age cohort. Part 1 - descriptions and dimensions

The aim of this study were to investigate the dimensionality of satisfaction with dental care, to control the reproducibility of the analysis over time, to investigate changes between the two studied years and to relate satisfaction with elapsed time since the most recent visit to dental care. All persons born in 1942 in two counties in Sweden, Orebro and Ostergötland, were surveyed by post in 1992 at the age of 50 and resurveyed at the age of 55. There were 5363 persons responding at both times, constituting the study group. In this study, opinions are analysed about general satisfaction with dental care and about the most recent dental visit. Factor analysis, one-way ANOVA and contingency tables were used. Overall satisfaction was high both as to general satisfaction and as to the most recent dental care visit. Those with their most recent dental visit more than a year ago felt more pain, anxiety and unpleasantness and were also more generally dissatisfied. Of those having experiences of pain, anxiety and unpleasantness at most recent visit, there was an overrepresentation of non regular attenders. Factor analysis showed that the questions used revealed a stable pattern. In conclusion, the overall satisfaction with dental care was high. Differences between the two studied years were small. Persons not visiting dental care within the last year were more dissatisfied both generally and with the most recent visit. A greater number of regular attenders had no feelings of anxiety, pain or unpleasantness at all

Dentists’ use of digital radiographic techniques: Part I – intraoral X-ray: a questionnaire study of Swedish dentists

<p><b>Objective:</b> The present study aims to gain knowledge about the dentist’s use and choice of digital intraoral imaging methods.</p> <p><b>Materials and methods:</b> A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the type of X-ray technique used, problems experienced with digital radiography, and reasons for choosing digital technology, and about indications, clinic size and type of service. Response rate was 53%.</p> <p><b>Results:</b> Ninety-eight percent of the dentists had made the transition to digital radiography; only 2% used film technique, and solid-state detector (SSD) was the most used digital technique. More years in service decreases the likelihood of applying individual indications for performing a full mouth examination. More retakes were done with SSDs compared to storage phosphor plates. Reasons for choosing digital techniques were that work was easier and communication with the patients improved. However, dentists also experienced problems with digital techniques, such as exposure and projection errors and inadequate image quality. The Swedish Radiation Safety Authority states that all radiological examinations should be justified, something not always followed.</p> <p><b>Conclusions:</b> This study showed that 98% of the respondents, Swedish dentists within the Swedish Dental Society, used digital techniques, and the most used was the solid-state technique.</p

Older people with swallowing dysfunction and poor oral health are at greater risk of early death

Objectives: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden. Methods: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI). Results: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02‐2.75; P = .041 and aHR: 1.98, 95% CI 1.07‐3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15‐5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%). Conclusions: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.Originally included in thesis in manuscript form</p

Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial

Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT &lt; 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people