Changes in perceived oral health in a longitudinal population-based study

Objectives: The aim was to examine whether the changes in different measures of perceived oral health (POH) were similar and related to each other over 11 years in the Finnish adult population in a longitudinal setting. Perceived oral health was measured by means of subjective oral health (SOH), self‐assessed treatment need (STN), and oral health‐related quality of life (OHRQoL).Methods: The data were collected as part of the nationally representative Health 2000 and Health 2011 (BRIF 8901) surveys on Finnish adults born in 1981 or earlier. SOH and STN were measured using single items and OHRQoL using the 14‐item Oral Health Impact Profile (OHIP‐14). The changes in STN and OHRQoL were reported by age group and by gender. Age groups (born in 1971 or later, in 1956‐1970, in 1946‐1955, or in 1945 or earlier) were based on access to subsidized oral health care. General linear mixed models for changes in perceived oral health variables were conducted.Results: Subjective oral health and oral health‐related quality of life with impacts occurring occasionally, fairly often, or very often (OFoVo) showed similar results and remained good or improved in the majority of the participants. Self‐assessed treatment need in the population showed less consistent results. Subjective oral health was good in the adult population. About half of the participants, regardless of age and gender, reported self‐assessed treatment need in both years, showing a decrease among women and an increase in the youngest group. Perceived oral health improved significantly in the two oldest age groups regardless of the measure. The general linear mixed model revealed that changes in all three perceived oral health variables were related even when adjusted for age and gender.Conclusion: Multiple perceived oral health measures might be useful for service planning, as the changes in the three separate measures used in this longitudinal study were various and thus measured different aspects of perceived oral health. Research including both self‐perceived and clinical indicators is needed to understand need for care as a whole.</p

Changes and determinants of unmet oral health treatment need

Objectives Our aim was to describe the nature and determinants of the changes in unmet treatment need between the years 2000 and 2011 after a major oral healthcare reform and a wider supply of subsidized care.Methods The study used a longitudinal sample (n = 3838) of adults who had participated in both the Health 2000 and 2011 surveys (BRIF 8901). Those reporting self-assessed treatment need without having visited a dentist in the previous 12 months were categorized as having unmet treatment need. Two logistic regression models were applied to determine the effects of predisposing and enabling factors on change in unmet treatment need. Model 1 was conducted among those who reported unmet treatment need in 2000 and evaluated the determinants for improvement. Model 2 was conducted among those who did not have unmet treatment need in 2000 to evaluate the risk factors for having unmet treatment need by 2011.Results Unmet treatment need was reported by 25% of the participants in 2000 and by 20% in 2011. Those with unmet treatment need in 2000 were less likely to report improvement by 2011 if they had poor subjective oral health, basic or intermediate education level, or poor perceived economic situation in 2000. Those who did not have unmet treatment need in 2000 were more likely to have it in 2011 if they were males or from northern Finland and less likely to if they came from central Finland or were older.Conclusions The wider supply of subsidized oral health care during the study years did not lead to complete elimination of treatment need. The determinants of unmet treatment need, such as low or intermediate education level and perceived economic difficulties, should be used in targeting the services at those with treatment need to achieve better oral health outcomes.</div

Association of service use with subjective oral health indicators in a freedom of choice pilot

Objectives: A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018–2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. Material and methods: SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). Results: Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. Conclusions: Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.publishedVersionPeer reviewe

Association of service use with subjective oral health indicators in a freedom of choice pilot

Objectives: A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot.Material and methods: SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome).Results: Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small.Conclusions: Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.</p

Longitudinal pathways between perceived oral health and regular service use of adult Finns

Objectives: Our aim was to evaluate changes in and pathways between different measures of perceived oral health (POH) and regular oral health service use between the years 2000 and 2011 among Finnish adults. POH was measured by means of oral health‐related quality of life (OHRQoL) and subjective oral health (SOH).Methods: The study was based on a longitudinal sample (n = 5525) of adults having participated both in the Health 2000 and 2011 Surveys (BRIF 8901). OHRQoL was measured with the Oral Health Impact Profile 14‐item questionnaire and SOH with a single question. Path analyses were used to determine whether SOH or OHRQoL affected service use or vice versa, grouped by age groups and self‐assessed treatment need.Results: The path analyses indicate that good OHRQoL leads to regular service use and regular service use leads to better SOH. The first path was stronger among the elderly (0.10) and the second among the younger age group (0.07). Both paths were stronger (0.12 and 0.06) among those who reported no treatment need in 2000.Conclusions: Good OHRQoL, indicated by a lack of perceived problems or symptoms, leads to regular service use. Our findings indicate that poor OHRQoL leads to nonregular service use, and nonregular service use leads to poor SOH.</p

Sealant retention is better assessed through colour photographs than through the replica and the visual examination methods

Item does not contain fulltextThe aim of this study was to test the hypothesis that the colour photograph method has a higher level of validity for assessing sealant retention than the visual clinical examination and replica methods. Sealed molars were assessed by two evaluators. The scores for the three methods were compared against consensus scores derived through assessing retention from scanning electron microscopy images (reference standard). The presence/absence (survival) of retained sealants on occlusal surfaces was determined according to the traditional and modified categorizations of retention. Sensitivity, specificity, and Youden-index scores were calculated. Sealant retention assessment scores for visual clinical examinations and for colour photographs were compared with those of the reference standard on 95 surfaces, and sealant retention assessment scores for replicas were compared with those of the reference standard on 33 surfaces. The highest mean Youden-index score for the presence/absence of sealant material was observed for the colour photograph method, followed by that for the replica method; the visual clinical examination method scored lowest. The mean Youden-index score for the survival of retained sealants was highest for the colour photograph method for both the traditional (0.882) and the modified (0.768) categories of sealant retention, whilst the visual clinical examination method had the lowest Youden-index score for these categories (0.745 and 0.063, respectively). The colour photograph method had a higher validity than the replica and the visual examination methods for assessing sealant retention

aMMP-8 Point-of-Care Test (POCT) Identifies Reliably Periodontitis in Patients with Type 2 Diabetes as well as Monitors Treatment Response

Background: The link between diabetes and periodontitis is bi-directional: high glucose levels increase the risk of periodontitis and elevated oral fluid aMMP-8 as well as diabetic development while untreated periodontitis worsens glycaemic control. Methods: Type-2 patients (N = 161) underwent an aMMP-8 Point-of-Care Test (POCT) at diabetes clinics. If the test was positive, the patient was sent to an oral health care clinic and oral health examination, health-promoting as well as necessary treatment procedures were carried out. Only 41 patients underwent full clinical evaluations. At the end of the treatment, an aMMP-8 POCT (B) was performed and if the test was positive, the treatment was continued and a new test (C) was performed, aiming for test negativity. The glycated haemoglobin (GHbA1c) test was performed approximately 6 months from the original appointment. Results: GHbA1c concentrations did not decrease during the follow-up. The concentrations of aMMP-8 assessed by POCT, and clinical parameters decreased. Changes in GHbA1c and aMMP-8 levels assessed by POCT during the treatment correlated positively with each other (p < 0.01). Conclusion: aMMP-8 POCT proved its reliability, and that its use is beneficial in the diabetes clinic, it enables identifying patients with periodontal findings reliably and guides them directly to an oral health clinic