Direct restorations and enhanced caries prevention among 20-to 60-year-olds attending Helsinki City Public Dental Service - a register-based observation

Objective Our retrospective register-based observational study evaluated age-specific aspects and changes in volume and content of direct restorative procedures, pulp cappings and enhanced caries prevention measures given to adults. Methods Data included all treatments provided for 20- to 60-year-olds visiting the Helsinki City Public Dental Service (PDS) in 2012 and 2017. For both years, the data were aggregated into 5-year age groups. Data included means of DMFT indices, number and size of direct restorations, number of specific codes for pulp cappings and enhanced prevention. Results Around half of all patients received restorations, 39,820 (50.9%) in 2012 and 43,392 (45.9%) in 2017. The greatest increase in DMFT means by age cohort was found for the 2012 age cohort of 25- to 29-year-olds and the smallest for the 2012 age cohort of 45- to 49-year-olds. In each same-age group and each age cohort, the enhanced prevention in 2017 was less frequent than in 2012. The proportion of two-surface restorations accounted for 44.7% of procedures in 2012 and 45.9% in 2017, followed by an increasing proportion of one-surface restorations, from 28.3% in 2012 to 32.9% in 2017. Associations between restoration size and age group were highly significant (p < .001). Conclusions The volume of direct restorative procedures and enhanced prevention measures were strongly age-dependent. Restorative treatment procedures were more frequent in older age groups than in younger age groups, and vice versa for enhanced prevention and pulp cappings. The magnitude of restorative treatment decreased slowly from 2012 to 2017, and overall enhanced preventive treatment was limited.Peer reviewe

Altavastaajasta tuhovoimaksi : sukellusveneaseen käyttöönotto ja kehitys

Sukellusveneen noin 400-vuotista historiaa ja sukellusveneluokkien levinneisyyttä kattavasti käsittelevä teos on ensimmäistä kertaa tehty. Maailmassa on valmistettu viimeisen 120 vuoden aikana noin 5 000 yli 400 luokkaan kuuluvaa sukellusvenettä. Se on kiehtova tarina alivoimaisen puolustajan kehittämän aseen kehittymisestä suurvaltojen voimatasapainon takaajaksi ja ydinasepelotteeksi. Altavastaajasta tuhovoimaksi kertoo maittain ja aikakausittain sukellusveneaseen leviämisen. Tutkimuksessa tarkastellaan myös sukellusveneiden koneistoja, tärkeimpiä laitteita ja aseita siinä laajuudessa, että lukija saa käsityksen niiden merkityksestä kehityskaaren eri vaiheissa. Kirjasta selviää 2010-luvulla lisääntynyt sukellusveneitä omistavien maiden määrä ja uusi rakentamisen painopistealue Kaakkois-Aasiassa. Teoksessa on käytetty postimerkeissä kuvattuja sukellusveneitä kertomaan, kuinka ja missä sukellusveneet ovat vuosisatojen aikana kehittyneet. Kommodori evp, sotatieteiden tohtori Kai Varsio on väitöskirjassaan ensimmäisenä tutkijana osoittanut postimerkkien käyttökelpoisuuden dokumentoitaessa merisotataidon kehittymistä

Use of oral health care services in Finnish adults - results from the cross-sectional Health 2000 and 2011 Surveys

Background: During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011. Methods: The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged >= 30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen's model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation. Results: No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector. Conclusions: Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care.Peer reviewe

Estimating molar-incisor-hypomineralization among 8-year-olds based on 15-year public oral health practice-based data

Background:A wide range in the prevalence of molar-incisor-hypomineralization (MIH) has been reported. Population-based studies are recommended. However, such studies are expensive and time-consuming. Objectives:To estimate the magnitude of MIH condition among 8-year-olds based on routine oral health examinations and to associate first permanent molar (FPM) affection with that of other permanent teeth over time. Materials and methods:This retrospective study, with cross-sectional and longitudinal components, was based on electronic oral health records; all 8-year-olds examined between 2002 and 2016 were included. Results:The average estimated prevalence of MIH was 8.3%; yearly range was 4.8-15.9%. The mean number of affected teeth was 1.4; 62% had one affected tooth. One-surface defects were the most frequent (66%). Asymmetric distribution of affected teeth was observed. In follow-up, 10.7%, 8.4%, and 11.2% had at least one affected permanent canine, premolar, or second permanent molar, respectively. The proportion of children with other MIH-affected permanent teeth was higher in the group with >= 2 MIH-affected teeth than in group with one affected FPM at the age of 8. Conclusions:The average prevalence of MIH was comparable to that reported elsewhere. The number of MIH-affected teeth at early mixed dentition predicts the affection of other permanent teeth over time, mainly that of permanent canines. Further screening of children with MIH is recommended to improve individually tailored early preventive and restorative dental care.Peer reviewe

Estimating molar-incisor-hypomineralization among 8-year-olds based on 15-year public oral health practice-based data

Background:A wide range in the prevalence of molar-incisor-hypomineralization (MIH) has been reported. Population-based studies are recommended. However, such studies are expensive and time-consuming. Objectives:To estimate the magnitude of MIH condition among 8-year-olds based on routine oral health examinations and to associate first permanent molar (FPM) affection with that of other permanent teeth over time. Materials and methods:This retrospective study, with cross-sectional and longitudinal components, was based on electronic oral health records; all 8-year-olds examined between 2002 and 2016 were included. Results:The average estimated prevalence of MIH was 8.3%; yearly range was 4.8-15.9%. The mean number of affected teeth was 1.4; 62% had one affected tooth. One-surface defects were the most frequent (66%). Asymmetric distribution of affected teeth was observed. In follow-up, 10.7%, 8.4%, and 11.2% had at least one affected permanent canine, premolar, or second permanent molar, respectively. The proportion of children with other MIH-affected permanent teeth was higher in the group with >= 2 MIH-affected teeth than in group with one affected FPM at the age of 8. Conclusions:The average prevalence of MIH was comparable to that reported elsewhere. The number of MIH-affected teeth at early mixed dentition predicts the affection of other permanent teeth over time, mainly that of permanent canines. Further screening of children with MIH is recommended to improve individually tailored early preventive and restorative dental care.Peer reviewe

Survival of primary molars with pulpotomy interventions : public oral health practice-based study in Helsinki

Objectives To assess long-term survival of pulpotomized primary molars and factors related to the survival of the teeth. Materials and methods This retrospective longitudinal study was based on electronic dental health records of children who attended public health service. Eligible children werePeer reviewe

Use of oral health care services in Finnish adults - results from the cross-sectional Health 2000 and 2011 Surveys

Background: During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011.Methods: The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged >= 30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen's model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation.Results: No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector.Conclusions: Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care

Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial

Abstract Background Supervised toothbrushing programs using fluoride dentifrice have reduced caries increment. However there is no information about the effectiveness of the professional cross-brushing technique within a community intervention. The aim was to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries. Methods A randomized double-blinded controlled community intervention trial to be analyzed at an individual level was conducted in a Brazilian low-income fluoridated area. Six preschools were randomly assigned to the test and control groups and 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice supervised directly by a dental assistant, was developed four times per year. At the remaining school days the children brushed their teeth under indirect supervising of the teachers. In test group, children also underwent a professional cross-brushing on surfaces of first permanent molar rendered by a specially trained dental assistant five times per year. Enamel and dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars during 18-month follow-up. Exposure time of surfaces was calculated and incidence density ratio was estimated using Poisson regression model. Results Difference of 21.6 lesions per 1,000 children between control and test groups was observed. Among boys whose caries risk was higher compared to girls, incidence density was 50% lower in test group (p = 0.016). Conclusion Modified program was effective among the boys. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs. Trial registration ISRCTN18548869