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Biomedical subjects

E Widström

Publications and source records attributed to E Widström.

At least 19 recordsLinked to original sources
PubMed2006

'Schools without walls?' Developments and challenges in dental outreach teaching - report of a recent symposium.

During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of 'care teams' in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental 'school without walls'. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed.

Asia, Southeastern↗
PubMed2003

A survey of dental hygienist numbers in Canada, the European Economic area, Japan and the United States of America in 1998.

OBJECTIVE: The aims of this study were to establish how many dental hygienists were licensed to practice in Canada, Japan, USA and the 18 member states of the European Economic Area (EEA) and to compare these with the populations and numbers of dentists practising in the countries concerned. METHOD: Data for the overall populations, numbers of 'active' dentists, of dental hygienists and of employed dental hygienists in the member states of the EEA in 1998 were taken from the responses to a Council of European Chief Dental Officers survey carried out in 2000/2001. Data for these variables for Canada, Japan and the USA in 1998 were accessed from published reports. The ratios of population: active dentist; population: dental hygienist; and active dentist: dental hygienist were calculated and compared. RESULTS: The overall populations and total number of active dentists in the 18 EEA member states and Canada plus Japan plus the USA were broadly similar in 1998 (EEA overall population 381 million with 245169 active dentists: Canada/Japan/USA overall population 421 million with 253825 active dentists). However, there were only 13295 dental hygienists in the EEA as opposed to a total of 215435 in Canada, Japan and the USA. In terms of population:dental hygienist and active dentist: dental hygienist ratios the UK was found to have proportionally far fewer dental hygienists than Canada, Japan, USA or the four Nordic members of the EEA. CONCLUSION: The survey revealed that relative to overall populations and numbers of dentists, there are far fewer dental hygienists in the EEA than in Canada, Japan and the USA and that scope for the UK to import dental hygienists from other EEA member states is probably very limited.

Canada↗
PubMed2003

The post-amalgam era: a selection of materials and their longevity in the primary and young permanent dentitions.

OBJECTIVES: During the last decade there has been a rapid change in the selection of dental restorative materials as the use of amalgam has decreased. The aim of this study was to obtain information on children's restorative dental care in Finland and to analyse the longevity of failed restorations. DESIGN: A random sample of public dental health care centres was drawn from the registers and the dentists working there were asked to record information for each restoration they placed during a three-day period. The survey data comprised a total of 2186 restorations in patients younger than 17 years. RESULTS: Of the children in need of restorative treatment, only a few had previous amalgam restorations. Primary caries was the main reason for restorative treatment in both primary and permanent dentitions (80% and 83%, respectively). In primary teeth, the most common restorative material was resin-modified glass ionomer cement (57.4%), whereas in permanent teeth, composite resin dominated (58.7%). Amalgam was not used at all in the primary dentition and in only 0.6% of permanent teeth. Eighteen per cent of treatments in primary and 12% in permanent teeth were replacements of previous fillings. The mean age of failed glass ionomer restorations was 2.8 years (n = 101) in the primary dentition, and 3.5 years (n = 54) in the permanent dentition. CONCLUSIONS: Until better restorative materials are developed, more attention should be paid to the prevention of dental caries as well as to the proper handling of alternative materials.

Adolescent↗
PubMed2001

Oral healthcare in transition in Eastern Europe.

Big changes have occurred in the oral healthcare delivery systems of most Eastern European countries since the fall of the Berlin wall in 1989 and the demise of communism in the former USSR in 1991. In the new situation it was necessary to reform the political and social systems including healthcare. Reforms were started to improve the economy and, in comparison with Western Europe, the generally lower living standards. It is difficult to obtain comprehensive data on oral healthcare in Eastern European countries but this paper reports data from nine countries and provides a 'macro' view of the current situation in these countries. Many countries seem to have adopted a Bismarckian model for the provision of oral healthcare based on a sickness insurance system.

Aged↗
PubMed2001

Intervals for oral health examinations among Finnish children and adolescents: recommendations for the future.

AIM: To review the frequency of routine annual dental examinations for children in Finland and to make recommendations for appropriate examination intervals for children and adolescents. METHOD: The National Research and Development Centre for Welfare and Health in Finland appointed an expert group to prepare a review. RESULTS: According to the literature, examination intervals for individuals with low caries risk can be extended to 1.5-2.0 years without jeopardising their oral health. If implemented, this would lead to a saving of 15% in treatment and examination times for children. Although there is no accurate measure for identifying high-risk individuals, a considerable proportion of low-risk children can be identified fairly accurately. CONCLUSIONS: The expert group recommended prolonging the average examination intervals to 1.5-2.0 years, taking into account the risk of each individual, the local distribution of oral health problems and cost-effective use of resources. Part of the savings could be redirected to children with high levels of dental need and/or at risk of dropping out from the oral health services.

Adolescent↗
PubMed2001

From amalgam to composite: selection of restorative materials and restoration longevity in Finland.

The aim of this study was to obtain information on restorative dental care in Finland and to analyze the changes in treatment over a 5-year period. A random sample of dentists was drawn from the registers of the health authorities and the dental association in Finland, and in the spring of 1997 a questionnaire was sent requesting the dentists to record information for each restoration placed during a given period. A total of 1,229 dentists were contacted, and 659 responded. The dentists treated 5,305 adults during the study period and placed 6,322 restorations. The most common restorative material was composite resin, which was used in 74.9% of the restorations, whereas amalgam was used in 4.8% and glass ionomers in 9.4% of the restorations. The median ages of failed restorations were nearly 12 years for amalgam, slightly less than 5 years for composite, and slightly more than 4 years for glass ionomer. The results indicate that clinical dentistry in Finland has made a definite step towards the post-amalgam era. However, the functional periods of the failed tooth-colored restorations were disappointingly short and warrant some serious consideration.

Adolescent↗
PubMed2000

A longitudinal study of young Finnish adults' use of subsidized, private sector dental care, 1986-1997.

OBJECTIVES: Finns born after 1956 are now entitled to subsidized private sector dental care, or such persons could be enrolled in the Public Dental Service. Until 1986, eligibility was more restrictive. The purpose of this study was to investigate the use and costs of private dental care and effects of regularity of care on costs and treatment received among young Finnish adults during 1986-1997. METHODS: All 1986, 1990 and 1994 recipients of reimbursement for dental care from the Social Insurance Institution were included in the study. Five separate age cohorts were compared. Using their civil registration numbers, individuals were tracked from their first contact with a private dentist in one of the years 1986, 1990 or 1994 until the year 1997. RESULTS: While the total number of young adults who had received reimbursement for private dental care increased from about 53000 (1986) to 200000 (1994) due to extended eligibility, the number of users in the youngest group decreased from 53000 to 23000. Attending infrequently (1-2 times during the study period) was most common among the youngest adults and frequent attendance (annually) was most common among older adults. The annual mean cost was slightly lower among the frequent attenders in almost every cohort. Variation in the mean number of annual visits was directly correlated with costs. Frequent attenders most often received diagnostic and preventive measures while restorations and surgery were most common for the infrequent attenders. CONCLUSIONS: A substantial decline in the demand for private services among the 19-25-year-olds and stable demand among 26-34-year-olds was detected, indicating falling treatment needs or a preference for the Public Dental Service. All groups had a stable mean number of visits per year and almost constant costs. The mean number of dental visits per year remained steady in all cohorts indicating rigid treatment patterns.

Adult↗
PubMed2000

Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students.

OBJECTIVE: To determine whether any differences existed in dental health behaviour between Japanese and Finnish dental students. SETTING: Hiroshima University School of Dentistry and the University of Helsinki. DESIGN: Comparison of cross-cultural differences of self-reported oral health behaviour. SUBJECTS: Dental students, 337 in Japan and 113 in Finland. METHOD: Subjects were surveyed using the Japanese and Finnish versions of a 20-item questionnaire entitled Hiroshima University--Dental Behavioural Inventory (HU-DBI). RESULTS: Only 2 per cent of Finnish students reported that they put off going to the dentist until they had toothache, compared to 56 per cent of Japanese students. Similarly, significantly more Japanese students thought that their teeth were getting worse despite their daily brushing, compared to their Finnish peers. The mean HU-DBI score of Year 1 Finnish students was higher than that of their Japanese peers, which suggested a higher level of dental health awareness in Finnish students upon entry into dental school. The mean scores of the Japanese students were lower than those of their Finnish peers until Year 3. The mean scores of Year 5 and Year 6 Japanese students were higher than that of Year 1 students, indicating raised self-care levels influenced by the course in preventive dentistry. The gender difference of the HU-DBI score was not a major feature in either country. CONCLUSIONS: Self-reported oral health behaviours seemed to be very different between the two countries, which reflected different culture and/or health education systems of the students.

Chi-Square Distribution↗
PubMed1998

Dental practitioners' experiences on the usefulness of restorative materials in Finland 1992-1996.

OBJECTIVE: To analyse general dentists' choice of restorative materials in Finland, where the use of amalgam has significantly decreased and the use of composites increased during the past 10 years. DESIGN AND SETTING: Postal survey in 1997 to a random sample of general dental practitioners mainly working with adult patients. MAIN OUTCOME MEASURES: Percentage distribution of dentists' opinions. RESULTS: The response rate was 82%. Tooth-coloured restorations were considered to be more time consuming, technically complicated and to have shorter life spans. Most dentists were not willing to return to the wide-scale use of amalgam restorations. CONCLUSIONS: The rapid changes in the restorative material selection have not resulted in serious problems in restorative therapy.

Adult↗
PubMed1998

Does dental service utilization drop during economic recession? The example of Finland, 1991-94.

UNLABELLED: After enjoying rapid economic growth in the 1980s, Finland suffered a deep economic recession that began in 1990. It has been claimed that recession and uneven subsidies influence the use of dental services negatively. Finnish adults born after 1956 and world war veterans are entitled to subsidized dental care either in the Public Dental Service (PDS) or in the private sector. Other adults pay their treatment costs. OBJECTIVES: The purpose of this paper is to determine whether the economic recession in Finland during the early 1990s affected the use of dental services. METHODS: The data were collected by the National Research and Development Centre for Welfare and Health using a method called CATI (Computer Assisted Telephone Interview). The target population was non-institutionalized persons aged 25-79 years. RESULTS: About one-third of those interviewed had visited a dentist during the previous 6 months and this proportion was stable during the years studied. Number of teeth, length of education, income and sex had the highest predictive values for use of dental services as analyzed by multiple logistic regression. Two-thirds had visited a private practitioner, one-third a PDS clinic and a small percentage some other dentist or denturist. CONCLUSIONS: The results showed that the dental service utilization by Finns was stable during this period of economic downturn and only minor changes occurred in the mean number of visits. The most prominent change was seen in the youngest age group, among whom dental utilization decreased by almost 10%. The study indicated that subsidies do not strongly affect dental utilization today.

Adult↗
PubMed1998

Cost and productivity analysis of orthodontic care in Finland.

The aim of the study was to investigate the costs of orthodontic care provided for children and adolescents up to the age of 18 by municipal health centers in Finland, and to study the productivity of these services. The data were gathered by a questionnaire sent to all health centers; 96% responded. The majority of respondents estimated the share of orthodontic care as 10% of the total gross costs of dental care, given that 14% of all dental visits were for orthodontic reasons. To study the productivity in individual health centers, the output was measured by the estimated number of completely treated patients. The cost of orthodontic treatment per completely treated patient was, on average, FIM 7358, ranging from FIM 1299 to FIM 24751. The strongest explanatory factor for the average total costs of orthodontic clinics was the number of general dentists with little experience in providing orthodontic treatment. Other explanatory factors were the number of orthodontists or experienced dentists, the percentage of orthodontic tasks performed by auxiliary personnel, and the timing of treatment. Savings might be obtained by devolving treatment to orthodontists or experienced dentists instead of to dentists with little orthodontic experience, and by starting treatment early. The estimated optimal size for an orthodontic clinic was found to be a unit with 830 completely treated patients per year, but most of the orthodontic clinics were in fact much smaller with, on average, 133 completely treated patients per year.

Cost-Benefit Analysis↗
PubMed1997

Extent and provision of orthodontic services for children and adolescents in Finland.

Orthodontic services for Finnish children and adolescents up to the age of 18 in 1992 were monitored by a questionnaire sent to all municipal health centres responsible for children's dental care in Finland, and 96% responded. All health centres provided some orthodontic treatment, but the percentage of 0 18-year-old children receiving treatment ranged from 1% to 19%. One-quarter of all dental visits of the 0 18-year-olds were in connection with orthodontics. The timing of treatment was early, the average age for starting was 9.5 years. In statistical analyses, the number of children receiving treatment was associated with the timing of treatment. At the age of 7, the most frequently used appliances were quad helix, removable appliance and orthopaedic headgear and, at the age of 13, fixed appliance and activator. Most treatments were provided by nonspecialists. The specialist expertise needed was usually purchased from an outside orthodontist by means of consultation contracts. Every fifth health centre, usually the largest, had employed one or more specialist orthodontists. The regional distribution of orthodontists was uneven, emphasizing regional variation in the delivery of orthodontic services.

Adolescent↗
PubMed1996

Factors influencing the selection of restorative materials in dental care in Finland.

OBJECTIVE: The aim of this study was to identify factors influencing the selection of restorative materials. METHODS: In 1992, a random sample of Finnish dentists working in the public and private health care sectors were asked to provide information on restorative treatments during a given period. The study material consisted of 9886 restorations placed by 855 dentists. RESULTS: The results indicate that private practitioners sought the opinions of their adult patients regarding the selection of restorative material more frequently (26% of restorative treatments) than their colleagues working in the public sector (11%; P < 0.001). The frequency of resin composite restorations increased and that of amalgam and glass ionomer restorations decreased when the patients' opinions were sought. Forty percent of restorations provided by public dentists and 69% of those completed by private practitioners were replacement restorations (P > 0.001). Secondary caries was the main reason for the replacement of amalgam restorations, whereas fractures of the teeth and restorations were the main reasons for the replacement of resin composite restorations. CONCLUSION: The results indicate that patients' opinions have a strong influence on the selection of restorative materials. A large proportion of the restorative treatment studied comprised replacement restorations.

Adolescent↗
PubMed1994

Selection of restorative materials in dental treatment of children and adults in public and private dental care in Finland.

To obtain information on the present selection of dental restorative materials and factors related to it, questionnaires were sent to a random sample of public health centres (47) and private dental practitioners (716) in May 1992. The dentists were asked to collect information on all fillings they placed during 3 and 1 working days, respectively. The study material consisted of 9886 fillings placed by 855 dentists. Glass ionomer was the major filling material in children younger than 17 years, ninety-one per cent of the fillings in deciduous teeth and 47% of those in permanent teeth were inserted using that material. In adults, composite was the most frequently used material, fifty-two per cent of the fillings placed by private practitioners and 43% of those placed in health centres. In total, amalgam was used in 15% of fillings placed for patients 0-16 years old and in 29% of fillings in adults. The results show that in children, glass ionomer is the most frequently used filling material and the use of amalgam is very limited. In adults as well, amalgam seems to be increasingly replaced by other filling materials.

Adolescent↗
PubMed1993

Nordic dentists' opinions on the safety of amalgam and other dental restorative materials.

The safety of amalgam and other restorative materials has caused concern among dental patients in recent years. The aim of this study was to obtain information on dentists' perceived competence in handling different filling materials and their opinions on the safety of these. A random sample of practising dentists in Denmark, Finland, Norway, and Sweden received a mail questionnaire in spring 1990. Answers were received from 1732 dentists (65%). The study showed that the respondents believed that their theoretic knowledge and clinical skills were generally at a high level regarding restorative materials. The risks of the side-effects of gold, ceramic materials, and glass ionomer were considered to be low by about 90% of the respondents. Amalgam was considered to be significantly more hazardous by the Swedish respondents than the others. Interestingly, composite was considered to be associated with a high risk of side-effects by about half of the dentists in all Nordic countries. The dentists' opinions were not found to be greatly influenced by their sex, age, or place of residence but rather by their country and service sector. Against the background of the present lack of scientific evidence on the hazardousness of amalgam or other restorative materials for patients' general health, these findings indicate that dentists are influenced by discussions in the mass media about dental treatment and materials and, of course, by the guidelines given by the health authorities in their own countries. Few dentists were shown to be concerned about occupational risks associated with the use of amalgam, and they had not had their own amalgam fillings replaced.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1992

Fear of amalgam: dentists' experiences in the Nordic countries.

The purpose of the present investigation was to study Nordic dentists' experiences with patients concerned about the possible adverse effects of dental restorations, their perceived ability to deal with this problem and their views as to the suitability of amalgam as a filling material. A random sample of practising dentists in Denmark, Finland, Norway and Sweden were sent a questionnaire in spring 1990. Responses were received from 1732 dentists (65 per cent). In 1989, virtually every dentist had seen patients concerned about possible adverse effects of their dental restorations. The reported mean number of such patients per dentist per year was 80.5 (SD = 128.1) in Denmark, 39.3 (SD = 68.4) in Finland, 83.3 (SD = 194.1) in Norway, and 124.4 (SD = 210.3) in Sweden. Ninety-two per cent of the patients' questions concerned amalgam fillings. About 70 per cent of the dentists believed that inexplicable symptoms associated with amalgam fillings had a psychosomatic background. Only about a fifth of the respondents felt able to examine such patients without seeking medical expertise. In the absence of oral or medical indications, 65 per cent of the respondents in Sweden and 77 per cent in the other countries considered that dentists should advise patients against having their amalgam fillings replaced. About 5 per cent of the respondents were ready to stop using amalgam in the near future.

Attitude of Health Personnel↗