Biomedical subjects

H Murtomaa

Publications and source records attributed to H Murtomaa.

At least 19 recordsLinked to original sources

PubMed2006

Disparities in oral health of children in Tehran, Iran.

AIM: This was to investigate the association between parents' educational level and oral health of Iranian primary school children. METHODS: Data came from the voluntary clinical examination in 2005 of a random sample of 459 third-year primary school children in the 16 schools in Tehran, together with a self-administered questionnaire regarding information on the educational level of the parents. The study used the dmft/DMFT values for dental status, and the CPI, and PI to assess periodontal condition. STATISTICS: One-way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. RESULTS: The mean dmft value was 4.2 (SD+2.9) in boys and 3.4 (SD+2.6) in girls for the whole study group. The children of the low education parents had more dental caries than those of high education parents in both primary (p<0.01) and in permanent teeth (p<0.05). A strong association was found between high parental education and restorations in primary teeth (p<0.001), but only a trend for restorations in permanent teeth. Mean number of sextants with a CPI score 0 was significantly associated with parents' educational level (p<0.01). CONCLUSION: The disparities in the oral health of children need to be considered when developing oral health promotion programmes.

Child↗

PubMed2006

Curriculum structure and the European Credit Transfer System for European dental schools: part I.

This paper presents a proposed curriculum structure and system of European Credit Transfer (ECTS) for undergraduate dental schools throughout Europe. It is the result of the work of a Taskforce ('Taskforce II'), appointed by DentEd, a thematic network of European dental schools and the Association for Dental Education in Europe (ADEE). There has been pan-European discussion of the document in draft stages (it was distributed to 200 dental schools) and following amendment, it was agreed formally at the National Assembly of ADEE in Athens, Greece, in September 2005. The main elements of the paper relate to: (i) a description of the framework proposed with relevance to the Bologna recommendations and common directive on recognition for professional qualifications as they apply to Dentistry; (ii) the structure of an undergraduate dental curriculum; (iii) student exchange and ECTS. In addition, the paper presents a series of requirements, guidelines and recommendations for action. ADEE expects that the 'requirements' proposed will be followed by dental schools in Europe, whilst the 'guidelines' and 'recommendations' also provided are open to local interpretation. The paper is also published on the ADEE website.

Advisory Committees↗

PubMed2006

Finger osteoarthritis and differences in dental work tasks.

Mechanical load has been proposed as a risk factor for hand osteoarthritis. Dentists produce high manual forces in their work tasks. We studied whether the pattern of dental work tasks was associated with finger osteoarthritis. Radiographs of both hands of 291 middle-aged female dentists were examined for the presence of osteoarthritis. Patterns of dental work tasks during work history were empirically defined by cluster analysis. Three patterns emerged reflecting high, moderate, and mild task variation. Age, specialization, years in clinical work, various activities requiring hand use, family history of Heberden's nodes, body mass index, and smoking were accounted for in logistic regression analyses. The dentists with a history of low task variation had a greater prevalence of osteoarthritis in the thumb, index, and middle fingers compared with dentists with high variation (OR 2.22; 95%CI 1.04-4.91). The pattern of dental work task history is associated with the localization of osteoarthritis in the fingers.

Cluster Analysis↗

PubMed2003

Dental health of dentists' children in Mongolia.

OBJECTIVES: To describe the dental health of dentists' children, to evaluate its association with their dentist-parents' background and work-related characteristics and to compare it with that of children in the general population in Mongolia. DESIGN: Cross-sectional survey, questionnaire-based data. SUBJECTS: Dentists' children, aged 3-13 years. SAMPLE: All dentists (n = 250) actively practising in the capital city of Mongolia. RESULTS: The dentists' children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries-free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = -0.22; P = 0.001). Dentist-parents' background and work-related factors were not associated with their children's caries status (P > 0.05). When dentists' children were compared with their counterparts at the population level, mean dmft for 6-year-olds was 2.6 for (urban) dentists' children, 6.5 for children in the urban population and 0.9 for those in rural population of equivalent age. Mean DMFT for 12-year-olds were 1.0, 1.8 and 1.2, respectively, in the same three groups. In general, (urban) dentists' children in all age groups had better dental health than did their urban counterparts at the population level. Among 5-7-year-olds, dentists' children had worse dental health than did their counterparts in the rural population. CONCLUSIONS: Despite the dentists' knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.

Adolescent↗

PubMed2002

Dentists' perception of their treatment practices versus documented evidence.

OBJECTIVE: To compare the quality of real-life treatment practices to dentists' perceptions of treatment rendered. SETTING: One administrative unit of the Finnish public oral health service. METHODS: The original oral health records of a randomly selected sample of young adults who received treatment during 1994-1996 provided data on actual clinical examinations (n=208), radiographs (n=312), and root canal treatment courses (n=148) carried out by 50 dentists. Dentists' perceptions of the treatment rendered were obtained through a structured questionnaire completed during their working hours in 1996. OUTCOME MEASURES: Criteria for assessing the quality of treatment practices were based on Finnish health legislation, authoritative instructions, and consensus reports. RESULTS: Based on responses, 77% of the dentists followed the prevailing instructions on oral health record keeping (82%, if partial agreement included). Most dentists (88% fully agreed, 95% at least partly) perceived that their knowledge gained through continuing education was being applied in practice; no one answered no. A gap was found between dentists' perception of the treatment rendered and everyday treatment practices as recorded on patient documents. CONCLUSIONS: Overall, dentists' perception of the quality of their treatment practices exceeded that found in patient documents. This gap deserves consideration while planning research, education, or quality-improvement projects that relate to dentists' opinions.

Adult↗

PubMed2002

Assessment of periodontal treatment needs among adults with diabetes in Finland.

OBJECTIVES: People with diabetes have a high risk for periodontal disease, which can be considered one of the complications of diabetes. We evaluated periodontal treatment needs using the Community Periodontal Index of Treatment Needs (CPITN) in relation to diabetes-related factors and oral hygiene. DESIGN: The sample consisted of 120 dentate diabetics, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic. The nurses, who interviewed the patients, collected data on duration and type of diabetes, complications, and HbA1c level. Clinical periodontal examination included identification of visible plaque, the presence of calculus and use of the CPITN. RESULTS: The CPITN score 3 was the most prevalent. According to the logistic regression model, poor metabolic control was significantly related to pathologic pockets. No significant association was found between diabetes-related factors and the highest individual CPITN score of 4, which was, in turn, significantly associated with extensive calculus. CONCLUSIONS: Excessive periodontal treatment needs found, indicate that current dental care may be insufficient in adults with diabetes. Oral health among high-risk groups, especially those with poor metabolic control, should be promoted by collaboration between dental and health care professionals involved in diabetes care.

Adult↗

PubMed2001

Report on the development of a new dental curriculum at Helsinki.

A review of the dental curriculum was undertaken in Helsinki in the mid 90s. The objectives of the new curriculum were to reinforce the links between basic biomedical and dental sciences in order to give more emphasis to oral medicine and comprehensive dental care. Furthermore, the curriculum needed to promote an interdisciplinary approach and encourage students to understand dental diseases in relation to the community at large. A two-year, topic-based, preclinical curriculum, fully integrated with medical students, was started. For didactic teaching in the clinical phase, new learning entities were established to promote an inter-disciplinary approach. For the first time in Finland, objectives were formulated for attitudes and interpersonal skills. Clinical training was conducted in a comprehensive clinic, based on the team concept, where emphasis was given to proven competency instead of to the number of procedures performed. The time spent in the clinic was kept the same as previously (1440 h). Students' learning process was assessed with a portfolio. The majority of students welcomed the comprehensive care clinic, especially its team concept and treatment planning seminars. However, feedback seminars after treatment of the patient were not in favour. As part of the evaluation process, a DENTED visitation took place in Helsinki in March 1999. The results obtained in the student questionnaire were consistent with the aims of the undergraduate training and with the present patient treatment range. In conclusion, the curriculum change enabled the school to broaden the biomedical aspects by increasing the period of preclinical studies. Although the extent of these studies was greater than in the past, and meant postponement of clinical skills courses by one semester, it did not jeopardise the competency in clinical dentistry, owing to the effective integration of the clinical phase teaching.

Attitude↗

PubMed2001

Oral self-care and periodontal health indicators among adults with diabetes in Finland.

We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral self-care, and more attention is needed for improving the quality and outcome of these habits.

Adolescent↗

PubMed2001

Recruiting phobic research subjects: effectiveness and cost.

Efficiently enrolling subjects is one of the most important and difficult aspects of a clinical trial. This prospective study evaluated strategies used in the recruitment of 144 dental injection phobics for a clinical trial evaluating the effectiveness of combining alprazolam with exposure therapy. Three types of recruitment strategies were evaluated: paid advertising, free publicity, and professional referral. Sixty-three percent of subjects were enrolled using paid advertising (the majority of them from bus advertisements [27.0%], posters on the University of Washington campus [20.1%], and newspaper advertisements [13.2%]). Free publicity (eg, television coverage, word of mouth) yielded 18.8% of enrolled subjects and professionaL referrals 14.6% of subjects. The average cost (1996 dollars) of enrolling 1 subject was $79. Bus and poster advertising attracted more initial contacts and yielded the greatest enrollment.

Adolescent↗

PubMed2000

Quality evaluation of young adults' radiographs in Finnish public oral health service.

OBJECTIVE: To evaluate the quality of young adults' radiographs exposed and processed under everyday clinical conditions. SETTING: One administrative unit of the Finnish public oral health service. DESIGN: Two reviewers independently evaluated the radiographs by the same written criteria that were designed as a checklist for on-site evaluations, without any further calibration. SAMPLE: In total, 312 radiographs (178 bitewing, 88 periapical and 46 panoramic) from 1990 to 1996, collected from patient documents of a randomly selected sample of young adults born in 1966-1971. OUTCOME MEASURES: Radiographs were assessed by quality indicators pertinent to the clinical utility as acceptable or unacceptable. If erroneous by some indicator(s) but still contributing to the diagnostic information, a radiograph was rated as diagnostically acceptable. A score of quality points was calculated for each radiograph. RESULTS: The overall kappa statistics for intra-examiner reliability was 0.63, the proportional agreement 83%. For inter-examiner reliability, 0.42 and 71%, respectively. Although the evaluation criteria took the clinical utility of the radiographs into consideration, only 15% of bite-wings, 13% of periapicals, and 2% of panoramics received the maximum quality points. Erroneous film positioning was the most common fault on intraoral radiographs. On panoramics, the most frequent faults were in density and contrast and in patient positioning. The radiological evaluation had only been recorded for less than one fifth of the films. CONCLUSIONS: A proportion of radiographs fell short of the ideal. There is room for improvement in the quality of radiography in order to obtain the greatest possible diagnostic yield from the exposed radiographs.

Adult↗

PubMed2000

Quality evaluation of process of root canal treatments performed on young adults in Finnish public oral health service.

OBJECTIVES: To evaluate the quality of root canal treatments performed in every-day practice on young adults. METHODS: A quality index related to the treatment process was developed based on the guidelines of the European Society of Endodontology. A random computerised selection of 134 young adults (born 1966-1971) produced 125 (93%) eligible oral health documents, including information on 148 teeth that were root canal treated by 47 dentists. The process of root canal treatment was evaluated according to the original oral health documents. The technical quality of root canal fillings was assessed on postoperative periapical radiographs. RESULTS: The overall Kappa statistics for the inter-examiner reliability of assessments was 0.63; the proportional agreement being 87%. The mean quality index was 6.2, s.d. 2.0, with none of the treatments scoring the maximum 13. On the 56 available postoperative radiographs, 52% of the fillings were optimal, showing a length within 0-3mm from the radiological apex, no voids in the apical part nor lumen apical to the filling. Of the completed 144 root canal treatments, only 11 included some recorded follow-up information within 15months from the termination of the treatment. CONCLUSIONS: The technical quality of the root fillings was similar to that found in previous studies. However, the quality index, paucity of pre- and post-operative radiographs, and the lack of follow-up all indicated a discrepancy between consensus guidelines and every-day practice.

Adult↗

PubMed1999

Dentists' selection of measures for assessment of oral health risk factors for Finnish young adults.

Dentists' selection of measures for assessing oral health risk factors for young adults, in relation to their oral health status and to those dentists' characteristics, was studied in one administrative unit of the Finnish public oral health service. A random selection (n = 239) was made of all young adults born in the period 1966-71 and clinically examined during 1994. On the original oral health records of those selected, all notes were scrutinized concerning the most recent clinical examination and treatment course; in total 208 (87%) records. We found that assessment of risk factors to oral health was rare. The patient's diet had been recorded as assessed in 7% of all cases, use of fluoride in 8%, and oral hygiene habits in 14%. No salivary tests were performed; nor was patients' use of tobacco assessed. No correlation was detected between measures used by these dentists and their patients' oral health status (DMFT and DT scores, number of approximal incipient lesions, and number of healthy sextants by CPITN). The oral health status impelled only slightly assessments by bite-wing radiographs. Fewer than half (44%) of the dentists performed and recorded any kind of assessment measure; 4% assessed diet, hygiene, and use of fluoride for all their patients in our sample. A dentist's gender showed no correlation with number of measures used; younger dentists tended to perform and record assessments slightly more often than did older dentists, but in all age groups there were those who had not done this. The practice of risk-factor assessment should be more widespread and standardized, contributing to needs-based treatment and allocation of resources.

Adult↗

PubMed1999

Subsidized dental care associated with lower mutans streptococci count in male industrial workers.

Salivary mutans streptococci count, dental status, and related factors were studied in male industrial workers (age 38-65 years) with or without access to subsidized dental care. Altogether 315 subsidized workers and 168 controls without subsidy were compared. A prior questionnaire survey had shown that the two study groups were similar in age, oral self-care habits, and socio-environmental factors. In the present study, the mean number of carious teeth was significantly lower in the subsidized group (0.4, SD 1.2) than in the control group (1.7, SD 3.2) (P< 0.001). Otherwise the study groups had similar dental status. A total of 92% subsidized employees had visited a dentist within the past 2 years, while 82% in the control group had done so (P< 0.01). According to the trend test, men in the subsidized group tended to have a lower mutans streptococci count than the control employees (P< 0.01). The logistic regression showed that the probability of having one or more carious tooth was significantly negatively associated with subsidized care and positively associated with high mutans streptococci count. It is concluded that subsidized dental care leading to a smaller number of untreated carious teeth might result in decreased levels of mutans streptococci.

Adult↗

PubMed1999

Treatment practices in caries prevention for 6-year-olds in Finland.

OBJECTIVES: To evaluate caries-preventive treatment practices in relation to caries state and eruption of first permanent molars (FPMs) among 6-year-olds (n = 3489) examined and treated in public dental clinics in Helsinki during 1992. METHODS: The study subjects were selected on the basis of their caries state using a two-point study design: the high-caries group (n = 99) had the greatest number of DT + dt, the cavity-free group (n = 32) had neither past nor present caries. Evaluation of dentists' caries-preventive treatment decisions was based on data from detailed personal oral health records. RESULTS: In total, 22% of the high-caries patients (mean DT + dt 8.7; range 4-18) had been judged by their dentists as high-risk patients. Eruption of FPMs had no influence on dentists' judgement on caries risk. A subject's number of DT + dt had no influence on the intensity of preventive treatment given, but those with a high-risk judgement from a dentist received more preventive measures per visit than did other high-caries patients. For high-caries patients with erupting FPMs, three visits in 10 included preventive intervention other than sealants, compared to nine in the cavity-free group. Intensity of oral hygiene instruction correlated with presence of erupting FPMs, yet 86% of the patients with erupting FPMs had received no oral hygiene instruction. CONCLUSIONS: Dentists should be encouraged to use standardized criteria, including data on caries state and eruption stage, in judging each patient's risk of caries to provide intensified caries-preventive treatment to those most in need.

Child↗

PubMed1999

Factors predictive of anxiety before oral surgery: efficacy of various subject screening measures.

Recruiting anxious people for analgesic and anxiolytic studies allows greater opportunities to study the positive effects of anxiolytic medication. The purpose of this study is to describe a population recruited for a study of anxiolytic medication using the third molar model and to evaluate the relative efficacy of different measures of dental anxiety as recruitment tools. A concerted effort was made to recruit anxious subjects. The following measures were tested: Corah's Dental Anxiety Scale (DAS), Kleinknecht's Dental Fear Survey (DFS), Litt's Oral Surgery Confidence Questionnaire (OSCQ), and Spielberger's State-Trait Anxiety Inventory. The influence of prior experience with tooth extractions on anxiety was also assessed. Subjects who had previously experienced tooth extraction reported higher anxiety before oral surgery than did subjects without such experience. DAS, DFS and state anxiety scores correlated with anxiety reported before oral surgery. However, OSCQ scores and trait anxiety were not related to anxiety reported before surgery. Linear regression indicated that the DFS predicted anxiety before oral surgery best of all measures that were used. Kleinknecht's DFS is thus recommended for use as a tool for recruiting anxious patients.

Adolescent↗

PubMed1999

Dental care of six-year-old high-caries patients in relation to their cooperation.

OBJECTIVE: To evaluate caries occurrence in, and dental care given to, 6-year-old high-caries patients in relation to their cooperation as judged by the dentist. DESIGN: Retrospective evaluation study. SETTING: Children selected on the basis of their high number of decayed teeth (dt + DT). Data from personal oral health records. PARTICIPANTS: High-caries children aged 6 years (n = 97) clinically examined and treated in public dental clinics in Helsinki, Finland, with mean dt + DT = 8.7, range 4-18. OUTCOME MEASURES: Data covering ages 3 to 7 years: utilization of dental services, operative and preventive treatment by visit. RESULTS: Treatment strategy for the 6-year-old high-caries patients was not preventive-oriented. High-caries patients had three to four times as many visits as all 6-year-old children on average, but the visits had mostly served for operative treatment. Dentists had judged 34% of the high-caries patients to be non-cooperative. These patients had more past and present caries in their deciduous teeth (P < 0.01), more dental visits (P < 0.01), and received more demanding treatment (P < 0.001) than the cooperative high-caries patients. Caries preventive treatment given to all high-caries patients was rare, number of preventive interventions per patient and per visit (intensity) tended to correlate negatively with patients' cooperation (r = -0.12 and r = -0.23). Treatment courses were completed in 39% among the non-cooperative and in 63 per cent among the cooperative high-caries patients (P < 0.05). CONCLUSION: Dentists should be encouraged to integrate preventive interventions more closely into the treatment of non-cooperative high-caries children.

Chi-Square Distribution↗

PubMed1999

Dentists' decisions as to mode of preventive treatment in adolescents and young adults in Finland.

OBJECTIVE: To evaluate dentists' real-life decisions as to mode of preventive treatment in adolescents and young adults, in relation to these patients' oral-health status, and to the dentists' characteristics. DESIGN: A random sample of 206 adolescents and 239 young adults (mean ages 13 and 27 years) produced 411 (92%) individual oral health records providing data on actual clinical examinations and treatment courses carried out by 56 dentists in one administrative unit of the Finnish public oral health service during 1994-1996. OUTCOME MEASURES: Preventive measures were defined as active and passive, active including any kind of motivation or instructions given to a patient concerning home self-care, and passive prevention being topical application of fluoride. RESULTS: More adolescents had received both active and passive prevention than had young adults (active: 27% vs. 20%; passive: 85% vs. 70%). Of adolescents, 7% and of young adults 25% were given no preventive treatment. The mean number of active preventive measures per adolescent during the treatment course was 0.3 and of passive measures 1.0; for young adults 0.2 and 0.8, respectively. A subject's oral health status made no significant difference in active prevention given. Active measures were more frequently given to all patients by male dentists, 35% vs. 22% (P < 0.02), and passive measures by females, 82% vs. 52% (P < 0.001). The odds of active prevention for adolescents were 7.4 comparing male dentists to female; of passive 13.8 comparing female to male. CONCLUSIONS: Dentists should be motivated to make considered treatment decisions on preventive treatment.

Adolescent↗

PubMed1998

Quality evaluation of oral health record-keeping for Finnish young adults.

The objective of this study was to assess the quality of oral health record-keeping in public oral health care in relation to dentists' characteristics. A random computerized selection of 239 subjects, born in 1966-71 and clinically examined during 1994 in an administrative unit of the public oral health service in southern Finland, included 4-5 cases per dentist, the number of dentists being 50. Data concerning actual clinical examinations and treatment courses carried out in public dental clinics came from original oral health records. Criteria for assessment of oral health record entries were based on Finnish health legislation and detailed instructions of health authorities. The results showed that each patient's identity was available in 90% of documents. Recordings concerning continuity of comprehensive care were infrequent; a questionnaire concerning each patient's up-to-date health history was in only 26% of the oral health records. Notes concerning each patient's bite and function of the temporomandibular joint were in 37% of the records, notes about oral soft tissues were in 11%, and the check-up interval was recorded in 21%. Recording of indices on periodontal and dental status varied greatly; the community periodontal index of treatment need was found in 93% and the index of incipient lesions in 16% of the records. Female dentists and dentists younger than 37 years tended to record more information. Dentists should be encouraged to better utilize the options offered by oral health records for individual treatment schemes.

Adult↗