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Biomedical subjects

J Paulander

Publications and source records attributed to J Paulander.

13 recordsLinked to original sources

Association between level of education and oral health status in 35-, 50-, 65- and 75-year-olds.

AIM: The aim of the present study was to evaluate the association between educational level and dental disease, treatment needs and oral hygiene habits. MATERIAL AND METHODS: Randomized samples of 35-, 50-, 65- and 75-year-olds, classified according to the educational level: [low (LE): elementary school or higher (HE)], were identified. In 1091 subjects, a number of characteristics such as (i) number of teeth, (ii) periodontal attachment levels (PAL), (iii) caries and (iv) occlusal function were recorded. Educational level, oral hygiene and dietary habits were self-reported. Non-parametric variables were analyzed by chi2, Mann-Whitney U-Wilcoxon's rank sum tests, and parametric variables by Student's t-test (level of significance 95%). A two-way anova was performed on decayed, missing and filled surfaces to investigate the interaction between age and educational level. All statistical procedures were performed in the SPSS statistical package. RESULTS: The number of remaining teeth was similar for LE and HE in the 35-year olds (25.8 versus 26.6), but in the older age groups LE had significantly a larger number of missing teeth. The LE groups (except in 65-year olds) exhibited significantly more PAL loss. LE had significantly fewer healthy gingival units in all but the 75-year age group. In all age groups, LE had fewer intact tooth surfaces and a significantly poorer occlusal function. The frequency of tooth cleaning measures and dietary habits did not differ between LE and HE. CONCLUSION: Educational level was shown to influence the oral conditions and should be considered in assessing risk, and in planning appropriate preventive measures.

Adult↗

Proximal caries prevalence in 19-year-olds living in Sweden. A radiographic study in four counties.

A random sample of all 19-year-olds in four counties in the middle of Sweden in 1994 constituted the group studied. The material consisted of posterior bitewing radiographs from 511 19-year-old patients. The purpose was to study the prevalence and distribution of initial and manifest caries. It was found that on the manifest caries level 56% of the subjects were 'free from caries', in good correspondence with the official epidemiological data from the Swedish National Board of Health and Welfare, but only 27% when initial caries was added. Initial caries lesions constituted 90% of all lesions. The distribution of caries was highly skewed on the manifest caries level whereas initial caries had a broader distribution. Thus, on the surface level 75% of the individuals had 16% of all manifest caries and restorations, and 33% of all initial caries. A high correlation was found between initial and manifest caries, besides increasing with the number of initial lesions. Thus, only 2.5% of individuals without initial caries had manifest caries, compared to 54% of individuals with more than eight affected surfaces. A correlation was also found between the prevalence of manifest caries and restoration. The prevalence of initial caries and its obvious significance for further caries development should be a reason for finding new strategies in caries prevention on a population basis.

Adult↗

Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals.

The aim of the present study was to examine the dental status and smoking habits in randomized samples of 35-, 50-, 65-, and 75-year-old subjects (n = 1093), recruited for a cross-sectional epidemiological study in the County of Värmland, Sweden. The following clinical variables were recorded by 4 well-calibrated dentists: number of edentuolous subjects, number of missing teeth, probing attachment level, furcation involvement, CPITN scores, DMF surfaces, plaque and stimulated salivary secretion rate (SSSR). In addition, the subjects reported in a questionnaire their tobacco habits, oral hygiene habits, dietary habits etc. The percentage of smokers in 35-, 50-, 65-, and 75-year-olds was 35%, 35%, 24% and 12%, respectively. In 75-year-olds, 41% of the smokers were edentulous compared to 35% of non-smokers. The difference in number of missing teeth between smokers and non-smokers was 0.6 (p=0.15), 1.5 (p=0.013), 3.5 (p=0.0007) and 5.8 (p=0.005) in the 4 age groups. Smokers had the largest mean probing attachment loss in all age groups. The differences between smokers and non-smokers in mean attachment level were 0.37 (p=0.001), 0.88 (p=0.001), 0.85 (p=0.001) and 1.33 mm (p=0.002) in the 35-, 50-, 65-, and 75-year-olds, respectively. Treatment need assessed by CPITN was in all age groups greatest among smokers. The number of intact tooth surfaces was fewer in 35-, 50-, and 75-year-old smokers than in non-smokers. The number of missing surfaces (MS) was higher in 50-, 65-, and 75-year-old smokers than in non-smokers. In addition, 35-year-old smokers exhibited a significantly larger number of decayed and filled tooth surfaces (DFS) than non-smokers. Male smokers had significantly higher SSSR than non-smoking males (p=0.012). Plaque index and oral hygiene were similar in smokers and non-smokers. Smokers reported a more frequent intake of sugar containing soft drinks (p=0.000) and snacks (p=0.003) than non-smokers. The opposite was reported for consumption of fruit (p=0.003). It was concluded that smoking is a significant risk indicator for tooth loss, probing attachment loss and dental caries.

Adult↗

Oral disease, impairment, and illness: congruence between clinical and questionnaire findings.

In 1992 a questionnaire was sent to 50-year-olds in two Swedish counties. These self-report data were compared with clinical observations with regard to number of teeth, removable dentures, caries, and periodontitis. Complete information from both data sources was obtained for 1041 persons. The relevant questionnaire item explained 71% of the missing tooth variance. An agreement of 0.91 (Cohen's kappa) was obtained for removable dentures. A question about problems in opening the mouth differentiated clearly with regard to measured mouth opening ability. Toothache and tooth sensitivity were reported with 95% probability when having 22 decayed teeth and with 46% when there were no decayed teeth (58% correctly predicted). Two teeth with pockets > or = 6 mm gave 5% probability and 22 such teeth gave 39% probability of reporting migration of front teeth. The main conclusion from this study is that there is good correspondence between subjective self-reports and clinical findings, especially for those conditions that are relatively easy for the patient to observe, such as the number of teeth and the presence of dentures. Thus questionnaire data can be used for information and screening about some well-defined oral conditions.

Dental Caries↗

Equality in satisfaction, perceived need, and utilization of dental care in a 50-year old Swedish population.

Satisfaction with dental care, perceived need for dental care, and dental care utilization were analyzed as to equality in geographical, socio-economic, and gender distributions. The study base was a cross-sectional mail questionnaire sent in 1992 to all 50-year old persons (totally 8890) in Orebro and Ostergötland counties in Sweden. Measures of the variables were all based on self-assessments. The response rate was 71.3%. The results showed no large inequalities as to satisfaction, except the aspect travel time for rural residents. They also had higher perceived need for dental care. For utilization of dental care, workers were relatively fewer among "high" consumers. Controlling for socio-economic group, there were twice as many men than women among "low" consumers. In conclusion, there was relative equality in the dental care delivery in this 50-year old Swedish population, with some remaining social differences, primarily socio-economically contingent.

Age Factors↗

Integrated caries prevention: effect of a needs-related preventive program on dental caries in children. County of Värmland, Sweden: results after 12 years.

Twenty years ago the caries prevalence in Swedish children was among the highest in the world; within Sweden, it was highest in the County of Värmland. Ongoing clinical research projects were initiated to evaluate the separate and combined effects of preventive measures, and in 1978 a preventive program, based on caries risk assessment, was introduced for 3- to 19-year-olds in the county. The effects were monitored by a computerized epidemiological system. From 1979 to 1991, caries prevalence and incidence decreased by 75-90 and 75-85%, respectively. The percentage of caries-free 3-year-old children increased from 51 to 94%, and in 12-year-old children, the caries prevalence decreased from 6.5 to 1.0 DFS, the lowest in Sweden. The program is very cost-effective, and in 1990 the mean annual treatment time per child was the lowest in Sweden. Currently, new methods of caries risk prediction and integrated caries prevention are being developed, with special reference to cost-effectiveness.

Adolescent↗

Effect of fluoride containing dentifrice, mouthrinsing, and varnish on approximal dental caries in a 3-year clinical trial.

The purpose of this study was to evaluate the separate effect of fluoride dentifrice, fluoride mouthrinsing and fluoride varnish on approximal dental caries. All 252 13-14-yr-old children at an elementary school were selected at random and divided among four groups for a 3-yr longitudinal study. Group 1 received a fluoride dentifrice for home care and a fluoride mouthrinse once a week. Group 2 received a fluoride dentifrice for home care and a placebo mouthrinse once a week. Group 3 received a fluoride dentifrice for home care and a fluoride varnish once every 3 months. Group 4 received a placebo dentifrice for home care and a fluoride rinse once a week. Fluoride rinsing did not give any additional effect compared with placebo-rinsing when a fluoride dentifrice was used for home care. Fluoride varnish gave a significant caries reduction compared with fluoride rinsing.

Adolescent↗