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Biomedical subjects

M Ahlqwist

Publications and source records attributed to M Ahlqwist.

At least 19 recordsLinked to original sources

[No connection between the number of amalgam fillings and health. Epidemiological observations from a population study of women in Gothenburg].

Number of dental amalgam fillings and baseline serum mercury concentration were assessed with respect to a number of health related variables as part of a population study of women. There was no increased incidence of symptoms, no derangement of laboratory variables of clinical significance, nor any increased mortality or increased risk of myocardial infarction, stroke, diabetes or cancer in women with many amalgam fillings compared with those with few fillings, nor in women with higher serum mercury concentration compared with those with lower serum mercury concentration.

Dental Amalgam↗

Factors associated with dental anxiety and attendance in middle-aged and elderly women.

The aim of this study was to analyze the association between dental anxiety, dental attendance, health status and social factors. Our previous studies have shown that dental anxiety declines with age and is associated with poor oral health. In addition, correlations between dental anxiety, dental utilization and dental status have been revealed. However, the association of these factors with general health and social factors has not been analyzed in our previous studies. In a study of women's health in Göteborg, Sweden in 1992, 1.017 urban women aged 38 to 84 years took part in a series of investigations including clinical examinations, interviews and questionnaires. In addition to descriptive and simple inference statistics, a two-part multiple logistic regression model was utilized to investigate dental anxiety and dental utilization. Dental fear was less prevalent among older women, dentate or not, although 10% of females 62 years of age and older still reported high dental anxiety (DAS > or = 12). 94% of the younger (< or = 62 yr) and 76% of the older (> or = 70 yr) women reported regular dental attendance. When separating all women into dentate and edentulous groups, 94% of the dentate and 11% of the edentulous respondents reported regular dental care. Due to the large difference in dental attendance between dentate and edentulous women, these groups were analyzed separately. Multiple logistic regression analyses showed that the following factors were associated with irregular dental utilization among dentate women: high dental anxiety, fewer teeth and restorations, more caries, poorer chewing ability and dissatisfaction with dental esthetics. In the multiple regression for dental anxiety, high fear was shown to be associated with irregular dental care, age (younger), fewer teeth, dissatisfaction with dental esthetics and lower scores on the SF-36 mental health scale. A separate analysis showed that individuals with high fear and regular, as opposed to irregular, dental attendance had more teeth at a statistically significant level, which were less often decayed and more often restored. In spite of the group with high fear and irregular attendance having fewer teeth, their level of decay was seven times higher. Overall, the results indicate a strong association between dental fear and dental attendance. Weak associations were found among socio-economic, dental health and general health factors.

Adult↗

Dental status of women in a 24-year longitudinal and cross-sectional study. Results from a population study of women in Göteborg.

The aim of the study was to describe dental health status among middle-aged and elderly women over a 24-year period. Because of the design of the study it was possible to make both longitudinal and cross-sectional comparisons. The study started in 1968-69 with a combined medical and dental examination of women aged between 38 and 60 years. New dental examinations of these same women were performed in 1980-81 and again in 1992-93, and included new cohorts of 38-year-old women on both occasions. In the cross-sectional perspective, it was shown that the number of edentate individuals decreased significantly during the 24-year period. Among dentate women, the number of remaining teeth and restored teeth increased significantly cross-sectionally. However, the youngest age group, women of 38 years, showed a lower number of restored teeth in the latest study (in 1992-93). There was also a lower number of crowns, root-fillings, and pontics in the latest study for the youngest age group. The two older age groups studied cross-sectionally showed similar numbers in all studies. In the longitudinal study, there was a decrease with time in incidence of edentulism. Among the dentate women in the longitudinal study the number of restored teeth related to those remaining was high (range 76-90%) and did not change much between the studies in the different age groups. There was a clear tendency during the 24-year period in all age groups for more teeth to be restored with crowns rather than different fillings. In conclusion, this population study, with a follow-up of 24 years, shows that dental status improved in that fewer individuals lost all their teeth and younger age groups have more remaining teeth and fewer restorations than previously.

Adult↗

Serum mercury concentration in relation to survival, symptoms, and diseases: results from the prospective population study of women in Gothenburg, Sweden.

A prospective population study of women in Gothenburg, Sweden was started in 1968-69 and comprised 1462 women aged 38, 46, 50, 54, or 60 years at baseline. Follow-up studies were carried out in 1974-75, 1980-81, and 1992-93. The baseline study included an extensive medical and dental examination. Serum mercury concentration (beta-HG) was determined in deep-frozen samples from all participants in 1968-69 and in a random subsample of sera from participants in 1980-81, about 20 years after the baseline examination. S-Hg was statistically significantly correlated with number of amalgam fillings at both examinations. Of 30 defined symptoms and 4 different clusters of symptoms, no one was independently correlated with S-Hg measured in the samples from 1968-69, while there was a negative statistically significant correlation with over-exertion and poor appetite in 1980-81. Blood hemoglobin and serum B-12 concentrations in 1968-69 were statistically significantly and positively correlated with S-Hg, while erythrocyte sedimentation rate and the serum concentrations of potassium and triglycerides were significantly and negatively correlated with S-Hg, also after including potential confounders. Blood hematocrit examined in 1980-81 was negatively correlated with S-Hg. When including potential confounders, serum IgA was also statistically significantly correlated with S-Hg, but not in univariate analysis. No statistically significant correlation was observed between S-Hg, on the one hand, and the incidence of diabetes, myocardial infarction, stroke, or cancer on the other, while a statistically significant negative correlation was observed with overall mortality when age and education were included as background variables. There were some correlations between biological variables and S-Hg, probably of no negative clinical significance, and we conclude that there is no association between disease and S-Hg on a population basis in middle-aged and older women.

Adult↗

Methylmercury and inorganic mercury in serum--correlation to fish consumption and dental amalgam in a cohort of women born in 1922.

Methylmercury in serum (S-MeHg) was assessed from serum concentrations of total (S-TotHg) and inorganic mercury (S-InoHg), determined by cold vapor-atomic absorption spectrometry. The samples were collected from 135 women on two occasions, in 1968-1969 and 1980-1981. In a subgroup of 29 women, an association was found between S-MeHg and the amount of fish consumed in 1968-1969 (r = 0.38, P = 0.04). The association was stronger (r = 0.50; P = 0.006) when the individuals' mean S-MeHg from 1968-1969 and 1980-1981 were plotted vs fish consumption 1968-1969. In the group, as a whole, there was an association between S-InoHg and number of dental amalgam surfaces, in both 1968-1969 (r = 0.48, P = 0.0001) and 1980-1981 (r = 0.57, P < 0.0001). The S-InoHg increased by approximately 0.1 nmol/L per amalgam tooth surface, corresponding to an uptake of approximately 0.2 microgram/day per amalgam surface, but with considerable interindividual differences. The levels were lower in 1980-1981 than in 1968-1969 for both MeHg and InoHg. The medians and ranges (nmol/L) were for MeHg 1968-1969: 3.6 (0.3-11.9); MeHg 1980-1981, 2.0 (-0.4-8.7); InoHg 1968-1969, 3.3 (0.7-11.8); InoHg 1980-1981, 1.7 (0.1-11.8); TotHg 1968-1969, 7.2 (1.9-18.8); and TotHg 1980-1981, 3.9 (1.0-14.2). The decrease in S-MeHg is probably due to a decreased consumption of MeHg via contaminated fish. The decrease in S-InoHg may reflect a decrease in environmental exposure, but the possibility of contamination of the 1968-1969 samples at sampling and/or storage cannot be excluded.

Aged↗

Reported burning mouth symptoms among middle-aged and elderly women.

The aims of this investigation were to assess the prevalence of burning mouth symptoms (BM) in a representative population of Swedish middle-aged and elderly women (n=1017) and its relation to general and oral health status. BM was reported by 4.6% (n=47), and 85% of the BM subjects had experienced BM for more than 6 months. A stepwise multiple logistic regression with BM/non-BM as dependent variable showed that 7 covariates were found to be predictive of BM. These variables were medication with antihypertensives, sedatives and female sex hormones. Moreover, headache, tinnitus, dry mouth, and reduced chewing ability were included in the final model.

Aged↗

The Prospective Population Study of Women in Gothenburg, Sweden, 1968-69 to 1992-93. A 24-year follow-up study with special reference to participation, representativeness, and mortality.

OBJECTIVE: To describe the fourth phase of the Prospective Population Study of Women in Gothenburg, Sweden, with special reference to participation and survival. DESIGN: Prospective population study. SETTING: City of Gothenburg with about 430,000 inhabitants. PARTICIPANTS: 1462 participants and 128 refusers aged 38-60 years at the time of the initial study in 1968-69, 282 women who were sampled but not invited to the study in 1968-69, and 266 women participating since 1980-81 and 32 women for the first time in 1992-93. MAIN OUTCOME MEASURES: Participation rate, survival, anthropometric and metabolic characteristics. RESULTS: The participation rate throughout the study period was high. The participants were mainly characteristic of women of the same ages in the general population even after 24 years. The mortality after 24 years was higher in non-participants than in participants, while there was no difference in survival between women who were invited and women who were not invited to the study. CONCLUSIONS: The initial participants were mainly characteristic of the general population, also after a long follow-up period. The long-term survival was lower in initial refusers than in initial participants.

Adult↗

Dental anxiety among middle-aged and elderly women in Sweden. A study of oral state, utilisation of dental services and concomitant factors.

The aim of this project was to investigate dental anxiety and its expression in utilisation of dental services, oral health and oral symptoms. In a cross-sectional study of women's health in Göteborg (population 432,000), Sweden, 1016 women aged 38 to 84 years participated. This randomly selected population took part in a series of investigative procedures including medical and dental clinical examinations, interviews and questionnaires. Levels of dental anxiety were measured on the Corah Dental Anxiety Scale (DAS). The average DAS score obtained was 7.2. The study showed that older women were significantly less anxious than younger ones. Severe dental anxiety (DAS > or = 15) was experienced by 3.9% of the participants. This frequency corresponds well with findings by Hällström and Halling in their analysis of data from the first Göteborg study of women's health 24 years ago. High levels of dental anxiety were correlated with longer intervals between dental visits, poorer oral function and aesthetics and a higher frequency of oral symptoms. Headaches were more prevalent in the younger age groups and a correlation with dental anxiety was revealed. Our previous studies have shown that symptoms such as tension headaches are prevalent among dental phobic patients and that they are reported to be reduced by therapy for dental fear. The clinical and radiographical examinations revealed a generally poorer oral status, with a statistically significant higher number of decayed teeth among women with high dental anxiety.

Adult↗

Association between radiographic findings in the mandibular condyle and temporomandibular dysfunction in an elderly population.

Our aims were to study the prevalence of abnormal radiographic findings in mandibular condyles and the possible association between such findings and clinical signs and symptoms of temporomandibular dysfunction (TMD) and dental state. Two cohorts of 70-year-old people, 384 men and 484 women, living in Göteborg, Sweden, participated in the study. The first cohort was examined in 1972 and the other one in 1992. Besides a functional and clinical examination, a questionnaire on TMD and panoramic radiography were included. A deviation from the normal appearance of one or both condyles was found in 26% of the subjects (17% of the condyles). There was no significant difference in this respect between the two cohorts. There were in general only minor and no statistically significant differences between those with normal and deviating condylar findings with regard to various TMD signs and symptoms. The subjects in Eichner group A (with dental support in all zones) showed a slightly lower frequency of abnormal radiographic condylar findings (22%) than those in groups B (reduced dental support) and C (edentulous in one or both jaws; both B and C, 28%). It is concluded that abnormal radiographic condylar findings in these elderly people were not at all or only weakly correlated with signs and symptoms of TMD and dental status.

Aged↗

Concentrations of blood, serum and urine components in relation to number of amalgam tooth fillings in Swedish women.

Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were examined in 1968/69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The examination was repeated in 1980/81 including a new dental examination. The results from a number of biochemical analyses of blood, serum and urine were analyzed for a possible statistical relationship to number of dental amalgam fillings. As emphasis has been put in the literature on special influence from amalgam on kidney function and on the immunological system, special attention was paid to variables which might reflect these functions in our analyses. When potential confounders were taken into consideration, no significant correlations remained which seemed to be of clinical importance. Specifically, amalgam fillings were not found to be associated with impairment of the kidney function or the immunological status.

Adult↗

Panoramic and restrictive intraoral radiography in comprehensive oral radiographic diagnosis.

It has been suggested that information from the panoramic radiograph makes it possible to appropriately select supplementary intraoral radiographs to achieve a comprehensive examination of teeth and surrounding bone with less patient dose but no significant information loss. Number of intraoral radiographs selected, information loss and monetary costs with such a procedure was evaluated in 40 patients. Results show that, on average, 5.1 intraoral radiographs were selected to supplement the panoramic radiograph. Of these, 3.1 contained information different from that in the panoramic radiograph but 2.0 did not. An additional 3.4 ought to have been taken to reach the result of the 'gold standard' achieved from a simultaneous evaluation by two expert observers of panoramic radiographs and full mouth surveys with intraoral radiographs. Sensitivity for the combined use of panoramic and supplementary intraoral radiographs was high (80-96%, depending on type of teeth) as regards periapical lesions and marginal bone loss but low for caries (42-96%). Specificity was high for periapical lesions and caries (95-97%) but low for marginal bone loss (50-92%). In Sweden, patient costs become almost the same for a combination of panoramic radiography and 8.5 intraoral radiographs as for a full mouth survey comprising 20 intraoral radiographs. The radiation dose reduction is 40-50% considering that the dose from a panoramic radiograph approximately corresponds to 2-4 intraoral radiographs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Image quality in panoramic radiography.

Because of the increase in panoramic radiography it is important to know if image quality has improved with recent technical developments and if there are differences between the different machines that can justify the difference in price. Six conventional panoramic units and the two panoramic programs (dental and jaw panorama) of the Scanora (Soredex, Orion Corporation Ltd, Helsinki, Finland) multi-modal unit were compared by evaluating the radiographs for subjective image quality and estimating the number of additional intra-oral radiographs necessary for a comprehensive evaluation of the periapical and periodontal bone status. Patients ranging in age from 40 to 60 years with teeth in all four quadrants were selected at random and radiographed with each machine or program. Thirty matching radiographs were selected from our archives in order to evaluate one machine (Orthopantomograph 5, Siemens AG, Bensheim, Germany) which was no longer in use. Seven oral radiologists scored the image quality of between 34 and 36 of the 240 radiographs on a 4-point scale and recorded the additional radiographs needed. The results showed that the mean score for the Scanora dental panorama was significantly higher than mean scores for the other machines/programs for both the periapical and crestal bone. The mean scores for the conventional machines and the Scanora jaw panorama program were not significantly different from each other. The image quality of radiographs obtained with the Orthopantomograph 5 was similar to that attained with the more modern machines. The mean number of additional intra-oral radiographs was lowest for the Scanora dental panorama. We conclude that the Scanora dental panorama program provided the best subjective image quality.

Adult↗

Number of amalgam fillings in relation to cardiovascular disease, diabetes, cancer and early death in Swedish women.

Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968-69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20-yr follow-up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death.

Adult↗

Comparison of panoramic and intraoral radiography for the diagnosis of caries and periapical pathology.

Panoramic and intraoral radiographs from 400 consecutive patients were compared for their ability to demonstrate periapical pathology and caries. Two hundred panoramic radiographs were exposed with the rotational technique and 200 with the intraoral X-ray tube technique. Periapical osteolytic and sclerotic lesions as well as approximal caries were recorded independently by two observes. Agreement with intraoral radiographs for periapical osteolytic lesions was, on average, 63% for the rotational and 55% for the intraoral X-ray tube technique and for sclerotic lesions 40% and 36%, respectively. The agreement varied with tooth type and lesion size. When teeth without periapical lesions were also included in the comparisons, the values for agreement were over 96%. Interobserver agreement for periapical osteolytic lesions was 61% for the rotational and 56% for the intraoral X-ray tube technique. The corresponding values for sclerotic lesions were 29% and 23%. Intraobserver agreement for periapical osteolytic lesions was 71% for the rotational and 67% for the intraoral X-ray tube technique. The corresponding values for sclerotic lesions were 46% and 56%. Agreement with intraoral radiographs for enamel caries was, on average, 21% for the rotational and 27% for the intraoral X-ray tube technique and for dentinal lesions 44% and 53%, respectively. When caries-free approximal surfaces were also included in the comparisons, the values for agreement were over 95%. It is concluded that panoramic and intraoral radiography perform equally well as diagnostic tools for the detection of periapical lesions, although the results are not identical.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Prevalence of impacted teeth and associated pathology in middle-aged and older Swedish women.

A representative sample comprising 1418 women from five age strata was examined by means of panoramic radiography. The prevalence of impacted teeth and the frequency and type of pathology associated with the impacted teeth were assessed. About 8% of the total sample had one or more impacted teeth. Among those, pathological conditions were found in 16%. Most were moderate and consisted in most cases of a slightly widened follicle or resorption of the crown. A new examination 12 yr later revealed unchanged conditions in 85% of the cases. The changes that had occurred were generally small.

Adult↗

Social factors and tooth loss in a 12-year follow-up study of women in Gothenburg, Sweden.

Representative samples of women in different age groups in Gothenburg, Sweden, were examined by means of panoramic radiography in 1968-69 and in 1980-81. Edentulousness and number of remaining teeth were assessed from the radiographs. Data on socioeconomic conditions, educational background and dental care attendance were obtained from a questionnaire. Cross-sectional results showed that improvements in dental status had occurred irrespective of socioeconomic conditions and educational levels and that differences between groups had decreased over the 12-yr period. Dental care attendance was high in all socioeconomic groups, but differences noted in 1968-69 remained in 1980-81.

Adult↗

Observer performance in the assessment of periapical pathology: a comparison of panoramic with periapical radiography.

Observer performance in the assessment of the periapical pathology from panoramic and periapical radiography was examined. Five endodontists, five general practitioners and five oral radiologists were asked to assess the periapical status of 117 teeth. The observers assessed the panoramic and periapical radiographs of the teeth, which were evenly distributed throughout the jaws with a 50% probability that either an osteolytic or sclerotic lesion was present. The results of the comparison between panoramic and periapical radiography were influenced by the selection of observers. When the oral radiologists acted as observers, the mean P(A) value for periapical radiography was higher than for panoramic radiography (P less than 0.001), resulting in periapical radiography presenting a higher overall diagnostic accuracy than panoramic radiography for all 15 observers (P less than 0.01). There was, however, no difference between panoramic and periapical radiography when the two groups of endodontists and general practitioners acted as observers. The comparison of the three groups of observers showed no difference between their diagnostic accuracy when assessing panoramic radiographs. With periapical radiography, the oral radiologists demonstrated a higher diagnostic accuracy than the endodontists (P less than 0.05). The observers in each group with the highest diagnostic accuracy also had the highest intra-observer agreement. The mean intra-observer agreement of the five general practitioners was higher than those of the other two groups of observers for panoramic radiography. For periapical radiography, the mean agreement rates of the groups were comparable.

Adult↗

Agreement between panoramic and intra-oral radiography in the assessment of marginal bone height.

Panoramic and intra-oral radiographs from 400 consecutive patients were evaluated for the assessment of the marginal bone height. Two hundred panoramic radiographs were exposed with the rotational technique and 200 with the intra-oral X-ray tube technique. Measurements of the approximal marginal bone level were independently performed by two observers. Complete agreement between panoramic and intra-oral radiographs was, on average, obtained in 55% and 49% of the sites, respectively. When the criterion for agreement was widened to include recordings with a difference of +/- 1 mm, the agreement was on average 87% irrespective of the techniques compared. The agreement varied with tooth type and severity of the marginal bone loss. Angular bony defects and furcation involvements were recorded separately. For angular bony defects there was a variation in agreement from 33% to 46% for the rotational technique and from 35% to 51% for the intra-oral X-ray tube technique depending on localization. Furcation involvements of the molars were equally recorded in 60% and 59%, respectively, but in only 12% and 28% for the upper premolars. Interobserver agreement was 58% for the intra-oral radiographs, 60% and 59% for the two panoramic techniques. Mean intra-observer agreement was 68%, 66% and 68%. It is concluded that panoramic radiography can often be used for the assessment of marginal bone loss alone, supplemented when necessary by intra-oral radiographs.

Adolescent↗