Changes in restorative caries treatment in 15-year-olds in Oslo,Norway, 1979-1996

OBJECTIVES: To examine changing patterns regarding restorative treatment criteria for dental caries. METHODS: A representative sample (n = 215) was drawn from all 15-year-olds receiving dental treatment in the Public Dental Service (PDS) in Oslo, Norway for each of the years 1979, 1989, 1993 and 1996. Information from clinical records and bitewing radiographs on caries treatment was collected. The results presented in this paper pertain to 198, 201, 209 and 208 subjects in each group. RESULTS: The results revealed dramatic changes in the use of restorative treatment criteria. Only 16% of tooth surfaces were treated in 1996 according to the criteria from 1979. The number of sound surfaces was found to have increased by 39% whereas the number of filled surfaces was reduced by 92%. In spite of more stringent criteria for restorative treatment, the number of D4 lesions did not increase. CONCLUSION: The practice of change in restorative treatment continued during the 17 years of study. Though the number of decayed surfaces appeared to be stable during the period, in reality, there was a reduction in caries occurrence during the first 10-year period (1979-1989). A conceptual model of dentists' caries-related treatment decisions outlined by Bader & Shugars may be used to explain parts of the rapid change in the criteria used in the PDS in Oslo.     

Changes in endodontic status 1973–1993 among 35-year-olds in Oslo, Norway

Epidemiological investigations from Scandinavia have documented high prevalence of apical periodontitis and inferior quality and results of endodontic treatment performed in general practice. The present investigation is part of a 20-year follow-up study on oral health in 35-year-old Oslo citizens focusing on endodontic con-ditions. The results indicate reduced prevalence of apical periodontitis and statistically significant improvement in endodontic status compared with results from a similar study performed in 1984.     

Design of a socio-ecologic caries model and testing on 50-year-old citizens of Oslo, Norway.

The purpose of the present study was to design a socio-ecologic caries model based on a general health model and to test the fit of data collected from a random sample of 200 50-year-old Oslo citizens to this designed model. The intention was also to investigate the relative importance of the four items environmental, behavioral, human biology, and health care organization factors. The dependent variable, number of carious surfaces, was recorded clinically and radiologically. The mean number of carious surfaces was 3.0 (SD, 3.5), with a range from 0 to 17, and the four items explained 5%, 25%, 28%, and 13% of the variance in number of carious surfaces, respectively. The complete model explained 42%, whereas traditionally used variables on the basis of the Keyes triad explained only 22% of the variance. The findings from the present study indicate that dental caries is a multifactorial disease with both behavioral and biologic determinants, and the socio-ecologic caries model represents a relevant supplement to the Keyes triad.     

Xerostomia and hyposalivation among a 65‐yr‐old population living in Oslo,Norway

This study aimed to describe the prevalence and associated factors for xerostomia and hyposalivation in a young‐elderly population. A random sample of 460 65‐yr‐old people living in Oslo, Norway, answered a questionnaire and underwent a clinical examination (237 men and 223 women; response rate 58%). Ten percent of respondents reported xerostomia. The median Summated Xerostomia Index was 6 (interquartile range [IQR]: 5–7) and the median Clinical Oral Dryness Score was 2 (IQR: 1–3). The median unstimulated whole saliva (UWS) secretion rate was 0.34 (IQR: 0.20–0.53) mL min^–1 and the median stimulated whole saliva (SWS) secretion rate was 1.74 (IQR: 1.24–2.38) mL min^–1. In 8% of the study participants the UWS secretion rate was ≤0.1 mL min^–1 and in 4% the SWS secretion rate was ≤0.7 mL min^–1. Three percent of the study participants had both xerostomia and hyposalivation with respect to UWS. Xerostomia was significantly associated with medication use, having rheumatic disease, and having received radiation therapy to the head/neck region. Hyposalivation with respect to UWS and SWS was significantly associated with medication use and type II diabetes. Even though xerostomia and hyposalivation were not prevalent conditions in this population, clinicians should be especially aware of the salivary conditions in patients taking four or more medications, patients diagnosed with type II diabetes, and those who have undergone radiation therapy to the head/neck region.     

Risk indicators for dental erosive wear among 18‐yr‐old subjects in Oslo,Norway

The aim was to investigate risk indicators associated with dental erosive wear among 18‐yr‐old subjects in Oslo, Norway. Of 3,206 adolescents invited to participate in a screening examination for erosive wear, 1,456 were examined (giving a response rate of 45%). As part of the examination all participants completed a self‐administered questionnaire. Associations between the presence of erosive lesions and the possible risk indicators were assessed by logistic regression analyses, taking into account the hierarchical relationships between the independent variables. Of all 18‐yr‐old subjects examined, 38% had at least one tooth with erosive lesions. Multivariate analyses showed significant associations between the presence of erosive wear and being male, brushing teeth once per day or less, episodes of vomiting, daily/weekly episodes of gastro‐oesophageal reflux, consumption of fruit juice and sugary soft drinks several times per day, as well as consumption of sugary soft drinks daily to once per week. In conclusion, in addition to gender, dietary habits such as frequent consumption of fruit juice and sugary soft drinks, and the occurrence of reflux and vomiting, appear to be risk indicators for erosive wear. When counselling adolescents at risk, the gender‐specific risk indicators should be taken into account.     

Awareness and attitudes related to dental erosive wear among 18‐yr‐old adolescents in Oslo,Norway

The aim of the present study was to describe awareness and attitudes related to dental erosive wear among 18‐yr‐old adolescents in Oslo and to explore attitudinal differences between participants with and without the condition. All 18‐yr‐old subjects scheduled for their routine examination at the Public Dental Service clinics during 2008 (n = 3,206) were invited, and 1,456 agreed to participate (a response rate of 45%). The data were collected using structured questionnaires and by clinical examination of the participants. Dental erosive wear was assessed using a pictorial manual – the Visual Erosion Dental Examination scoring system – as a guide. Overall, 88% of participants had heard about dental erosive wear; however, of participants with erosive lesions only 56% were aware of, and only 47% could recall their dentist mentioning, the condition. Participants with erosive wear were more likely to have low or moderate positive attitudes towards acidic drink consumption and to be reluctant to change. In multivariate analyses controlling for gender and behavioural variables, weak or moderate positive awareness of acidic drinks remained significantly associated with higher erosion risk. This study emphasizes the importance of assessment and understanding of awareness and attitudinal aspects in relation to dental erosive wear.     

Caries increment in children aged 3-5 years in relation to parents' dental attitudes: Oslo, Norway 2002 to 2004

Abstract – Objectives: To assess the relationship between parents’ dental attitudes and the caries increment in their children from the age of 3 to 5 years. Methods: Data based on parental questionnaires and dental examinations were collected from children participating in a follow‐up study from age 3 years (n = 354) in 2002 to 5 years (n = 304) in 2004. The children were categorized as western‐native (WN) and immigrants (IM). The items used were significantly related to caries experience in a multicentre study [ 1 Community Dent Health, vol. 21, pp. 121–30]. The responses to attitudinal items were weighted as positive if they would promote good dental health, and negative if not. Composite attitudinal variables relating to hygiene, diet and indulgence were calculated as a summation of the weighted responses to selected items. Regression analyses (bivariate and multiple) were performed to assess associations during the period between the attitudinal predictors/other control variables and caries increment (Δd_3‐5mfs). Results: Bivariate logistic regression analyses revealed that ‘Attitude to Diet’ and ‘Parental Indulgence’ were clearly related to caries increment. The more exposed children were to negative parental attitudes, the higher the OR. ‘Attitude to Diet’ also persisted in a multiple logistic regression model, showing a higher OR value than caries experience. ‘Immigrant Status’ was the most potent predictor of caries increment. Parents were found to be more indulgent among IM than among WN groups. Conclusion: Parental dental attitudes are clearly shown to be associated with caries increment in early childhood. The relationship is of such strength that it deserves to be taken into account in future preventive dental strategies.