Caries-preventive methods used for children and adolescents in Denmark, Iceland, Norway and Sweden

Denmark, Iceland, Norway, and Sweden have all had a similar decline in dental caries during the last 20 years, although the decline has come later in Iceland. The purpose of this study was to compare the caries-preventive methods used for children and adolescents in these four countries. Questionnaires were sent to random samples of dentists, dental hygienists, and dental nurses working with children during 1995 and 1996. The results showed that the use of preventive methods was generally consistent between the countries. Nevertheless there were differences between the countries concerning the choice of preventive strategy for risk patients and also in how prevention was implemented. Danish dental care providers chose oral hygiene education as the priority, which they put into practice. Apart from fluoride varnish for some patients, most of them did not use or recommend fluoride except fluoride toothpaste. The Norwegian and Icelandic dental care providers chose both oral hygiene education and the use of fluoride as priorities, while most Swedish dental care providers preferred to provide dietary advice and oral hygiene education, and additional fluoride for risk patients. The differences could not be explained by other variables than nationality, implying that there are differences between the dental cultures in the four countries. The informational basis of decisions on preventive strategies varied between the different dental professionals in each country as well as between the countries, indicating that national professional cultures are being shaped differently. Despite the differences in choice of preventive methods, the dental health of children varies little across the frontiers. This raises the question of the significance of the choice of preventive methods to the decline of dental caries and points towards an urgent need to develop evidence-based preventive strategies.     

Dental care practices and socio-economic status in Denmark

abstract A sociologic survey of dental care practices and related attitudes and knowledge was conducted on 2071 16- to 45-year-old Danes in three selected areas. The complete findings were published in 1971 in a Danish thesis; only the findings on the frequency of dental visits (in childhood and at present), toothbrushing habits, and the selfreported number of teeth are presented here in detail. Particular emphasis is placed on the marked relationship of these factors to socio-economic status, the latter being determined by the respondents' education and occupation. Among the 35- to 45-year-olds, 84 % of the “high” SES group made regular dental visits, as opposed to 55% of the “middle” and 37 % of the “low” SES group. Similar trends were demonstrated in all age groups and for all the parameters investigated.     

Dental care for institutionalized geriatric patients in Germany

summary This investigation determined the level of dental care for institutionalized geriatric patients residing in nursing home facilities. A total of 364 patients from nine different geriatric care units within the city of Berlin were involved in this study. On average the patients were 84.9 years old. Women represented 87.3% of the patients. A standardized questionnaire and a clinical examination of the mouth were utilized to assess patient satisfaction with geriatric care, their general medical status and their oral health status. The results demonstrated that patients in geriatric care did not undergo routine dental check-ups. Oral hygiene was sufficient in only 12.6% of the patients, and prosthesis hygiene in 45% of the cases. Only 37.6 of the dentures exhibited sufficient retention and stability. In 80% of the patients dental treatment was necessary. Recommendations for improvement of dental care delivery to institutionalized geriatric patients are given. It has to be concluded that dental management of institutionalized geriatric patients is an essential yet presently underfulfilled service.     

Caries preventive services for children and adolescents in Denmark, Iceland, Norway and Sweden: strategies and resource allocation

Abstract– According to the dental acts of Denmark, Iceland, Norway and Sweden, emphasis is placed on preventive dental care. The purpose of this study was to describe and compare two aspects of the caries preventive services: the strategies and the resource allocation for preventive dental care of children and adolescents in Denmark, Iceland, Norway and Sweden. Questionnaires were sent to samples of dentists and other dental personnel who provided preventive care to children during 1995 and 1996. Comparisons between the countries showed significant differences in recall routines and in implementation of risk-based and population-based preventive strategies. Multivariate analyses showed that the time used for preventive care varied by country and was not associated with the DMFT of the children. More time was allocated for prevention when more operating dental auxiliaries were available at the clinic, when the recall interval was shorter, when the time used for routine examination was longer and when the clinician was an auxiliary rather than a dentist. In conclusion, resource allocation and strategies used for prevention were not consistent between the countries.     

Dental care of young adults in west Sweden

107 Swedish subjects, all 20 years old, were studied for the first three years (1990-1992) after they had left the organised dental care for children and adolescents (which is free of charge for all youth through the age of 19). They were registered in four different risk-grouping systems in order to estimate the amount of their future dental care. Three of the systems used registrations from the Public Dental Service records and in the fourth one a dentist made a subjective estimation. The follow-up used dental insurance claims to study performed treatments, courses of treatments and cost. The risk group system that used subjective estimations appeared to be the one that most accurately predicted the actual dental care consumption. Approximately 70% of the subjects received some kind of dental care during the three years. The distribution was not confined to any particular risk group. Ten per cent had received complete dental care annually. Twenty-five per cent went to a private dentist and 75% continued to go to the Public Dental Service. Those who went to a private dentist received substantially more treatment and the annual cost was a little more than twice as much as in the Public Dental Service.     

Dental health, dental care, and dietary habits in children in different parts of Sweden

An epidemiological study of dental health, dental health care, and sociodemographic data in 817 4-, 8-, and 13-year-old children was carried out in 1980/81 in two areas in the county of V?sterbotten, northern Sweden, and in one area in the northern part of the county of Alvsborg, in southwestern Sweden. Dietary habits and nutrient intake were studied in 738 of the children. The aim of the study was to examine the dental health in the different areas and to study the importance of variations in related background factors. The results showed great differences in dental health in all age groups between the two counties. There were also differences between the two areas in the north, but these were not as evident. A discriminant function analysis showed that age when organized dental care started and tooth-brushing frequency had greater explanatory power on dental caries than food habit factors.     

Dental care visits among dentate adults with diabetes, United States, 2003

OBJECTIVES: Regular dental assessments are beneficial to adults with diabetes. This analysis evaluates nationally representative data to test the relation between diabetes status and dental care visits, and to compare diabetes care, foot care, eye care, and dental care visits among dentate adults with diabetes. METHODS: Data from the 2003 National Health Interview Survey were used to test whether diabetes status was associated with dental care visits among dentate adults aged > or =25 years, controlling for available covariates. RESULTS: There was a significant interaction between diabetes status and sex for the odds of having a dental care visit. Among dentate men, there was no significant association between diabetes status and dental care visits. Dentate women with diabetes were significantly less likely to have had a dental care visit than were dentate women without diabetes. Of the four types of health care visits compared, dentate adults with diabetes were least likely to have had a dental care visit in the preceding year. Disparities in health care visit rates across race/ethnicity, poverty status, and education categories were most pronounced for dental care. CONCLUSIONS: Having diabetes is associated with a variety of adverse health outcomes, including periodontitis. Adults with diabetes would benefit from regular health care visits to address these concerns, but this report shows that women with diabetes are underutilizing dental care services. The underutilization may be a result of the barriers to dental care that disproportionately affect women. Additional research should test the plausibility of these explanations and the influence of sex.     

Dental health habits in Austria, England, Finland and Norway

Individually, people can prevent dental caries by sugar restriction and periodontal disease by toothbrushing. The aim of this study was to determine the toothbrushing frequency and consumption of sweets and soft drinks in some European countries. The data were obtained during the winter of 1983-84 from schoolchildren aged 11.5, 13.5 and 15.5 in Austria, England, Finland and Norway. Except for England, the samples were nationally representative. The questionnaires were completed at school. Dental health habits apparently were best in Norway, as the toothbrushing frequency was highest and the consumption of sweets and soft drinks was lowest. The toothbrushing frequency of boys was lowest in Finland. The consumption of sweets and soft drinks was very high in Austria and England. Such international comparisons should be used when evaluating and directing national programmes of preventive dentistry.     

Dental care of infectious patients in Denmark, 1986–1993: theoretical considerations and empirical findings

Abstract Changes in infection control and behavior and attitudes towards HIV-infected patients from 1986 to 1992/93 were studied among a random sample of 335 Danish dentists; previous studies among random samples of Danish dentists served as references. 249 (74.3%) returned a mailed questionnaire together with a time, steam, temperature (TST) control indicator strip processed in their steam autoclaves. 3.4% of the autoclaves had not sterilized properly, which was an insignificant decrease compared to 1986. Overall, infection control had improved since 1986. In 1992/93 17.3% of dentists surveyed reported use of gloves always: in 1986 0.8% did so. Many (60.2%) reported at least one needlestick or cut accident within the last year. The number of dentists who were willing to treat HIV-infected patients and the number of clinics that found they could treat infectious patients safely had increased from 56.1%, to 78.7%, and from 43.0% to 66.8%, respectively. Other attitudinal dimensions, for example views on secrecy of HIV test results and HIV screening policy, had not changed. A conceptual model based on the theory of reasoned action formed the framework for multiple logistic regression analysis with two different outcomes: Willingness to treat HIV-infected individuals and Treatment of HIV-infected patients. In particular, expected staff problems turned out to have a high explanatory value (odds ratio = 18.2) if HIV-infected patients were received. In both models Certainty about hygienic precautions had some explanatory value. The findings may give some clues about how to plan and implement future continuing education on infection control and attitudinal and behavioral aspects of caring for infectious patients.     

Subjective need for implant treatment among middle-aged people in Sweden and Denmark

Background: The use of oral implants in prosthodontics has become widespread and regarded as a predictable treatment modality. However, there is a lack of knowledge among the general population about the prevalence and need for implant treatments. Purpose: This study was undertaken to register and compare the prevalence of dental implants and the subjective need for implant treatment among people in Sweden and Denmark. Materials and Methods: Random samples taken from the national population registers in Sweden and Denmark comprised 1001 Swedish subjects aged 55 to 79 years and 1175 Danish subjects aged 45 to 69 years. Subjects were requested to fill out questionnaires regarding dental conditions, subjective need for implant treatment, whether they had received treatment with dental implants during the previous 10 years, and so on. Results: Of the Swedes, 4.8% reported that they had dental implants, compared with 2.5% of the Danes. In the Swedish sample, age was significantly associated with subjective need for implant treatment. In the Danish sample, women showed a significantly higher subjective need for implant treatment than did men. Conclusions: Compared with the Swedish sample, the subjective need for treatment with dental implants was higher in the Danish sample, although the patient fees were substantially higher in Denmark.     

Preventive oral health care and health promotion provided for children and adolescents by the Municipal Dental Health Service in Denmark

Summary. Objective . To describe the current organization of health promoting and preventive activities within the Danish Municipal Dental Health Service and to assess how the service has chosen to comply with the directives as formulated by the National Board of Health.
Design . A cross-sectional survey of the municipal dental health services was carried out on a national scale. Postal questionnaires were used to collect information on active and passive preventive care activities and community-orientated health promotion.
Setting . The survey was conducted to aid the reorientation and adjustment of the Municipal Dental Health Services in Denmark.
Subjects . All municipal dental health services in Denmark were considered relevant for the survey and 141 services (71%) responded to the questionnaire.
Outcome measures . Quantitative methods were used to measure recall-intervals for children and adolescents, passive and active prevention, identification of and care for individuals at risk, and health education. Qualitative methods were applied to record the organization of community health activities.
Results and conclusions . The majority of dental services stated that preschool children are called at regular intervals (every 3, 6 or 8 months); school-children and adolescents are most often recalled according to individual needs. Chairside assistants, dentists or dental hygienists give oral hygiene instructions systematically to children of grades 0 through to 3. Fluoride is frequently administered through topical application by dentists; fluoride tables are not used. Permanent molars are sealed when this is indicated. Clinical and socio-behavioural criteria are used to identify children at risk. Half of the services reported school-based health education, and in one-quarter of the municipalities community health activities took place. Adjustment of the services should consider population-directed activities and greater use of ancillary personnel.