Three methods of oral health education in secondary schools.

In 1990, three methods of oral health education (OHE) were implemented in three secondary schools in the city of Pori, Finland, one method in each school. The traditional OHE consisted of a lecture given by a dentist with the aid of transparencies and slides. The peer OHE consisted of a lecture given by six pupils from the upper grades. These pupils used transparencies and extracts of video films and had a classroom exhibition with pictures, slogans, and dental aids and instruments. The self-teaching OHE was based on an exhibition from which the pupils searched for the information themselves. After the programs, the pupils' opinions about the method itself, its contents and implementation, knowledge about certain oral health issues, and the possible effect of the method were determined by a questionnaire. The attitudes and opinions were most positive in the peer OHE group. The traditional OHE was quite well accepted, but the self-teaching method was not very successful. The participants in the traditional OHE more often felt that they had been encouraged to pursue good oral health habits. In all groups, the topic considered to be the most boring was tooth brushing. Peer OHE can be recommended for Finnish secondary schools. The issue of tooth brushing should be played down, however, as too frequent repetition of the topic may cause more negative attitudes towards oral health education and practices.

Perspectives on poor dental health and its determinants.

This paper is based on a cross-sectional study of 35-64-year-old Finnish adults. In the study poor dental health was defined in three ways: (1) high prevalence of dental diseases; (2) edentulousness; and (3) subjects' dissatisfaction with their dental appearance or function. The aim of the study was to determine the relationship of these conditions to certain sociodemographic background factors which are known to be associated with health. Statistical analysis was carried out by means of logistic regression analysis. The background factors associated with poor dental health varied according to the condition under consideration. Education was a factor that was associated with each of them and other associated background factors are also discussed.

Use of oral health services and adult oral health in Finland.

This paper describes changes in use of oral health services and oral health in Finnish adults. The figures are taken from the Mini-Finland study of people aged 30 years or over (1980), a study of the oral health of persons aged 35 to 64 years old in the Jämsä Health Centre region (1990), and a study on the oral health of people aged 65 or over in the Varkaus region (1990). In 1980 one-third of Finnish adults aged 30 years or over visited a dentist at least once every two years. In 1990, 41% of the population between 35 and 64 years old visited a dentist at least once every two years. Among those aged 65 or over, however, most subjects visited a dentist only if they had an acute dental problem. An oral health check-up was the reason given for their last dental visit by 25% of adults in 1980. The percentage was slightly greater in 1990. Regular use of oral health services was reflected in better oral health. Occurrence of dental caries correlated strongly with use of oral health services. In 1980 only 4% of Finnish adults had a healthy periodontium. There was no marked improvement in 1990 in periodontal health. The most radical positive development was observed in relation to degree of periodontal loss. Despite some positive development, the association between oral health and use of oral health services has remained unchanged. The results support encouragement of an oral health check-up at least once every two years.

Background factors affecting dental caries in permanent teeth of Finnish and Soviet children.

The aim of this study was to analyze the association between some general background factors and caries experience in two groups of Finnish children (from Helsinki and Kuopio) and Soviet children (Moscow and Leningrad). A total of 1187 schoolchildren, ages seven, nine and twelve years, were examined and information about their health habits was gathered by questionnaire. Questions included use of sweets, cakes, soft drinks, sugar-sweetened coffee and tea, toothbrushing frequency and mother's education. Except for age, the factors that explain caries experience clearly differ in Finnish and Soviet children.

Background factors of enamel focal demineralization in groups of Finnish and Russian children.

The aim of this study was to analyze the occurrence of EFD lesions in relation to some background factors in Finnish and Soviet children. Children aged 7, 9 and 12 years (n = 1187) were examined clinically in Helsinki, Kuopio (Finland), Moscow and Leningrad (USSR). A questionnaire sent to the parents was used to collect data on toothbrushing frequency, use of sweets, cakes, soft drinks, sugar-sweetened tea/coffee and mother's education. In addition to bivariate analysis, log-linear regression models were used for comparing the simultaneous association in two ethnic groups. In general, the Finnish children had more EFD lesions than the Soviet children did. Among the Finns no consistent associations were found between the number of EFD lesions and the use of different sugar products or differences in toothbrushing habits. The number of EFD lesions decreased consistently according to mother's education with the Finnish children, but not with the Soviet children. The final multivariate model for Finnish children included age, toothbrushing frequency, place of residence (Kuopio) and use of soft drinks. The respective model for the Soviet children included age and place of residence (Leningrad). Evidently, the demineralization process or tooth resistance differs in these two ethnic groups.

Surface-specific effect of a mineralizing agent on the permanent teeth and on periodontal status.

In a two-year clinical trial the surface-specific effect of a mineralizing agent on selected permanent teeth was evaluated as well as the effect of this agent on periodontal health in children. Compared with positive controls (Control group, n = 123, biweekly mouthrinsing with placebo and 0.2% NaF solutions), among children in the test group (n = 123, biweekly mouthrinsing with 2% Remodent and 0.2% NaF solutions) the mineralizing agent clearly affected periodontal health (as determined by the prevalence of subjects with gingival bleeding and occurrence of affected sextants at risk) positively, in addition to having a positive effect on the incidence of EFD lesions. The mineralizing agent tested was not found to have adverse effects (as determined by the prevalence of subjects with dental calculus and occurrence of affected sextants at risk). Use of the mineralizing agent is recommended especially during posteruptive maturation of permanent teeth.

Occlusal characteristics in groups of Tanzanian and Finnish urban schoolchildren.

The occurrence of different occlusal and space anomalies was studied in groups of 642 Tanzanian and 458 Finnish school-children. Similar diagnostic criteria and methods were used in both countries. The Finnish children had significantly higher prevalences of distal occlusion and crowding and a lower prevalence of anterior openbite than the Tanzanian children. The proportion of subjects with no occlusal or space anomalies was considerably higher among the Tanzanians than among the Finns, 55% and 12% to 22%, respectively. The distinct differences found in occlusion of Tanzanian and Finnish children in this study seem to reflect differences in hereditary or environmental factors, which are expressed as craniofacial or dentoalveolar differences between these ethnic groups.

Oral health education in Finnish schools.

The public system of oral health care in Finland, as in the other Nordic countries, is responsible for arranging oral health education for school classes. In this study the coverage and the personnel implementing these lessons in Finnish schools were assessed. A questionnaire was sent to all health centers (n = 214). The response rate was 87%. A total of over 23,000 oral health lessons were arranged in schools during the year studied. Coverage was high in primary schools, lower in secondary schools and lower still in high schools. The main implementers of the lessons were dental assistants. The conclusions of the study were: 1) coverage of teenagers should be increased, 2) the role of dental hygienists and dentists in implementing the program should be greater, and 3) oral health personnel and teachers should cooperate more actively.

Subjective need of removable denture treatment in Finnish adults.

The aim of this study was to analyse the clinical dental health, use of dental services and socio-economic factors correlating with the subjective need for removable dentures in Finnish adults aged 30 years and older. A total of 2528 persons who had lost one or more natural teeth (wisdom teeth excluded) and who had not been provided with any dentures, were selected for this study. Subjects who had subjective need for prosthetic treatment had statistically significantly fewer teeth and fewer fillings, and more decayed teeth than others. Irregular users of dental services felt the need for a prosthesis more often than did regular users of those services. Irregular brushing of teeth was also associated with a greater need for prosthetic treatment. Men, older individuals and persons with less education and a smaller family income felt the need for prosthetic treatment more often than women, younger individuals and better educated persons. The factors differentiating between the two groups with and without a subjective prosthetic treatment need were analysed by discriminant analysis. The best differentiating factors were frequency of dental visits, caries score, frequency of brushing teeth, family income, number of fillings and sex.

Effectiveness of children's habitual toothbrushing.

Individual toothbrushing habits are usually consistent. Frequency, pattern and duration are different aspects of the toothbrushing habit. The aim of this study was to analyze the effect of habitual toothbrushing in children. The schoolchildren (n = 110) aged 13, were examined clinically before and after brushing their teeth in the habitual way; the brushing procedure was filmed without the children's knowledge. From the film, the pattern of brushing was assessed by three dentists, and the duration measured in seconds. Frequency of toothbrushing was assessed by postal questionnaire 2 months after the clinical examination. The examination included both photographed plaque and disclosed plaque diagnosed clinically. From the photographs, plaque was measured by computer planimeter as a % of plaque area and clinically by the oral debris index recommended by WHO. Subjects who had little plaque before toothbrushing were excluded from the analyses. Frequency seemed to affect plaque removal only in boys and only in the maxillary teeth. The pattern affected plaque removal in girls, but for boys, this aspect of toothbrushing affected only the left side of the jaws. Duration had produced the strongest effect on plaque removal. Therefore, duration of toothbrushing should be emphasized more in dental health education.

Use of fluorides by Finnish adolescents.

According to the recommendations of the National Board of Health in Finland fluoride tablets should be used daily from the age of 6 months to 15 yr in fluoride deficient areas. Topical fluorides are recommended in addition to systemic fluorides. The aim of this study was to analyze the use of fluoride tablets and topical fluorides by Finnish adolescents. Teenagers (n = 4705) representing Finnish youth aged 12, 14, 16 and 18 yr were sent mail questionnaires in February 1981. The response rate was 88%. The proportion of daily fluoride tablet users was 12% among 12-yr-old girls, 3% among 14-yr-old girls and among boys 10% and 4%, respectively. Fluoride rinses at home were used daily by only 1%. During the most recent school term, 34% had several times, and 8% once, participated in classroom fluoride rinsing. In the same period 14% had used fluoride gel several times, and 10% once. Thus despite dental health education, fluoride tablets and rinses are used very rarely at home by Finnish teenagers. The recommendations of the National Board of Health are far removed from the behavior of adolescents. Use of fluoride tablets and topical fluorides do not seem to be a practical alternative to drinking-water fluoridation, because of the low level of compliance.

Oral hygiene, dental visits and age of denture for prevalence of denture stomatitis.

A representative sample of Finnish denture wearers (n = 3875) aged 30 or over were examined clinically and interviewed about their oral hygiene habits, use of dental services and possible prosthetic treatment during last visit to a dentist. Of these denture wearers, over 80% brushed their dentures at least once a day, and 16% visited a dentist at least once in 2 yr. For denture stomatitis the age-standardized risk ratio decreased with brushing frequency in women and increased in men. For frequency of dental visits the prevalence of denture stomatitis increased in both men and women when visits were made over 2-yr intervals. The prevalence of denture stomatitis was higher in the group with dentures over 1 yr old. It seems that the oral hygiene measures as they are generally carried out and regular dental visits are not effective enough methods in preventing denture stomatitis.

Dental caries in the adult population in Finland: I. Prevalence of dental caries.

The aim of this study was to describe the prevalence of untreated dental caries in the adult population aged 30 years and over in Finland according to sex, age, region of living, and socioeconomic status. The level of untreated caries per subject also was studied and population estimates were made for prevalence and level of untreated caries. The representative sample used in this study included 5028 dentate subjects. Data were collected using interviews and clinical examination. The prevalence of untreated caries was 55% in women, and the figure for men was 67%. In eastern Finland the figures for women and men differed significantly. The mean number of decayed teeth was 2.5 per person. Men had more decayed teeth per person than women did. The number decreased significantly with increasing socioeconomic status. The data presented in the study provide a reliable picture of the occurrence of untreated dental caries in Finnish adults and form the basis for further analyses.

Toothbrushing frequency in 4 consecutive studies of Finnish adolescents.

This study aimed at analyzing the pattern of toothbrushing frequency over a period of 2 years in a group of Finnish adolescents. Data for this study were collected from 4 questionnaires distributed to a sample of adolescents born in 1960, 1962, and 1964. Subjects were divided into 4 groups according to their reported toothbrushing frequencies. Half of the subjects remained in the same category of brushing frequency (in 3 categories) during the consecutive studies. Among those having changed the frequency (54%), changing to a better toothbrushing frequency was more common among girls than among boys.

Oral hygiene status and habitual toothbrushing in children.

The purpose of this study was to investigate the effects of frequency, duration and systematicness of toothbrushing on the amount of dental plaque in school children. School children in four classes (n = 110, mean age = 13.5 years) were included. Data were collected using clinical examination and questionnaire. Data were first analyzed separately for girls and boys according to background factors and then by the components of toothbrushing, success in school, and the father's education. Boys had more plaque than girls did; the amount was influenced by background factors. Amount of plaque and frequency of toothbrushing were not clearly correlated with each other. Duration of brushing and amount of plaque, instead, were highly correlated. On the other hand, systematicness of brushing and amount of plaque were not clearly related. The results of this study indicated the need for broader evaluation of the information and methods used in oral health education in order to raise the effectiveness of habitual toothbrushing.