Utilization of dental care after the introduction of the Swedish dental health insurance.

The dental care utilization rate in an urban Swedish population over an 11-year period was studied, starting at the time of the introduction of a national dental health insurance. The systematically selected samples comprised, for each calendar year of the period, approximately 11,000 inhabitants more than 20 years of age in the city of Göteborg. In 1976 and 1984 information on utilization was coupled to information about various demographic, socioeconomic, and disablement factors. In addition, a longitudinal study was performed of 8012 people who resided in Göteborg in 1976 and 1984, correlating dental attendance rates with the same factors. The results showed that dental care utilization increased among both men and women, mostly in age groups more than 65 years of age. Utilization rate in 1976 and in 1984 was independently associated with age, sex, income, marital status, disablement, and regions of the city, and it is concluded that the goal of the dental insurance act, which was, among other things, to contribute to a more equitable distribution of dental care, in many respects has not been achieved. Early identification of people with low utilization may provide a means to obtain the most pronounced improvement in dental health.

Prognosis of and factors associated with dental status in the adult Swedish population, 1975-1989.

The aim was to describe changes in dental status in the Swedish population during the period 1975-89 and to make a prognosis based on these data for the year 2000. This study is based on investigations of the living conditions in 1975, 1977, 1980/81 and 1988/89 performed by The National Central Bureau of Statistics. The samples varied for each year from 11,500 to 15,000 participants and a response rate from 80 to 86%. The odontological questions of the interview were focused on dental status, utilization of dental services and chewing ability. The prevalence of edentulism in age group 16-74 yr decreased from 15% in 1975 to 6% in 1988/89. In 1988/89 19% of the 65-74-yr-old inhabitants of the big cities were edentulous and 45% in rural populations, indicating a 15-20-yr delay of the development in rural areas. The prognosis for the year 2000 indicates a further decrease of edentulism to 3-4% in age groups 45-64 yr and in age 75-84 yr more than 60% will be dentate. As a consequence of the reduction in edentulism and changes in populations the number of dentate inhabitants in age group 25-74 yr increased by about 800,000 from 1975 to 1989 and a further increase of 400,000 will occur up to the year 2000. The consequences of these changes for the dental care services are discussed.

Cohort comparisons of dental status in the adult Swedish population between 1975 and 1981.

The aim was to describe and analyze changes in dental status in Sweden over a 6-yr period, and to establish a baseline for a subsequent investigation. Representative samples of the Swedish population in 1975, 1977, and 1981 were investigated by means of interviews. The participation rate varied between 81 and 86% and the number of participants between 11,582 and 14,964. Dental status, based on a question about natural teeth and/or removable denture(s), was analyzed in relation to demographic, socio-economic, social support and life style factors. The prevalence of edentulism in the age group 16-74 years decreased during the observation period from 12.7% to 9.9% in men and from 15.5% to 11.2 in women. Besides age, urbanization, occupation and tobacco smoking had the highest explanatory value for edentulism. The findings are discussed with respect to the increasing life expectancy and possible changes in the need and demand for dental care.