Survival of endodontically treated teeth in public dental service in Northern Finland: a practise-based register study.

OBJECTIVE: The aim of this study was to explore the factors associated with the survival of root canal treated teeth in a practise-based study setting in a 5-year period. MATERIAL AND METHODS: This retrospective study used data from the electronic patient registration system of the public dental services of the City of Oulu, Finland. The inclusion criteria for this study were patients aged ≥ 20 years who had root canal treatment (RCT) that was initiated in 2014. One RCT per patient was included in the study. A total of 713 patients met the inclusion criteria. The outcome variable for this study was the extraction of the RCT tooth during the 5-year period. Explanatory variables included age, diagnosis, tooth type (incisive, canine, premolar, molar), RCT technique (manual, motorized), time from RCT initiation to final restoration and type of final restoration (composite, glass ionomer, fixed dental prosthesis). To evaluate the association between the outcome variable and explanatory variables, Cox regression analyses were performed. RESULTS: The overall survival rate was 91%. The middle-aged (40-59-years-old) and the oldest (60 and older) patients had a two-fold risk of extraction compared to younger (20-40-years-old) patients. Similarly, a short length of time from RCT initiation to final restoration (0-14 days) resulted in a nearly three times higher risk of extraction compared to a longer period (≥ 90 days). CONCLUSIONS: The 5-year survival rate of RCTs seems high. Extractions were more common among patients over 40 years of age and if the RCT was completed shortly after its initiation.

The association between dental caries and physical activity, physical fitness, and background factors among Finnish male conscripts.

Studies on measured physical fitness and oral health are sparse. The aim of this study was to investigate the associations between self-reported physical activity and measured physical fitness and oral health of young men. The study population consisted of 13,564 Finnish male conscripts who had mandatory clinical oral examinations and physical fitness tests at the beginning of military service in 2011. Finally, around 10,800 conscripts had physical fitness test outcomes available and a total of 8552 conscripts answered a computer-based questionnaire on background factors. Decayed Tooth (DT) and Decayed, Missing, or Filled Tooth (DMFT) indices, outcomes of surveys and fitness tests were used in analyses by cross-tabulation and multivariable logistic regression model (odds ratios [OR] with 95% confidence interval [CI]) were calculated. Regularly exercising conscripts had a reduced need for dental restorative treatment than those reporting no physical activity (p < 0.0001). The proportion of participants with sound dentition (DT = 0) increased steadily with increasing physical activity (39.0-59.4%). Good measured physical fitness was a protective factor against increased dental restorative treatment need. A low prevalence of smoking and low use of alcohol and energy drinks were associated with frequent exercise, whereas consumption of sport drinks and snuff use were common among those who exercised frequently. Good measured physical fitness and self-reported physical activity are associated with reduced caries burden. There is a need for information about the harms of tobacco products and the benefits of a healthy diet, even for the increased energy needs of the physically active.

Mineralization of dental tissues and caries lesions detailed with Raman microspectroscopic imaging.

Dental caries is the most common oral disease that causes demineralization of the enamel and later of the dentin. Depth-wise assessment of the demineralization process could be used to help in treatment planning. In this study, we aimed to provide baseline information for the development of a Raman probe by characterizing the mineral composition of the dental tissues from large composition maps (6 × 3 mm2 with 15 µm step size) using Raman microspectroscopy. Ten human wisdom teeth with different stages of dental caries lesions were examined. All of the teeth were cut in half at representative locations of the caries lesions and then imaged with a Raman imaging microscope. The pre-processed spectral maps were combined into a single data matrix, and the spectra of the enamel, dentin, and caries were identified by K-means cluster analysis. Our results showed that unsupervised identification of dental caries is possible with the K-means clustering. The compositional analysis revealed that the carious lesions are less mineralized than the healthy enamel, and when the lesions extend into the dentin, they are even less mineralized. Furthermore, there were more carbonate imperfections in the mineral crystal lattice of the caries tissues than in healthy tissues. Interestingly, we observed gradients in the sound enamel showing higher mineralization and greater mineral crystal perfection towards the tooth surface. To conclude, our results provide a baseline for the methodological development aimed at clinical diagnostics for the early detection of active caries lesions.

Can health kiosks be used to identify oral health care needs? A pilot study.

OBJECTIVE: The aim of this study was to investigate the reliability of digital imaging for detecting restorative treatment need among individuals in their 20s by comparing the outcome of digital imaging with clinical caries findings at the patient level. MATERIAL AND METHODS: Five intraoral clinical daylight and digital fluorescence images were taken extraorally of 21 patients. A clinical examination was then performed by a trained and calibrated dentist. Additionally, the patients answered a multiple-choice questionnaire about their health habits. The images were analysed and caries findings were recorded. For statistical analysis, sensitivity and specificity were calculated. Results were shown as ROC curves and AUC values. All analyses were done using SPSS (version 24.0, Chicago, IL). RESULTS: Caries lesions were most often detected in molars and least often in canines. When using the clinical status as gold standard, digital imaging gave an AUC value of 0.617, whereas the outcome by questionnaire gave an AUC value of 0.719. When using the combined outcome of digital imaging and the questionnaire, the AUC value was 0.694 with clinical validation. CONCLUSIONS: It can be concluded that health kiosks may help to reduce the number of patients waiting for dental treatment; more specifically, the questionnaire with individual feedback may provide a new instrument for providing instructions for homecare online. However, the camera system must be developed further, and dentists and dental hygienists require training to analyse the images.

Knowledge on and treatment practices of erosive tooth wear among Finnish dentists.

OBJECTIVES: To investigate Finnish dentists' knowledge on and means of recording, detecting and diagnosing erosive tooth wear (ETW). Treatment options and possible differences in treatment decisions between general and specialized dentists were also evaluated. MATERIALS AND METHODS: An electronic questionnaire was sent by e-mail to 3664 Finnish dentists. Respondents' gender, age, work experience, field of specialty, and practice location were requested. The questionnaire also included a patient case where the dentists were asked about their choice of treatment. Statistical analyses were performed using means, proportions, and cross tabulations. RESULTS: Response rate was 24% (n = 866). Almost all respondents (98.0%) recorded ETW in patient files, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. Use of carbonated beverages (84.3%), energy drinks (57.0%), and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patient's dietary history while 1.9% evaluated saliva secretion rate. When asked about treatment decisions of ETW patients, the differences between general dentists and specialized dentists were not as obvious as hypothesized. CONCLUSIONS: This study suggests that the Finnish dentists who participated in this survey are able to detect and/or diagnose erosive tooth wear, but there is variation in recording it. The differences in treatment decisions between general dentists and specialized dentists seem to be moderate. The treatment practices for ETW are not established and further research to create clinical guidelines seems to be needed.

Consumption of snacks and dental caries among Finnish young men: a cross-sectional epidemiological study.

The aim of this study was to investigate the frequency of consumption of snack products, as well as the association between snacking and restorative treatment need, and associated factors among a healthy Finnish male population. Approximately 8500 conscripts answered a computer-based questionnaire covering their snacking habits and other health behaviours. Restorative treatment need and history (DT, DMFT) were examined by trained and calibrated dentists. Cross-tabulations were used to investigate the associations between snacking habits and the other researched variables, and logistic regression analyses (odds ratio and 95% confidence interval) were used to investigate the variables influencing the restorative treatment need. In the present study, almost one-third of the study group consumed snack products daily, most often fizzy and energy drinks. Only 10% had received a diet counselling. The most common situations involving snacking were at the cinema and while playing computer games. According to Pearson's Chi square test, snacking was associated with smoking and snuffing and infrequent tooth brushing (p < 0.001). According to the regression analyses, daily snacking, smoking, and doing exercise daily increased the odds for restorative treatment need whereas higher education level and tooth brushing twice or more often per day decreased the odds for restorative treatment need. It can be concluded that daily snacking is common among Finnish young men and is associated with restorative treatment need. Snacking is also associated with other harmful oral and general health habits. Individual dietary counselling should be routinely offered to everybody in dental clinics.

Association of dietary habits with restorative dental treatment need and BMI among Finnish conscripts: a cross-sectional epidemiological study.

OBJECTIVE: Processed foods and fatty, sugary snacking products, such as fizzy drinks and desserts, have become more popular, causing a desire to replace meals with snacks worldwide. High-sugar and fat-rich food components have been reported to be associated with increased level of dental caries as well as underweight and overweight. The aim of the present cross-sectional population-based study was to analyse the eating behaviours of young, healthy Finnish males in association with oral health and BMI, considering self-reported and residential background factors. DESIGN: Cross-sectional study. SETTING: Finnish Defence Forces, Finland. PARTICIPANTS: The used clinical data were gathered from 13 564 Finnish conscripts born in the beginning of the 1990s through clinical check-ups. In addition, about 8700 of the conscripts answered a computer-assisted questionnaire ('Oral Health of the Conscripts 2011' data) about their background information and health habits. RESULTS: There was distinct variation in dietary patterns. Eating breakfast, regular physical exercise and daily tooth brushing all decreased the odds for restorative dental treatment need (decayed teeth), whereas smoking and drinking fizzy drinks for quenching thirst increased it. Eating breakfast and dinner were each associated with lower BMI, but smoking increased the odds for higher BMI (≥25 kg/m2). CONCLUSIONS: Regular, proper meals and especially eating breakfast decreased the odds for both dental caries and high BMI (≥25 kg/m2).

Profiling of smokers and snuffers among young Finnish men - cross-sectional epidemiological study.

OBJECTIVE: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. MATERIAL AND METHODS: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. RESULTS: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. CONCLUSIONS: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing.

Association of smoking and snuffing with dental caries occurrence in a young male population in Finland: a cross-sectional study.

OBJECTIVE: The aim of this study was to investigate the prevalence of smoking and snuffing habits in association with dental caries occurrence in a male cohort born in the early 1990s in Finland. The impact of health behaviours and factors related to the place of residence were included in analyses. MATERIALS AND METHODS: Oral health of 8537 conscripts was screened in a cross-sectional study. In the same occasion they also answered a questionnaire covering their smoking and snuffing habits and other background factors. The residence-related factors were obtained from the Defence Forces' database. Cross-tabulation together with chi-squared test and generalized linear mixed models were used for analyses. RESULTS: Almost forty per cent (39.4%) of the men reported smoking daily and 9.0% reported daily snuffing. Restorative treatment need of those who reported frequent smoking was more than 2-fold (mean DT = 2.22) compared to the non-smokers (mean DT = 1.07). Smoking was statistically significantly associated with other harmful health behaviours. The snuffers reported more snacking than the non-smokers, but were most frequent brushers. The result from the statistical modelling showed that smoking, low tooth brushing frequency, eating sweets and consuming energy drinks frequently were significantly associated with restorative treatment need. CONCLUSION: In this cross-sectional study, association between smoking and dental caries was distinct. The high rate of restorative treatment need among smokers may be explained by their poor health behaviours. Dietary habits of the snuffers seem harmful too, but are compensated by good tooth brushing frequency.

Cigarette smoke and nicotine effect on human mesenchymal stromal cell wound healing and osteogenic differentiation capacity.

INTRODUCTION: Mesenchymal stromal cells (MSCs) play a crucial role in promoting tissue regeneration and healing, particularly in bone tissue. Both smoking and nicotine use are known to delay and inhibit the healing process in patients. This study aims at delineating these cellular effects by comparing the impact of nicotine alone to cigarette smoke with equivalent nicotine content, and shedding light on potential differences in the healing process. METHODS: We examined how cigarette smoke and nicotine affect the migration, proliferation, and osteogenic differentiation of human patient-derived MSCs in vitro, as well as the secretion of cytokines IL-6 and IL-8. We measured nicotine concentration of the cigarette smoke extract (CSE) to clarify the role of the nicotine in the effect of the cigarette smoke. RESULTS: MSCs exposed to nicotine-concentration-standardized CSE exhibited impaired wound healing capability, and at high concentrations, increased cell death. At lower concentrations, CSE dose-dependently impaired migration, proliferation, and osteogenic differentiation, and increased IL-8 secretion. Nicotine impaired proliferation and decreased PINP secretion. While there was a trend for elevated IL-6 levels by nicotine in undifferentiated MSCs, these changes were not statistically significant. Exposure of MSCs to equivalent concentrations of nicotine consistently elicited stronger responses by CSE and had a more pronounced effect on all studied parameters. Our results suggest that the direct effect of cigarette smoke on MSCs contributes to impaired MSC function, that adds to the nicotine effects. CONCLUSIONS: Cigarette smoke extract reduced the migration, proliferation, and osteogenic differentiation in MSCs in vitro, while nicotine alone reduced proliferation. Cigarette smoke impairs the osteogenic and regenerative ability of MSCs in a direct cytotoxic manner. Cytotoxic effect of nicotine alone impairs regenerative ability of MSCs, but it only partly explains cytotoxic effects of cigarette smoke. Direct effect of cigarette smoke, and partly nicotine, on MSCs could contribute to the smoking-related negative impact on long-term bone health, especially in bone healing.

Prevalence and polarization of dental caries among young, healthy adults: Cross-sectional epidemiological study.

OBJECTIVE: Oral health of young people has improved in the industrialized countries during past decades. However, stagnation of this progress has been reported recently. The main aim of this epidemiological study was to investigate the level of cariological treatment history and need (DMFT, DT) and polarization of dental caries among a healthy young male population born in the early 1990s. MATERIALS AND METHODS: Oral health of 13,564 men and 255 women born in 1990, 1991 or 1992 was screened based on the WHO criteria for epidemiological studies by 15 calibrated dentists in 20 garrisons (of a total 24) of the Finnish Defence Forces in January and July 2011. Mean DMFT and DT (SD) values and their distribution were calculated excluding wisdom teeth. Polarization was investigated using the Lorentz analysis. RESULTS: Mean DMFT, DT and FT values were DMFT = 4.1 (SD = 4.2), DT = 1.4 (SD = 2.5) and FT = 2.7 (SD = 2.9). Almost half of the men (45.1%) and one third of the women (37.3%) had at least one tooth needing restorative treatment. About 30% of the conscripts had 90% of all caries lesions and ∼ 10% of the conscripts had half of all lesions. CONCLUSIONS: Oral health of young males has not improved since the previous study among conscripts 15 years ago. Polarization of dental caries still exists. About half of the young male population still has manifested dental caries. Oral health promotion must not be neglected, even in countries with low caries prevalence.

General- and Oral-Health-Related Predisposing Factors for Interrupting Military Service in the Finnish Defence Forces.

INTRODUCTION: Finland's security policy relies heavily on its own independent national defense, which is based on conscription. In 2011, 26,492 conscripts started their military service in Finland. Of these, 1,706 interrupted their military service and 191 changed to civilian service. Conscripts who interrupt their service seem to have an increased tendency to smoking, alcohol consumption, and taking snuff, which previous studies suggest to have strong associations with the need for restorative dental treatment and with lower socioeconomic status. The aim of this study was to compare the general and oral health habits between Finnish conscripts who interrupt their service and those who completed their military service and to find out what general- and oral-health-related factors could be used in predicting interruption of service. METHODS: The study population consisted of 13,819 conscripts taking an oral examination during the service. Of these, 8,449 answered a computer-based anamnestic questionnaire and 264 interrupted their service.Predisposing factors on the anamnestic questionnaire for interrupting military service were evaluated by using a binary logistic regression model. The statistically significant factors were selected to form a sum variable which finally consisted of seven predisposing questions. Odds ratio (OR) values and 95% confidence intervals were calculated for each question and for the sum variable. Predictive accuracy was assessed by area under the receiver-operating curve. RESULTS: The most obvious predisposing factor among those who interrupted their service compared to the reference group was lack of weekly physical exercise (OR = 5.80). The risk for interruption of military service was 68.6 times higher in cases where a subject exhibited six predisposing factors out of seven compared to those who had none. CONCLUSION: As a conclusion, a set of statistically chosen anamnestic questions could help identify conscripts who have an increased risk of interruption of military service in addition to a risk of dental problems.

Procedure time and filling quality for bulk-fill base and conventional incremental composite techniques-A randomised controlled in vitro trial.

OBJECTIVES: The aims of this randomised controlled laboratory trial were to determine the procedure time and immediate quality (surface porosity and marginal gaps) of fillings placed using the bulk-fill base technique and the conventional incremental technique in simulated clinical settings. METHODS: Forty-two dentists and dental students were randomly allocated to use either the bulk-fill base technique or the conventional incremental technique to fill an identical class II disto-occlusal cavity in a maxillary left first molar typodont tooth. We recorded the time the participants used to fill the cavity and evaluated the surface porosity and marginal gaps on the approximal surfaces of the fillings using a stereomicroscope and specific probes according to the FDI criteria for restoration evaluation. Data were analysed using the Mann-Whitney U, Kruskal-Wallis, and chi-square tests. RESULTS: The median time ± interquartile range was 186 ± 80 s for the bulk-fill base technique and 463 ± 156 s for the conventional incremental technique (p < 0.001). The quality of the fillings was better for the bulk-fill base technique than for the conventional incremental technique (X2 = 9.5, p = 0.002). Neither operator experience nor the usual technique of choice were associated with the procedure time or the quality of the fillings. CONCLUSIONS: Compared to the conventional incremental technique, the use of the bulk-fill base technique shortened the time to fill a cavity by 59.8 % or 4 min and 36 s, and it improved the immediate surface and marginal quality of the fillings, regardless of the operator's experience or technique preference. CLINICAL SIGNIFICANCE: The use of the bulk-fill base technique instead of the conventional incremental technique leads to significant time-savings when placing large class II composite fillings. Additionally, the use of the bulk-fill base technique instead of the conventional incremental technique improves the immediate quality of large class II composite fillings.

Association of Dental Fear with Caries Status and Self-Reported Dentition-Related Well-Being in Finnish Conscripts.

The main aim of this cross-sectional study was to examine the prevalence of dental fear among Finnish conscripts. Other aims were to study the association between dental fear and cariological status as well as their self-reported, dentition-related well-being. The study material consisted of 13,564 men and 255 women conscripts who underwent oral examinations. Of those, 8713 responded to a computer-based questionnaire. The mean number of decayed teeth (DT) was used in analyses for cariological status. Self-reported dental fear, dentition-related well-being and regular check-ups were analysed. Data were analysed with cross tables, Pearson Chi-Square tests, Fisher's exact test and binary logistic regressive analysis. High dental fear or finding dental visits very scary was associated with DT > 2 both among women (14.6%, when DT = 0; 33.3%, when DT > 2) and men conscripts (2.3% and 10.8%, respectively). In addition, those reporting that dental health had a negative impact on their well-being and had no regular check-ups were more likely to need cariological treatment than the rest. A high education level, both one's own and parental, was a protective factor for restorative treatment need in male conscripts. The findings of this study support the concept of a vicious cycle of dental fear and dental caries. A preventive, interactive way of work by dental teams would most likely be beneficial for dental health, avoiding the development of dental fear, and dentition-related well-being.

Caries Experience and Erosive Tooth Wear in Finnish Men Conscripts 2021: A Cross-Sectional Study.

BACKGROUND: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. METHODS: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. RESULTS: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.6%) had BEWE (basic erosive wear examination) of 0­2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3-13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14-18). CONCLUSIONS: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts.

Correction: Patinen et al. Caries Experience and Erosive Tooth Wear in Finnish Men Conscripts 2021: A Cross-Sectional Study. Dent. J. 2022, 10, 122.

There was an error in the original publication [...].

A Hands-On Exercise on Caries Diagnostics among Dental Students-A Qualitative Study.

According to current care practices, the aim is to prevent the onset of caries lesions and to stop the progression of incipient lesions. A visual lesion assessment system, International Caries Detection and Assessment System (ICDAS), has been developed to promote reliability and repeatability of assessment of different stage caries lesions. The aims of this study were to evaluate the experiences of a hands-on exercise with authentic teeth as an adjunct to lecturing among third-year dental students and to evaluate the learning process during the hands-on exercise measured by qualitative (inductive content) analysis of the given feedback. In 2018, 51 third-year dental students at the University of Oulu, Finland, participated in a hands-on exercise on caries detection, where they assessed the depth and activity of lesions in extracted teeth using the ICDAS classification. After the lecture, students evaluated the exercise, giving feedback according to five given topics, three of which were analyzed using inductive content analysis. The exercise was considered useful and necessary but, overall, also challenging. The diverse activities and materials, as well as observational methods, promoted learning. The classification of lesions, the diagnostic methods, and the fact that there was not enough time to adopt things during the exercise were found to be challenging. For developing the exercise, the students suggested that more time should be scheduled for it and there should be more individual teaching. This qualitative study showed that, despite the challenge in caries diagnostics, dental students perceive the hands-on exercise as both a communal and individual learning experience.

Usefulness of an Endodontic Case Difficulty Assessment Form of Root Canal Treatments in Dental Education in Finland.

According to current care guidelines, it would be beneficial to evaluate the difficulty of a root canal treatment (RCT) after the decision of an indicated RCT. For this matter, several difficulty assessment forms have been developed. In this pilot study, fifth-year dental students evaluated the usefulness of the Endodontic Case Difficulty Assessment Form (ECAF) presented in the Finnish Current Care Guidelines for Endodontic Treatment (2014). Another aim was to postoperatively investigate how well the evaluation by dental students using the ECAF associated with the outcome of RCT evaluated by a specialist in endodontics. The dental students' (n = 33) and the supervisor's assessments of the RCTs were compared postoperatively at the Dental Educational Unit, Oulu, Finland. After completing the ECAF, the students' experiences of its use were explored with a structured form. In ECAF, patient-derived factors, such as gagging, deviant crown morphology, and complications in previous endodontic treatment, were all significantly associated with complications in RCTs by the dental students (p < 0.05). The assessments by students and the supervisor differed in 55% of cases, especially in moderately difficult cases. In the majority of these cases (71%), the students evaluated the case to be easier than the teacher. Students found the ECAF user-friendly, even if it did not demonstrate their competence in accomplishing RCTs. The ECAF appears useful for junior dentists, specifically in terms of distinguishing the least and most difficult cases. A simpler form could be useful for students and clinicians.

Association of Temporomandibular Disorder Symptoms with Physical Fitness among Finnish Conscripts.

Studies on the role of physical fitness, physical activity and obesity as risk factors for temporomandibular disorders (TMD) are scarce. The aim of the present study was to evaluate the association of TMD symptoms with physical fitness, physical activity and body mass index (BMI) among Finnish conscripts. The study sample consisted of 8685 Finnish conscripts. Data on self-reported TMD symptoms were used as outcome variables. Physical activity (questionnaire), physical fitness (measured with physical tests: Cooper test, push-ups, sit-ups and standing long jump) and body mass index (BMI) were used as explanatory variables. The associations between TMD symptoms and explanatory variables were evaluated using Chi-squared test and logistic regression analysis. The prevalence of all TMD symptoms was significantly higher among those who exercised more rarely than weekly. Pain-related TMD symptoms were also significantly more frequent among those who were overweight (BMI ≥ 25). Poor push-up results and overweight (BMI ≥ 25) were significantly associated with jaw pain and TMJ pain at jaw rest. The present study showed that good physical fitness may be a protective factor against TMD pain. Dentists should also be prepared to motivate TMD patients to physical activity and regular exercise as part of the treatment.

Regional Variation in Restorative Treatment Need among Finnish Young People.

AIM: To evaluate the regional variation in restorative treatment need among Finnish young people based on the socioeconomic factors. MATERIALS AND METHODS: This cross-sectional study was conducted in 20 garrisons of the Finnish Defence Forces in January and July 2011. The study population comprised 13,819 Finnish conscripts born in the beginning of 1990s, including females. A computer-based survey was done together with clinical oral examination to gather background information, e.g., educational status. Furthermore, average annual income of the conscript's residence municipality was achieved from the Statistics of Finland. The zip code of the place of residence of each conscript was later extracted from the Mildoc® system. Georeferenced place of residence and income status were merged as information on provinces' level in a dataset. The association between the outcome variable and explanatory variables was determined by using the generalized linear mixed model, and geomaps were constructed. RESULTS: Mean D value was 1.41 ranging from 0.89 (Kymenlaakso) to 2.33 (Kainuu). Higher education and high-income level were protective factors for restorative treatment need. Restorative treatment need was also low in those areas with high (OR: 0.70, 95% CI: 0.56-0.87) and medium (OR: 0.79, 95% CI: 0.70-0.89) yearly income compared to low yearly income. The high odds for the need of restorative treatment were discovered in Northern Ostrobothnia (OR: 2.26, 95% CI: 1.53-3.33) followed by Central Ostrobothnia (OR: 2.08, 95% CI: 1.17-3.70), Uusimaa (OR: 1.55, 95% CI: 1.16-2.08), and Central Finland (OR: 1.54, 95% CI: 1.10-2.16) compared to Varsinais-Suomi. CONCLUSION: In conclusion, there is a significant regional variation in restorative treatment need among Finnish young people in their twenties based on the socioeconomic factors.