Changes in tooth mortality between 1990 and 2002 among adults in Västerbotten County, Sweden: influence of socioeconomic factors, general health, smoking, and dental care habits on tooth mortality.

The objectives of the study were to analyse changes in tooth mortality among adults in Västerbotten County, Sweden, between 1990 and 2002 and determine whether socioeconomic factors, general health, smoking, and dental care habits influenced tooth mortality. The study was based on samples drawn from the adult population in Västerbotten County in 1990 and 2002. The studied age groups were 35-, 50-, and 65-year-olds. In 2002 75-year-olds were included. The surveys comprised a clinical examination and a questionnaire.The latter focused on oro-facial symptoms, socioeconomic factors, general health, smoking, and dental care habits. Complete data were obtained from 715 individuals in 1990 and from 768 individuals in 2002.Variables used to depict tooth mortality were edentulousness, occlusal supporting zones (Eichner index), and number of teeth. The prevalence of edentulousness in Västerbotten County decreased from 12.7% in 1990 to 3.7% in 2002 (P < 0.001). The mean number of teeth increased in all age groups between 1990 and 2002, and so did the number of individuals with tooth contact in all occlusal supporting zones and no gaps between teeth. Low educational level, weak economic status, smoking, and irregular visits to the dental clinic were all significantly related to increased tooth mortality. Between 1990 and 2002 tooth mortality decreased significantly in the adult population of Västerbotten County, Sweden. Cross-sectional analysis identified socioeconomic factors, smoking, and irregular use of dental care services as being related to tooth mortality in both 1990 and 2002.

Oral health in the adult population of Västerbotten, Sweden--a comparison between an epidemiological survey and data obtained from digital dental records.

UNLABELLED: The objective of this study was to analyse the possibilities and limitations of using data drawn from electronic dental patient records (EDPRs) in monitoring dental health among adults in a northern Swedish county. MATERIALS AND METHODS: The study population comprised all 35-, 50-, 65- and 75-year-old patients who were examined and, where required, received treatment at the Public Dental Service (PDS) in Västerbotten, Sweden, in 2003 and in 2004. In total 2,497 patients in 2003, and 2,546 patients in 2004 met the inclusion criteria. As controls, 779 subjects randomly drawn from the adult population in the same age groups and from the same county were used. They participated in an oral health survey and were examined clinically between October 2002 and March 2003. RESULTS: When oral health was estimated based on EDPRs the prevalence of edentulous subjects was significantly underestimated, while the mean numbers of teeth and the mean values of sound teeth were significantly overestimated. No statistically significant difference was found in prevalence of primary decayed tooth surfaces (DS). The prevalence of filled teeth (FT) was fairly similar between the study samples. Registrations of periodontal status were mainly missing in the EDPRs. Since registrations related to temporomandibular disorders are not included in the T4 system its prevalence could not be assessed and accordingly not compared with the epidemiological sample. CONCLUSION: The study shows that clinical registration based on EDPRs is at present not accurate enough to be used as indicators of oral health status among adults in a community.

Comparison of the effectiveness of fissure sealants in Finland, Sweden, and Greece.

OBJECTIVE: To evaluate the effectiveness of sealant treatment in preventing dental restorations due to caries in a practice-based research network in Finland, Sweden, and Greece. MATERIAL AND METHODS: Times of tooth emergence, sealing treatment, and dental caries were compiled from the dental charts of 4735 subjects born in 1970-72 in Finland and in 1980-82 in Finland, Sweden, and Greece. Survival time between tooth emergence and placement of first restoration was measured and estimated using survival analysis methodology. RESULTS: At the end of follow-up (7-10+ years), 30-40% of sealed molars and 60-80% of non-sealed molars were restored. Early sealant placement compared to late sealing did not result in significantly higher survival of 1st molars. The strategy of sealing the 1st molars only in high caries risk subjects was as effective as sealing all the molars and premolars routinely without caries risk determination. CONCLUSIONS: The sealing of all molar fissures proved to be no more effective than sealing risk fissures of subjects. Early sealing did not result in any better outcome than late sealing. The effectiveness of sealant treatment in preventing dental restorations is dependent on the caries risk of individuals and caries prevalence of the country.

Timing and effect of fissure sealants on permanent molars: a study in Finland and Sweden.

Fissure sealants are frequently used in the Nordic countries for the prevention of caries in children. The aim here was to analyse their use and effect on dental health in children and adolescents in Finland and Sweden. A retrospective longitudinal population-based study was performed in northern Finland and Sweden, where different strategies have been adopted for sealing teeth. The timing of sealant and restoration placements up to 18 years was studied in representative samples of subjects born in the early 1980s in Kemi, Oulu, Raahe and Tornio in Finland (n = 908) and compared with a random sample of subjects from Norrbotten, Sweden (n = 634). A sensitive survival analysis method was applied to all the permanent molars separately (Virtanen et al. 1996). About 80-90% of molars had been sealed in the Finnish subjects, and approximately 30% in the Swedish cases, employing selective criteria. The filling increments were statistically significantly higher in Sweden than in Finland, although the differences were not of the same magnitude as the reduction in sealants. More than 30% of first molars and 50% of second molars had not been treated, i.e. were without sealants or fillings, by the end of the follow-up in Sweden, compared with 10% and 20%, respectively, in Finland. Fissure sealants were effective in preventing caries in molars in children and adolescents, and the use of selective criteria for targeting this treatment can yield savings in effort and costs in a low caries situation, although more research is needed to find the optimum cost-effective strategy.