Young adults' views on the relevance of three measures for oral health-related quality of life.

OBJECTIVE: The aim of this study was to explore the views of young adults on the relevance of three measures of oral health-related quality of life (OHRQoL). METHODS: Sixteen young adults aged 21-29 years were interviewed. The selection was strategic with reference to age (21-25 years.; 26-30 years), sex and education (university degree; upper secondary school). The interview guide covered areas on the content and construction of the measures: The Oral Health Impact Profile (OHIP), the Oral Impacts on Daily Performances (OIDP) and the Oral Health-Related Quality of Life UK (OHRQoL-UK). The data were analysed using qualitative content analysis. RESULTS: A theme expressing the latent content was formulated during the data analysis: 'young adults' own experiences were reflected in their views on the OHRQoL measures'; that is, the experiences of young adults of own oral problems and aspects that were found to be especially important for their age group influenced their view on the measures. The self-reported ability to understand and answer the questions varied and the perceived advantages and disadvantages were almost equally distributed among the three measures. CONCLUSIONS: The OHIP, OIDP and OHRQoL-UK were evaluated as being equal by the young adults in this study, with regard both to their pros and cons. The clarity of the measures was regarded as the most important factor, while the length and assessment period were less significant.

Caries increment in primary teeth from 3 to 6 years of age: a longitudinal study in Swedish children.

AIM: To longitudinally follow and analyse caries prevalence and development in primary dentition in Swedish preschool children from 3 to 6 years of age. STUDY DESIGN: A longitudinal clinical study. METHODS: Three hundred 3-year-old children in the Public Dental Service were consecutively included. The children underwent annual clinical examinations at 3, 4, 5 and 6 years of age, performed by four calibrated dentists in clinical settings. Initial (d1-2) and manifest (d3-5) lesions were registered at surface and tooth level. Radiographs were taken when indicated and possible. STATISTICS: Chi-squared test was used for group comparisons. Friedman's test, Wilcoxon non-parametric test and logistic regression analyses explored caries development over the years. RESULTS: The parents of 271 children agreed to their children participating in the study (total dropout rate at 6 years, 10.3%). At baseline, 27.3% of the children had carious lesions (d1-5 mean 0.98, SD ± 2.44), and only 50.6% of the children were totally caries-free at 6 years (d1-5 mean 1.88, SD ± 2.81). Initial carious lesions made up the greater share at all ages. The greater part of the caries increment occurred between 3 and 4 years of age (p < 0.001). Having initial and/or manifest carious lesions at 3 years of age was a significant explanatory factor for new lesions at 6 years of age (OR 2.29; 95% CI 1.58-3.31). CONCLUSION: Children with an early caries experience had a high risk of further disease progression. Oral health promotion and prevention programmes should target small children and their carers.

Group treatment of obesity in primary care practice: a qualitative study of patients' perspectives.

AIMS: To explore patients' experiences of very low calorie diet (VLCD) and subsequent corset treatment of obesity in a primary care setting, and to explore their perceptions of factors influencing weight control. METHODS: In western Sweden, five focus group sessions were carried out. The main themes for the discussions were the informants' perceptions of the treatment they had received and their experiences of living with obesity. The analysis was based on the Grounded Theory methodology. RESULTS: The outcomes reflect obese individuals' struggle to handle the demands of their life situation and to recognize their own resources. The core category generated was labelled ''Achieving a balance in life and adjusting one's identity''. Three categories related to the process of weight reduction were identified: living with obesity, reducing weight and developing self-management. The group treatment with VLCD was positively perceived by the participants, but the corset treatment was considered to be of less value. CONCLUSIONS: Maintenance after weight reduction was demanding and the findings indicate a need for extended support. For some individuals the corset treatment could be a psychological support. Follow-up after weight reduction programmes should focus on long-term self-help strategies.

Clinical correlates of oral impacts on daily performances.

OBJECTIVES: The aim of this study was to investigate the associations between oral health measures and oral health-related quality of life as captured by OIDP (oral impacts on daily performances). METHODS: The study was performed in three dental clinics in Sweden and included 204 patients, 43.8% men and 56.2% women (aged 20-86 years), consecutively recruited in connection with their routine dental examination. The patients were interviewed using the OIDP followed by a clinical examination. Four bite-wing radiographs were taken in two of the clinics (n = 154). A self-administered questionnaire provided information about socio-economic data. RESULTS: Subjects >or=60 years had significantly more missing teeth, lesser maximal jaw opening, higher number of sites with alveolar bone loss and proportionally more filled teeth than younger individuals. Impacts related to the oral health that affected their daily life were reported in 39.7%. Multivariate logistic regressions analysis showed that missing teeth (>or=10) and a limited jaw opening (<40 mm) were significantly associated with having one or more impact as measured with the OIDP [odds ratio (OR) 6.50, 95% CI 1.48-28.43 and OR 2.87, 95% CI 1.03-7.96, respectively]. CONCLUSIONS: Individuals with diminished functional oral health status (missing teeth and limited jaw opening) had significantly more often one or more oral impacts on daily life than those with fewer than 10 missing teeth and a jaw opening >or=40 mm. The OIDP instrument may be valuable for use in routine dental check-ups in patients with related problems to determine possible oral impacts on daily life.

Self-perceived oral health in adolescents associated with family characteristics and parental employment status.

OBJECTIVE: To investigate self-perceived oral health and its associations with family characteristics and parental employment status in an adolescent population from a gender perspective. DESIGN: A cross-sectional study using self-reported questionnaires answered anonymously in classrooms. SETTING: All senior (13-15 years) and upper secondary (16-18 years) level schools in Skaraborg County, Sweden. SUBJECTS: 17,035 students, participation rate 88.5%. OUTCOME MEASURES: A single-item rating of self-perceived oral health; satisfaction with the appearance of the teeth; self-assessed gingival bleeding; a perceived oral health index. RESULTS: Independent of family characteristics and parental employment status, girls, more often than boys, perceived their oral health to be good and had less self-assessed gingival bleeding but were less satisfied with the appearance of their teeth. Adolescents living with a single mother (senior level odds ratios OR 0.71 [Confidence Interval CI 0.59,0.84], upper secondary level OR 0.76 [CI 0.62,0.92]) or with neither parent were less likely to perceive their oral health as good when single-item rated and reported more gingival bleeding (living with a single mother: senior level OR 1.37 [CI 1.20.1.57], upper secondary level OR 1.51 [CI 1.28,1.77]) than those who lived with both parents, while adolescents who lived with a single father did not. Associations between parental employment status and self-perceived oral health were weak and inconsistent. CONCLUSIONS: Family characteristics were important for adolescents' self-perceived oral health while parental employment status was not. Children living in single-parent households should be supported and recognised in strategies for oral health promotion and prevention. Gender differences should also be taken into consideration.

A gender perspective of self-perceived oral health in adolescents: associations with attitudes and behaviours.

OBJECTIVE: To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population. DESIGN: A census survey. Self-reported questionnaires were answered anonymously in a standardised manner in classrooms. Attitudes studied included the importance of sound teeth and feelings towards visits to the dentist. Behaviours were represented by floss usage and sweets consumption. SETTING: All senior and upper secondary level schools in Skaraborg County, Sweden. SUBJECTS: 17,280 students, aged 13-18 years. OUTCOME MEASURES: Self-perceived oral health, represented by a single-item rating; satisfaction with the appearance of the teeth; self-assessed gum bleeding; and a perceived oral health (POH) index. RESULTS: Recognising sound teeth as important was a predominating attitude among the respondents (boys 94%, girls 97%) and was significantly associated with a good perceived oral health overall. Individuals who experienced visits to dentist as unpleasant (boys 36%, girls 43%) were less likely to perceive good oral health as single-item rated (OR for boys 0.55[0.49, 0.63], girls 0.40[0.34, 0.47]). Regular use of floss had a small protective effect on bleeding gums. Daily sweets consumption showed a significant and inverse association with self-perceived oral health as single-item rated (OR for boys 0.53[0.44, 0.66], girls 0.49[0.40, 0.60]). Girls, more often than boys, perceived their oral health to be good, except in the perception of the appearance of their teeth. CONCLUSIONS: It is concluded that the strong associations between attitudes and self-perceived oral health should be recognised in strategies for oral health promotion and that gender differences must be considered.

Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents.

A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level, and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR) = 5.8 [3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR = 1.7 [1.4-2.1]) and the older (OR = 2.4 [1.9-3.1]) adolescents. It is concluded that most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys.