Dental anxiety and dental attendance among 25-year-olds in Norway: time trends from 1997 to 2007.

BACKGROUND: So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults. This study aimed to 1) determine the frequency of dental anxiety and regular dental attendance among 25-year-olds in Norway in 1997 and 2007, 2) to study the development (time trend) of dental anxiety and the socio-behavioral distribution of dental anxiety from 1997 to 2007. METHOD: Random samples of 1,190 and 8,000 25-yr-olds were drawn from the populations of three counties in Western Norway in 1997 and 2007, respectively. The eligible participants received questionnaires by mail including questions on socio-demographics, dental anxiety (DAS) and dental attendance. RESULTS: In 1997, 11.5% males versus 23% females reported high dental anxiety (DAS ≥ 13). Corresponding figures in 2007 were 11.3% and 19.8%. The proportions who had attended yearly for a dental check-up during the past 5 years fell from 62% in 1997 (men 56.9% and women 66.4%) to 44.6% (men 38.1% and women 48.6%) in 2007. After controlling for potential confounding factors, the 25-year-olds were 1.4 times more likely to report dental anxiety in 1997 compared to 2007. The decrease was largely attributable to a lower mean DAS score among higher educated females in 2007 than in 1997. The discrepancy in dental anxiety between regular and non-regular dental attendees had decreased, largely attributable to a decline in dental anxiety among irregular dental attendees. CONCLUSION: The study showed reduced dental anxiety and dental attendance among 25 year-olds in Norway from 1997 to 2007. This study points to the importance of controlling for possible changes in socio-demographic distributions when different cohorts are compared.

The risk of enamel fluorosis and caries among Norwegian children: implications for Norway and the United States.

BACKGROUND: The authors investigated the associations between enamel fluorosis, caries and early fluoride use among Norwegian children who received fluoride supplementation under a protocol similar to the current U.S. protocol. METHODS: Two examiners whose techniques were calibrated examined randomly selected middle-school-aged children living in Bergen, Norway-where the water supply contains less than 0.10 milligrams of fluoride per liter-for both enamel fluorosis and caries by using the Fluorosis Risk Index and modified National Institute of Dental and Craniofacial Research criteria. The authors ascertained past fluoride exposure via a follow-up questionnaire mailed to parents. RESULTS: The questionnaire had an 88 percent response rate and 87 percent reliability. Adjusted analyses revealed a strong association between regular supplementation (given in the form of lozenges) and mild to moderate enamel fluorosis (odds ratio [OR], 6.85; P < .05), as well as fluorosis of lesser severity (OR, 3.07; P < .05). No children who had exclusively used only a pea-sized amount of toothpaste (0.1 percent fluoride) had mild to moderate fluorosis. The authors found a 40 percent reduction in caries risk associated with early use of pea-sized amounts of fluoridated toothpaste and a 46 percent reduction associated with regular use of fluoride supplement lozenges. CONCLUSIONS: These findings suggest that both risk of fluorosis development and caries-preventive benefit are associated with regular use of fluoride supplements, and caries prevention was associated with early use of a pea-sized amount of toothpaste. CLINICAL IMPLICATIONS: These findings underscore the need for clinicians to consider thoroughly-and discuss with a child's parent or guardian-both the benefit and the potential risk of fluorosis development associated with preventive fluoride agents before introducing them. Clinicians also should emphasize the proper use of such agents.

Tracking of parents' attitudes to their children's oral health-related behavior-Oslo, Norway, 2002-04.

OBJECTIVES: To investigate dental beliefs and attitudes of a diverse group of parents from their children when they were aged 3 and 5 years old and to identify possible mediators for a group composed of the parents with the most negative dental attitudes. MATERIAL AND METHODS: Data were collected by parental questionnaire when the children were aged 3 years in 2002 and again 2 years later. The inclusion criteria were children with mothers from Norway (N group) or non-Western countries (IM(1) group). Questionnaires were extensive and had previously been used in a multicenter study. Three composite attitudinal variables relating to oral hygiene, diet and parental indulgence were calculated and an "attitudinal risk group" identified. The association between those variables and the assignment to the group was measured by odds ratio (bivariate and multiple logistic regression). RESULTS: The N parents' dental attitudes were significantly more positive in 2004 when their children were 5 years old than when they were 3 years old (p < 0.0001), but this was not the case among immigrant parents. "Education" and "Immigrant status" [odds ratio (OR) 3.3, 95% confidence interval (CI) 1.6-7.0; and OR 2.8, CI 1.1-7.3, respectively] were significantly associated with the defined "attitudinal risk group". CONCLUSIONS: Only dental attitudes among N parents were significantly more positive in 2004 than in 2002. Not having higher education and being of non-Western background were associated with belonging to the "attitudinal risk group". Culturally tailored programs of dental health education are needed to promote more positive attitudes to oral health.

Change in oral health status among the institutionalized Norwegian elderly over a period of 16 years.

OBJECTIVE: To assess the oral health status of elderly residents living in nursing homes, and to determine whether there have been any changes between 1988 and 2004. MATERIAL AND METHODS: The dental, periodontal, prosthetic, and oral mucosal status was recorded for 155 elderly long-term residents in five nursing homes. The results were compared with those of an identical cross-sectional study from 1988, using the same nursing homes, examination procedures, and evaluation criteria. The participation rate was 89.6%. RESULTS: Edentulism was less frequent in 2004 (43%) than in 1988 (71%), and the mean number of teeth among the dentate participants had increased from 10.7 to 14.6. The proportion of subjects with decayed teeth increased from 55% in 1988 to 72% in 2004, and the mean DMFT (decayed, missing, and filled teeth) increased from 19.4 to 23.2. The frequency of subjects with periodontal pockets of 4 mm or more increased from 43% to 65% during the 16-year period. More participants had crowns or bridges. Of the denture-wearing subjects, more were affected by stomatitis in 2004 than in 1988; however, a decrease in the degree of severity was evident. CONCLUSIONS: As more people retain their own teeth throughout life and the prevalence of oral diseases increases among the institutionalized elderly, their objective need for dental treatment is even greater than before. This underscores the necessity for developing effective and oral care programs for the elderly.

Socio-economic inequality in the self-reported number of natural teeth among Norwegian adults--an analytical study.

OBJECTIVE: To assess inequality in dental status associated with educational level, gross personal and family income among Norwegian adults. METHODS: Data were collected by Norway's Central Bureau of Statistics in November-December 2003. A two-stage, proportional random sample comprising 2000 persons aged 16-79 years was drawn from the national population register. Information became available for 1309 subjects by interview. The present analyses pertain to 1092 subjects aged 25-79 years (response rate 66%, mean age 47.9 years). RESULTS: Of the respondents, 3% were edentulous and 9% had fewer than 20 teeth. The mean number of teeth was 27.1 (SD 7.0). In multiple logistic regression analysis, low gross personal and adjusted family income were associated with increased likelihood of having fewer than 20 natural teeth (OR = 2.84, 95% CI 1.58, 5.10; OR = 3.63, 95% CI 1.99, 6.62, respectively). Educational level was significantly associated with dental status in bivariate but not in multivariate analyses, except once among males. The predictors of socio-economic inequality in dental status accounted for a limited proportion of explained variance (Nagelkerke's R(2)) when controlling for age, place of residence, perceived oral health compared with others, perceived importance of oral health, dental attendance and smoking. CONCLUSION: Socio-economic inequality in dental status persists among Norwegians aged 25-79 years but absolute differences have decreased during the last 30 years. The findings are encouraging but challenging as far as choice of strategy for further reduction of differences in tooth loss.

Parental beliefs and attitudes towards child caries prevention: assessing consistency and validity in a longitudinal design.

BACKGROUND: Exploring the stability of self-reports over time in observational studies may give valuable information for the planning of future interventions. The aims of the present study were: 1) to explore the consistency of parental self-reports of oral health habits, beliefs and attitudes towards child oral health care over a two-year period; 2) to evaluate possible differences in item scores and consistency between parents with different immigrant status; and 3) to assess the construct validity of items measuring parental beliefs and attitudes towards child oral health care. METHODS: The sample (S1, n = 304) included parents of 3-year-old children in Oslo, Norway; 273 mothers of western origin (WN-group) and 31 of non-western origin (IM-group). They were surveyed in 2002 (child age 3 years) and in 2004 (child age 5 years). Two additional samples of parents were also included; one with 5-year old children in 2002 (S2, n = 382) and one with 3-year-old children in 2004 (S3, n = 427). The questionnaire included items measuring child oral health habits and parental beliefs and attitudes towards child oral health care. RESULTS: In 2002, 76.8% of the parents reported that they started to brush their child's teeth before the age of 1 year. Eighty-five percent of them reported the same in 2004; 87.0% of the WN-group and 33.3% of the IM-group (P < 0.001). For 17 of 39 items measuring beliefs and attitudes the responses were more positive for the WN-compared to the IM-group. Parents of caries-free children in 2004 reported significantly more positive beliefs and attitudes towards child oral health care in 2002 compared to parents of children with caries in 2004 (P < 0.05, P < 0.01 and P < 0.001). No differences in mean item scores were found between the three samples S1, S2 and S3. CONCLUSION: The results showed a fair to good consistency of parental self-reports from 2002 to 2004. They also indicate that parents with different cultural backgrounds should be evaluated separately and in a cultural context.

Ecological time-trend analysis of caries experience at 12 years of age and caries incidence from age 12 to 18 years: Norway 1985-2004.

OBJECTIVES: The purpose of the present investigation was to report on caries experience among Norwegian 12-year-olds from 1985 to 2004 and to assess caries incidence from 12 to 18 years of age for birth cohorts 1973 to 1986. MATERIAL AND METHODS: Aggregated data from the Norwegian Public Dental Services and from official statistics were employed. Information was available about the number of subjects, the proportion receiving treatment, sales of fluoride tablets, socio-demographics, caries prevalence, and the number of decayed, missing, and filled teeth (DMFT). RESULTS: An almost linear decline in caries prevalence and mean D3MFT (dentine level) occurred among 12-year-old children from 1985 until the year 2000, but from 2000 to 2004 an increasing trend was observed. The highest mean 6-year D3MFT increment (age 12-18 years) was 4.1 (cohort 1976), while the lowest was 3.2 (cohorts 1982 and 1983). In multiple linear regression analyses of trend, baseline D3MFT accounted for more than 91% of total explained variance in D3MFT increment (Models I and III). Without baseline D3MFT as predictor (Models II and IV), there was a significant association between education, social assistance, mobility, infant mortality, percentage examined, and the additive interaction terms year + income and year + education and D3MFT increment after controlling for confounding and multicollinearity. CONCLUSIONS: Four consecutive years of increase in caries experience among 12-year-old children after 15 years of decline and evidence of stability or increase of the caries increment from 12 to 18 years of age among Norwegian teenagers give cause for concern.

Tooth loss and associated risk indicators in an adult urban population from south Brazil.

The aim of the present study was to assess the prevalence, extent, and risk indicators of tooth loss in a representative adult, urban population in the Brazilian state of Rio Grande do Sul. A sample of 974 subjects (ages 30 to 103 years, mean 48.7, SD 13.4) representative of the metropolitan area of Porto Alegre, Brazil was selected by a multi-stage probability cluster sampling strategy. In all, 94% of the subjects had experienced tooth loss. The mean tooth loss was 11.2 teeth, and varied between 5.5 and 20.2 teeth in the 30-39 and 60 + years age groups, respectively. The multivariable analysis, adjusted for age, showed that subjects who had lost 7-13 or > or = 14 teeth were more likely to be females (odds ratio (OR) = 1.4, 2.4), of low (OR = 2.8, 5.1) or middle socio-economic status (OR = 2.3, 3.4), and heavy smokers (OR= 2.0, 2.3) than those with 6 or fewer missing teeth. Furthermore, loss of > or = 14 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR= 5.7), and loss of 7-13 teeth was associated with presence of > 50% teeth with attachment loss > or = 5 mm (OR = 2.4) and having 15-30% or > 30% decayed-filled teeth (OR = 2.7 and 4.1). In conclusion, tooth loss is highly prevalent in this urban Brazilian population. Gender, socio-economic status, cigarette smoking, caries experience, and attachment loss are important risk indicators. A reduction in the population's tooth loss may be achieved by the implementation of community programs for the prevention and treatment of dental caries and periodontal diseases.

Analysis of the ups and downs of caries experience among Norwegian children aged five years between 1997 and 2003.

OBJECTIVE: To study caries trends and investigate the possible reasons for changes among 5-year-old Norwegian children in the period 1997-2003. In this cross-sectional analytical time trend study at district, county, and national levels, aggregated data from the Public Dental Services (PDS) and official statistics were used, i.e. number of children and percentage receiving treatment, sale of fluoride tablets, socio-economic background, caries prevalence, and d3mft scores. RESULTS: Caries prevalence increased from 30% in 1997 to just over 40% in 2001, but by 2003 it had dropped to 36%. The corresponding mean number of d3mft were 1.1, 1.6, and 1.4 at national level. Caries prevalence and experience varied considerably between counties and between dental districts throughout the observation period. Multivariate analyses at county level indicated a significant negative association (p < 0.05) between caries prevalence, the sale of fluoride tablets, and net mobility. The impacts of the predictor variables education, income, infant mortality, proportion of immigrants, and the percentage of children treated varied but were rarely significant. CONCLUSIONS: The increasing trend in the prevalence of caries among 5-year-old Norwegian children in the period 1997 to 2001 has reversed. The deterioration in dental health of 5-year-olds after 1997 was associated with a reduction in the sale of fluoride tablets, whereas increased sales of fluoride tablets after 1998 reflect improved caries prevention among preschool children and may explain the improved caries status of these children in 2003.

Developing a scale for measuring expectancy of retaining natural teeth for life and comparison of results obtained using a global item and a multi-item scale of measurement.

OBJECTIVE: To develop and test a scale for measuring expectancy of retaining teeth for life and to compare the estimates when using a global item with those obtained with a multi-item scale of measurement. MATERIAL AND METHODS: The design of the study was cross-sectional selected and random sample surveys using a self-administered questionnaire or interview. There were two groups of patients and a national sample aged 16-79 years (n=1274); response rate 64%. The main results pertain to dentate subjects in a global group (n=615) and in a scale group (n=609). The outcome measure was expectancy of retaining natural teeth for life. Results. When using the global item, 92% (95% CL 89.8, 94.1) of the respondents believed they would definitely or possibly retain their natural teeth for life, significantly higher than the 81% (95% CL 77.6, 84.0) obtained with the 4-item conditional scale. Cronbach's alpha was 0.89 for the 4-item scale and the test-retest reliability moderate (kappa = 0.51; 0.77 for +/-1). The adults' belief in retaining teeth for life was significantly associated with having a live-in partner (p = 0.009) when the global question was the dependent variable; and sex (p = 0.000) and education (p = 0.004) when the 4-item scale was the dependent variable. Explained variance was 3.8% and 4.5%, respectively. Conclusions. The internal reliability of the 4-item scale was high. A significantly lower proportion of people reported belief in retaining natural teeth for life when employing the 4-item conditional scale than when the unconditional global question was used.

Occurrence and risk indicators of increased probing depth in an adult Brazilian population.

BACKGROUND/AIMS: There is little information about the occurrence and risk indicators for periodontal diseases in Latin America. The present study describes the prevalence, extent and severity of periodontal probing depth (PPD) and assesses the association between demographic, behavioural and environmental risk indicators and the extent and severity of PPD in this population. MATERIALS AND METHODS: The target population was urban adults aged > or =30 years in Rio Grande do Sul state in South Brazil. A representative sample was selected using a multi-stage, probability, cluster sampling strategy and included 853 dentate subjects 30-103 years of age. A full-mouth clinical examination was carried out at six sites per tooth on all permanent teeth, excluding third molars, and was conducted in a mobile examination centre. RESULTS: Approximately 65% and 25% of the subjects and 19% and 5% teeth per subject had PPD > or =5 and > or =7 mm, respectively. 31.6%, 33.7% and 34.7% subjects had generalized, localized or no PPD > or =5 mm, respectively. Probing depth increased in prevalence with increasing age, and leveled off at around 50 years of age and beyond. PPD > or =5 mm was significantly higher in males than in females, and in non-Whites than in Whites. Cigarette smokers had a significantly higher occurrence of PPD > or =5 mm than non-smokers, and this relationship was dose dependent. A multivariate model showed that generalized PPD > or =5 mm was associated with subjects aged > or =40 years, males, non-Whites and moderate or heavy cigarette smokers (relative risk ratios: 2.0, 2.0, 2.2, 2.4 and 6.8, respectively). CONCLUSION: Moderate and deep probing depth was a common finding in this urban adult Brazilian population. Older age, male gender, non-White race and moderate and heavy cigarette smoking were significant risk indicators of increased PPD, and these may be useful indicators of periodontal disease high-risk groups.

Influence of perceived provider performance on satisfaction with oral health care among adolescents.

OBJECTIVE: To investigate satisfaction with dental care received at the last dental appointment among adolescents and to analyse factors influencing their satisfaction scores. METHOD: A total of 1146 subjects (mean age 15.8 years) attending secondary schools in Kampala (urban, n = 591) and Lira (rural, n = 555) completed structured questionnaires at school in 2001. RESULTS: A total of 63% and 75% of Kampala and Lira students, respectively, reported attendance to dental clinics during the previous 2 years. The corresponding rates of students who confirmed satisfaction with oral health care services received were 73 and 77. In a logistic regression model, the students of Kampala who attended a dentist more than once, had no painful experience at the visit, evaluated their oral condition positively, were satisfied with the dentist's communication and dentist's information, were more likely to be satisfied with the oral health services received (OR = 1.7, 2.2, 4.1, 2.9 and 4.9, respectively). Regarding rural students, being satisfied with oral condition, dentist's communication and dentist's information were associated with higher odds of being satisfied with oral health care services (OR = 2.9, 1.9 and 2.3, respectively). CONCLUSION: Inter-personal interaction with the dentist is a key determinant in establishing satisfaction with dental care among urban as well as rural adolescents.

Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population.

BACKGROUND: Gingival recession is a common manifestation of periodontal disease, but it is also associated with other risk factors. A few studies have investigated the epidemiology and risk factors of this condition. This study describes the epidemiology of gingival recession in a representative, urban Brazilian population and assesses various risk indicators. METHODS: A representative sample of 1,460 subjects was selected using a multi-stage, probability, cluster sampling strategy. The subjects were interviewed using a structured questionnaire and had a full-mouth clinical examination in a mobile examination center. RESULTS: More than half (51.6%) and 22.0% of the individuals and 17.0% and 5.8% of teeth per individual showed gingival recession > or = 3 mm and > or = 5 mm, respectively. The prevalence, extent, and severity of recession correlated with age. Recession showed a nonlinear relationship with age, with 25 to 50 year olds showing the highest level of recession. Males aged > or = 30 years showed significantly higher prevalence and extent of gingival recession than females. The percentage of teeth with recession was significantly higher in the lower socioeconomic groups irrespective of age, and in subjects > or = 30 years of age with irregular dental care than in subjects with regular care. Using a multivariable model, cigarette smoking and presence of supragingival calculus were the factors most significantly associated with localized and generalized recession, whereas gender, dental visits, and socioeconomic status were not significant risk indicators. CONCLUSIONS: The high level of gingival recession in this Brazilian population may be primarily related to destructive periodontal disease and is significantly associated with a high level of supragingival dental calculus and cigarette smoking. Population-based programs aimed at the prevention of periodontal diseases may reduce the prevalence of severe gingival recession in this and similar populations.

Periodontal attachment loss attributable to cigarette smoking in an urban Brazilian population.

AIMS: The present study estimated the percentages of cases with severe periodontal attachment loss (PAL) attributable to cigarette smoking in a representative adult urban population in southern Brazil. METHODS: A representative sample comprising 853 dentate individuals (age: 30-103 years) was selected by a multistage, probability sampling method. A full-mouth clinical examination of six sites per tooth was performed and an interview using a structured written questionnaire was undertaken. Cases were defined as individuals with > or =30% teeth with PAL > or =5 mm. A multivariate logistic regression analysis for complex surveys was performed, and adjusted for age, gender, race, socioeconomic status and dental calculus. RESULTS: The prevalence of cases in this population was 49.7%, or 739,000 subjects. Overall, 50.9% of this adult population, or approximately 757,000 subjects have had a lifetime exposure to cigarette smoking. Multivariate analysis showed that heavy and moderate smokers had a significantly higher risk for PAL > or =5 mm than non-smokers (odds ratio=3.6, 2.0, respectively) after adjusting for the above covariates. We estimated that the number of moderate and heavy smokers with > or =30% teeth with PAL > or =5 mm might be reduced by approximately 28% and 48%, respectively, had they not smoked cigarettes. We project that a smoking cessation program could result in a reduction in the number of cases by up to 12% in this population, or approximately 90,000 potential cases. CONCLUSION: Cigarette smoking was strongly associated with severe attachment loss in this population. A significant percentage of cases may have been prevented if smoking cessation interventions had been implemented. The results support the implementation of population-based smoking cessation programs to reduce the prevalence of severe attachment loss in populations with high level of smoking exposure.

Periodontal attachment loss in an urban population of Brazilian adults: effect of demographic, behavioral, and environmental risk indicators.

BACKGROUND: There is little information about the occurrence and risk factors of periodontal diseases in developing countries. This study describes the clinical attachment loss (CAL) in an adult Brazilian population and performs a risk assessment of demographic, behavioral, and environmental exposures. METHODS: A representative sample of 853 dentate individuals (age: 30 to 103 years) was selected by a multistage probability sampling method. The subjects had a full-mouth clinical examination of six sites per tooth and were interviewed using a structured written questionnaire. RESULTS: Seventy-nine percent (79%) and 52% of the subjects and 36% and 16% of the teeth per subject had CAL > or = 5 and > or = 7 mm, respectively. A multivariable model showed that 40 to 49 and > or = 50 years olds had 3.0 and 5.9 times higher risk for moderate CAL and 7.4 and 25.4 times higher risk for severe CAL, compared to the 30 to 39 years olds. Moderate cigarette smokers had a significantly higher risk for moderate (relative risk ratio [RRR] = 2.1) and severe CAL (RRR = 3.4), and heavy smokers had a higher risk for moderate (RRR = 3.0) and severe CAL (RRR = 8.2) compared to non-smokers. A significantly higher risk for severe CAL was also present in males (RRR = 1.6), subjects with low (RRR = 1.8) or medium socioeconomic status (RRR = 1.6), and those with a history of irregular dental visits (RRR = 2.1). Diabetic status and race did not show significant associations with CAL after adjusting for other effects. CONCLUSIONS: This Brazilian population had a high occurrence of attachment loss. A population-based strategy that includes the establishment of prevention and health promotion programs targeting high-risk groups is highly desirable for controlling the high occurrence of attachment loss in this population.

Variation in caries experience and sugar intake among secondary school students in urban and rural Uganda.

The objective was to assess the socio-demographic variation in caries experience and sugar intake among urban (Kampala) and rural (Lira) students in Uganda. In a cross-sectional survey, a total of 1146 adolescents aged between 13 and 19 years (response rate 87%) attending 10 secondary schools, 5 rural and 5 urban, completed questionnaires in respective schools. Clinical examination was conducted among 372 respondents (response rate 90%) from the main survey and dental caries was assessed. The results showed that a total of 80% of the students had DMFT >0. The corresponding rates in Kampala and Lira were 85% and 76% (P < 0.05), respectively. The mean DMFT, DT, and MT for the sample were 2.9, 2.5, and 0.5. Adjusted mean DMFT scores were 2.4 in Kampala and 3.3 in Lira (P < 0.05). The mean frequency sugar score was 2.6 and sugar consumption was higher in females and in students of highly educated parents compared to their counterparts in the opposite groups. In conclusion, higher mean DMFT scores in urban than in rural areas are often reported from developing countries but this does not seem to apply to the Ugandan areas investigated. Kampala and Lira students were equally exposed to sweets and soft drinks but the differences in sugar consumption between students of higher and lower educated parents were most marked in Lira.

Incidence and predictors of self-reported tooth loss in a representative sample of Norwegian adults.

OBJECTIVES: The purpose of this study was to determine the self-reported 12-month incidence of tooth loss among Norwegian adults and to assess the association between tooth loss and some predictor variables. METHODS: Of a two-stage nation-wide, representative random sample (n = 3958), information was obtained from 2682 subjects aged 20-79 years and the response rate was 68%. Telephone or face-to-face interviews by interviewers employed by the Central Bureau of Statistics (CBS) of Norway. Information was collected about demographic characteristics, the number of natural teeth present, the number of teeth lost during the last 12 months, and belief in keeping natural teeth for life. The present analyses are based on 2520 persons 20-79 years of age. RESULTS: The proportion of respondents who reported losing one or more teeth was 6.45% (95% confidence limits (CL) = 5.49, 7.41). The participants who reported extractions had lost on average 1.54 (range 1-9) teeth. Multiple logistic regression analysis revealed a borderline significant effect of the level of education (OR = 0.68, 95% CL = 0.46, 1.00), i.e. the odds of losing one or more teeth during the last 12 months were lower among persons with more than 12 years of education than among persons with less education. The explained variance was 1.9%. CONCLUSION: The annual incidence rate of tooth loss among Norwegian adults was found to lie within the range reported from other industrialized countries. After controlling for socio-demographic variables and the number of teeth present, the only borderline significant predictor of the incidence of tooth loss was the level of education.

Analyses of the caries decline and incidence among Norwegian adolescents 1985-2000.

Since most studies of caries decline are descriptive time-trend analyses, the purpose of this article was to identify factors statistically associated with the caries decline among Norwegian adolescents after 1985. The DMFT scores for the age groups 12 and 18 years reported annually by 19 counties were analysed. The average caries-free proportions of 18-year-olds increased from 2% to 15% between 1985 and 2000, while the DMFT declined by 49%; 10.2 +/- 0.75 to 5.2 +/- 0.78. The decline for the 12-year-olds was 53%. The mean DT at the dentinal level remained at about 0.8 for 12-year-olds and 1.5 for 18-year-olds throughout the observation period. There was no significant difference in DMFT increment from age 12 to 18 between the birth cohorts 1973 (3.8 +/- 0.46) and 1982 (3.0 +/- 0.52) when controlling for counties. The variables migration and children per dentist were significantly associated with the DMFT decline in multivariate analyses. The caries decline for 18-year-olds was significantly steeper before than after 1990. The decline among the 18-year-olds may be attributed to fluoride and more restrictive criteria for placement of fillings in teenagers in the 1980s and fewer filled teeth before the age of 12 years in the 1990s.

Caries experience and caries predictors--a study of Tanzanian children consuming drinking water with different fluoride concentrations.

The aim of this investigation was to assess the role of predictors of caries experience among children in urban and rural areas of northern Tanzania. Children of the different communities had varying dietary habits and consumed water with varying fluoride (F) concentration. Subjects (n=256) aged 9-14 years were examined in high-F areas (3.6 mg F/l, Arusha and Arusha Meru, n=101) and low-F areas (<0.4 mg F/l, Moshi and Kibosho, n=155). Dental caries was assessed under field conditions using the decayed, missing, filled teeth (DMFT) index and the WHO criteria. The prevalence of caries was 14%. The mean DMFT score was 0.22 (n=256), the range between areas 0.07-0.66. Carious lesions were mainly observed in mandibular first molars. Logistic regression analyses indicated that subjects in the high-F and urban Arusha municipality were at a significantly higher risk of dental caries than children in the low-F areas (odds ratio [OR] 2.6). Controlling for ethnicity, children in urban areas were at higher risk for caries (OR 5.4) than children living in low-F rural Kibosho.

Measurement and predictors of young adults' perceived ability to cope with dental life events.

The purpose of the present study was to assess coping skills and predictors of the ability to cope with dental life events employing a 10-item rather than a 48-item rating questionnaire. A representative random sample of 1490 subjects aged 25 years from 3 Norwegian counties received a mail questionnaire in March 1997. The response rate was 62% after 1 reminder. Eight selected items from the Social Readjustment Rating Questionnaire (SRRQ) plus 2 dental items were presented as graphic rating scales with the endpoints 'not difficult at all' and 'more difficult than anything'. Mean values were used to rank the life events and for comparison with findings from a previous study. Information was also collected for 16 predictor variables (Table 2). The informants found it moderately difficult to cope with losing one or more teeth and with getting dentures. A 10- and a 48-item rating scale seemed to give comparable results. In multiple logistic regression analysis, controlling for having experienced extraction during the previous 5 years, gender, and dental anxiety were significant predictors of both dental life events; education, many cavities, and belief in keeping teeth for life influenced coping with getting dentures. The identified predictors of dental life events explained <11% of the variance. In addition to extending the list of predictors of perceived need for skills to adjust to dental life events, the study also provided evidence to suggest that it may be acceptable to rely on a shorter rating questionnaire.