Traditionally removed mandibular central incisors and oral health-related quality of life: a cross-sectional study among adolescents in Maasai populated areas, Northern Tanzania.

BACKGROUND: The traditional removal of mandibular anterior teeth has been existing for many years in the Sub-Saharan African countries. This study aimed to assess the prevalence and sociodemographic distribution of traditionally removed mandibular central incisors (TRMCI) and its association with oral impact on daily performance (OIDP) among adolescents in Maasai populated areas in the Northern part of Tanzania. METHODS: Using a two-stage cluster sample design, with schools as the primary sampling unit, 23 out of 66 eligible rural schools were randomly selected. From each selected school, one class, expected to contain adolescents aged 12-14 years, was identified. The students from these selected classes were invited to participate in the study. A total of 989 adolescents were invited and 906 (91.6%) accepted to participate and completed both an interview and a clinical oral examination. RESULTS: Mean age was 13.4 years (12-17 years, SD 1.2) and 43.9% were males (n = 398). The participants from Longido district amounted to 47.1%. The Maasai group constituted 79.6% of the study participants. The frequency of the participants missing at least one mandibular central incisor were 18.5%. Multivariable logistic regression revealed that adolescents from Longido district were more likely to report at least one TRMCI (OR = 2.5, 95% CI 1.4-3.3). Adolescents from non-Maasai group were less likely to have atleast one TRMCI compared to adolescents from Maasai ethnic group (OR = 0.02, 95% CI 0.002-0.15). Adolescents with at least one TRMCI were more likely to report impacts on OIDP (OR = 3.3, 95% CI 1.9-5.7) than those without TRMCI. Independent of the TRMCI status, adolescents from Longido district were less likely than their counterparts to report oral impacts (OR = 0.4, 95% CI 0.2-0.6). Similarly, adolescents from non-Masaai group were more likely than their counterparts to report oral impacts (OR = 2.2, 95% CI 1.4-3.5). CONCLUSION: TRMCI is common among adolescents in the Maasai populated areas in the Northern part of Tanzania and strongly associated with the district of residence and Maasai ethnicity and has a negative impact on oral health related quality of life. There is a need for oral health education in the rural Maasai communities in Tanzania to increase awareness of the negative consequences of this practice.

Xerostomia in 75-85-year-olds: A longitudinal population study.

BACKGROUND: Xerostomia can pose significant problems for many elderly people. OBJECTIVES: To investigate longitudinal changes in prevalence, persistence, progression, remission and incidence of xerostomia from age 75 to 85 years. METHODS: All 75-year-olds (born 1932) from two Swedish counties, Sweden were mailed a questionnaire in 2007 (N = 5195), and again in 2017 when they were aged 85 (N = 3323). The total response rates at ages 75 and 85 years were 71.9% and 60.8%, respectively. A 'panel', those who participated in both surveys, comprised 1701 individuals (response rate 51.2%). RESULTS: At age 85, there was almost a doubling of self-reported 'yes often' xerostomia compared with age 75 (from 6.2% to 11.3%) and was almost twice as common in women than men (p < .001). When combining 'yes often'/'yes sometimes', xerostomia increased from 33.4% to 49.0%, and was more so among women (p < .001). Xerostomia was commoner at night than daytime, with 23.4% reporting 'yes often' night-time xerostomia at 85 compared with 18.5% at 75, and was also higher in women (p < .001). Progression rates for daytime and night-time xerostomia were 34.2% and 38.1%, for persistence 67.4% and 68.6%, and for remission 24.4% and 16.5%. Average yearly incidence was higher in women than men for both daytime (3.6% vs. 3.2%) and night-time (3.9% vs. 3.7%). Regression analyses predicted protective factors for developing xerostomia reported at age 75 as good general and oral health, absence of medications/intraoral symptom/s, good chewing function and social interaction. CONCLUSIONS: Xerostomia increases markedly from age 75 to 85 years.

Eating Disorders: An Analysis of Self-Induced Vomiting, Binge Eating, and Oral Hygiene Behavior.

Background: Self-induced vomiting (SIV) is often present in patients with eating disorders (ED) and potentially damaging for oral health. Related behaviors, such as binge eating and oral hygiene habits, may equally increase the risk for dental damage. This study aimed to investigate behaviors and habits in patients with ED and SIV in relation to oral health. Methods: All patients enlisting for treatment in an ED clinic for 1 year were offered to take part in the study. Fifty-four of 65 patients were accepted to participate, and a questionnaire included questions on dietary and oral hygiene habits was included. A subgroup consisting of only those 17 ED patients who reported SIV during the previous six months comprised the sample for this study and received additional questions related to other compensatory behaviors and oral hygiene habits in relation to oral health. Results: Binge eating before SIV was common (14/17 patients). Time point for SIV after binge eating and the procedures performed after vomiting varied. Tooth brushing after vomiting was common (7/17). Food and drinks during binge eating included mainly items rich in calories (sugar/fat) or acid. All 17 patients believed that vomiting could damage their teeth, but only one of them had informed the dentist about having an ED. A number of oral symptoms were reported. Ten patients considered their oral health to be good/fairly good, while the remaining seven patients reported their oral health as not so good/bad/very bad. Information on how ED could affect their teeth was commonly received from the media. Conclusions: The dental team should be made aware of the likely detrimental effects of binge eating and vomiting on oral health in patients with eating disorders. The team should also be aware of the cyclical nature of the disease and the similarities and diversities that exist within this group of ED patients. Since ED patients hide their disease from the dental team, this stresses the importance of open and trustful communication between patients and health workers. An organized collaboration between ED clinics and dental professionals is suggested as well as a development of avenues for information about ED and oral health.

Satisfaction with dental appearance in two cohorts of 75-year-olds examined in 2007 and 2017: A repeated cross-sectional study.

BACKGROUND: Satisfaction with dental appearance plays an important role in the self-esteem and psychological well-being of the elderly, the significance of which the attending dentist may not always be fully cognisant of. OBJECTIVES: To assess the level of satisfaction with dental appearance, its associated factors and temporal changes in two cohorts of 75-year-old Swedes born 10 years apart. METHODS: In 2007, a questionnaire was mailed to all those living in Örebro and Östergötland counties, Sweden, who were born in 1932 (n = 5195), and in 2017 to all born in 1942 (n = 7204). The evaluation was carried out with a global question 'Are you satisfied with the appearance of your teeth?', and four attitude-related statements about dental appearance. RESULTS: About 80% in both cohorts were 'very satisfied' or 'to large extent satisfied' with their dental appearance. The 1932 cohort was significantly more concerned about their dental appearance than the 1942 cohort, and women were generally also significantly more concerned than men. In the regression analysis, 'very satisfied' with dental appearance was predicted by good chewing efficiency, having complete dentures, no impact from Oral Impacts on Daily Performance, disagreement that 'minor esthetic imperfections of the teeth have no importance, only they should function well', better perceived general health than same-aged peers and belonging to the 1932 cohort. CONCLUSION: Satisfaction with dental appearance among 75-year-olds was generally high, with attitudes varying by gender and temporally. Women and the earlier-born generation (1932) were more concerned about dental appearance than men and the later-born generation (1942), respectively.

Oral impacts on daily performances and its socio-demographic and clinical distribution: a cross-sectional study of adolescents living in Maasai population areas, Tanzania.

BACKGROUND: In a global perspective, oral health among adolescents has improved during recent decades. However, oral problems still persist especially in many underprivileged societies. This study aimed to estimate the prevalence of oral impacts in adolescents and to identify important clinical- and socio-demographic covariates. In addition, this study compares Maasai and non-Maasai adolescents regarding any association of socio-demographic and clinical covariates with oral impacts on daily performances. METHODS: A total of 989 adolescents were invited from 23 randomly selected public primary schools in Monduli and Longido districts, Tanzania. All adolescents attending 6th grade classes were invited to participate. A total of 930 accepted and of those 24 were excluded, leaving 906 (91.6%) participants for the study. RESULTS: A total of 143/906 (15.8%) had at-least one oral impact on daily performances (OIDP > 0), 14.6% among the Maasai and 20.5% among the non-Maasai ethnic group. Cluster adjusted logistic regression revealed that: adolescents from Longido district (OR = 0.4) and adolescents with good oral hygiene (OR = 0.7) were less likely to report OIDP> 0 and; non Maasai (OR = 1.6), those with least poor parents (OR = 2.0), DMFT> 0 (OR = 3.1) and those with positive answers to questions regarding TMD pain, 2Q/TMD > 0 (OR = 3.9) were more likely to report OIDP> 0. Stratified logistic regression by ethnicity revealed that, among the non-Maasais, older adolescents (OR = 3.7, 95% CI 1.1-12.8), those with DMFT> 0 (OR = 3.3 (1.2-9.0) and 2Q/TMD > 0 (OR = 9.0, 95% CI 3.3-25.0) were more likely to report at least one OIDP. The corresponding figures among the Maasais were (OR = 0.9, 95% CI 0.5-1.7), (OR = 2.8, 95% CI 1.4-5.5) and (OR = 3.0, 95% CI 1.7-5.2), respectively. CONCLUSIONS: The prevalence of oral impacts was moderate but higher among the non-Maasai- than Maasai-adolescents attending rural primary schools in the Maasai population areas of Tanzania. This study also confirmed socioeconomic and oral clinical disparities in OIDP, some of which differed according to ethnicity. Caries experience and self-reported TMD pain associated more strongly with OIDP among the non-Maasais than among the Maasais. These results are important for public oral health decision makers who plan strategies for optimal primary oral health care and quality of life among adolescents belonging to minority groups in Tanzania.

Changes in conditions related to reported oral and general health over a ten-year period as reflected in two cohorts of 75-year-old subjects examined in 2007 and 2017.

BACKGROUND: The rapidly ageing and increasingly dentate population puts great demands on society regarding the provision of adequate medical and dental care facilities. OBJECTIVES: To present changes in reported demographic, general and oral health factors in two cohorts of 75 year olds in 2007 and 2017, and to analyse factors associated with self-reported number of remaining teeth and chewing efficiency. MATERIAL AND METHODS: All 75-year-old people living in two Swedish counties received a questionnaire in 2007 and in 2017. The response rates in 2007 and in 2017 were 71.9% (n = 3735) and 70.7% (n = 5091), respectively. Reported number of teeth was clinically validated in a selected subgroup. RESULTS: The 2017 cohort reported significantly better general health and dental state. Edentulousness was 7.8% in 2007 and 2.3% in 2017, while 'very good' chewing efficiency was 55.2% and 60.5%, respectively. Born outside Sweden, single living, not feeling healthy and smoking predicted reduced number of teeth in both cohorts. Impaired chewing efficiency in both cohorts was predicted by being born outside Sweden, lower education, not feeling healthy, reduced number of teeth and denture wearing. CONCLUSIONS: Seventy-five-year-old people in Sweden reported much better oral and general health in 2017 compared to 2007. In 2017, 75% had practically all natural teeth present and only 2% were edentulous. This development of an increasingly dentate and partially dentate ageing population will put high demands on the oral healthcare system and will need adapting undergraduate/postgraduate education and management strategies to meet the requirements of the elderly.

Self-reported dry mouth in 50- to 80-year-old Swedes: Longitudinal and cross-sectional population studies.

Xerostomia is a common condition among elderly. The objectives were to examine prevalence, persistence, progression, yearly incidence of xerostomia, associated background factors and its influence on oral impacts on daily performances (OIDP) in 50- to 80-year-old people. In 1992, a questionnaire was sent to all 50-year-old (n = 8888) and in 2007 to all 75-year-old persons (n = 5195) living in two Swedish counties. In 2012, the same questionnaire was sent to both age cohorts, now 70- and 80-year-old. Response rate was for the 50-, 70- 75- and 80-year-old groups 71.4%, 72.2%, 71.9% and 66.4%, respectively. In the 50- to 70-year-old sample, 40.3% of the participants answered all five examinations and in the 75-80 group 49.5% (intact samples). In all age groups, xerostomia was significantly more prevalent in women than in men. At age 80, "often mouth dryness at night" was reported by 24.3% and 16.2% of women and men, respectively. Prevalence increased with age and was more frequent at night-time. Persistence of xerostomia was reported by 61.4%-77.5%, progression by 11.5%-33.0% and remission by 5.7%-11.3%. Average yearly incidence was 0.99%-3.28%. Xerostomia was more prevalent in those who reported a negative impact on OIDP. Highest odd ratios for xerostomia were burning mouth (OR 12.0), not feeling healthy (OR 5.1) and medicine usage (OR 3.9). Xerostomia is common in older age, persistence is high and progression common. The comorbidity between xerostomia, oral health problems and impaired general health needs to be taken into consideration when providing dental care to elderly patients.

Oral diseases and oral health related behaviors in adolescents living in Maasai population areas of Tanzania: a cross-sectional study.

BACKGROUND: Oral diseases, such as dental caries, tooth wear, dental erosion and periodontal diseases are major health problems in many societies. The study aim was to explore the association between oral health related behaviors and the presence of oral diseases in adolescents living in Maasai population areas in the northern part of Tanzania. METHODS: A cross sectional study was conducted in 2016 using one stage cluster sample design. A total of 989 adolescents were invited and 906 (91.6%; (Maasais n = 721, non Maasais n = 185) accepted the invitation and completed an interview and clinical oral examination in a school setting (mean age 13.4 years, SD 1.2, range 12-17 years). Chi-square test, bivariate analysis and logistic regression were performed to analyze data. RESULTS: Logistic regression revealed that: adolescents with low frequency of tooth cleaning (OR = 10.0, CI 4.3-20.0) was associated with poor oral hygiene and that more regular tooth cleaning (OR = 0.1, CI 0.04-0.14) and the use of plastic type of tooth brush (OR = 0.7, CI 0.53-0.99) were associated with less gingival bleeding. High consumption of biscuits (OR = 2.5, CI 1.7-3.8) was associated with presence of dental caries and the use of magadi (OR = 24.2, CI 11.6-50.6) as a food additive was the covariate for more severe dental fluorosis (TF grade 5-9). Regular intake of carbonated soft drinks (OR = 1.6, CI 1.1-2.5) and regular tooth cleaning (OR = 1.7, CI 1.1-2.6) were independently associated with dental erosion. Using teeth as a tool for: biting nails (OR = 1.9, CI 1.4-2.4), opening soda (OR = 1.8, CI 1.4-2.4) and holding needles (OR = 1.6, CI 1.3-2.1) were covariates for tooth wear. Adolescents who reported to clench/grind their teeth (OR = 2.3, CI 1.5-3.7) was the only covariate for TMD. In several of the investigated factors, there were significant differences between the Maasai and non Maasai ethnic groups. CONCLUSION: Oral health related behaviors have a significant impact on oral diseases/conditions among adolescents attending primary schools in Maasai population areas with obvious differences in behavior between the Maasai and non Maasai ethnic groups. There is a need for addressing oral health and to encourage behaviors that promote good oral health and dental care service utilization in this society.

Oral diseases and socio-demographic factors in adolescents living in Maasai population areas of Tanzania: a cross-sectional study.

BACKGROUND: Oral diseases may cause serious health problems, especially in socially disadvantaged populations and in low-income countries. In populations living in the rural areas of Tanzania there is paucity of reports on oral health. The study aim was to estimate the prevalence, severity and socio-demographic distribution of oral diseases/conditions in adolescents living in Maasai population areas of Tanzania and to compare oral diseases/conditions between Maasai and non-Maasai ethnic groups. METHODS: A total of 23 schools were randomly selected from 66 rural public primary schools in Monduli and Longido districts, Tanzania. All pupils in the selected classes, 6th grade, were invited to participate in the study. A total of 989 were invited and 906 (91.6%) accepted the invitation and completed an interview and a clinical oral examination. RESULTS: Out of 906 study participants (age range 12-17 years), 721(79.6%) were from Maasai and 185 (20.4%) from non-Maasai ethnic groups. Prevalence of poor oral hygiene, gingival bleeding, dental caries experience (DMFT> 0), dental fluorosis TF grade 5-9, dental erosion (into dentin), tooth wear (into dentin) and TMD was 65.6, 40.9, 8.8, 48.6, 1.9, 16.5 and 11.8%, respectively. Multiple variable logistic regression analysis revealed that, girls (OR = 2.0) and participants from Longido (OR = 2.6) were more likely to present with good oral hygiene (p < 0.05). Adolescents from Monduli (OR = 1.7), males (OR = 2.1), being born within Arusha region (OR = 1.9) and Maasai (OR = 1.7) were more likely to present with gingival bleeding (p < 0.05). DMFT> 0 increased by age (OR = 2.0) and was associated with non-Maasai ethnic group (OR = 2.2), (p < 0.05). Adolescents from Monduli district (OR = 10.0) and those born in Arusha region (OR = 3.2) were more likely to present with dental fluorosis (p < 0.05). Dental erosion was more common among non-Maasais (OR = 2.0) as well as having mother with high education (OR = 2.3), (p < 0.05). CONCLUSIONS: Oral diseases like dental caries and dental erosion were less common, but gingival bleeding, dental fluorosis, tooth wear and TMD were common findings in adolescents attending primary schools in the Maasai population areas of Tanzania. Notable differences between Maasai and non-Maasai ethnic groups and certain correlations to sociodemographic factors were detected. Our findings can be utilized by policy makers in the planning of oral health programs in public primary schools of Maasai population areas of Tanzania.

Dental erosion in groups of Yemeni children and adolescents and the modification of an erosion partial recording system.

BACKGROUND: The prevalence of dental erosion is rising especially among children and adolescents and its grading needs further investigation. AIMS: To determine the prevalence and severity of dental erosion in groups of Yemeni children and adolescents, and to clinically compare an erosion partial recording system (EPRS) with a proposed modified-simplified version (EPRS-M). DESIGN: Of 6163 individuals aged 5-6, 13-14 and 18-19 years, 911 were randomly selected, of which 668 participated in the study. Dental erosion was graded using EPRS. EPRS-M was proposed, and its sensitivity and specificity was calculated in relation to EPRS. RESULTS: Prevalence of erosion extending into dentine on at least one tooth was 6.8% among 5- to 6-year-olds, 3.0% among 13- to 14-year-olds and 14.6% among 18- to 19-year olds. The highest prevalence was 19.2% among girls aged 18-19 years which was significantly higher than boys (10.4%) in the same age group (P = 0.044). Sensitivity and specificity for EPRS-M in relation to EPRS were 85.7% and 100% for primary teeth, and 84.1% and 100% for permanent teeth. CONCLUSIONS: Dental erosion was common among children and older teenagers and highest among older girls but less common among younger teenagers. The tested accuracy of EPRS-M qualifies it to be used as an initial quick detection tool in future dental erosion research.

Reporting dental caries disease in longitudinal studies - a suggestion.

In general, most infectious and/or lifestyle-related diseases are defined as being present when sufficient signs or symptoms occurs in an individual. The term "sufficient".is a relative concept and a disease can therefore be measured with different degrees of certainty.These symptoms are commonly defined in such a way that it is possible to determine the incidence and prevalence of the disease and also the proportion of individuals that are cured from the dis- ease. If dental caries is an individual disease which can be compared to other diseases regarding incidence and prevalence, it is important to determine for how long an individual must be free from new signs of the disease before being considered cured or free from the disease and to define the "sufficient" signs or symptoms needed for a diagnose. Based on these thoughts, the purpose of this study was to calculate caries incidence and prevalence in a group of adolescents from a definition of dental caries based on ICD-1o. This study included all12 year olds in 1990 who attended a clinical dental examination in 1990-1995 in Orebro County, Orebro, Sweden, yearly during these six years. Dental caries disease at the individual level was defined as K02.1 (dentinal caries) according to ICD-io while freedom of caries was defined as the absence of K02.1 during a three-year period. In this study the yearly prevalence was 12%, the three year cu- mulative incidence was 18% and the incidence rate 13%. Results of this study highlight the poor outcomes in curing caries disease in this age-group, according to the criteria in this study, as only 17% of the children with caries at the outset of the study were free from the disease three years later. Defining both a practical level to measure signs of dental caries, and the period an individual must be free from them to be classified as cured from the disease create new oppor- tunities to compare and communicate the disease of dental caries with other diseases.This way of registration is also of advantage for planning purposes as there the centre of interest must be the individual patient and not the tooth or surface.

Eating disorders and biochemical composition of saliva: a retrospective matched case-control study.

This study aimed to compare the biochemical composition of saliva from patients with eating disorders (EDs) with saliva from control subjects with no ED. All patients who initiated outpatient treatment in an ED clinic during a 12-month period were invited to participate. Of the 65 patients who started treatment during the period, 54 (50 female patients/four male patients; mean age: 21.5 yr) agreed to participate. The controls were 54 sex- and age-matched patients from a dental health clinic. All participants completed a questionnaire and underwent dental clinical examinations, including laboratory analyses of saliva. The proportion of subjects with unstimulated salivary hyposalivation was lower in the ED group and not correlated with intake of xerogenic drugs. Significant differences in the biochemical composition of saliva were found almost exclusively in the unstimulated state, with albumin, inorganic phosphate, aspartate aminotransferase (ASAT), chloride, magnesium, and total protein all being significantly higher in the ED group. Conditional logistic regression showed that higher ASAT and total protein concentrations were relatively good predictors of ED, with sensitivity and specificity of 65% and 67%, respectively. In conclusion, elevated salivary concentrations of ASAT and total protein may serve as indicators of ED as well as of disease severity. Future studies are needed to corroborate these initial findings.

Awareness and knowledge of dental erosion among Yemeni dental professionals and students.

BACKGROUND: This study explored Yemeni dentists' and dental students' knowledge about the associated factors, approaches to diagnosis and preventive methods of dental erosion (DE), as well as any associations between DE awareness and some potentially related variables. METHODS: A self-administered questionnaire was distributed to general dental practitioners (n = 323) in Sanaa and to fifth year dental students (n = 97) at the University of Science and Technology, Sanaa, Yemen during the period from July to November 2013. Descriptive and logistic regression analyses were conducted. RESULTS: Overall response rate was 79 %. Results indicated that 61 % of respondents learned about DE from dental school, 27 % from their own studies and the rest from continuing education courses and the media. DE was reportedly most frequently seen on incisors by 46 % of respondents and on premolars and molars by 24 %. While 48 % reported DE to be more common in male patients, no gender differences were reported by 20 % of respondents. Acidic drinks were believed to be causative factors for DE by 41 % of dentists and 52 % of students, while 90 % of respondents believed that patients' dietary history is important during DE diagnosis. As preventive measures for DE, reduction of acidic drink consumption was advised by 51 % of respondents while only 37 % advised their patients to use fluoridated toothpastes. Younger respondents (≤35 years) were more likely to identify the commonly-known causative factors for DE (P = 0.024). Twenty-seven percent of the respondents reportedly used an index to grade DE. Dental students were more likely than dentists to use such an index (P <0.001) and to more frequently advise their patients to reduce intake of acidic drinks (P = 0.02) compared to dentists. CONCLUSIONS: In-depth knowledge about causative factors, diagnosis and preventive methods of DE was apparent among only half the respondents and approaches to early diagnosis were insufficient. There would appear to be an urgent need for enhancing awareness and knowledge about DE within the Yemeni dental community.

Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists.

BACKGROUND: The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. METHODS: In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. RESULTS: The participation rate was 40 % (47 % women and 53 % men). Their knowledge about ED was often retrieved from common media sources and the greater part of the participants reported they had seen very few patients with ED during their professional career. Female dentists reported superior knowledge about ED compared to males, but the former experienced greater difficulties to inform about the condition. Referrals of the patient to other health facilities were significantly more common among female compared to male dentists. The majority of dentists (76 %) reported a need of more education related to ED management. CONCLUSIONS: The Norwegian dentists in this study reported limited clinical experience and insufficient knowledge regarding ED. There is therefore a need to increase both undergraduate and continuing education in this field, which can improve preventive and management measures that a dentist can provide for ED patients.

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents.

OBJECTIVE: The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. MATERIALS AND METHODS: A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression. RESULTS: Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer. CONCLUSION: High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.

General and orofacial symptoms associated with acute and long COVID in 80- and 90-year-old Swedish COVID-19 survivors.

OBJECTIVES: To describe acute and long COVID-19 symptoms among older elderly Swedes and to find predictive factors for the development symptoms associated with acute and long COVID. MATERIAL AND METHODS: A questionnaire about general and oral health was mailed to all 80-year-olds (born 1942, n = 6299) and 90-year-olds (born 1932, n = 1904) in two Swedish counties. Participants reporting COVID-19 were asked to complete an additional questionnaire. RESULTS: Overall response rate was 66 % (n = 5375). Affirmative responses to having been sick/tested positive for COVID-19 were reported by 577 persons. Response rate to the COVID-19 questionnaire was 49 %. The majority (88 %) reported some general symptoms during the acute stage while 44 % reported orofacial symptom/s. Reporting of any form of long-COVID general symptoms was 37 and 35 % for orofacial symptoms. Predictive factors for contracting COVID-19 (based on self-report from 2017) were living in elderly housing/senior care facility (OR 1.6, CI 1.0-2.3), large number (>10) of weekly social contacts (OR 1.5, CI 1.3-1.9), being married (OR 1.4, CI 1.1-1.7) and high school/university education (OR 1.3 CI 1.1-1-6). The highest odds ratio for general symptoms of long-COVID were a single complete denture (OR 5.0, CI 2.0-12.3), reporting bad breath (OR 3.7, CI 1.9-7.2) and daytime dry mouth (OR 2.2, CI 1.1-4.2). Regarding long-COVID orofacial symptoms, the highest risk factors were bad breath (OR 3.8, CI 1.9-7.5) and a single complete denture in one jaw (OR 3.4, CI 1.2-9.8). CONCLUSION: Long-COVID general and orofacial symptoms are common among older elderly COVID-19 survivors CLINICAL SIGNIFICANCE: Oral microorganisms may be responsible for development of long-COVID symptoms. Health personnel managing COVID-19 patients should carefully examine dental status, especially in those having acrylic-based removable dentures, for oral signs and symptoms. If found, rigorous oral hygiene procedures should be carried out including cleaning/disinfection of the denture.

Eating disorders and oral health: a matched case-control study.

The aim was to compare the oral health status of patients with eating disorders (EDs), with sex- and age-matched controls, with a view to identify self-reported and clinical parameters that might alert the dental healthcare professional to the possibility of EDs. All patients who entered outpatient treatment in an ED clinic during a 12-month period were invited to participate. Of 65 ED patients who started psychiatric/medical treatment, 54 agreed to participate. Eating disorder patients and controls answered a questionnaire and underwent dental clinical examinations. Multivariate analysis identified significantly higher ORs for ED patients to present dental problems (OR = 4.1), burning tongue (OR = 14.2), dry/cracked lips (OR = 9.6), dental erosion (OR = 8.5), and less gingival bleeding (OR = 1.1) compared with healthy controls. Sensitivity and specificity for the correct classification of ED patients and controls using the five variables was 83% and 79%, respectively. The ED patients with vomiting/binge eating behaviors reported worse perceived oral health (OR = 6.0) and had more dental erosion (OR = 5.5) than those without such behavior. In ED patients with longer duration of the disease, dental erosion was significantly more common. In conclusion, oral health problems frequently affect ED patients, and this needs to be considered in patient assessment and treatment decisions.

Extensive composite molar restorations: 3 years clinical evaluation.

Abstract Objective. To evaluate the clinical performance of extensive direct composite restorations in molars after 1 and 3 years and to find out the importance of extent of the restorations and other factors related to their performance. Materials and methods. Seventy-four patients with a molar tooth in need of a restoration covering at least three surfaces and one cusp were selected. Patient-related factors were registered and the tooth was prepared and restored by using a nano-filled composite. A topographic system for classification of extensive posterior restorations was developed. At baseline, the operator recorded a clinical evaluation, using modified USPHS-criteria. After 1 and 3 years, an independent observer evaluated the restorations. Post-operative problems arising during the observation period were registered. Results. A change in clinical score from baseline to the 1 and 3 year recall was recorded for all clinical criteria. A total of nine restorations were graded as unacceptable after 3 years (3-year survival rate of 87.7% and a mean annual failure rate of 4.2%). Except for gender (p = 0.022), none of the patient-related factors investigated (age, caries risk, extension of the restoration and presence of cervical enamel) had a significant influence on the survival of the restorations. Conclusions. Extensive direct posterior composite restorations showed an acceptable clinical performance after 3 years. Men had a significantly greater restoration failure rate than women.

A comparison of two clinical methods for measuring saliva in patients with Sjögren's syndrome.

OBJECTIVE: The aim of the present study was to evaluate two different ways of measuring unstimulated and stimulated whole salivary output in the dental clinic, namely by volume (mL/min) and by weight (g/min). MATERIALS AND METHODS: Thirty-one patients diagnosed with Secondary Sjögren's syndrome (SSS) participated in the study. RESULTS: The results showed a large discrepancy between the measurements performed by volume and by weight (p < 0.001) and additionally when taking into account density calculation, especially in individuals with low salivary secretion rate. CONCLUSION: It is suggested that weight measurement of saliva should be more routinely implemented, especially in patients with reduced salivary secretion.

Self-reported dry mouth in Swedish population samples aged 50, 65 and 75 years.

BACKGROUND: Reduced salivary flow may have a negative impact on general well-being, quality of life and oral health. OBJECTIVES: To examine xerostomia in 50-, 65- and 75-year-olds, background factors and effect on Oral Impacts on Daily Performances (OIDP). METHODS: In 1992, a questionnaire was sent to all 50-year-old persons (n = 8888) in two Swedish counties. In 2007, the same questionnaire was sent to all 65-year-olds (n = 8313) in the two counties and to all 75-year-olds (n = 5195). Response rate was for the 50, 65 and 75 year olds 71.4, 73.1 and 71.9%, respectively. RESULTS: Xerostomia was higher in women than in men in all age groups. There was higher prevalence of xerostomia with increasing age in both sexes and it was more frequent at night than during daytime. 'Often mouth dryness' was 2.6-3.4 times more prevalent in those who reported an impact from OIDP. The highest odd ratios were for daytime xerostomia and for the variables burning mouth (17.1), not feeling healthy (4.5), daily smoking (4.4), and medication (4.1). CONCLUSIONS: The dramatic increase of xerostomia between age 50 and 75, especially amongst women, needs to be considered in the management of this age group.