Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway: a cross-sectional study from the Tromsø Study Fit Futures cohort.

BACKGROUND: Non-communicable general and oral health conditions share common risk factors. Studies investigating common social determinants as risk factors for overweight/obesity and dental caries among the same adolescents are scarce and inconclusive. METHODS: This cross-sectional study included data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010-2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate). Multivariable binary logistic regression analyses stratified by sex were used to investigate the association between socioeconomic position indicators (adolescent's own study program, parents' education and employment status) and overweight/obesity indicated by body weight and waist circumference, untreated dental caries in dentine, and when these conditions were considered simultaneously. RESULTS: Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (POR 0.42, 95% CI 0.20-0.86 and POR 0.24, 95% CI 0.08-0.73, respectively), of having high waist circumference (POR 0.39, 95% CI 0.21-0.75 and POR 0.25, 95% CI 0.10-0.64, respectively), dental caries (POR 0.57, 95% CI 0.32-0.99 and POR 0.47, 95% CI 0.22-0.98, respectively), and being simultaneously overweight/obese, having high waist circumference and dental caries (POR 0.24, 95% CI 0.07-0.81 and POR 0.11, 95% CI 0.01-0.98, respectively). Girls enrolled in the general studies program (versus vocational) had lower odds of having dental caries (POR 0.50, 95% CI 0.30-0.84). CONCLUSIONS: Adolescent's own study program was identified to be a common social determinant for overweight/obesity and dental caries among boys. These results support the broader concept of social determinants as common risk factors for general and oral health conditions, and call for common health promotion strategies addressing these common social determinants among adolescents. However, there is a need for more studies to investigate and better understand the influence of social determinants on health conditions among adolescents.

Oral health in the indigenous Sámi population in Norway - the dental health in the North study.

Objective: This study aims at presenting the feasibility of using the public oral health clinics in indigenous Sámi communities, as arena for a comprehensive data collection for population-based epidemiological oral health research among adults (age, 18-75 years) in a multi-ethnic setting.Material and methods: The study design was cross-sectional. The data collection was incorporated into the clinical procedure at six public dental clinics situated in the Administrative Area for the Sámi Language in Finnmark County, Northern Norway, during 2013-2014. Both clinical- and questionnaire-data were collected. The quality of clinical data was thoroughly calibrated and validated.Results: Altogether, 2235 people participated in the study gave a crude response rate at 88.7%. In the final data sample (n = 2034), 56.9% were female. We constructed three ethnic groups (Sámi, Mixed Sámi/Norwegian and Norwegian). Altogether, 67.7% reported Sámi or mixed Sámi ethnicity. The internal validity of the clinical data was found to be satisfactory when assessed by comprehensive quality procedure, calibration and reliability assessments.Conclusion: This study design and method assessments provide solid documentation that public dental clinics are suitable as arenas for data collection in epidemiological oral health studies in the Sámi population in this region.

Oxidative stress levels and oral bacterial milieu in the saliva from pregnant vs. non-pregnant women.

BACKGROUND: Saliva plays a significant role in maintaining oral health and oral bacterial milieu. Difference in oxidative stress (OS) levels in saliva in conjunction with bacterial load between pregnant and non-pregnant women has not been studied previously. We hypothesized that the physiological changes in pregnancy alter oral bacterial milieu by promoting growth of Streptococcus mutans (SM) and Lactobacillus (LB), and increase OS in saliva. The aim of this study was to measure and compare the oral bacterial milieu, OS and total anti-oxidative capacity (TAC) in the saliva of pregnant and non-pregnant women. METHOD: In this cross-sectional study, we assessed oral bacterial milieu by culturing the SM and LB by using commercial kits, TAC by measuring 2, 2'-Azino-Bis-3-Ethylbenzothiazoline-6-Sulfonic Acid (ABTS) free radical scavenging activity spectrophotometrically and OS levels by measuring malondialdehyde (MDA) levels with commercial kits in the saliva of pregnant women (n = 38) at 18-20 weeks of gestation, who were compared with age-matching healthy non-pregnant women (n = 50). RESULTS: Streptococcus mutans were found to be more abundant in the saliva of pregnant women compared with non-pregnant women (p = 0.003) but the difference was not significant for the LB (p = 0.267). TAC was found to be 46% lower in pregnant women's saliva compared to non-pregnant women [optical density (OD) measured at 731 nm as 0.118 ± 0.01 vs. 0.063 ± 0.02; p < 0.001]. OS, expressed as saliva MDA levels, was found to be 16% higher in pregnant women compared to non-pregnant women (1.07 nM MDA vs. 0.92 nM MDA; p = 0.023). CONCLUSION: Pregnancy has an adverse impact on oral bacterial milieu as demonstrated by increased colonization with Streptococcus mutans together with higher OS levels and decreased TAC levels in saliva. This emphasizes the importance of improved oral hygiene and provision of oral healthcare services during pregnancy care.

Knowledge about preventive dentistry versus self-reported competence in providing preventive oral healthcare - a study among Nepalese dentists.

BACKGROUND: Dentists' and dental healthcare providers' professional knowledge and attitude towards the prevention of oral diseases may have an impact on the oral health of the general population. The aim of this study was to describe Nepalese dentists' competency in giving preventive education and treatment to their patients, and to assess their level of knowledge about preventive dental health. METHODS: This was a cross-sectional study of 195 dentists (71 males and 124 females). Knowledge of preventive oral healthcare and self-reported aspects of preventive oral healthcare were assessed using a close-ended multiple-choice questionnaire. Statistical evaluation was done using chi-squared test, independent sample t-test and factor analysis as appropriate. RESULTS: More than 90% of dentists self-reported to be competent in providing preventive treatment and oral hygiene education to their patients. Female dentists reported being more competent in giving oral hygiene education than their male counterparts (p = 0.045). Dentists scored a mean of 24.06 ± 3.8 [range (15-33)] out of 56 on knowledge based on self-reported awareness of seven different aspects of preventive dentistry. More than 70% of the dentists had relatively good knowledge regarding the use of fluoride, whereas the preventive knowledge in other aspects of dental health such as frequency of sugar consumption, xylitol use, dental visits, sealant, gingival health, dental and general health was found to be limited. CONCLUSIONS: The majority of participating dentists reported a high level of general competency in providing preventive treatment and oral health education to their patients, whereas their knowledge was found to be limited in some aspects of preventive dentistry.

Dental caries experience and determinants in young adults of the Northern State Medical University, Arkhangelsk, North-West Russia: a cross-sectional study.

BACKGROUND: Little information exists about the experience of and risk factors for dental caries in young adults in Russia. We investigated dental caries experience and determinants in medical and dental students in North-West Russia. METHODS: This cross-sectional study included 442 medical and 309 dental undergraduate students of Russian nationality aged 18-25 years from the Northern State Medical University, Arkhangelsk, Russia. Information on socio-demographic factors and oral health behaviour (regularity of dental visits, frequency of tooth-brushing, using toothpaste with fluoride, and skipping tooth-brushing) was obtained from a structured, self-administered questionnaire. Dental caries experience was based on the decayed (D) missing (M) filled (F) teeth (T) index and the Significant Caries (SiC) index, which were assessed through dental examination. Students with a DMFT index ≥9 were placed in the SiC group. Negative binomial hurdle and multivariable binary logistic regressions were used for statistical analyses. RESULTS: The prevalence of dental caries (DMFT >0) was 96.0%, overall mean DMFT index was 7.58 (DT: 0.61, MT: 0.12, and FT: 6.84), and the corresponding SiC index was 12.50. Age 21-25 years (incidence rate ratio [IRR] = 1.09, 95% confidence interval [CI]: 1.01-1.18), being a female (IRR = 1.10, 95% CI: 1.01-1.20), high subjective socioeconomic status (SES) [IRR = 1.11, 95% CI: 1.02-1.21], and skipping tooth-brushing (IRR = 1.09, 95% CI: 1.00-1.19) were associated with a higher DMFT index. DMFT index also increased among students who reported regular dental visits (IRR = 1.22, 95% CI: 1.10-1.36), but their odds of being in the dental caries-free group decreased (odds ratio [OR] = 0.38, 95% CI: 0.18-0.82). Significant predictors of being categorised to the SiC group were older age (OR = 1.41, 95% CI: 1.03-1.92), high subjective SES (OR = 1.57, 95% CI: 1.13-2.19), and regular dental visits (OR = 2.34, 95% CI: 1.56-3.51). CONCLUSIONS: A high prevalence of dental caries and high DMFT index, with a dominance of FT, were observed in our Russian medical and dental students. Age, sex, subjective SES, regular dental visits, and skipping tooth-brushing were determinants of dental caries experience.

Do dentists have better oral health compared to general population: a study on oral health status and oral health behavior in Kathmandu, Nepal.

BACKGROUND: Dentists are considered role models by the general population in regards to oral hygiene and oral health behavior. This study aimed to access the oral health status of dentists and laypersons, and compare the dentists' practice of preventive dentistry and oral self-care behaviors to that of the laypersons. METHODS: This cross-sectional study recruited 472 participants (195 dentists and 277 laypersons from the general population). Their oral health/hygiene behavior was assessed using a standardized close-ended multiple choice questionnaire. Oral examination was performed to assess caries using Decayed Missed Filled teeth (DMFT) index and periodontal status using Community Periodontal Index of Treatment Needs (CPITN). RESULTS: Ninety-six percent of dentists brushed their teeth at least once daily, using fluoridated toothpaste and 80.5% twice daily. Although 94% of laypersons brushed their teeth once daily, they seldom used fluoridated toothpaste. Ten percent of participants in each group were caries free. The mean number of teeth present in the oral cavity (27.4 versus 25.4), mean number of teeth with caries (1.8 versus 3.7) and fillings (2.5 versus 0.4) were significantly different (p < 0.0001) between dentists and laypersons, respectively. Regarding the periodontal status, 82% of dentists had CPITN score of 0 whereas 71% of laypersons had the highest score 3 (p = 0.007), and 81% of the laypersons reported tooth mobility compared to 1% of dentists (p < 0.0001). CONCLUSIONS: The participating dentists had better periodontal status and better self-reported oral health behaviors than the laypersons. Despite similar prevalence of caries in the two groups, the prevalence of decayed and unfilled teeth was lower among the dentists.

Impact of traumatic dental injuries with unmet treatment need on daily life among Albanian adolescents: a case-control study.

BACKGROUND: Traumatic dental injuries (TDI) are common in children and adolescences. Neglected or inadequate treatment may lead to psychosocial distress during late adolescence. AIM: To investigate the potential impact of traumatic dental injuries (TDI) with unmet treatment need, on the quality of life of 16-19 year-olds in Tirana, Albania. MATERIAL AND METHODS: A case-control survey (1:2) was conducted in public high schools in Albania, comprising 95 subjects affected by TDI with unmet treatment need based on objective clinical signs. Controls (n = 190) with no history of TDI were matched by age, sex and belonging to the same school class and group of friends as the respective case. The Oral Impact on Daily Performances (OIDP) index was used to measure the impacts. DMFT, Community Periodontal Index and the Aesthetic Component of the Index of Orthodontic Treatment Need as well as social parameters were recorded. RESULTS: The response rate was 98%. Overall, the impact prevalence of OIDP was 88.4% among the cases, and 58.9% among the controls (P < 0.001). The most prevalent OIDP impact was 'smiling and showing teeth without embarrassment': cases had significantly higher values than controls (78.9% vs 31.6%). Multiple conditional logistic regression analysis was used to disclose the effect of TDI with unmet treatment need on quality of life by adjusting for possible confounders. Compared to the control group, TDI cases with unmet treatment need are at greater overall risk of impacts measured as OIDP, with an odds ratio of 3.9 (95% CI: 1.6-9.1). CONCLUSION: TDI with unmet treatment need in this sample of adolescents is associated with reduced OHRQoL. Compared to adolescents with no history of TDI, those affected by TDI with unmet treatment need are at greater risk of suffering impacts on OHRQoL in the form of OIDP.

Corrigendum to "Health-Related Quality of Life and Sleep Quality after 12 Months of Treatment in Nonsevere Obstructive Sleep Apnea: A Randomized Clinical Trial with Continuous Positive Airway Pressure and Mandibular Advancement Splints".

[This corrects the article DOI: 10.1155/2020/2856460.].

Evaluation of oral health-related quality of life among Sudanese schoolchildren using Child-OIDP inventory.

BACKGROUND: Information on oral health-related quality of life, in addition to clinical measures, is essential for healthcare policy makers to promote oral health resources and address oral health needs. OBJECTIVES: This paper aimed at evaluating the psychometric properties of the Arabic version of Child-OIDP, estimating the prevalence, severity and causes of oral impacts on daily performances in 12-year-old public and private school attendees in Khartoum State and to identify socio-demographic and clinical correlates of oral impacts as assessed by the Child-OIDP inventory. METHODS: The Child-OIDP questionnaire was translated into Arabic was administered to a representative sample of 1109 schoolchildren in Khartoum state. Clinical measures employed in this study included DMFT index, Gingival index, Plaque index and Dean's index. A food frequency questionnaire was used to study the sugar-sweetened snack consumption. RESULTS: The instrument showed acceptable psychometric properties and is considered as a valid, reliable (Cronbach's alpha 0.73) and practical inventory for use in this population. An impact was reported by 54.6% of the schoolchildren. The highest impact was reported on eating (35.5%) followed by cleaning (28.3%) and the lowest impacts were on speaking (8.6%) and social contact (8.7%). Problems which contributed to all eight impacts were toothache, sensitive teeth, exfoliating teeth, swollen gums and bad breath. Toothache was the most frequently associated cause of almost all impacts in both private and public school attendees. After adjusting for confounders in the 3 multiple variable regression models (whole sample, public and private school attendees), active caries maintained a significant association with the whole sample (OR 2.0 95% CI 1.4-2.6) and public school attendees (OR 3.5 95% CI 2.1-5.6), and higher SES was associated with only public school attendees' Child-OIDP (OR 1.9 95% 1.1-3.1). CONCLUSION: This study showed that the Arabic version of the Child-OIDP was applicable for use among schoolchildren in Khartoum. Despite the low prevalence of the dental caries pathology (24%), a significant relationship, with an average moderate intensity was found with OHRQoL. Focus in this population should be on oral health education, improving knowledge of the prospective treatment opportunities and provision of such services.

Weather Conditions and Outdoor Fall Injuries in Northwestern Russia.

This study aimed to investigate associations between the weather conditions and the frequency of medically-treated, non-fatal accidental outdoor fall injuries (AOFIs) in a provincial region of Northwestern Russia. Data on all non-fatal AOFIs that occurred from January 2015 through June 2018 (N = 1125) were extracted from the population-based Shenkursk Injury Registry (SHIR). Associations between the weather conditions and AOFIs were investigated separately for the cold (15 October-14 April) and the warm (15 April-14 October) seasons. Negative binomial regression was used to investigate daily numbers of AOFIs in the cold season, while zero-inflated Poisson regression was used for the warm season. The mean daily number of AOFIs was 1.7 times higher in the cold season compared to the warm season (1.10 vs. 0.65, respectively). The most typical accident mechanism in the cold season was slipping (83%), whereas stepping wrong or stumbling over something was most common (49%) in the warm season. The highest mean daily incidence of AOFIs in the cold season (20.2 per 100,000 population) was observed on days when the ground surface was covered by compact or wet snow, air temperature ranged from -7.0 °C to -0.7 °C, and the amount of precipitation was above 0.4 mm. In the warm season, the highest mean daily incidence (7.0 per 100,000 population) was observed when the air temperature and atmospheric pressure were between 9.0 °C and 15.1 °C and 1003.6 to 1010.9 hPa, respectively. Along with local weather forecasts, broadcasting warnings about the increased risks of outdoor falls may serve as an effective AOFI prevention tool.

Perceived Stress and Associated Factors in Russian Medical and Dental Students: A Cross-Sectional Study in North-West Russia.

The aim was to assess perceived stress (PS) and factors associated with PS in Russian medical and dental students. A total of 406 medical and 283 dental students aged 18-25 years that attended the Northern State Medical University in Arkhangelsk, North-West Russia participated in this cross-sectional study. A structured, self-administered questionnaire was used to collect information on socio-demographic and socioeconomic factors, oral health (OH) behavior, and self-reported OH. All students were clinically examined to assess dental caries, oral hygiene, and gingiva. PS was measured by the Perceived Stress Scale 10 (PSS-10). Of the students, 26.0%, 69.1%, and 4.9% reported low, moderate, and high PS, respectively. Female sex (b = 2.28, 95% confidence interval (CI): 1.38-3.18), dental faculty (b = 1.74, 95% CI: 0.94-2.54), low subjective socioeconomic status (SES) (b = 1.71, 95% CI: 0.91-2.51), and irregular dental visits (b = 1.65, 95% CI: 0.72-2.58) were associated with higher PSS-10 score. These factors were assumed to be clinical meaningful, given that minimal clinically important difference of PSS-10 fell between 2.19 and 2.66 points. The majority of the medical and dental students reported moderate PS. Based on statistical significance and clinical meaningfulness, socio-demographic factors (sex, faculty), subjective SES, and OH behavior (regularity of dental visits) were associated with PS.

Friedman Score in Relation to Compliance and Treatment Response in Nonsevere Obstructive Sleep Apnea.

Nonsevere obstructive sleep apnea (OSA) is most often treated with a continuous positive airway pressure (CPAP) device or a mandibular advancement splint (MAS). However, patient compliance with these treatments is difficult to predict. Improvement in apnea-hypopnea index (AHI) is also somewhat unpredictable in MAS treatment. In this study, we investigated the association between Friedman tongue position score (Friedman score) and both treatment compliance and AHI improvement in patients with nonsevere OSA receiving CPAP or MAS treatment. 104 patients with nonsevere OSA were randomly allocated to CPAP or MAS treatment and followed for 12 months. Data were collected through a medical examination, questionnaires, sleep recordings from ambulatory type 3 polygraphic sleep recording devices, and CPAP recordings. Associations between Friedman score, treatment compliance, and AHI improvement were analysed with logistic regression analyses. Friedman score was not associated with treatment compliance (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.59-1.23), or AHI improvement (OR: 1.05, 95% CI: 0.62-1.76) in the overall study sample, the CPAP treatment group, or the MAS treatment group. Adjustment for socioeconomic factors, body mass index, and tonsil size did not significantly impact the results. Although Friedman score may predict OSA severity and contribute to the prediction of success in uvulopalatopharyngoplasty, we found no association between Friedman score and treatment compliance in patients with nonsevere OSA receiving CPAP or MAS treatment, nor did we find any association between Friedman score and AHI improvement. Factors other than Friedman score should be considered when deciding whether a patient with nonsevere OSA should be treated with CPAP or MAS.

Health-Related Quality of Life and Sleep Quality after 12 Months of Treatment in Nonsevere Obstructive Sleep Apnea: A Randomized Clinical Trial with Continuous Positive Airway Pressure and Mandibular Advancement Splints.

In this randomized controlled trial, patients with nonsevere obstructive sleep apnea (OSA) were treated with continuous positive airway pressure (CPAP) or a twin block mandibular advancement splint (MAS). The primary objective was to compare how CPAP and MAS treatments change the health-related quality of life (HRQoL) and self-reported sleep quality of patients after 12 months of treatment. In total, 104 patients were recruited: 55 were allocated to the CPAP treatment group and 49 to the MAS treatment group. We used the SF36 questionnaire to evaluate HRQoL and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. All patients were included in the intention-to-treat analyses. These analyses showed improvements in the SF36 physical component score (from 48.8 ± 7.6 at baseline to 50.5 ± 8.0 at follow-up, p=0.03) in the CPAP treatment group and in the mental component score (from 44.9 ± 12.1 to 49.3 ± 9.2, p=0.009) in the MAS treatment group. The PSQI global score improved in both the CPAP (from 7.7 ± 3.5 to 6.6 ± 2.9, p=0.006) and the MAS (8.0 ± 3.1 to 6.1 ± 2.6, p < 0.001) treatment groups. No difference was found between the treatment groups in any of the SF36 scores or PSQI global score at the final follow-up (p > 0.05) in any analysis. The improvement in the SF36 vitality domain moderately correlated to the improvement in the PSQI global score in both groups (CPAP: |r|=0.47, p < 0.001; MAS: |r|=0.36, p=0.01). In the MAS treatment group, we also found a weak correlation between improvements in the SF36 mental component score and PSQI global score (|r|=0.28, p=0.05). In conclusion, CPAP and MAS treatments lead to similar improvements in the HRQoL and self-reported sleep quality in nonsevere OSA. Improvements in aspects of HRQoL seem to be moderately correlated to the self-reported sleep quality in both CPAP and MAS treatments.

Injury registration for primary prevention in a provincial Russian region: setting up a new trauma registry.

BACKGROUND: The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications. METHODS: Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015-June 2016. Chi-square tests were used to assess differences between the registered and missed cases in the registry and Cohen's kappa were applied to assess the agreement between independent data entries. RESULTS: The completeness of the SHIR with respect to the coverage of cases treated at the Shenkursk central district hospital was 86%. There were no differences between the registered and the missed injuries by sex, ICD-10 codes, weekday of admission, but there were differences in their distribution by attending physicians. Also, higher proportions of child injuries and injuries in the summer time were among the missed cases. Signs of lower injury severity (different distribution by ICD-10 codes and lower proportion of traffic injuries) were observed among injuries in rural areas which were not covered by the registry because of treatment at rural primary health care units without referrals to the central hospital. Two independent data entries from standard paper injury registration forms showed a 79-99% agreement, depending on the variable considered. CONCLUSION: With consideration of possible insubstantial overestimates of the average injury severity, the SHIR data can be considered sufficiently complete, reliable, and representative of the injury situation in the Shenkursk District. Therefore, SHIR is an adequate evidentiary basis for planning local injury prevention.

Prevalence of and factors associated with dental anxiety among medical and dental students of the Northern State Medical University, Arkhangelsk, North-West Russia.

The objective was to assess the prevalence of and factors associated with dental anxiety (DA) in medical and dental students in North-West Russia. This cross-sectional study included 422 medical and 285 dental undergraduate Russian students aged 18-25 years from the Northern State Medical University in Arkhangelsk. Corah's Dental Anxiety Scale (DAS) was applied to measure DA. Information on socio-demographic and socioeconomic factors, oral health behaviour and general and oral health was obtained from a structured, self-administered questionnaire. A clinical examination was performed to assess caries experience, Simplified Oral Hygiene Index, and Gingival Index. DAS score ≥13 was found in 13.7% and 2.2% of medical and dental students, respectively. Female sex (incidence rate ratio [IRR] = 1.11, p = 0.013), lower education of mother (IRR = 1.13, p = 0.001), and poor self-assessed oral health (IRR = 1.15, p < 0.001) were associated with DA in medical students. Corresponding factors in dental students were female sex (IRR = 1.16, p = 0.001), irregular dental visits (IRR = 1.19, p = 0.001), infrequent tooth-brushing (IRR = 1.17, p = 0.007), pain in mouth (IRR = 1.09, p = 0.031) and number of missing teeth (IRR = 1.13, p = 0.007). The prevalence of high DA was lower in dental students than in medical students. DA was associated with sex, mother's education, poor oral health behaviour and self-assessed and clinically assessed oral health.

Oral Health-Related Quality of Life in Young Adults: A Survey of Russian Undergraduate Students.

BACKGROUND: Oral health (OH) is poor among young adults in Russia, but there is little information on OH-related quality of life (OHRQoL) in this population. We investigated how socio-demographic factors, self-reported OH characteristics, oral health behaviour, and clinically-assessed OH are related to OHRQoL in medical and dental students in North-West Russia. METHODS: This cross-sectional study included 391 medical and 275 dental Russian undergraduate students aged 18-25 years. Information on socio-demographic, self-reported OH characteristics, and oral health behaviour was obtained from a structured, self-administered questionnaire. A clinical examination was performed to assess dental caries experience based on the decayed (D) missing (M) filled (F) teeth (T) index; Simplified Oral Hygiene Index; and Gingival Index. OHRQoL was measured by the OH Impact Profile (OHIP-14). RESULTS: 53.6% of students reported low OHRQoL during the last 12 months. Female sex (odds ratio [OR] = 1.48, 95% confidence interval [CI]: 1.00-2.19), rural place of childhood residence (OR = 1.56, 95% CI: 1.06-2.28), poor self-assessed dental aesthetic (OR = 1.75, 95% CI: 1.16-2.64), dissatisfaction with mouth and teeth (OR = 2.51, 95% CI: 1.68-3.77), and DMFT index (OR = 1.05, 95% CI: 1.01-1.09), were all significantly, independently associated with low OHRQoL. CONCLUSION: Socio-demographic factors (rural place of childhood residence, female sex), poor self-reported OH characteristics, and high DMFT index were associated with low OHRQoL.

Dental caries and preterm birth: a systematic review and meta-analysis.

OBJECTIVES: The primary objective of this systematic review was to evaluate the association between dental caries and preterm birth (PTB). The secondary objective was ascertaining the difference between women with dental caries who experienced PTB and those who did not with regard to decayed, missing and filled teeth (DMFT), and decayed, missing and filled surfaces (DMFS) indices. METHODS: MEDLINE, Embase, CINAHL and Cochrane databases were searched initially in November 2015 and repeated in December 2016. We included observational cohort and case-control studies. Only studies reporting the risk of PTB in women affected compared with those not affected by dental caries in pregnancy were included. Random-effect meta-analyses were used to compute the summary OR of PTB among women with caries versus women without caries, and the mean difference in either DMFT or DMFS indices between women experiencing PTB and those without PTB. RESULTS: Nine observational studies (4826 pregnancies) were included. Women affected by dental caries during pregnancy did not show a significantly higher risk of PTB (OR: 1.16, 95% CI 0.90 to 1.49, P=0.25, I2=35%). Also, the women with PTB did not show significantly higher DMFT or DMFS indices (summary mean differences: 1.56, P=0.10; I2=92% and -0.15, P=0.9, I2=89%, respectively). CONCLUSION: Dental caries does not appear to be a substantial risk factor for PTB. TRIAL REGISTRATION NUMBER: NCT01675180; Pre-results.

Periodontitis Prevalence and Severity in Adults: A Cross-Sectional Study in Norwegian Circumpolar Communities.

BACKGROUND: The aim of this study is to describe the prevalence, severity, and extent of periodontitis in the adult population of circumpolar communities in Norway using data from the Tromstannen-Oral Health in Northern Norway study. METHODS: In this cross-sectional survey, data were collected from a randomized population sample (aged 20 to 79 years) in Northern Norway. Periodontal conditions were assessed for 1,911 dentate adults with a full-mouth periodontal examination. Probing depth (PD) and bleeding on probing were measured at six sites per tooth. Radiographic bone loss (BL) was examined using orthopantomograms. RESULTS: According to the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions, 49.5% of participants had periodontitis, and 9.1% had severe periodontitis. Periodontitis prevalence and severity increased with age. Extent of BL and PD ≥4 mm also increased with age, but more rapidly and to a greater extent for BL. Prevalence of periodontitis was higher among men and varied between urban and rural areas. Periodontitis prevalence was positively associated with smoking, lower levels of education, and income. CONCLUSIONS: This study reveals a high burden of periodontitis among adults living in circumpolar communities in Norway. The results showed sociodemographic disparities regarding periodontitis and highlights the importance of further investigation of factors influencing periodontal health.

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.

Predictors of Norwegian dentists' decisions to recommend replacement of teeth at the time of extraction.

OBJECTIVE: To study predictors of dentists' recommendations to replace the teeth which they extracted for adult patients in Norway in 1998. DESIGN: Cross-sectional postal questionnaire survey. PARTICIPANTS: A systematic random sample of 1,500 Norwegian general dental practitioners and response rate of 67% after two reminders. After exclusions, 302 dentists who had extracted 822 permanent teeth for 587 patients (16-92 years old) over a period of two weeks, were accepted for the study. RESULTS: According to the dentists, 30% of the patients were in definite need of a replacement for the extracted tooth or teeth, 29% were cases open to question and 41% had no need for a replacement. Model I: Tooth type extracted and the number of teeth extracted per patient were the most important predictors of the dentists definitely recommending a replacement after tooth extraction. Model II: When including the group of patients for whom a replacement was open to question, the odds of the dentists recommending a replacement for having an extracted anterior tooth or premolar increased from 13 (95% CI 6.16, 26.07) to 21 (95% CI 10.51, 40.69). Demographic characteristics had no significant effect on the dentists' decision. CONCLUSIONS: The two most important predictors for recommending a replacement after extraction were the position of the tooth or teeth and the number of teeth extracted. The reason why the number of remaining teeth had no significant independent effect was possibly because this group of patients had a relatively high number of natural teeth.