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Despite differences in the dental health care services and the recording and reporting systems, a consistent and similar decline in dental caries is evident for Denmark, Finland, Norway and Sweden during the last two decades. Iceland has experienced a later onset but a steeper decline in dental caries than the other Nordic countries. Public reports demonstrate that in 1991/92 23-49 per cent of the 12-year-old children were caries-free and the mean tooth prevalence was 1.2-2.5 DMFT. Fluoride in various forms has been instrumental in these changes, and public dental health programmes appear to have played an important role, at least in the initiation of the decline. Caries has been slowed down and delayed, but has not been eradicated.

Occlusal and incisal tooth wear were evaluated for the purpose of assessing their prevalence, severity and distribution in a selected Swedish high-wear patient sample and in a young adult Saudi non-patient population. Furthermore, an attempt was made to investigate, by means of a questionnaire and a clinical examination, the association of various factors with wear; any observed associations were further analyzed with reference to possible cause and effect relationships. The scales used for evaluating the severity and the progression of wear provided high inter- and intra-observer concordances. The results revealed a high wear experience in the Saudi population compared to Western equivalents. Dietary, para-functional, anamnestic, occlusal and salivary factors exhibited certain correlations with wear. Progression of tooth wear was shown to be a slow process in the Swedish sample. The common element of a harsh desert terrain in the Saudi sample may constitute the dominant passive abrasive etiological factor in this population. While progression of wear seems to be of a "linear" nature in the Saudi population, it is postulated that wear in Western populations may, in addition to a "linear" deterioration, occur in "bursts", coinciding with the presence of certain causative factors. The results from this study also indicate that the effects of excessive function, including that of wear, on certain dentoalveolar morphological features are similar in modern man and his ancestors. On the basis of the findings, not only is the multifactorial etiology of occlusal tooth wear a reality, but so too is the complex interdependence of these factors in the prevalence, severity, distribution and progression of wear.

The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.

This investigation comprises a longitudinal (2 yr) study of development in oral and general health among 100 institutionalized elderly people in Gothenburg. The aim of the study was to photographically document variations in oral health in relation to variation in the general health of these individuals during the period of the project. Changes noted from one examination to the next were limited to a judgment of an "unchanged", "deteriorated", or "improved" status. Medical analyses were based upon information collected from medical charts and the subjective impressions of the care staff, and odontological analyses were based upon photographic screening according to a set of given criteria. Results demonstrated a relation between developments in oral and general health among older people. The strongest relationships were registered between changes on the tongue and general health. The project has shown that a standardized photographic follow-up of health developments in oral tissues can be a valuable aid in cooperative efforts between medical physicians and dentists regarding health supervision of the elderly.

In an epidemiologic study in the middle of Sweden comprising 425 000 children age 3-19 yr, 105 children were diagnosed as having hereditary amelogenesis imperfecta (HAI). The material then was primarily classified upon clinical criteria into different subgroups either associated to a hypoplastic or to a hypomineralized type of HAI. Analyzing available genetic data obtained from 95 children in 76 families and further 11 adults in 10 families, eight different entities of HAI could be identified in a classification of HAI. In both of the basic types of HAI, the hypoplastic and the hypomineralized, autosomal dominance was the most common mode of inheritance, even if an autosomal recessive inheritance could be identified in some of the subgroups of HAI. The hypoplastic type (rough-pitted), autosomal dominance with incomplete penetrance was dominating in the material, 47 out of 105 cases. The clinical classification seemed to be relevant when testing the material on a genetic basis showing that the clinical criteria provide a strong support for a classification of HAI.

The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal or occlusal wear was evaluated for each single tooth in accordance with the following criteria: 0 = no wear or negligible wear of enamel; 1 = obvious wear of enamel or wear through the enamel to dentin in single spots; 2 = wear of dentin up to one-third of the crown height; 3 = wear of dentin more than one-third of the crown height and/or excessive wear of tooth restorative material. Among the 20-year-olds 35% of the subjects had no or slight incisal or occlusal wear. The corresponding figures for the 30- to 80-year age groups were 20%, 32%, 18%, 14%, 26%, and 23%, respectively. For the age groups 20-80 years, the percentage of teeth with incisal or occlusal wear in accordance with criteria 1-3 was 13%, 20%, 16%, 24%, 23%, 23%, and 23%, respectively. Men presented more teeth with wear than women, the difference being significant for all age groups except the 20- and 60-year-olds. Among the 20-year-olds 6% had one or more teeth with wear scored 2. Among subjects aged 30 and 70 years 10% and 31%, respectively, showed tooth wear with score 2. Wear with score 3 was only found in 2% of the total population. There was an increase in the number of teeth with incisal or occlusal wear with age. With increasing age, there was also a change in distribution of wear within the dentition.