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The objective was to investigate the variability in dental caries experience in Swedish children and adolescents, at two different area levels: dental clinics and SAMS (small areas for market statistics), with respect to multiple individual socioeconomic factors (SES). Records of manifest caries using the DMFT indices (decayed, missing, filled teeth, dependent variables) were collected from electronic dental records for 300,988 individuals aged 3-19 years (97.3% coverage) from the Region Västra Götaland, Sweden. SES data were obtained from official registers and covered ethnicity, wealth, parental education, and employment. The SES variables were used as an independent aggregated variable - an in dex - categorized in deciles. Age and gender were independently included in the multilevel models. Two-level logistic regression analyses explored the probability of a dental caries experience and the variability (intracluster correlation) within dental clinic areas and SAMS, respectively. The most deprived (10th decile, SAMS level) 3- to 6-year-old children had an OR of 5.00 (95% CI 4.61-5.43) for dental caries experience (deft), compared with children in the 1st to 5th deciles. For older children and adolescents (≥7 years), the corresponding OR (DFT) was 2.25 (95% CI 2.15-2.35). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics. SES was more strongly related to the risk of dental caries experience than age and gender. In conclusion, the associations between SES and dental caries experience in Swedish children and adolescents were strong in the study and strongest in young children at a low level.

The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.

OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence. MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used. RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts. CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.

The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21-29 years, were interviewed. The findings from the interviews were summarized under the theme "Young adults reflected on their OHRQoL in a time perspective" consisting of three categories: "Past experiences, Present situation, and Future prospects." The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up. © 2015 G. Johansson & A.-L. Östberg.

Objective The aim of this study was to explore the views of young adults on the relevance of three measures of oral health-related quality of life (OHRQoL). Methods Sixteen young adults aged 21–29 years were interviewed. The selection was strategic with reference to age (21–25 years.; 26–30 years), sex and education (university degree; upper secondary school). The interview guide covered areas on the content and construction of the measures: The Oral Health Impact Profile (OHIP), the Oral Impacts on Daily Performances (OIDP) and the Oral Health-Related Quality of Life UK (OHRQoL-UK). The data were analysed using qualitative content analysis. Results A theme expressing the latent content was formulated during the data analysis: ‘young adults' own experiences were reflected in their views on the OHRQoL measures’; that is, the experiences of young adults of own oral problems and aspects that were found to be especially important for their age group influenced their view on the measures. The self-reported ability to understand and answer the questions varied and the perceived advantages and disadvantages were almost equally distributed among the three measures. Conclusions The OHIP, OIDP and OHRQoL-UK were evaluated as being equal by the young adults in this study, with regard both to their pros and cons. The clarity of the measures was regarded as the most important factor, while the length and assessment period were less significant. © 2014 John Wiley & Sons A/S.

The aim of the study was to describe Swedish young adults’ views on three measures of OHRQOL. Background: Many measures have been developed to estimate the impact of oral health on quality of life (OHRQOL). However no measure has been especially developed för young adults. This study describes how young adults consider the appropriateness of three available validated and translated measures of OHRQOL. Methods: The study had a qualitative approach. Sixteen informants (eight woman and eight men) aged 21-29 years were interviewed during 2010-2011 about their views on the Oral Health Impact Profile (OHIP), the Oral Health-Related Quality of Life-UK (OHRQoL-UK) and the Oral Impacts on Daily Performances (OIDP). The sampling of informants was strategic with reference to age (21-25 yrs, 26-29 yrs), education (compulsory school vs more). Two of the measures were sent to the informants two weeks before the day for the interview, and they were asked to fill in and bring them to the interview. The third measure (OIDP) was presented and the informants answered it orally in connection with the interview. Data was collected by thematic, open-ended interviews. The data analysis was performed by manifest and latent content analysis. The study was approved by the Ethics Committee of Lund University, Lund, Sweden (Dnr 209/124). Results: The informants considered the measures to contain relevant and important aspects concerning the oral health related quality of life in young adults. The questionnaires were not to time-consuming to fill in. Furthermore, the young adults were most concerned about their oral health and especially the aesthetics. Conclusions: The content in the analysed measures was deemed relevant to the informants but highlighting aspects important to the agegroup would be useful for research and in clinical praxis. Acknowledgements: The study was supported by Malmö University, Malmö and Halmstad University, Halmstad, Sweden.

The aim of this epidemiological survey was to describe and analyze oral health habits and life-style factors in relation to the priority of regular dental care in 19-year-old individuals with specific reference to gender, residential area and socio-economic grouping. The data were generated from a randomized sample of 758 (63%) individuals in three residential areas in Western Sweden (two rural, one urban) who answered a set of questionnaires prior to a dental examination. The analysis revealed that males had significantly less favourable oral health habits than females. Forty-one % of the males and 30% of the females did not plan regular dental visits after the age of 20 when they will be charged for the care (p = 0.002). There were no statistically significant differences in oral health habits and dental care priorities with regard to residential areas and socio-economic groups. In a multivariate model, three significant factors for the probability of "not planning for future regular dental visits" were identified: toothbrushing less than twice daily (OR 1.94; 95% CI 1.28-2.94), smoking (OR 1.68; 95% CI 1.10-2.56) and male gender (OR 1.54; 95% CI 1.05-2.24). The findings emphasize the need for promotion of favourable oral health habits and smoking prevention among adolescents. There is also a need for dental personnel to recognize differences with regard to oral health-related attitudes and behaviours between males and females.

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

The paper aims to analyse measures of oral health-related quality of life (OHQOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health

Aim The aim of the present study was to explore the association between tooth loss and obesity in a defined adult Swedish population and to investigate whether psychosocial factors could explain a tentative association. Methods The study is based on a population survey 2001-2005 in two municipalities within the same mainly rural area in south-western Sweden, being part of a comprehensive epidemiological study on hypertension, type 2 diabetes, and obesity (The Skaraborg Project). A random sample of 30-74-year-olds (five year strata) was selected and 2,918 people participated (76%). Information on remaining number of teeth was collected by a self-administered questionnaire. Tooth loss was defined as <20 remaining teeth, as compared to 20. Obesity was defined as body mass index (BMI) 30 kgm-2. Associations were estimated using logistic regression and adjustments were made for demographic, clinical and life-style variables as well as co-morbidity. Results The mean BMI value was 26.9 kgm-2 in men and 26.8 kgm-2 in women. Obesity was still more frequent among women than among men (23.6% versus 17.7%, p<0.001). Including all ages, there was a statistically significant association between tooth loss and obesity among women (OR 1.98; CI 1.44-2.72), but not among men (1.40; 0.98-2.00). However, in participants below 60 years of age, this association was stronger and statistically significant in both genders, while it was lost in older participants. Conclusions In this study, tooth loss was associated with obesity in the younger adults with a stronger association in women than in men