Anna L. Suominen

Odour annoyance and physical symptoms among residents living near waste treatment centres

Waste treatment processes produce odours and biological emissions to the environment, but their health effects are controversial. The aim of our study was to assess odour-associated self-reported physical symptoms among residents living near waste treatment centres. The study was conducted in the surroundings of five large-scale Finnish waste treatment centres with composting plants. In 2006, 1142 randomly selected residents living within 1.5, 3.0 and 5.0 km of these centres were interviewed by telephone. A questionnaire with 102 items asked about respondents personal characteristics, odour exposure and symptoms during the preceding 12 months. Physical symptoms were analysed by distance to the waste treatment centre and by the respondents perception and annoyance of waste treatment odour. The residents who were classified as annoyed of the odour reported following physical symptoms more than the others did: unusual shortness of breath (OR 1.5, 95% CI 1.0-2.2), eye irritation (1.5, 1.1-2.1), hoarseness/dry throat (1.5, 1.1-2.0), toothache (1.4, 1.0-2.1), unusual tiredness (1.5, 1.1-2.0), fever/shivering (1.7, 1.1-2.5), joint pain (1.5, 1.1-2.1) and muscular pain (1.5, 1.1-2.0). Moreover, the ORs for almost all other physical symptoms were elevated among the annoyed respondents. Reported odour annoyance near the waste treatment centres showed an association with many physical symptoms among residents living in the neighbouring areas.

Education level and oral health in Finnish adults: evidence from different lifecourse models

AIMnTo assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models.nnnMATERIALS AND METHODSnThis study analysed data from 7112 subjects, aged 30 years or over, who participated in the nationally representative Finnish Health 2000 Survey. Parental and own education levels were the childhood and adulthood socioeconomic measures, respectively. Oral health was indicated by edentulousness, perceived oral health and levels of dental caries and periodontal disease. Three conceptual lifecourse models, namely critical period, accumulation and social trajectories, were separately tested in regression models.nnnRESULTSnIn line with the critical period model, parental and own education levels were independently associated with oral health after mutual adjustment. There was also a graded linear relationship between the number of periods of socioeconomic disadvantage and oral health, corresponding to the accumulation model. Gradual declines in oral health were evident between social trajectories from persistently high to upwardly mobile, downwardly mobile and persistently low groups.nnnCONCLUSIONnThere was similar support for the lifecourse models of critical period, accumulation and social trajectories. They collectively contribute to a better understanding of oral health inequalities.

Periodontal pathogen carriage, rather than periodontitis, determines the serum antibody levels

AIMnWe investigated in a nationally representative sample, how periodontitis modifies the association between the carriage of periodontal pathogens and serology.nnnMATERIALS AND METHODSnThe population comprised 1586 dentate subjects who participated in an interview, clinical and radiological oral health examination, and saliva collection. Serum immunoglobulin A (IgA)- and IgG-class antibody levels against Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis and their salivary occurrence were determined in the whole population. The quantity of the pathogens was measured in a subpopulation.nnnRESULTSnIn the univariate analyses, the corresponding antibody levels were higher in the pathogen carriers compared with the non-carriers, and clearly higher in the carriers with periodontal pockets compared with the carriers without. In the multi-variate analyses, however, all antibody levels associated strongly with age (p<0.001) and the carriage of the corresponding pathogen (p<0.001), but only weakly with the presence or number of teeth with periodontal pockets. In the subpopulation, the antibody levels and the numbers of corresponding bacteria in saliva had a positive association, which was not affected by the disease.nnnCONCLUSIONSnThe carriage of A. actinomycetemcomitans and P. gingivalis is the strongest determinant of the systemic antibody response to these pathogens, and the extent of periodontitis has at most a modest modifying effect.

Association of clinical findings of temporomandibular disorders (TMD) with self‐reported musculoskeletal pains

Background and aims: Temporomandibular disorders (TMD) can be related to self‐reported musculoskeletal pains. The aim of the study was to investigate the association of clinical findings of TMD with self‐reported pain in other parts of the body, and to discriminate pain clusters according to definite profiles of pain conditions including TMD among subjects in general population.

The role of sugar, xylitol, toothbrushing frequency, and use of fluoride toothpaste in maintenance of adults' dental health: findings from the Finnish National Health 2000 Survey.

We assessed the effect of certain oral health-related behaviours on adults dental health. As part of the Finnish nationwide Health 2000 Survey, dentate subjects, 30-64 yr of age, reported their frequency of consumption of eight sugar- and xylitol-containing products, together with toothbrushing frequency and use of fluoride toothpaste, and underwent clinical oral examination (n = 4,361). The mean number of teeth present (NoT) was 24.2 and the mean numbers of sound teeth (ST), filled teeth (FT), and decayed teeth (DT) were 10.8, 12.1, and 1.1 for men and 9.6, 13.8, and 0.5 for women, respectively. Consumption of sugar-sweetened beverages was more frequent than that of other sugar-containing products, and greater in men than in women. Daily use of xylitol chewing gum was reported by 13% of the men and by 22% of the women. Toothbrushing at least twice daily was reported by 47% of the men and by 79% of the women; 86% and 96%, respectively, reported daily use of fluoride toothpaste. The frequency of consumption of sugar- and xylitol-containing products and of toothbrushing, as well as use of fluoride toothpaste, play a role in the dental health of dentate adults, with the impact being weak on NoT, ST, and FT, but stronger on DT, especially concerning toothbrushing frequency (relative risk = 1.5) and use of fluoride toothpaste (relative risk = 1.8). Understanding the impact of certain oral health-related behaviours on dental health in adults would facilitate better targeting of oral self-care messages.

Smoking as a significant risk factor for infections after orthognathic surgery

PURPOSEnThis study was conducted to determine risk factors for infections after orthognathic surgery.nnnPATIENTS AND METHODSnThis was a retrospective cohort study, including files of patients who had undergone 1-jaw orthognathic surgery (ie, bilateral sagittal split osteotomy or Le Fort I osteotomy) during a 7-year period. The outcome variable was surgical site infection. Predictor variables were age, gender, general disease, smoking habit, site of orthognathic surgery, duration of operation, type of osteosynthesis material, and use of postoperative drainage. Data analysis was performed with χ(2) test and logistic regression analysis.nnnRESULTSnIn total 286 patients met the inclusion criteria (174 women, 60.8%). Patients age range was 17 to 56.5 years (average, 34.8 years). The infection rate was 9.1%. The only statistically significant risk factor for infection was smoking.nnnCONCLUSIONSnThe results emphasize the importance of preoperative patient information about smoking. Orthognathic surgery, because of the long orthodontic preoperative treatment period, provides a good opportunity to encourage and assist patients to cease smoking and thus avoid an increased risk for postoperative infections.

The role of sugar, xylitol, toothbrushing frequency, and use of fluoride toothpaste in maintenance of adults' dental health: findings from the Finnish National Health 2000 Survey

We assessed the effect of certain oral health-related behaviours on adults dental health. As part of the Finnish nationwide Health 2000 Survey, dentate subjects, 30-64 yr of age, reported their frequency of consumption of eight sugar- and xylitol-containing products, together with toothbrushing frequency and use of fluoride toothpaste, and underwent clinical oral examination (n = 4,361). The mean number of teeth present (NoT) was 24.2 and the mean numbers of sound teeth (ST), filled teeth (FT), and decayed teeth (DT) were 10.8, 12.1, and 1.1 for men and 9.6, 13.8, and 0.5 for women, respectively. Consumption of sugar-sweetened beverages was more frequent than that of other sugar-containing products, and greater in men than in women. Daily use of xylitol chewing gum was reported by 13% of the men and by 22% of the women. Toothbrushing at least twice daily was reported by 47% of the men and by 79% of the women; 86% and 96%, respectively, reported daily use of fluoride toothpaste. The frequency of consumption of sugar- and xylitol-containing products and of toothbrushing, as well as use of fluoride toothpaste, play a role in the dental health of dentate adults, with the impact being weak on NoT, ST, and FT, but stronger on DT, especially concerning toothbrushing frequency (relative risk = 1.5) and use of fluoride toothpaste (relative risk = 1.8). Understanding the impact of certain oral health-related behaviours on dental health in adults would facilitate better targeting of oral self-care messages.

Oral health-related behaviours among dentate adults in Finland: findings from the Finnish Health 2000 Survey

The aim of this study was to assess oral health-related behaviours among dentate adults. As part of the comprehensive Finnish Health 2000 Survey, this study included dentate subjects, 30-64 yr of age (n = 4,417). Based on interview and questionnaire data, information on nine oral health-related habits was elicited. On average, study subjects reported 4.4 (SD = 1.5) oral health-promoting behaviours among the nine behaviours investigated, the mean number differing according to subjects gender, educational level, marital status, and employment status. Older age, higher level of education, cohabiting, and being employed were indications of higher numbers of oral health-promoting habits than were younger age, lower levels of education, being single, or being unemployed. Oral health-promotion activities should be tailored and targeted in terms of adults socio-economic and demographic characteristics, and directed especially towards men, those with lower education, and those who are single or unemployed.

Childhood socioeconomic position, adult sense of coherence and tooth retention.

OBJECTIVEnTo explore the role of sense of coherence (SOC) as a mediator in the relationship between childhood socioeconomic position (SEP) and tooth retention in adulthood.nnnMETHODSnData from 5401 dentate adults aged 30 and over who participated in the nationally representative Finnish Health 2000 Survey were analysed. Participants provided information on demographic characteristics (sex and age), childhood SEP (parental education), adulthood SEP (years of education and household income), the SOC scale and oral health-related behaviours (dental attendance, toothbrushing frequency, sugar intake frequency and daily smoking). They also had a clinical oral health examination. Structural equation modelling was used to test a model including adulthood SEP, SOC and oral health-related behaviours as mediators of the relationship between childhood SEP and tooth retention. Multigroup comparison was also conducted to test the hypothesized model within each sex and age group (<45 years, 45-59 years and 60+ years).nnnRESULTSnThe relationship between childhood SEP and tooth retention in adulthood was to a large extent mediated by adulthood SEP and to a much lesser extent by SOC. There was only a weak association between childhood SEP and adult SOC, but favourable oral health-related behaviours appeared to link a strong SOC with greater tooth retention. The model was invariant across sexes and age groups.nnnCONCLUSIONSnSOC is associated with tooth retention through oral health-related behaviours, but contributes little to the relationship between childhood SEP and tooth retention.

Exploring the associations between somatization and dental fear and dental visiting

While somatization has been investigated as an important variable in relation to excessive health-service utilization, its role in relation to dental visiting and dental fear has received limited attention. It was hypothesized that an excessive focus on physical symptoms might lead somatizers to experience dental treatment as more traumatic, resulting in greater dental fear. The aims of this study were to determine whether somatization was associated with dental fear, reduced dental visiting, and symptomatic visiting. Questionnaire data were collected from 5,806 dentate Finnish adults, with somatization measured using 12 items from the Symptom Check List (SCL-90). Dental fear was measured using a single-item question and dental visiting was assessed by questions relating to time since last dental visit and the usual reason for dental visiting. Multinomial logistic regression analyses indicated that somatization has a statistically significant positive association with both dental fear and symptomatic dental visiting after controlling for age, gender, and education. However, the association between dental-visiting frequency and somatization was not statistically significant. The results were consistent with the hypothesized role of somatization in the development of dental fear. Further investigation of how somatization is related to dental fear and dental-service utilization appears warranted.