Anne Nordblad

The relationship among sense of coherence, socio‐economic status, and oral health‐related behaviours among Finnish dentate adults

This study assessed the independent and interactive associations between sense of coherence (SOC) and socio-economic status (SES) with oral health-related behaviours. Data from 5,399 dentate adults regarding their demographic characteristics, years of education, SOC score, and oral health-related behaviours were analysed. Household income was obtained from tax authorities. Logistic regression was used to test the adjusted association of SOC with each behaviour and to test the statistical interaction between each SES indicator and the SOC score. Subjects were 1.20 [95% confidence interval (95% CI): 1.11-1.28] and 1.22 (95% CI: 1.12-1.32) times more likely to visit dentists regularly for check-ups and to brush their teeth twice daily or more often, respectively, and were 1.11 (95% CI: 1.03-1.20) and 1.21 (95% CI: 1.12-1.32) times less likely to be daily smokers and to consume sugar-added products on a daily basis, respectively, for every unit increase in SOC score. The findings provide strong support for an association between higher levels of SOC and more favourable oral health-related behaviours, independently of current SES and demographic characteristics of the participants and across the four behaviours assessed. By contrast, the findings give limited support for the moderating role of SOC on the relationship between SES and oral health-related behaviours.

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

AIM To assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models. MATERIALS AND METHODS This 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. RESULTS In 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. CONCLUSION There 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.

Dental fear among population aged 30 years and older in Finland

Objective. The aim of the study was to examine how the percentage of subjects reporting dental fear varied in accordance with age, gender, level of educational attainment, and marital status in a nationally representative sample of the adult population in Finland. Material and Methods. The two-stage stratified cluster sample (n=8028) represented the population aged 30 years or older living in Finland. Of this nationwide sample, 88% participated. Dental fear was measured with the question: “How afraid are you of visiting a dentist?” The reply alternatives were: “Not at all”, “Somewhat”, and “Very much”. Age-specific multiple logistic regression analyses were used to explore the associations between dental fear and age, gender, marital status, and level of educational attainment. Results. Overall prevalence of being somewhat or very afraid of visiting a dentist among adults in Finland was high (37%), particularly among 30 to 34-year-olds (47%). Among men and women of different ages, 5% to 19% were very afraid and 16% to 59% at least somewhat afraid of visiting a dentist. Female gender was the best determinant of dental fear. Those with higher educational attainment were about half as likely to be very much afraid of dentistry compared to those with secondary educational attainment. Among the youngest age group, non-singles were more likely to report being very much afraid of dentistry than single subjects. Conclusions. The fairly high prevalence of reported dental fear among adults, especially in the youngest age group, presents a challenge to dental personnel in Finland.

The influence of sense of coherence on the relationship between childhood socioeconomic status and adult oral health-related behaviours.

OBJECTIVES To assess the role of adulthood socioeconomic status (SES) and sense of coherence (SOC) in the relationship between childhood SES and adult oral health-related behaviours. METHODS This study analysed responses of 5318 dentate subjects aged 30 years and over who participated in the Finnish Health 2000 Survey. Participants provided information on their demographic characteristics (sex, age, marital status and urbanization), childhood SES (parental education), adulthood SES (years of education and household income), the SOC scale and four oral health-related behaviours (dental attendance, toothbrushing frequency, sugar intake frequency and daily smoking). Structural equation modelling was used to test a model including adult SES and SOC as mediating factors of the relationship between childhood SES and adult oral health-related behaviours. Multi-group comparison was conducted to test the model within each sex and age group. RESULTS Childhood SES was related to adult oral health-related behaviours (P < 0.001) but only indirectly, via adulthood SES (P < 0.001) and adult SOC (P = 0.001). However, the relationship via adulthood SES was much stronger than that via SOC (standardized path coefficients were 0.24 and 0.01 respectively). In the multi-group comparison, the model was invariant across sex and age groups. CONCLUSIONS The relationship between childhood SES and adult oral health-related behaviours was mainly mediated by adulthood SES, and to a much less extent by SOC. A stronger SOC was significantly associated with better adult oral health-related behaviours, after controlling for the effect of adulthood SES and demographic characteristics of the participants.

Prevalence and simultaneous occurrence of periodontitis and dental caries

AIM The aim of the study was to evaluate the prevalence and simultaneous occurrence of periodontal disease and dental caries in Finnish adults. MATERIAL AND METHODS The study was performed as part of the nationally representative Health 2000 Survey. The study population was 5255 subjects aged 30 years and older. Probing pocket depth (PPD) and untreated dentinal caries were recorded by tooth. Teeth with PPD 4mm and deeper indicated periodontal disease, and teeth with PPD 6mm and deeper indicated a severe periodontal disease. RESULTS Sixty-four percent of persons had periodontal disease, 21% had a severe periodontal disease, and 29% had dental caries. Persons having periodontal disease had significantly more often dental caries (33%) compared with those without periodontal disease (23%). This was even more evident in persons having severe periodontal disease (44%). Accordingly, persons having dental caries had significantly more often severe periodontal disease (31%) compared with those without dental caries (16%). The mean number of teeth with dental caries or periodontal disease per person was greater when the mean number of teeth with the other disease was also greater. CONCLUSIONS These data indicate that especially severe periodontal disease and dental caries tend to accumulate in the same subjects.

The T‐Health index: a composite indicator of dental health

The aim of this study was to determine the most appropriate set of weights with which to calculate the number of sound-equivalent teeth (T-Health index) against perceived oral health, which was used as a proxy of oral health status. This study used data from 5,057 dentate subjects, > or = 30 yr of age, who ere participating in the Finnish Health 2000 Survey. Subjects provided information on socio-demographic characteristics, behaviours and perceived oral health, and had a clinical examination. The T-Health index was calculated by assigning different weights to missing, decayed, filled, and sound teeth. Thirty-six alternative sets of weights were evaluated. The most appropriate set of weights was judged by the strength of the adjusted association between the T-Health index and levels of perceived oral health in ordinal logistic regression models and by the invariance of this association according to the extent of restorative treatment (non-significant statistical interaction). Among the 36 sets of weights used to calculate the T-Health index, assigning twice the weight of a decayed tooth to a filled tooth whilst keeping the weight for a filled tooth < or = 0.20 provided the strongest association with levels of perceived oral health and did not vary according to the extent of restorative treatment.

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

OBJECTIVE To explore the role of sense of coherence (SOC) as a mediator in the relationship between childhood socioeconomic position (SEP) and tooth retention in adulthood. METHODS Data 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). RESULTS The 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. CONCLUSIONS SOC is associated with tooth retention through oral health-related behaviours, but contributes little to the relationship between childhood SEP and tooth retention.

Childhood socioeconomic position, adult sense of coherence and tooth retention

OBJECTIVE To explore the role of sense of coherence (SOC) as a mediator in the relationship between childhood socioeconomic position (SEP) and tooth retention in adulthood. METHODS Data 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). RESULTS The 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. CONCLUSIONS SOC is associated with tooth retention through oral health-related behaviours, but contributes little to the relationship between childhood SEP and tooth retention.

Radiographic assessments on prevalence and technical quality of endodontically-treated teeth in the Finnish population, aged 30 years and older.

Abstract Objective. To assess the prevalence and technical quality of endodontic treatment (ET) in Finland by panoramic radiography. Materials and methods. As part of the Finnish nationwide Health 2000 Survey, panoramic radiographs of 5244 dentate subjects, aged 30–95 years, were analyzed. The criterion for a technically adequate ET was a distance from the root filling to the root apex of ≤3 mm. Results. Sixty-one per cent of subjects had one or more teeth with ET. ET was more prevalent in older subjects and among women. Of all teeth (n = 120 250), 7% had had ET, the percentages being greatest for molars and premolars. Technical quality was adequate in 47% of all ET, in 71% of anterior teeth, in 51% of premolars and in 25% of molars. Conclusions. Prevalence and technical quality of endodontic treatment in Finland are comparable to that reported elsewhere, but are still calling for improvement in endodontic treatment, especially regarding molars.

Food consumption and nutrient intake in relation to denture use in 55- to 84-year-old men and women —Results of a population based survey

ObjectiveTo study differences in consumption of foods and intake of nutrients attributable to denture status.Design, setting and participantsData from a cross-sectional, nationally representative Health 2000 Survey, subjects aged 55–84 years (n=2,241).MeasurementsDenture status (edentulous with full dentures, own dentition with removable dentures, own dentition with no removable dentures) was used as an explanatory variable. The consumption of foods and intake of nutrients was used as an outcome variable and was measured using a validated Food Frequency Questionnaire.ResultsDenture status associated with food choices. Full denture wearers consumed less vegetables (p = 0.013 among men and p = 0.001 among women) and fruits (p = 0.001 among women), more sugary products (p = 0.012 among men and p = 0.008 among women), and their balance in fatty acids was less favourable than among dentate participants. Among dentate participants, the differences between the two groups were small and statistically significant differences were seen mostly in women.ConclusionsWearing full dentures appears to be associated with unhealthier food choices, lower consumption of some foodstuffs and lower intake of certain nutrients when compared to the food choices of dentate persons.