Karin Ridell

Periapical status and technical quality of root-filled teeth in Swedish adolescents and young adults. A retrospective study

Objective. The aim was to study periapical status and the technical quality of root-filled teeth in Swedish adolescents and young adults in Malmö, Sweden. Material and Methods. The sample, collected from dental records in the Public Dental Service, consisted of notes and radiographs of all root-filled permanent teeth in all 19-year-olds born in 1979 (mean age at root filling = 16.2 years). The sample for assessing periapical status and technical quality consisted of 124–153 teeth. The criterion for inclusion for assessing periapical status was a follow-up time of at least one year. Periapical status was assessed with the Periapical Index (PAI). Technical quality was analyzed from radiographs in two respects: sealing quality of the root canal and distance from the root filling to the radiographic apex. The radiographs were analyzed independently by two observers with inter-examiner kappa values of 0.82–0.85. Results. Apical periodontitis was found in 52% of the teeth and occurred significantly more often among molars than among anterior teeth. As judged radiographically, 51% of the teeth were inadequately sealed. In 38%, the distance to the apex was >2 mm and overfilling was registered in 14% of the teeth. Compared with anterior teeth, significantly more root fillings of molars had a distance to the apex of >2 mm. Technical quality was statistically significantly correlated with periapical status at follow-up. Conclusions. The technical quality and periapical status of root-filled teeth in adolescents and young adults were unsatisfactory in about half of the teeth.

Oral health-related quality-of-life in Swedish children before and after dental treatment under general anesthesia

Abstract Objective. This study evaluated oral health-related quality-of-life (OHRQoL) in children and families before and after dental treatment under general anesthesia because of severe caries or molar-incisor hypomineralization (MIH). Materials and methods. A consecutive sample of the parents/caregivers of children (3–14 years) in need of treatment under general anesthesia participated in the study. The children were divided into two groups: 3–6 years and 7–14 years. The 49-item questionnaire that was administered before and after general anesthesia comprised the Child Oral Health Quality of Life-components of the Parental-Caregivers Perception Questionnaire (P-CPQ), the Family Impact Scale (FIS) and two global questions concerning oral health and general well-being. The P-CPQ domains were Oral symptoms, Functional limitations, Emotional well-being and Social well-being. The FIS items assessed impact on family life. Results. In both age groups, a significant decrease (p < 0.001) occurred in overall P-CPQ and the Oral symptoms, Functional limitations and Emotional limitations domains of the P-CPQ. Mean values for the Social well-being domain decreased significantly in the older (p < 0.05) but not the younger age group. Mean values for FIS decreased significantly in the younger (p < 0.001) and the older (p < 0.05) age groups. Conclusions. Dental treatment of severe caries or MIH, performed under general anesthesia, had an immediate effect on the oral health-related quality-of-life in the children in this study and a positive impact on the family situation.

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

The objectives of this longitudinal study were to assess: (a) the prevalence of unrestored dentin caries among 15-year-olds, (b) the proportion of these lesions that had progressed to deep dentin lesions (inner half of dentin) since the immediately preceding examination at the age of 14 and (c) the frequency of deep restorations (extending into the inner half of the dentin). The sample consisted of all 15-year-olds (n = 2,487) born in 1990 and included in the Public Dental Service in Malmö, Sweden. Bitewing radiographs taken during 2005–2007 and the immediately preceding radiographs were analysed and scored by two examiners. The main radiographic scores were: sound; radiolucency in the outer or inner half of dentin; restored surface. The results showed that 22% of the individuals had 1 or more dentin lesions left unrestored from the time of the examination at the age of 14 until the next recall examination at the age of 15. During the observation period (median time 1.2 years), 9% of the unrestored outer dentin lesions progressed to deep dentin lesions. The majority of these (93%) were in molars. One or more deep restorations were found in 22% of the 15-year-olds; the majority involved occlusal surfaces of first molars. In conclusion, unrestored dentin lesions were common in 15-year-olds. Progression to deep dentin lesions occurred in 9% of these lesions and was most common in first molars. Occlusal surfaces of first molars had the highest frequency of deep restorations.

Specialist paediatric dentistry in Sweden 2008 - a 25-year perspective.

International Journal of Paediatric Dentistry 2010; 20: 313-321 Background. Paediatric dentistry in Sweden has been surveyed four times over the past 25 years. During this period postgraduate training, dental health, and the organization of child dental care have changed considerably. Aim. To investigate services provided by specialists in paediatric dentistry in Sweden in 2008, and to compare with data from previous surveys. Design. The same questionnaire was sent to all 30 specialist paediatric dental clinics in Sweden that had been used in previous surveys. Comparisons were made with data from 1983, 1989, 1996 and 2003. Results. Despite an unchanged number of specialists (N = 81 in 2008), the number of referrals had increased by 16% since 2003 and by almost 50% since 1983. There was greater variation in reasons for referrals. The main reason was still dental anxiety/behaviour management problems in combination with dental treatment needs (27%), followed by medical conditions/disability (18%), and high caries activity (15%). The use of different techniques for conscious sedation as well as general anaesthesia had also increased. Conclusions. The referrals to paediatric dentistry continue to increase, leading to a heavy work load for the same number of specialists. Thus, the need for more paediatric dentists remains.

Background factors associated with endodontic treatment due to caries in young permanent teeth

Objective. The aim of this retrospective cohort study was to assess the association between background factors and future endodontic treatment due to caries in young permanent teeth. Material and methods. The material comprised all 19-year-olds born in 1979 in a city in Sweden who had experienced endodontic treatment due to caries in permanent teeth (n=105) and a control group with no endodontic treatment. From dental records, the following independent variables were derived from age 7 to age 19: immigrant background, caries prevalence (DMFT values) at age 10, occurrence of dental anxiety, and missed or cancelled appointments before endodontic treatment. The outcome variable was presence or absence of endodontic treatment due to caries. Bivariate analysis and a multiple logistic regression model were used to analyse the data. Results. In the bivariate analyses, all independent variables except cancelled appointments were statistically significantly associated with future endodontic treatment. Of these, immigrant background did not remain as a statistically significant factor in the multiple regression model. The highest odds ratios were 4.3 for >2 DMFT at age 10 and 4.1 for >20% missed appointments. Conclusion. In the present sample, with a relatively high proportion of individuals with an immigrant background, >2 DMFT at age 10, many missed appointments and dental anxiety were all risk indicators for future endodontic treatment due to caries up to age 19.