Rasa Skudutyte-Rysstad

Risk indicators for dental erosive wear among 18-yr-old subjects in Oslo, Norway

The aim was to investigate risk indicators associated with dental erosive wear among 18-yr-old subjects in Oslo, Norway. Of 3,206 adolescents invited to participate in a screening examination for erosive wear, 1,456 were examined (giving a response rate of 45%). As part of the examination all participants completed a self-administered questionnaire. Associations between the presence of erosive lesions and the possible risk indicators were assessed by logistic regression analyses, taking into account the hierarchical relationships between the independent variables. Of all 18-yr-old subjects examined, 38% had at least one tooth with erosive lesions. Multivariate analyses showed significant associations between the presence of erosive wear and being male, brushing teeth once per day or less, episodes of vomiting, daily/weekly episodes of gastro-oesophageal reflux, consumption of fruit juice and sugary soft drinks several times per day, as well as consumption of sugary soft drinks daily to once per week. In conclusion, in addition to gender, dietary habits such as frequent consumption of fruit juice and sugary soft drinks, and the occurrence of reflux and vomiting, appear to be risk indicators for erosive wear. When counselling adolescents at risk, the gender-specific risk indicators should be taken into account.

Changes in caries experience among 35-year-old Oslo citizens, 1973–2003

Objective. The aims of the present study were to describe caries experience among 35-year-olds in Oslo in 2003 and to assess changes in caries experience during the past 30 years using data from cross-sectional studies performed in 1973, 1984, and 1993. Material and Methods. The dental status of 149 randomly selected 35-year-olds in Oslo was examined in 2003 (response rate 64%) and the data were compared with available data from earlier studies. Dental caries was registered clinically and radiographically at the surface level, applying the same criteria as used in previous studies, and recorded as DMFS/T. Results. The results indicate a gradual decrease in the mean DMFS scores by 62% from 68.2 in 1973 to 26.1 in 2003. There was an 83% decrease in the mean number of DS, a 73% decrease in the mean number of MS, and a 56% decrease in the mean number of FS during this 30-year period. The proportion of individuals with DS = 0 gradually increased from 5% in 1973 to 54% in 2003. There was also a significant decrease in the prevalence of recurrent caries from 2.8% in 1984 to 1.2% in 2003. While a statistically significant reduction in the number of decayed, missing, and filled surfaces was observed during the period 1984–1993, in the past decade (1993–2003) a significant decrease appeared only in the case of the filled surfaces. Conclusions. The results indicate that dental health among 35-year-olds in Oslo, measured as a reduction in caries experience, has improved substantially from 1973 to 2003.

Dental health and disease determinants among 35-year-olds in Oslo, Norway

Objective. The aim of the present study was to identify non-biological determinants associated with the number of sound teeth (ST) and presence of decayed surfaces (DS) among 35-year-old Oslo citizens. Material and methods. Randomly selected participants (n=149, response rate 64%) completed a self-administered questionnaire and were examined clinically and radiographically. Dental caries was registered clinically following World Health Organization (WHO) diagnostic criteria for caries registration, and the findings were combined with radiographic caries recordings. The number of sound teeth and the presence of two or more dentine caries lesions (D3S≥2) were selected as dependent variables. Associations between selected dependent variables and possible determinants were assessed by linear and logistic regression analyses, taking into account the hierarchical relationships between the independent variables. Results. On average, 35-year-olds had 17.1 (SD=5.6) ST. Half of the participants had no DS and 26% had D3S≥2. Non-Western region of birth, being single, and having a university education were significantly associated with higher numbers of ST. Low family income, presently a smoker, and irregular dental visits were significantly associated with the presence of dentine caries. Conclusions. The results of this study indicate that several non-biological determinants operating at different levels are important for health and disease in this adult population.

Sour Sweets and Acidic Beverage Consumption Are Risk Indicators for Dental Erosion

This study aimed to investigate the association between dental erosive wear and potential background, behavioural and dietary risk indicators and to assess whether there is a dose-response relationship between the level of acidic beverage consumption and dental erosive wear among adolescents. Of 846 adolescents (aged 16-18 years) scheduled for dental recall examinations, 795 (94%) accepted to participate. All participants completed a self-administered questionnaire regarding their background (gender and age), tooth-brushing frequency and dietary habits (the amount and frequency of acidic food and beverage consumption as well as the chosen method and manner of consuming acidic drinks). The association between the presence of erosive lesions and the possible risk indicators was assessed by logistic regression analyses. Of all participants examined, 37% had ≥3 surfaces with dental erosions and were considered to be affected individuals. In the present study, multivariate logistic analyses revealed a significant association between the dental erosive wear and high consumption of sour sweets and sports drinks. The tooth-brushing frequency was not significantly associated with dental erosive wear. Additionally, to the best of our knowledge, the results are the first to indicate a dose-response relationship between the daily consumption of acidic drinks and dental erosive wear.

Chair-side preventive interventions in the Public Dental Service in Norway

Objective and setting In Norway, the Public Dental Service (PDS) caters for the young (<19 years) and smaller numbers of adults, mostly special needs patients. This study surveyed chair-side preventive measures used in the public clinics and compared them with recommendations in evidence-based guidelines in the neighbouring countries.Materials and methods After ethical approval, the regional Chief Dental Officers (CDOs) emailed questionnaires to their local clinics (N = 421) where the most experienced dentist and dental hygienist were asked to respond on behalf of the clinic. Answers were received from 256 clinics (response rate 61%). Altogether, 215 dentists and 166 dental hygienists answered.Results Of the respondents, 26% reported that their clinic had agreed guidelines on preventive treatment to be used by all staff. Oral hygiene and fluoride toothpaste recommendations were considered appropriate. Almost 60% claimed that flossing instructions were given to all children and adolescents and 40% that fluoride varnish was used on all the young. Fissure sealants were used after individual assessment (80%). A third of the respondents claimed that fluoride tablets and fluoride rinse were recommended for all or most children and fluoride rinses for adults, even in addition to regular use of fluoride toothpaste. Dental hygienists used all methods more often than dentists. On adults, preventive measures were more often used on individual assessment. Half (48%) of the respondents were interested in new evidence-based national guidelines on preventive care.Conclusions Chair-side preventive treatment measures were numerous in the well-resourced Norwegian PDS, but partly outdated.

Risk factors for caries development on tooth surfaces adjacent to newly placed class II composites – a pragmatic, practice based study

OBJECTIVES To assess risk factors for caries development on approximal surfaces in contact with newly placed Class II composite restorations. METHODS 750 surfaces, either sound or with caries confined to enamel, in contact with newly placed Class II composite restorations, placed by PDS dentists in Norway were evaluated by clinicians, using standardized clinical and radiographic criteria. RESULTS After the observation period (mean 4.9 year, SD 0.67), 38.8% of the initially sound contact surfaces (n=417) remained sound, 34.0% developed caries confined to enamel and 27.2% developed caries into dentine. Of surfaces with caries confined to enamel present at baseline (n=333), 57.3% remained in enamel, while 42.7% progressed into dentine. Risk factors for dentine caries development were assessed by logistic regression analyses. The risk of developing caries on surfaces that were initially sound at baseline was higher in patients with poor or medium oral hygiene (OR 1.53; CI 1.10-3.68), higher DMFT at baseline (OR 1.12; Cl 1.04-1.20). Maxillary teeth (OR 2.01; Cl 1.14-3.56) and surfaces on the right side of the mouth (OR 1.65; Cl 1.01-2.72) were also risk factors. For surfaces with enamel caries present at baseline, the risk of dentine caries was higher in patients with higher DMFT (OR 1.06; CI 1.00-1.13). In both analyses the treating dentists had a significant impact on the caries development. CONCLUSIONS Both patient- and dentist related variables are risk factors for caries development on approximal surfaces in contact with newly placed Class II composite restorations. CLINICAL SIGNIFICANCE All clinicians should be aware of a notable risk of caries development on the adjacent tooth surface, especially when placing approximal restorations in high caries risk patients, and should consider greater use of preventive strategies or non-operative treatment that should be evaluated and repeated at every recall.

Awareness and attitudes related to dental erosive wear among 18-yr-old adolescents in Oslo, Norway

The aim of the present study was to describe awareness and attitudes related to dental erosive wear among 18-yr-old adolescents in Oslo and to explore attitudinal differences between participants with and without the condition. All 18-yr-old subjects scheduled for their routine examination at the Public Dental Service clinics during 2008 (n = 3,206) were invited, and 1,456 agreed to participate (a response rate of 45%). The data were collected using structured questionnaires and by clinical examination of the participants. Dental erosive wear was assessed using a pictorial manual - the Visual Erosion Dental Examination scoring system - as a guide. Overall, 88% of participants had heard about dental erosive wear; however, of participants with erosive lesions only 56% were aware of, and only 47% could recall their dentist mentioning, the condition. Participants with erosive wear were more likely to have low or moderate positive attitudes towards acidic drink consumption and to be reluctant to change. In multivariate analyses controlling for gender and behavioural variables, weak or moderate positive awareness of acidic drinks remained significantly associated with higher erosion risk. This study emphasizes the importance of assessment and understanding of awareness and attitudinal aspects in relation to dental erosive wear.