Sinikka Varsio

Do self-assessed oral health and treatment need associate with clinical findings? Results from the Finnish Nationwide Health 2000 Survey

Abstract Objective. To associate self-assessed oral health and treatment need with clinically determined findings. Materials and methods. As part of the Finnish nationwide comprehensive Health 2000 Survey, the present cross-sectional study included dentate participants aged 30–64 years who self-assessed their oral health and treatment need in an interview and who underwent a clinical oral health examination (n = 4385). Self-assessed oral health and treatment need were used as subjective indicators. Clinically determined dental and periodontal status described objective dental and periodontal health and treatment need. The evaluation of relationships between subjective and objective findings was based on two-by-two tables and multivariate analyses. Results. The better the self-assessed oral health, the better the objective dental and periodontal health. Those reporting need for treatment more often had the objective need in terms of dental or periodontal treatment, also when controlling for background factors. Of the subjective indicators, good self-assessed oral health best reflected the absence of clinically determined dental or periodontal treatment need. Those who reported a need for treatment were mainly adults with an objective dental and periodontal treatment need. Conclusions. Self-assessed good oral health is a fairly good estimate for the absence of clinically determined dental and periodontal treatment need. As implication for practice, self-assessed data could be used for screening purposes for oral health service planning and for priority allocation in large adult populations.

Survival of extensive restorations in primary molars: 15-year practice-based study

BACKGROUND Caries decline in the western world is accompanied by strong polarization among children; 8% of Finnish 5-year-olds having 76% of untreated caries. This high caries risk group needs preventive and restorative strategies. AIM To explore survival of extensive restorations in primary molars. DESIGN This study was based on health records from 2002 to 2016 of children under 18 years. RESULTS Of severely affected primary molars (n = 1061), 41% were restored with preformed metal crowns (PMCs), 38% with glass-ionomer cement (GIC)/polyacid-modified resin composite (PAMRC)/resin-modified GIC (RMGIC), and 21% with resin composites (RC). Younger children (3-8) received 97% of the PMCs and 86% of GIC/PAMRC/RMGIC; older ones (≥9) 91% of the RC restorations. Neither amalgam nor indirect restorations were registered. General dentists (GDs) engaged in primary care restored with GIC/PAMRC/RMGIC (52%) or RC (48%). GDs in general anesthesia care service placed 66% and specializing/specialized dentists 31% of PMCs. PMCs had lower failure rate (1.4% vs 3.0%) than GIC/PAMRC/RMGIC (P = 0.001). Choosing PMCs reduced patient visits compared to other restorations (P < 0.001). CONCLUSIONS Severely affected primary molars of children at high caries risk are better managed, using PMCs to optimize the resources in public oral health services.