Thore Martinsson

Incidence of, and reasons for, tooth mortality among mentally retarded adults during a 10-year period.

The aim of the study was to investigate the reasons for, and incidence of, tooth mortality over a 10-year period in mentally retarded adults receiving regular dental care. The number of teeth present in 115 individuals (mean age in 1984 was 41.0, range 19-83 years) was registered in 1984 and 1994. The reasons for tooth mortality, medication utilization, frequency of dental care visits and cooperation during dental treatment were registered and related to tooth loss. The average incidence of tooth mortality was 3.72 teeth during the 10-year period. The mean number of dental care visits per year was 6.6. Most of the 428 teeth (58%) were lost due to periodontal disease. The preventive dental care given was not sufficient to arrest oral diseases. The data indicate, however, that achievement of cooperation in dental care situations not only makes dental treatment possible, but also leads to a decreased incidence of tooth mortality.

Computerized measurements of the lower third molar related to chronologic age in young adults

Chronologic age is an utmost important birth record in many industrialized Western countries. When the date of birth is unknown, there is a demand for establishing the chronologic age. Dental methods for age estimations are considered more reliable than most other methods by the majority of researchers and are among the most commonly used means to determine age. Traditionally, these methods have most often been based on subjectively estimated, radiographic stages of tooth development. In the present study metric measurements of the length of the forming root have been used and are compared with one standard method. The formed part of the root of the lower third molar as seen in a panoramic radiograph was digitized. Data were directly stored in a computer for subsequent statistical analysis. The technique of collecting data with the aid of a computer had some statistical advantages. The precision of age estimations was, however, slightly inferior to the standard method.

An estimation of dental treatment needs in two groups of refugees in Sweden

The aim of this study was to estimate dental treatment need in groups of Chilean and Polish refugees in Sweden. Of the Nordic countries, Sweden accepts the greatest number of refugees. An average of 5000 refugees arrived annually in 1981-85, increasing to 15,000 during 1986-87. Refugees and their families now comprise 93% of non-Nordic immigration. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm was selected for this study. Dental treatment needs were calculated in accordance with CPITN and the working study of Swedish dentistry, which formed the basis for the Swedish scale of dental fees for the National Dental Insurance Scheme. The estimated mean treatment time (+/- SD) in the Chilean sample was 6.9 +/- 2.3 h and in the Polish group 8.4 +/- 3.0; in comparison with estimated treatment needs in a Swedish material, both would be classified as extreme risk groups. There was no correlation between the number of months in Sweden and the estimated treatment needs. The results indicate a cumulative, unmet need for dental care in these groups. Barriers to ensuring adequate health care for immigrants persist; special outreach programmes, conducted by dental health personnel, may be an effective means of introducing immigrants to the Swedish dental care system.

Dental health status in two groups of refugees in Sweden

The aim of this study was to determine dental health status in two separate groups of Chilean and Polish refugees in Sweden. In Scandinavia, Sweden has the largest number of immigrants--1 million out of a population of 8.3 million. Since 1975, most immigrants have been refugees and their families. During 1978-82 Sweden granted residency to 20,000 refugees, the two largest groups being Chileans and Poles. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm were selected for this study. The investigation consisted of a questionnaire followed by clinical examination, including roentgenograms. The average age was 34.0 years in the Chilean group and 34.8 years in the Polish group. The Chileans had been in Sweden for 17.3 months on an average and the Poles for 16.0 months. The Chileans had an average of 10.0 carious surfaces, D(s), and the Poles 11.3. Gingivitis was recorded in 87% of the total number of sites examined in the Chilean group. The corresponding figure in the Polish group was 79%. Of the Chileans 36.5% and of the Poles 32.5% had periodontal pockets measuring more than 5 mm. The results indicate that, when compared with Swedish individuals of a corresponding age, the refugee groups have a high prevalence of caries and periodontal disease.

Move of Adults with Mental Retardation from Institutions to Community-based Living: Changes in the Oral Microbiological Flora

In the Western world, the policy of de-institutionalization and integration of individuals with mental retardation is generally accepted. We tested the hypothesis that de-institutionalization may lead to changes of habits with a potential to influence oral health. When 57 adults with mental retardation moved from an institution to community-based living, their oral hygiene habits, gingival bleeding, and a three-day food record were registered one month before and 9 and 21 months after the move. Mutans streptococci and lactobacilli in saliva, P. intermedia/P. nigrescens, P. gingivalis, and A. actinomycetemcomitans in supragingival plaque, and C. albicans on mucous membranes were analyzed. After 21 months of community-based living, fewer persons showed high classes of mutans streptococci, growth of P. intermedia/P. nigrescens, and high frequency of sucrose intake, and more subjects showed growth of C. albicans. In a short perspective, the indicators of oral diseases suggest an unchanged or lower risk of oral diseases after the de-institutionalization of individuals with moderate or severe mental retardation.

Use of Dental Services by Finnish Immigrants in Sweden Assessed by Questionnaire

The purpose of this work was to assess the dental visiting behaviour of Finnish immigrants in Sweden, and factors which determined this. The initial material consisted of a probability sample of 1332 Finnish citizens aged 20 to 59 years, resident in a Stockholm suburb. The response rate was 80%. About 23% of the respondents had never been to a dentist in Sweden. They were mostly newly immigrated and had a poor knowledge of Swedish. About 36% of the subjects visited a dentist in Sweden regularly (at least every second year), a lower rate than reported from studies on Swedish populations. Twenty-three per cent of the subjects had on some occasion been to a dentist in Finland while resident in Sweden. Difficulty in getting an appointment, indifference, fear, language difficulties and poor knowledge of the dental care system in Sweden were mentioned as reasons for not attending a dentist. Thus prevailing attitudes as well as the many other problems in connection with immigration seemed to result in dental health being given low priority by Finnish immigrants in Sweden.

Fluoride sources and dental attendance habits among adults in communities with optimal and low water fluoride concentrations

The aim of this study was to obtain data on local fluoride supply, dental attendance, and dental care habits in two sociologically similar municipalities with optimal, 1.0 ppm, and low, 0.3 ppm, water fluoride concentrations, respectively. The participants in the study were 30- to 40-year-old lifetime residents in the two municipalities: 569 individuals from the 1-ppm fluoride community and 466 from the low-fluoride community. There were no intergroup differences in the fluoride mouthrinse utilization rate of 1%. Fluoride toothpaste was much more common in the low-fluoride area. In the 1-ppm fluoride area more people drank tea, and they went more regularly to the dentist. It is suggested that dental attendance habits and various fluoride sources should be taken into account in studies evaluating the effect of fluoride in drinking water.