Oral health and self-perceived oral treatment need of adults in Sweden

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Oral health and self-perceived oral treatment need of adults in Sweden

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dc.contributor.author Lundegren, Nina
dc.date.accessioned 2012-02-09T14:31:37Z
dc.date.available 2012-02-09T14:31:37Z
dc.date.issued 2012 en_US
dc.identifier.citation 151 en_US
dc.identifier.isbn 978-91-7104-389-4 en_US
dc.identifier.issn 0348-6672
dc.identifier.uri http://hdl.handle.net/2043/13374
dc.description Ett mål med denna avhandling var att undersöka vilka faktorer som har samband med den vuxna patientens syn på sitt tandvårds-behov i Sverige. Ett annat mål var att beskriva hur den vuxna skånska befolkningen såg på sitt behov av tandvård. Ytterligare ett mål var att beskriva den vuxna skånska befolkningens munhälsa, ur patientens och tandläkarens perspektiv. I en första studie undersöktes 20 till 25-åringar boende i Sverige, via en enkät, angående bland annat deras syn på sitt tandvårdsbe-hov. Enkäten nådde 611 individer och besvarades av 78%. Deras tandläkare fick en enkät med frågor om sin patients munhälsa och tandvårdsbehov. Statistiska analyser genomfördes för att undersö-ka vilka faktorer som hade samband med patientens upplevda tandvårdsbehov. Det visade sig att uppgifterna från tandläkarnas enkät inte var av betydelse för patientens uppfattning. Patientens utbildningsnivå, uppfattning om sin munhälsa och oro över sin munhälsa var de faktorer som visade starkast samband med patientens upplevda tandvårdsbehov. I en andra studie skickades en enkät ut till den vuxna befolk-ningen i Skåne (20 till 89-åringar). Enkäten nådde 9 690 individer och besvarades av 63%. Den innehöll bland annat frågor om synen på den egna munhälsan och det egna tandvårdsbehovet. En majoritet av den vuxna befolkningen var nöjd med sina tänder, speciellt i de yngre åldersgrupperna. De flesta hade förlorat få tänder och avtagbara proteser var ovanligt. En tredjedel bedömde att deras tandvårdsbehov var stort eller mycket stort. Störst andel med stort eller mycket stort upplevt behov av tandvård fanns i åldergruppen 70 till 79 år (38%). Patienterna upplevde generellt en sämre munhälsa med ökad ålder och männen var mer positiva angående sin munhälsa. I en tredje studie där materialet från studie två analyserades, un-dersöktes vilka faktorer som hade samband med patientens upp-levda tandvårdsbehov. Det upplevda tandvårdsbehovet studerades hos alla vuxna och analyserades mot patientens egna uppgifter. De faktorer som visade samband med patientens upplevda tandvårds-behov var i studie tre liksom i studie ett, utbildningsnivå (här var en lägre nivå relaterat till ett större behov) och hur man upplevde sin munhälsa (upplevelse av dålig munhälsa var relaterat till ett större behov). Fler faktorer som också hade samband med det upplevda tandvårdsbehovet var att man hade fått information om ett existerande tandvårdsbehov från sin vårdgivare, ett tidigare ej tillfredställt tandvårdsbehov och att man ansåg att någon annan hade kontrollen över ens munhälsa. I den fjärde studien fick 966 vuxna individer i Skåne erbjudandet om att delta i en klinisk undersökning om sin munhälsa och 47% tackade ja. Dessa blev undersökta och röntgade av en tandläkare. Fynden från denna studie var att en högre ålder visade samband med en högre förekomst av munsjukdomar (undantaget karies) och tandreparationer. Det var inga skillnader mellan könen avseende munsjukdomar och tandreparationer. Att vara född i ett annat land än Sverige och att inte ha universitets/högskoleutbildning visade samband med en sämre munhälsa. Slutsatserna var att munhälsan i Skånes vuxna befolkning var god, sett ur patientens och tandläkarens perspektiv, jämfört med hur det ser ut historiskt och internationellt. Det fanns dock grupper som hade en ökad risk för en sämre munhälsa, nämligen äldre, utlandsfödda och individer utan universitets/högskoleutbildning. Patientens upplevda tandvårdsbehov påverkades av patientens socioekonomiska bakgrund och uppfattning om sin orala hälsa. en_US
dc.description.abstract The main aim of this thesis was to study the oral health and the self-perceived oral treatment need of adults in Sweden. The first step was to analyse the self-perceived oral treatment need in a random national sample of young adults (20 to 25-year-olds). This study used one patient and one dentist questionnaire. The patient questionnaire was sent to 611 young adults and the response rate was 78%. After permission from 377 of these indi-viduals, a questionnaire was sent to their dentists and answers were received from 85% (321 dentists). How the individuals perceived their oral treatment need was used as a dependent variable in a multivariate logistic regression model. Independent variables were self-assessed socio-economic situation, general health and dental attitudes together with information from the dentists on their pa-tient’s dental status. The results showed that having a low educa-tional level, poorer oral health compared to one’s peers, and being concerned about one’s oral health significantly increased the odds for a high perceived oral treatment need. In this group of young adults, 33% perceived a high oral treat-ment need. In order to study if the oral treatment need was the same in all adult age groups and how the perceived oral health was in an adult Swedish population, a new questionnaire was sent to a random sample of 9 690 individuals, 20 to 89-year-olds, living in Skåne, Sweden. The response rate was 63%. The results showed that a majority of the adult population in Skåne had a positive perception of their oral health, in particular the individuals in the youngest age group. Most individuals had lost few teeth and re-movable dentures were uncommon. One third rated their dental treatment need as high. The highest proportion of individuals with a perceived high oral treatment need was found in the age group 70-79. In order to study the perceived oral treatment need in all adult age groups, the questionnaire was further analysed. The Andersen behavioural model was used as a theoretical framework for a mul-tivariate logistic regression model. Questions that fit the compo-nents of individual characteristics, health behaviour and outcomes in the model were used as independent variables. The self-perceived oral treatment need was used as a dependent variable. The results showed that the Andersen behavioural model was found to be a useful tool when studying the perceived oral treatment need, and variables from all of the components in the model were significant. Important factors for the prediction of a high oral treatment need were a low educational level, previous unmet perceived oral treat-ment need, frequent visiting pattern, perception of worse oral health, external locus of control, and to have received information from one’s dental caregiver about a need for oral treatment. The evaluated oral health was also studied using another sample of adults from the same region and of the same age. 966 individu-als were invited to participate in a clinical study and 47% of the final sample was examined. Since socio-economic factors have been shown to be related to oral health, the clinical findings were studied in cross tabulations and chi-2 tests together with age, gender, ethnicity and educational level. The results showed that older age was related to a higher prevalence and an increased severity of oral diseases (except for caries) and a higher number of dental restorations. There were no significant differences between the genders. Individuals with a lower educational level had fewer teeth remaining, had more caries lesions, and had worse periodontal conditions and a higher DMFT. Individuals not born in Sweden had fewer teeth remaining, had worse periodontal conditions, more apical destructions and had received less dental fillings than those born in Sweden. Conclusions: The self-assessed and the professionally evaluated oral health of the adult population in Skåne is good both in a his-torical and international perspective. The evaluated oral health is comparable to other Swedish studies. There is, however, a group of individuals that has an increased risk for oral diseases. The self-perceived oral treatment need is largely affected by the patient’s socio-economic background and perceptions of oral health. en_US
dc.language.iso eng en_US
dc.relation.ispartofseries Swedish dental journal. Supplement; 223
dc.subject.classification Medicine en_US
dc.title Oral health and self-perceived oral treatment need of adults in Sweden en_US
dc.type Doctoral Thesis
dc.identifier.paperprint 0 en_US
dc.contributor.department Malmö University. Faculty of Odontology
dc.description.other en_US
dc.subject.srsc Research Subject Categories::ODONTOLOGY en_US
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