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Henni SH, Ansteinsson V, Mamykina L, Szyszko Hovden EA, Hove LH, Hellesø R. Factors influencing home health care providers' performance of oral health care for older people: A qualitative study. Int J Older People Nurs 2023; 18:e12561. [PMID: 37485757 DOI: 10.1111/opn.12561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/04/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
AIM To examine factors that affect the performance of oral health care (OHC) for older people receiving nursing care at home. BACKGROUND Oral health is often neglected by health care providers caring for older people. Research shows that health care providers' provision of OHC may be influenced by various factors (barriers and facilitators). When this research was conducted, health care providers from home healthcare services (HHCS) and nursing homes were grouped together despite setting differences; therefore, this study focuses on the performance of OHC by home health care providers (HHCPs) as a single group. DESIGN Explorative design with a qualitative approach. METHODS The managers of four HHCS units recruited 17 HHCPs to participate in focus group interviews. One interview was conducted per unit, and there were four to five participants in each interview. The analysis of interviews was based on theoretical thematic analysis and the PRECEDE constructs in the PRECEDE-PROCEED model. Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used in reporting this study. FINDINGS The analysis resulted in two themes with predisposing factors (HHCPs' professional responsibilities, older people's attitude), five themes with enabling factors (knowledge and skills, older people/carer trust, available time, available equipment and collaboration with public dental service (PDS)), and two themes with reinforcing factors (routines and OHC focus on the workplace) that affect the provision of OHC. The factors were categorised as individual, organisational and collaboration factors. CONCLUSIONS In addition to individual factors found in previous studies, factors related to the organisation of services and communication between HHCPs and PDS seem to affect HHCPs' provision of OHC for adults receiving HHCS. IMPLICATIONS FOR PRACTICE This study provides in-depth knowledge that can contribute to increasing HHCPs' provision of OHC and thereby prevent oral and dental disease among older people receiving HHCS.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vibeke Ansteinsson
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Lena Mamykina
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | | | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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2
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Kopperud SE, Ansteinsson V, Mdala I, Becher R, Valen H. Oral lesions associated with daily use of snus, a moist smokeless tobacco product. A cross-sectional study among Norwegian adolescents. Acta Odontol Scand 2023:1-6. [PMID: 36799465 DOI: 10.1080/00016357.2023.2178502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Use of snus, a moist, smokeless tobacco product, may lead to local changes in the oral mucous membrane in the area where the snus is placed. It can also cause irreversible gingival retraction. This cross-sectional study aimed to investigate the relationship between use of snus, oral mucosal lesions (snus induced lesions) and gingival retractions among adolescents in Norway. MATERIAL AND METHODS All 18-20 years olds visiting public dental health clinics in the south-eastern region of Norway between October 2015 and December 2016 were invited to participate. All participants (n = 1363) filled in an electronic questionnaire before a clinical examination. Of these, 216 used snus daily. RESULTS Snus induced lesions were observed in 79.2% of daily snus using participants. In adjusted regression analyses, the odds of having a more severe lesion as opposed to a less severe lesion were 1.12 times greater for each additional box of snus used in a month (p < .01). Women were 46% less likely to have a severe lesion than men (p = .03). Gingival retractions were observed in 18.4% of the participants. The odds for dental retraction were significantly higher by 34% for each year of snus use. CONCLUSIONS Most of the adolescents using snus had snus induced lesions, whereas approximately one-fifth had gingival retractions. The severity of the lesion and gingival retraction increased with the amount of snus boxes used and the duration of the snus use, respectively.
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Affiliation(s)
| | | | - Ibrahimu Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE), Oslo, Norway
| | - Rune Becher
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway.,Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway.,Norwegian Institute of Public Health (NIPH), Oslo, Norway
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3
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Ansteinsson V, Mdala I, Becher R, Grøtvedt L, Kopperud SE, Rukke Valen H. Factors associated with initiation and use of snus among adolescents. Scand J Public Health 2023; 51:44-52. [PMID: 34965802 DOI: 10.1177/14034948211062311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents' own educational plans, the parents' educational level(s) and tobacco habits were estimated. METHODS In this cross-sectional questionnaire-based study, 1465 patients aged 18-20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. RESULTS Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. CONCLUSIONS
These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents' influence on their children's tobacco use.
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Affiliation(s)
| | - Ibrahimu Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE), Oslo, Norway
| | - Rune Becher
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway.,Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Liv Grøtvedt
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | | - Håkon Rukke Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway.,Norwegian Institute of Public Health (NIPH), Oslo, Norway
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4
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Henni SH, Skudutyte-Rysstad R, Ansteinsson V, Hellesø R, Hovden EAS. Oral health and oral health-related quality of life among older adults receiving home health care services: A scoping review. Gerodontology 2022; 40:161-171. [PMID: 35943193 DOI: 10.1111/ger.12649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To map the literature on subjective and objective oral health indicators and oral health-related quality of life (OHRQoL) in older adults receiving home health care services (HHCS). BACKGROUND The proportion of older adults in need of HHCS will increase in the coming years. Previous studies indicate that frail and dependent older adults are at increased risk for oral diseases, due to challenges with daily oral hygiene and regular access to dental services. MATERIALS AND METHODS Four databases were searched in November 2020 for relevant literature. Search terms included a comprehensive list of terms for adults 65 years or older receiving HHCS, clinical and subjective oral health indicators, and OHRQoL. The literature was reviewed based on inclusion and exclusion criteria. RESULTS Of the 3114 sources identified, 18 were included. Data on oral diseases and symptoms among older adults receiving HHCS were limited and heterogeneous. Overall, older adults often lacked some of their natural teeth and often had removable dentures that needed repair. In addition, plaque, caries, xerostomia, and chewing and swallowing problems were common among the population group. Data on OHRQoL were scarce and indicated a positive association with a higher number of present teeth, while decayed teeth, root remnants, and dry mouth had substantial negative impacts on the daily activities of older adults receiving HHCS. CONCLUSION This scoping review show that older adults above 65 years receiving HHCS generally have poor oral health status and that there is a knowledge gap regarding their OHRQoL.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Rasa Skudutyte-Rysstad
- Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway.,Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Vibeke Ansteinsson
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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5
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Haereid MK, Stangvaltaite-Mouhat L, Ansteinsson V, Mdala I, Ørstavik D. Periapical status transitions in teeth with posts versus without posts: a retrospective longitudinal radiographic study. Acta Odontol Scand 2022; 80:561-568. [PMID: 35350966 DOI: 10.1080/00016357.2022.2049865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The aim of this study was to compare periapical status transitions in teeth after post placement compared with other post-endodontic treatments in root-filled teeth. MATERIAL AND METHODS This retrospective longitudinal radiographic study included radiographs of 284 patients with root filled and restored teeth with composite fillings (Endo-fill group, n = 100), crown or fixed prosthesis (Endo-crown group, n = 82) or post and core restorations (Endo-post group, n = 102). All post and core restorations were made of gold alloy. The radiographs taken at the end of endodontic treatment, at the end of post-endodontic treatment and at least 8 months after post-endodontic treatment were evaluated. Post-operative periapical status was assessed according to the periapical index (PAI) and all teeth included in the study had no apical periodontitis preoperatively. Multi-state Markov analysis was used to assess periapical status transitions among the treatment groups. RESULTS Of 284 root-filled teeth without apical periodontitis at baseline, 7.7% developed clear apical pathology within a minimum of 8 months observational period. In the Endo-post group 11 (10.78%) teeth transited from Healthy (PAI 1) to Disease (PAI 2-4) state compared with eight (9.75%) in the Endo-crown group and four (4%) in the Endo-fill group. The transition probabilities from Healthy (PAI 1) to Mild diseased (PAI 2) were 17.5% in the Endo-post group, 13.1% in the Endo-crown group and 5.3% in the Endo-fill group. Multivariate analysis showed that teeth in the Endo-fill group had 60% lower hazard to transit from Healthy (PAI 1) to Mild diseased (PAI 2) state [HR 0.40; 95% CI 0.12, 0.94]. A period exceeding 8 months between the end of the endodontic treatment and prosthetic treatment significantly increased the hazard of disease progression by three times compared with a period of ≤8 months [HR 3.16; 95% CI 1.06, 9.42]. CONCLUSIONS Teeth without radiographic lesions at baseline and restored with posts had higher hazard to transit from healthy to diseased periapical status compared with teeth restored with composite restorations. Controlled clinical trials with longer follow-up periods are needed to validate these findings.
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Affiliation(s)
| | | | - Vibeke Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - Ibrahimu Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - Dag Ørstavik
- Department of Endodontics, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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6
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Uhlen MM, Tseveenjav B, Wuollet E, Furuholm J, Ansteinsson V, Mulic A, Valen H. Stainless-steel crowns in children: Norwegian and Finnish dentists' knowledge, practice and challenges. BMC Oral Health 2021; 21:190. [PMID: 33845821 PMCID: PMC8040753 DOI: 10.1186/s12903-021-01556-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists. METHODS The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists' perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents' background and their answers were evaluated. RESULTS Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type. CONCLUSION Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.
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Affiliation(s)
- M M Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway.
| | - B Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - E Wuollet
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - V Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
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7
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Camassa LMA, Ervik TK, Zegeye FD, Mdala I, Valen H, Ansteinsson V, Zienolddiny S. Characterization and toxicity evaluation of air-borne particles released by grinding from two dental resin composites in vitro. Dent Mater 2021; 37:1121-1133. [PMID: 33846018 DOI: 10.1016/j.dental.2021.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The project aims to evaluate whether inhalation of particles released upon grinding of dental composites may pose a health hazard to dentists. The main objective of the study was to characterize the dust from polymer-based dental composites ground with different grain sized burs and investigate particle uptake and the potential cytotoxic effects in human bronchial cells. METHODS Polymerized blocks of two dental composites, Filtek™ Z250 and Filtek™ Z500 from 3M™ ESPE, were ground with super coarse (black) and fine (red) burs inside a glass chamber. Ultrafine airborne dust concentration and particle size distribution was measured real-time during grinding with a scanning mobility particle sizer (SMPS). Filter-collected airborne particles were characterized with dynamic light scattering (DLS) and scanning electron microscopy (SEM). Human bronchial epithelial cells (HBEC-3KT) were exposed to the dusts in dose-effect experiments. Toxicity was measured with lactate dehydrogenase (LDH) assay and cell counting kit-8 (CCK8). Cellular uptake was observed with transmission electron microscopy (TEM). RESULTS Airborne ultrafine particles showed that most particles were in the size range 15-35 nm (SMPS). SEM analysis proved that more than 80% of the particles have a minimum Feret diameter less than 1 μm. In solution (DLS), the particles have larger diameters and tend to agglomerate. Cell toxicity (LDH, CCK8) is shown after 48 h and 72 h exposure times and at the highest doses. TEM showed presence of the particles within the cell cytoplasm. SIGNIFICANCE Prolonged and frequent exposure through inhalation may have negative health implications for dentists.
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Affiliation(s)
- L M A Camassa
- National Institute of Occupational Health, Oslo, Norway
| | - T K Ervik
- National Institute of Occupational Health, Oslo, Norway
| | - F D Zegeye
- National Institute of Occupational Health, Oslo, Norway
| | - I Mdala
- Institute of Health and Society, University of Oslo, Oslo, Norway; Oral Health Centres of Expertise in Eastern Norway, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials, Oslo, Norway
| | - V Ansteinsson
- Oral Health Centres of Expertise in Eastern Norway, Oslo, Norway
| | - S Zienolddiny
- National Institute of Occupational Health, Oslo, Norway.
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8
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Wuollet E, Tseveenjav B, Furuholm J, Waltimo-Sirén J, Valen H, Mulic A, Ansteinsson V, Uhlen MM. Restorative material choices for extensive carious lesions and hypomineralisation defects in children: a questionnaire survey among Finnish dentists. Eur J Paediatr Dent 2020; 21:29-34. [PMID: 32183525 DOI: 10.23804/ejpd.2020.21.01.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM This survey assessed Finnish dentists' treatment decisions and choices of restorative materials in selected paediatric dental patient cases, with special emphasis on stainless steel crowns (SSCs). METHODS A questionnaire with patient descriptions and tooth photographs was e-mailed to members of Finnish Dental Society (n=3,747). The respondents were asked to choose their preferred treatment in cases describing 1) extensive occlusal carious lesion in a primary molar of a cooperative child; 2) an identical lesion, treated under dental general anaesthesia (DGA); and 3) a symptomatic first permanent molar with enamel hypomineralisation (consistent with Molar-Incisor Hypomineralization, MIH) and post-eruptive breakdown. Only responses from dentist treating children were included (final n=765). RESULTS The majority (47.3%) would have preferred restoration of the extensive primary tooth caries in a normal setting using resin-modified glassionomer cement, and 4.3% by using SSC. The preference of SSC as treatment choice increased to 25.4% upon implementation of DGA. The majority would treat the symptomatic permanent MIH molar with a resin composite restoration (45.0%), while 10.5% suggested SSC. Compared to general dentists, paediatric dentists had a stronger preference for SSCs. CONCLUSIONS Although the respondents emphasised patient cooperation, but also tooth prognosis and material strength behind their treatment decisions, SSC was an uncommon choice.
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Affiliation(s)
- E Wuollet
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - B Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Waltimo-Sirén
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - H Valen
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
| | - A Mulic
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
| | - V Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - M-M Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
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9
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Tanner T, Valen HR, Grøtvedt L, Kopperud SE, Becher R, Karlsen LS, Ansteinsson V. Prevention of snus use: Attitudes and activities in the Public Dental Service in the south-eastern part of Norway. Clin Exp Dent Res 2019; 5:205-211. [PMID: 31249700 PMCID: PMC6585576 DOI: 10.1002/cre2.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 11/06/2022] Open
Abstract
Dental health care professionals have the opportunity to play a key role in tobacco prevention and cessation among adolescents. Snus use has increased in Norway, especially in the age group 16-24, whereas there has been a decline in smoking. This study investigated attitudes and activities related to snus prevention among dental health care professionals working in the Public Dental Service (PDS) in south-eastern Norway. A web-based survey with a total of 557 dentists and dental hygienists in seven counties in Norway, with a response rate of 53.5%, was carried out in 2017. Dentists' and dental hygienists' activities regarding preventive snus use intervention were analysed using the chi-square test. Intervention was measured with a score (1-5) based on four questions. Bivariate and multivariate linear regression analyses were used to investigate the associations between the explanatory variables of attitudes/activities and the outcome intervention variable. Approximately 87% of the dentists and 58% of the dental hygienists were not familiar with the "minimum intervention method" for tobacco prevention and cessation. Dental hygienists were most active in informing and supporting their patients in prevention and cessation of snus use. The PDS is an underutilized arena for tobacco prevention and cessation among adolescents, and the intervention potential is particularly high among the dentists.
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Affiliation(s)
- Tarja Tanner
- Department of Cariology, Endodontology and Pediatric Dentistry, Research Unit of Oral Health SciencesUniversity of OuluOuluFinland
- Nordic Institute of Dental Materials (NIOM)OsloNorway
| | | | - Liv Grøtvedt
- Department of Air Pollution and NoiseNorwegian Institute of Public Health (NIPH)OsloNorway
| | | | - Rune Becher
- Nordic Institute of Dental Materials (NIOM)OsloNorway
- Department of Air Pollution and NoiseNorwegian Institute of Public Health (NIPH)OsloNorway
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10
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Uhlen MM, Valen H, Karlsen LS, Skaare AB, Bletsa A, Ansteinsson V, Mulic A. Treatment decisions regarding caries and dental developmental defects in children - a questionnaire-based study among Norwegian dentists. BMC Oral Health 2019; 19:80. [PMID: 31077165 PMCID: PMC6509767 DOI: 10.1186/s12903-019-0744-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/24/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Current knowledge on treatment strategies and choice of restorative materials when treating deep caries or severe dental developmental defects (DDDs) in young individuals is scarce. Therefore, the aim was to investigate Norwegian dentists´ treatment decisions and reasons for treatment choice when treating deep caries in primary teeth and severe DDDs in permanent teeth in children. METHODS A pre-coded questionnaire was sent electronically to all dentists employed in the Public Dental Service (PDS) in Norway (n = 1294). The clinicians were asked about their background characteristics and how often they registered DDDs. Three clinical cases were presented to the dentists and asked to prioritize treatment options and reasons for their choice. RESULTS After three reminders, 45.8% of the dentists answered. Most clinicians were general practitioners (96.3%), females (77.9%), under 41 year-olds (59.4%), graduated in 2001 or later (61.1%), and representing all regions of Norway. The respondents registered molar incisor hypomineralisation (MIH), other DDDs and dental fluorosis (DF) frequently, 523 (91.1%), 257 (44.8%) and 158 (27.5%), respectively. In case 1a with severe dental caries in a primary molar, the preferred treatment was resin-modified glass ionomer cement (RMGIC) (58.3%), followed by glass ionomer cement (GIC) (17.9%) and zinc oxide-eugenol (ZOE) (13.2%). Extraction, compomer or stainless steel crowns (SSC) were preferred by 0.9, 0.7 and 0.4%, respectively. In case 1b, which was identical to case 1a, but treated under general anaesthesia, the preferred treatment alternatives were RMGIC (37.1%), resin composite (RC) (17.6%) and GIC (17.2%). Extraction and SSC were chosen by 15.1 and 7.2%, respectively. In case 2, showing a severely hypomineralised and symptomatic first permanent molar, the dentists preferred RC (38.4%), followed by RMGIC (26.6%) and GIC (19.0%). Extraction and SSC were chosen by 8.7 and 5.4%, respectively. The treatment choices were not significantly affected by the dentists' background characteristics. The reasons for dentists' treatment decisions varied for each patient case; patient cooperation, prognosis of the tooth and own experience were the dominant reasons. CONCLUSIONS A notable disparity in treatment choices was shown indicating that Norwegian dentists evaluate each case individually and base their decisions on what they consider best for the individual patient.
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Affiliation(s)
- M. M. Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - H. Valen
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
| | - L. S. Karlsen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A. B. Skaare
- Oral Health Centre of Expertise in Southern Norway (OHCE-S), Arendal, Norway
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - A. Bletsa
- Oral Health Centre of Expertise in Western Norway Hordaland (OHCE-W Hordaland), Bergen, Norway
| | - V. Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A. Mulic
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
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11
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Torper J, Ansteinsson V, Lundeby T. Moving the four habits model into dentistry. Development of a dental consultation model: Do dentists need an additional habit? Eur J Dent Educ 2019; 23:220-229. [PMID: 30659766 DOI: 10.1111/eje.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
A consultation model for dentistry is presented, with communication skills in a didactic and structural format, applicable for most types of visits, patients and problems. A characteristic of the dental visit is its division into dialogue phases and clinical phases, which makes verbal exchange especially challenging. The original Four Habits Model (4H) has been adapted from medicine to the specific structure and content of a dental visit, and a modified model is proposed. The dental model consists of a structural core framework relevant for all dental consultations, and additional extensions applicable to commonly occurring issues. Facilitate Perceived Control has been added to the model, due to its crucial importance in dental visits, and we suggest naming the model "The Four + One Habits Model for Dental Visits (4 + 1HD)." The proposed model should have clinical relevance for improving patient care and patient experience, as well as easing the busy everyday life for dentists in a variety of clinical settings. It is also likely to be a flexible framework for communication skills training at all levels of dental education. More research is needed to validate and test the model in various clinical and educational settings.
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Affiliation(s)
- Jorun Torper
- Oral Health Centre of Expertise (OHCE) in Eastern Norway, Oslo, Norway
- Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Tonje Lundeby
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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Morisbak E, Ansteinsson V, Samuelsen JT. Cell toxicity of 2-hydroxyethyl methacrylate (HEMA): the role of oxidative stress. Eur J Oral Sci 2015; 123:282-7. [DOI: 10.1111/eos.12189] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 12/28/2022]
Affiliation(s)
| | - Vibeke Ansteinsson
- Nordic Institute of Dental Materials; Oslo Norway
- Department of Clinical Dentistry; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
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13
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Mathisen GH, Ansteinsson V, Samuelsen JT, Becher R, Dahl JE, Bølling AK. TEGDMA and filler particles from dental composites additively attenuate LPS-induced cytokine release from the macrophage cell line RAW 264.7. Clin Oral Investig 2014; 19:61-9. [PMID: 24615298 DOI: 10.1007/s00784-014-1212-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 09/12/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Due to incomplete curing and material degradation, cells in the oral cavity may be exposed to monomers and filler particles from dental composite fillings. The objective of the present study was to investigate if combined exposures to particles and a methacrylate monomer from composite fillings resulted in additive effects on the macrophage immune response. MATERIAL AND METHODS Two filler particles, Nanosilica (12 nm) and Quartz (1 μm), were studied at concentrations 0.5-4 μg/cm(2), while the methacrylate monomer triethyleneglycol dimethacrylate (TEGDMA) was applied at 5 and 50 μM. RAW 264.7 macrophages were exposed to monomers and/or particles for 24 h, with a subsequent 24 h combined exposure to monomers and/or particles and the bacterial factor lipopolysaccharide (LPS) to stimulate an immune response. Release of the pro-inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were measured as well as the cellular viability. RESULTS Co-exposure to Nanosilica and Quartz resulted in an additive attenuation of the LPS-induced IL-1β release. Moreover, co-exposure to TEGDMA and both types of filler particles also resulted in an additive attenuation, although with a weak synergistic trend. The cellular viability and TNF-α release were not significantly affected by the exposures. CONCLUSION The present findings emphasize the necessity of considering effects of combined exposure to dental degradation products in future risk assessments. CLINICAL RELEVANCE Attenuated cytokine release could have implications for the macrophage immune response and result in impaired bacterial clearance. Further studies are necessary to determine implications for formation of dental biofilms and caries development.
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Affiliation(s)
- Gro H Mathisen
- Nordic Institute of Dental Materials AS, PO Box 3874, Ullevaal Stadion, 0805, Oslo, Norway
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14
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Ansteinsson V, Kopperud HB, Morisbak E, Samuelsen JT. Cell toxicity of methacrylate monomers-The role of glutathione adduct formation. J Biomed Mater Res A 2013; 101:3504-10. [DOI: 10.1002/jbm.a.34652] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 02/04/2013] [Accepted: 02/11/2013] [Indexed: 01/02/2023]
Affiliation(s)
- V. Ansteinsson
- Department of Clinical Dentistry; University of Bergen; Faculty of Medicine and Dentistry; Bergen Norway
- Nordic Institute of Dental Materials (NIOM); PO Box 3874 Ullevaal stadion N-0805 Oslo Norway
| | - H. B. Kopperud
- Nordic Institute of Dental Materials (NIOM); PO Box 3874 Ullevaal stadion N-0805 Oslo Norway
| | - E. Morisbak
- Nordic Institute of Dental Materials (NIOM); PO Box 3874 Ullevaal stadion N-0805 Oslo Norway
| | - J. T. Samuelsen
- Nordic Institute of Dental Materials (NIOM); PO Box 3874 Ullevaal stadion N-0805 Oslo Norway
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Bølling AK, Samuelsen JT, Morisbak E, Ansteinsson V, Becher R, Dahl JE, Mathisen GH. Dental monomers inhibit LPS-induced cytokine release from the macrophage cell line RAW264.7. Toxicol Lett 2013. [DOI: 10.1016/j.toxlet.2012.11.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ansteinsson V, Solhaug A, Samuelsen J, Holme J, Dahl J. DNA-damage, cell-cycle arrest and apoptosis induced in BEAS-2B cells by 2-hydroxyethyl methacrylate (HEMA). Mutation Research/Genetic Toxicology and Environmental Mutagenesis 2011; 723:158-64. [DOI: 10.1016/j.mrgentox.2011.04.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 04/13/2011] [Accepted: 04/24/2011] [Indexed: 12/18/2022]
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