The aim of the this study was to present data on oral care habits and knowledge of oral health in... more The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city of Jönköping, Sweden, in 1973, 1983, 1993, 2003, and 2013. The 1973 study constituted a random sample of 1,ooo individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993, 2003, and 2013 studies, which comprised 1,104; 1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-60 years were treated by the ...
The aim of this epidemiological study performed in 2013 was to analyze various clinical and radio... more The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment. The frequency of edentulous individuals aged 40-70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture weareryounger than 80-years old was found in 2013. During the 40-year per...
This study comprises a survey of Swedish dentists'treatment preferences in cases of carious e... more This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were as...
Objective. To study the association between type of restoration and apical periodontitis (AP) in ... more Objective. To study the association between type of restoration and apical periodontitis (AP) in root filled teeth. Materials and methods. The present study used data from surveys conducted in 1983, 1993 and 2003. In 1983, 130 randomly selected subjects aged 3-80 years in the city of Jönköping, Sweden, were invited for a clinical and radiological examination. The study was repeated in 1993 and 2003. New participants were, thus, recruited with the same sampling criteria and sample size in the same geographical area in 1993 and 2003, respectively. In the present study, only dentate individuals aged 20-70 years with ≥1 root filled tooth were included, yielding a sample of 788 subjects with 2634 root filled teeth. Apical periodontitis on the tooth level was the dependent variable. Periapical status was assessed according to Periapical Index (PAI). Independent variables were root filling quality, recurrent caries, type of restoration, number of teeth with apical periodontitis, age and ge...
Pulp biology Dental pulp disease Restorative dentistry a b s t r a c t Background: This systemati... more Pulp biology Dental pulp disease Restorative dentistry a b s t r a c t Background: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time. Study design: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on
Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root ... more Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in Jö nkö ping, Sweden. International Endodontic Journal, 41, 958-968, 2008. Aim To study changes in technical quality of root fillings and periapical status in root filled teeth in random samples of 20 to 70 year-olds between 1973 and 2003. Methodology Data from dentate subjects aged 20-70 years from examinations conducted in 1973 (n = 498), 1983 (n = 530), 1993 (n = 547) and 2003 (n = 491) were used for the analysis. Length of root fillings were measured on radiographs to the nearest 0.1 mm. Adequate seal was defined as a root filling without lateral and/or apical voids. Periapical status was assessed according to the periapical index. All observations were made by one calibrated observer registered from full mouth radiographic examinations. Teeth with root fillings ending within the canal without lateral or apical voids were considered adequate. The association between root filling quality and periapical status was analysed by means of the Chi-squared test and a multilevel logistic regression analysis. Results Adequately root filled teeth had a significantly lower frequency of apical periodontitis than inadequately root filled teeth (11.8% vs. 22.8%). The frequency of technically adequate root fillings increased statistically significant from 1973 (23.7%) to 2003 (36.4%) without a concomitant improvement of the periapical status in root filled teeth over time (24.5% vs. 24.6%). Conclusions This study reports on an improving technical quality of root fillings over time, without a concomitant improvement of the periapical status in root filled teeth. A larger proportion of treated molars over time may be of importance for the result.
The aim of the study was to test the hypothesis that root-filled teeth are at a higher caries ris... more The aim of the study was to test the hypothesis that root-filled teeth are at a higher caries risk than non-root-filled teeth. Two sub-samples from epidemiologically obtained data collected in 1983, 1993 and 2003 in the city of Jönköping, Sweden, were analysed. All the participants were examined clinically and radiographically and the type of filling and the presence or absence of caries were recorded. Sub-sample 1 comprised 832 individuals (9202 teeth) aged 20-70 years with at least eight premolars/molars. In sub-sample 2, 163 subjects (577 teeth) with only one or two decayed tooth surfaces and at least one tooth with full crown coverage were analysed. Logistic regression analysis found that root-filled teeth were predictive of recurrent caries when controlling for the type of restoration in sub-sample 1 (OR = 1.68; 1.41-2.0; CI 95%) and sub-sample 2 (OR = 2.20; 1.07-4.52; CI 95%). In support of the suggested hypothesis, the data revealed a significant association between root-filled teeth and recurrent caries.
This cross-sectional study was designed to explore a possible association between endodontic dise... more This cross-sectional study was designed to explore a possible association between endodontic disease variables and coronary heart disease (CHD). Dental infections are hypothesized to be linked to atherosclerosis and could be a cause of vascular changes crucial for the development of CHD. Most studies have focused on periodontal disease. To our knowledge, no one has specifically studied endodontic variables as risk factors for the development of CHD. In 1992-93, a representative sample (n = 1056) of women in Göteborg, Sweden, aged between 38 and 84 years, took part in a combined dental and medical survey. The dependent variable was CHD, i.e. subjects with angina pectoris and/or a history of myocardial infarction (n = 106). The independent variables were number of root-filled teeth (RF), number of teeth with periapical radiolucencies (PA), tooth loss (TL), age, life situation, marital status, smoking, alcohol habits, body mass index, waist-hip ratio, serum cholesterol and triglyceride concentrations, hypertension and diabetes. The multivariate logistic regression analysis did not prove the endodontic variables to be predictive of CHD. Only age and tooth loss were significantly associated with CHD, with OR = 1.07 (CI = 1.03-1.12) and OR = 2.70 (CI = 1.49-4.87), respectively. The bivariate logistic regression analysis showed a positive significant association between subjects with RF = 2 and CHD, but for PA the bivariate analysis did not support an association with CHD. This cross-sectional study did not reveal a significant association between endodontically treated teeth and CHD nor between teeth with periapical disease and CHD.
The aim of this study was to reveal possible socio-economic risk indicators for apical periodonti... more The aim of this study was to reveal possible socio-economic risk indicators for apical periodontitis. In 1992-93 a representative sample of women in Göteborg, Sweden, aged 38-84 years, participated in a medical and dental survey (n=981) which included dental and medical examinations and dental radiographic examination (OP). The dependent variable was apical periodontitis (AP=0, AP>0). The independent variables were age, number of teeth, number of restored teeth, number of root-filled teeth, number of teeth with carious lesions, satisfactory masticatory function, and dental esthetics as crude measures of self-reported dental health, dental anxiety, time elapsed since last visit to a dental office, regular dental visiting habits, smoking, alcohol habits, and marital status. A subjective evaluation of economy, health and life situation (acceptable or poor) was accounted for as socio-economic variables. The oldest age group, women born 1908, and edentulous individuals were omitted, leaving 844 subjects for analysis. Statistical analysis included multivariate logistic regression, chi-squared test, and independent t-test for comparison of group characteristics (AP=0 vs AP>0). For socio-economic variables there was a significant association between acceptable health and apical periodontitis (OR=1.72 (CI=1.09-2.70)). For oral-related variables, root-filled teeth (OR=1.17 (CI=1.10-1.23)) and teeth with carious lesions (OR=1.48 (CI=1.19-1.85)) were predictive of apical periodontitis. In the present study, socio-economic variables and dental visiting habits did not appear to have obvious implications for periapical health, whereas root-filled teeth and carious lesions were associated with apical periodontitis.
The aim was to assess survival in the Swedish population of teeth treated by nonsurgical root can... more The aim was to assess survival in the Swedish population of teeth treated by nonsurgical root canal treatment during 2009. Data from the Swedish Social Insurance Agency were analyzed by Kaplan-Meier analysis to assess cumulative tooth survival during a period of 5-6 years of all teeth that were root-filled during 2009. In 2009, 248,299 teeth were reported as root-filled. The average age of the patients at the time of the root filling was 55 years (range, 20-102 years). The teeth most frequently root-filled were the maxillary and mandibular first molars. During the 5- to 6-year period 25,228 of the root-filled teeth (10.2%) were reported to have been extracted; thus 223,071 teeth (89.8%) survived. Tooth survival was highest in the youngest age group (93.2%). The highest survival (93.0%) was for the mandibular premolars, and the lowest (87.5%) was for the mandibular molars. Teeth restored with indirect restorations within 6 months of the root filling had higher survival rates (93.1%) than those restored with a direct filling (89.6%). In the adult population of Sweden, teeth that are root-filled by general practitioners under the tax-funded Swedish Social Insurance Agency have a 5- to 6-year survival rate of approximately 90%.
The aim of the this study was to present data on oral care habits and knowledge of oral health in... more The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city of Jönköping, Sweden, in 1973, 1983, 1993, 2003, and 2013. The 1973 study constituted a random sample of 1,ooo individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993, 2003, and 2013 studies, which comprised 1,104; 1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-60 years were treated by the ...
The aim of this epidemiological study performed in 2013 was to analyze various clinical and radio... more The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment. The frequency of edentulous individuals aged 40-70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture weareryounger than 80-years old was found in 2013. During the 40-year per...
This study comprises a survey of Swedish dentists'treatment preferences in cases of carious e... more This study comprises a survey of Swedish dentists'treatment preferences in cases of carious exposure of the dental pulp in adults.The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines.Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included.The final study sample comprised 412 participants.The dentists were presented with two case scenarios. In Case 1 a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14.The participants were as...
Objective. To study the association between type of restoration and apical periodontitis (AP) in ... more Objective. To study the association between type of restoration and apical periodontitis (AP) in root filled teeth. Materials and methods. The present study used data from surveys conducted in 1983, 1993 and 2003. In 1983, 130 randomly selected subjects aged 3-80 years in the city of Jönköping, Sweden, were invited for a clinical and radiological examination. The study was repeated in 1993 and 2003. New participants were, thus, recruited with the same sampling criteria and sample size in the same geographical area in 1993 and 2003, respectively. In the present study, only dentate individuals aged 20-70 years with ≥1 root filled tooth were included, yielding a sample of 788 subjects with 2634 root filled teeth. Apical periodontitis on the tooth level was the dependent variable. Periapical status was assessed according to Periapical Index (PAI). Independent variables were root filling quality, recurrent caries, type of restoration, number of teeth with apical periodontitis, age and ge...
Pulp biology Dental pulp disease Restorative dentistry a b s t r a c t Background: This systemati... more Pulp biology Dental pulp disease Restorative dentistry a b s t r a c t Background: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time. Study design: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on
Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root ... more Frisk F, Hugoson A, Hakeberg M. Technical quality of root fillings and periapical status in root filled teeth in Jö nkö ping, Sweden. International Endodontic Journal, 41, 958-968, 2008. Aim To study changes in technical quality of root fillings and periapical status in root filled teeth in random samples of 20 to 70 year-olds between 1973 and 2003. Methodology Data from dentate subjects aged 20-70 years from examinations conducted in 1973 (n = 498), 1983 (n = 530), 1993 (n = 547) and 2003 (n = 491) were used for the analysis. Length of root fillings were measured on radiographs to the nearest 0.1 mm. Adequate seal was defined as a root filling without lateral and/or apical voids. Periapical status was assessed according to the periapical index. All observations were made by one calibrated observer registered from full mouth radiographic examinations. Teeth with root fillings ending within the canal without lateral or apical voids were considered adequate. The association between root filling quality and periapical status was analysed by means of the Chi-squared test and a multilevel logistic regression analysis. Results Adequately root filled teeth had a significantly lower frequency of apical periodontitis than inadequately root filled teeth (11.8% vs. 22.8%). The frequency of technically adequate root fillings increased statistically significant from 1973 (23.7%) to 2003 (36.4%) without a concomitant improvement of the periapical status in root filled teeth over time (24.5% vs. 24.6%). Conclusions This study reports on an improving technical quality of root fillings over time, without a concomitant improvement of the periapical status in root filled teeth. A larger proportion of treated molars over time may be of importance for the result.
The aim of the study was to test the hypothesis that root-filled teeth are at a higher caries ris... more The aim of the study was to test the hypothesis that root-filled teeth are at a higher caries risk than non-root-filled teeth. Two sub-samples from epidemiologically obtained data collected in 1983, 1993 and 2003 in the city of Jönköping, Sweden, were analysed. All the participants were examined clinically and radiographically and the type of filling and the presence or absence of caries were recorded. Sub-sample 1 comprised 832 individuals (9202 teeth) aged 20-70 years with at least eight premolars/molars. In sub-sample 2, 163 subjects (577 teeth) with only one or two decayed tooth surfaces and at least one tooth with full crown coverage were analysed. Logistic regression analysis found that root-filled teeth were predictive of recurrent caries when controlling for the type of restoration in sub-sample 1 (OR = 1.68; 1.41-2.0; CI 95%) and sub-sample 2 (OR = 2.20; 1.07-4.52; CI 95%). In support of the suggested hypothesis, the data revealed a significant association between root-filled teeth and recurrent caries.
This cross-sectional study was designed to explore a possible association between endodontic dise... more This cross-sectional study was designed to explore a possible association between endodontic disease variables and coronary heart disease (CHD). Dental infections are hypothesized to be linked to atherosclerosis and could be a cause of vascular changes crucial for the development of CHD. Most studies have focused on periodontal disease. To our knowledge, no one has specifically studied endodontic variables as risk factors for the development of CHD. In 1992-93, a representative sample (n = 1056) of women in Göteborg, Sweden, aged between 38 and 84 years, took part in a combined dental and medical survey. The dependent variable was CHD, i.e. subjects with angina pectoris and/or a history of myocardial infarction (n = 106). The independent variables were number of root-filled teeth (RF), number of teeth with periapical radiolucencies (PA), tooth loss (TL), age, life situation, marital status, smoking, alcohol habits, body mass index, waist-hip ratio, serum cholesterol and triglyceride concentrations, hypertension and diabetes. The multivariate logistic regression analysis did not prove the endodontic variables to be predictive of CHD. Only age and tooth loss were significantly associated with CHD, with OR = 1.07 (CI = 1.03-1.12) and OR = 2.70 (CI = 1.49-4.87), respectively. The bivariate logistic regression analysis showed a positive significant association between subjects with RF = 2 and CHD, but for PA the bivariate analysis did not support an association with CHD. This cross-sectional study did not reveal a significant association between endodontically treated teeth and CHD nor between teeth with periapical disease and CHD.
The aim of this study was to reveal possible socio-economic risk indicators for apical periodonti... more The aim of this study was to reveal possible socio-economic risk indicators for apical periodontitis. In 1992-93 a representative sample of women in Göteborg, Sweden, aged 38-84 years, participated in a medical and dental survey (n=981) which included dental and medical examinations and dental radiographic examination (OP). The dependent variable was apical periodontitis (AP=0, AP>0). The independent variables were age, number of teeth, number of restored teeth, number of root-filled teeth, number of teeth with carious lesions, satisfactory masticatory function, and dental esthetics as crude measures of self-reported dental health, dental anxiety, time elapsed since last visit to a dental office, regular dental visiting habits, smoking, alcohol habits, and marital status. A subjective evaluation of economy, health and life situation (acceptable or poor) was accounted for as socio-economic variables. The oldest age group, women born 1908, and edentulous individuals were omitted, leaving 844 subjects for analysis. Statistical analysis included multivariate logistic regression, chi-squared test, and independent t-test for comparison of group characteristics (AP=0 vs AP>0). For socio-economic variables there was a significant association between acceptable health and apical periodontitis (OR=1.72 (CI=1.09-2.70)). For oral-related variables, root-filled teeth (OR=1.17 (CI=1.10-1.23)) and teeth with carious lesions (OR=1.48 (CI=1.19-1.85)) were predictive of apical periodontitis. In the present study, socio-economic variables and dental visiting habits did not appear to have obvious implications for periapical health, whereas root-filled teeth and carious lesions were associated with apical periodontitis.
The aim was to assess survival in the Swedish population of teeth treated by nonsurgical root can... more The aim was to assess survival in the Swedish population of teeth treated by nonsurgical root canal treatment during 2009. Data from the Swedish Social Insurance Agency were analyzed by Kaplan-Meier analysis to assess cumulative tooth survival during a period of 5-6 years of all teeth that were root-filled during 2009. In 2009, 248,299 teeth were reported as root-filled. The average age of the patients at the time of the root filling was 55 years (range, 20-102 years). The teeth most frequently root-filled were the maxillary and mandibular first molars. During the 5- to 6-year period 25,228 of the root-filled teeth (10.2%) were reported to have been extracted; thus 223,071 teeth (89.8%) survived. Tooth survival was highest in the youngest age group (93.2%). The highest survival (93.0%) was for the mandibular premolars, and the lowest (87.5%) was for the mandibular molars. Teeth restored with indirect restorations within 6 months of the root filling had higher survival rates (93.1%) than those restored with a direct filling (89.6%). In the adult population of Sweden, teeth that are root-filled by general practitioners under the tax-funded Swedish Social Insurance Agency have a 5- to 6-year survival rate of approximately 90%.
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