Barn och unga som vårdas inom SiS har samma rätt till bästa möjliga hälsa, inklusive en god munhälsa, som andra jämnåriga. Dock har det saknats studier som undersökt munhälsan hos barn och ungdomar placerade på SiS och hur ansvariga verksamheter ser till att deras eventuella vårdbehov blir tillgodosedda.

Syftet med studien som presenteras i denna rapport var att öka kunskapen om munhälsan hos unga placerade på SiS och hanteringen av konstaterade vårdbehov. Forskarna ville också undersöka de ungas uppfattningar om munhälsa och stöd före och under placering. Studien genomfördes på två ungdomshem där data samlades in genom klinisk undersökning samt intervjuer med 107 respektive 23 unga. Det utfördes även en enkätundersökning där ytterligare ett ungdomshem deltog. Utöver detta har forskarna via bland annat journaler undersökt i vilken grad de unga fått den behandling som de remitterats till.

Resultaten visar att de unga på SiS institutioner lider av omfattande munhälsoproblem och att det råder stora brister i vårdkedjan. Rapporten mynnar ut i flera implikationer för ungdomshem, socialtjänst, region, nationella organisationer, myndigheter och lagstiftande politiker.  

Oral dryness is common in persons with untreated obstructive sleep apnoea (OSA) as well as in those using positive airway pressure (PAP). OSA with or without PAP treatment could therefore be a risk factor of dental caries.

Objectives: To describe and compare the prevalence of dental caries among persons with or without PAP-treated OSA.

Methods: Cross-sectional data derived from a clinical examination of 121 adults without OSA, and with or without long-time experience of PAP treated OSA (>10 years) were used. The participants responded to a questionnaire and were clinically and radiographically examined. Decayed, missing, and filled teeth, decayed surfaces, gingivitis and presence of dental plaque were registered. Descriptive analyses were performed to describe dental caries prevalence among groups. To compare groups, one-way ANOVA and Kruskal-Wallis tests was conducted.

Results: Participants (52% females, mean age 69.5±5.8 years) were categorised into groups based on OSA status; non-OSA (n=49), non-PAP-treated OSA (n=38), and PAP-treated OSA (n=34). Dental caries prevalence showed no statistically significant differences among groups, except for occlusal caries, where the PAP-treated OSA group had a higher mean compared to the non-OSA group (p=0.033). Most participants did not report xerostomia, but the highest prevalence was found in the non-PAP-treated OSA group (31.6%).

Conclusions: The prevalence of dental caries was slightly higher in persons with PAP treated OSA compared to non-PAP-treated OSA and persons without OSA, but the results were not statistically significant.

OBJECTIVES: To investigate the association between the individuals' level of sense of coherence (SOC) and periodontal disease severity.

METHODS: The study populations originated from two stratified cross-sectional random samples of residents in a medium-sized Swedish city in 2003 and 2013, respectively. The final samples constituted 491 individuals in 2003 and 538 individuals in 2013. The samples were classified into three groups according to the severity of periodontitis (no/minor, moderate and severe). The 13-item Swedish version of Antonovsky's "Orientation to life" questionnaire, measuring the individual's SOC, was filled out. Descriptive statistics were performed as well as multinomial logistic regression analysis. Dependent variable was the severity of periodontal disease and independent variables, age in years, presently smoking and education at university level.

RESULTS: In the multinomial regression analysis, smoking, age, and total SOC score were significantly associated with severe periodontitis at both examinations. The strongest predictor of severe periodontal disease was smoking. The total SOC score did not differ between the examinations, but there was a statistically significant difference in two of the SOC dimensions, manageability (lower), and comprehensibility (higher), over time.

CONCLUSIONS: Individuals with severe periodontitis had significantly lower SOC compared to subjects periodontally having no/minor periodontal disease. Smoking was the strongest overall predictor of having severe periodontitis.

BACKGROUND: Oral diseases have been associated with cardiovascular diseases, and persons with continuous positive airway pressure [CPAP]-treated obstructive sleep apnoea [OSA] have an increased risk for negative consequences for both oral and general health. CPAP treatment is often life-long and adherence to treatment is essential. Xerostomia is a common side-effect which can lead to treatment abandonment. Oral health is a changeable part of our general health and well-being and exploring the views of oral health determinants from persons with experience of CPAP-treatment is important to prevent adverse oral health outcomes. The purpose of this study was to explore what persons with experience of CPAP-treated OSA view as determinants for their oral health.

METHODS: Eighteen persons with long-term experience of CPAP-treated OSA were purposively selected. Data were collected by semi-structured individual interviews. A code book based on the World Dental Federation's [FDI] theoretical framework for oral health was developed and used to analyse the data using directed content analysis. The domains in the framework's component driving determinants were used as pre-determined categories. Using the description of driving determinants as a guide, meaning units were extracted from the interview transcripts through an inductive approach. Then, by employing a deductive approach the code book was used to categorise the meaning units into the pre-determined categories.

FINDINGS: The views on oral health determinants described by the informants were compatible with the five domains in the component driving determinants in the FDI's theoretical framework. Ageing, heredity, and salivation (biological and genetic factors), influences from family and the wider society (social environment), location and re-localisation (physical environment), oral hygiene habits, motivation, willingness to change, professional support (health behaviours), and availability, control, finances, and trust (access to care) were viewed as important oral health determinants by the informants.

CONCLUSION: The study points to a variety of individual oral health-related experiences that oral healthcare professionals could consider when designing interventions to reduce xerostomia and prevent adverse oral health outcomes for persons undergoing long-term CPAP-treatment.

Introduction: The World Dental Federation (FDI) has recently proposed a new definition and theoretical framework of oral health. The theoretical framework includes 4 main components and describes the relationships amongst them. In 2020, an international work group proposed the minimum Adult Oral Health Standard Set (AOHSS) of variables to measure oral health, which was mapped onto the FDI's theoretical framework. By using an empirical data set, the proposed variables in the AOHSS and the potential interactions amongst the components of the FDI's theoretical framework can be tested. The purpose of this research was to investigate structural relations of the components of the FDI's theoretical framework of oral health based on data from a general adult population.

Methods: Data from a previously conducted Swedish cross-sectional study focusing on oral health were utilised (N = 630; women, 55.2%; mean age, 49.7 years [SD, 19.2]). Variable selection was guided by the AOHSS. Structural equation modeling was used to analyse relationships amongst the components of the FDI's theoretical model (core elements of oral health, driving determinants, moderating factors, and overall health and well-being).

Results: The Oral Health Impact Profile (OHIP)-14, xerostomia, and aesthetic satisfaction had statistically significant direct effects on overall health and well-being (p < .05). Driving determinants and moderating factors had statistically significant direct effects on all core elements of oral health (p < .05) except aesthetic satisfaction (p = .616). The predictors explained 24.1% of the variance of the latent variable overall health and well-being. Based on several indices, the proposed model showed acceptable model fit.

Conclusions: The FDI's theoretical framework can be used to describe different components of oral health and the relationship amongst them in an adult general population. Further research based on the FDI's theoretical framework in other populations and settings is needed to explore complex interactions and possible relationships that form oral health and to investigate other or additional important social determinants.

Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

Objectives: Obstructive sleep apnea (OSA) has an impact on an individual's quality of life and general health, and can also affect their oral health. The patient's experiences, together with intraoral signs and symptoms could indicate the presence of OSA. Knowledge that the patient has, or is at high risk for having OSA can help the dental healthcare provider maintain the oral health and general health for these patients. The purpose was to explore dentists and dental hygienists' experiences when encountering adult patients with potential, untreated and treated OSA.

Methods: A qualitative inductive approach was used. Experienced dentists and dental hygienists working within Swedish Public Dental Service were strategically selected. Semi-structured face-to-face interviews were performed followed by qualitative content analysis.

Results: Interviews from 13 participants, seven dental hygienist and six dentists, led to three areas describing varied experience: Importance of the patient encounter and identifying intraoral signs both of which describe experiences related to the importance of the initial unstructured conversation and focused clinical assessments, and strategies for nurturing care which point to interest about care, treatment, and collaborations with medical health care providers.

Conclusions: Dental professionals are not able to consistently recognize patients who have, or are at high risk for OSA. During the patient encounter, is it important to determine if a patient is at risk for, or has oral signs of OSA.