Self-assessed bleeding and plaque as methods for improving gingival health in adolescents.

The aim of this longitudinal study was to compare the effectiveness, in terms of cognitive and clinical changes, of two oral self-care promoting interventions based on a self-assessment of bleeding from gums or of presence of plaque. Adolescent students (age 14.0 + 0.7 years) from two health districts in Helsinki, Finland, participated in this one-year study. The self-assessment of bleeding group (n = 172) recorded bleeding during tooth brushing and inter-proximal cleaning with toothpicks on a single session. The self-assessment of plaque group (n = 156) recorded the presence of plaque with disclosing dye. Both programmes resulted in comparable clinical improvement in bleeding on probing over 9 months. Increased awareness of gingivitis was associated with clinical improvement. The subjects' socio-economic background, baseline gingival health status and age were statistically significantly associated with gingival health improvement during the follow-up. The results support earlier reports on self-assessment and suggest that both self-assessment approaches are beneficial for promoting gingival health in adolescents.

Seafaring: a risk for seamen's oral health?

Information about the oral status and dental health behavior and the working history of 369 Finnish seamen on different types of ships was gathered by means of a questionnaire. A control group of workers on shore was formed for sailors 35-44 years of age. Removable dentures were worn by 16% of the seamen. Oral disorders during the week before the study were reported by one-third. During the previous 2 years 14% of the sailors had had at least one episode of oral troubles, 15% twice and 9% three or even more times. One-third of seamen with oral trouble had needed pain-killing tablets or antibiotics. Sick leave days had been needed by 3% of respondents during the previous 2 years because of oral disorder (mean length of sick leave period was 1.4 days). The control group reported gum bleeding more often than the seafarers. Even though there were no signs of poorer dental condition in sailors than in the controls on shore, the possibility that the seafaring could constitute a risk for the oral health of seamen in other age groups cannot be excluded.

Utilization of dental services by Finnish seamen.

Utilization of dental services by Finnish seamen was surveyed late in 1990. Three hundred and sixty-five respondents on different vessels at sea for more than 5 days returned a pretested questionnaire. A randomly drawn control group of 230 workers at a ventilation-equipment-producing plant was also surveyed. Fifty-five per cent of the seamen studied and 73% of the control group stated they had visited a dentist within the year before the survey. One-third of the seamen stated that an acute dental condition had been the reason for their last dental visit. Almost one-third of the seamen and 5% of the control group reported having last visited a dentist at a health center. When questioned separately, 14% of the seamen stated that they had not received dental treatment fast enough when needed. One-third of the seamen surveyed offered ideas for improving their dental services, half of them suggesting an increase in facilities and personnel at health centers for seamen. Periodic oral examinations for and full use of oral health self-care procedures by seamen are recommended.

The Dental Fear Survey Schedule: a study with Finnish children.

The reliability and validity of the Dental Fear Survey Schedule for Children (DFSS-C) was examined in a sample of 828 school children in Finland. The DFSS-C mean was 22.1. Choking, injections and drilling were the most common fears. Internal consistency indicated a high level of reliability. Factor analysis (principal components, varimax rotation) found three factors accounting for 54% of the scale variance. Factors were defined as (1) fear of highly invasive procedures, such as injections and drilling; (2) fear of potential victimization, including fear of strangers, choking and hospitals; and (3) fear of less invasive procedures, such as opening the mouth and being examined by the dentist. The factor pattern was similar to results obtained with a sample of children in the United States. There were significant differences in fear score for children whose parents reported them fearful and/or reported them to have had a previous bad experience at the dentist. Boys (but not girls) who had a DMFT score of at least 1 had a significantly higher mean DFSS-C score (21.1) than those who were caries free (20.0). These data suggest the DFSS-C operates in Finland as it does in the United States, but that culture-specific minimal scores for determining high dental fear are needed.

Prediction of periodontal treatment capacity.

This study analyzes factors having influence on dentists' capacity to give periodontal therapy. The data was collected by the questionnaire from 134 randomly selected Finnish dentists. The effects were examined by two- and multiway frequency tables. The results indicated that the time since graduation had the strongest single effect. Also the prediction categories dealing with continuing education and scientific interest were related to periodontal capacities of dentists. The combined effects of certain variables as sex, type of position and place of practice indicate that the cumulation of certain favourable factors is needed to accomplish periodontal therapy in Finland. It was concluded that the promotion of periodontal care can be realized reliably by improved levels of undergraduate and postgraduate education.

Use of services, care-seeking behavior and satisfaction among university dental clinic patients in Finland.

This paper analyzes use of services, behavioral features and their intercorrelations among a random sample of 94 patients visiting University of Connecticut dental clinics. The data were collected in interviews and patient records. In care seeking the greatest percentage (34%) of respondents relied on the advice of friends, relatives or neighbors. This finding confirms the importance of the lay referring system. The influence of regular source of care was apparent when patients' frequency of visits in clinics exceeded considerably their visit frequency in the past. Even earlier irregular visitors made many visits during the past 12 months. The following dimensions of satisfaction were measured: difficulty in getting an appointment, general satisfaction with care, costs of care in general, convenience in treatment and satisfaction with oral health. The results show that opinions toward care and about dental health were dominantly positive ranging from 60 to 94% of all the answers. Costs were regarded as high by 54% of the subjects. There was a positive and significant correlation between degree of utilization and satisfaction with care. The correlation between satisfaction with oral health and number of teeth was non-significant. There were several cumulative correlations, which suggests that one health related feature may predict a similar tendency in other health behaviors.

Effects of fluoride and regular dental care on personal dental expenditures of young adults in Finland.

This paper analyzes the relationship among presence of fluoride in the drinking water, oral health and dental expenditures in four towns in Finland. A two-stage least-squares model is used to determine the effect of fluoridated water and other independent variables on the number of missing teeth and per capita annual dental service expenditures for 555 adults. The results show that regularity of dental visits is the only significant factor explaining per capita expenditures. In contrast, many factors affect the number of missing teeth; most importantly, the number of dentists per capita, level of fluoride, age, education, use of services and smoking habits. These findings suggest that fluoride significantly improves oral health status but does not reduce adult per capita dental expenditures.