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  • 1.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att ha eller riskera funktionsnedsättning och genomgå utbildning till sjuksköterska2015Student paper otherStudent thesis
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  • 2.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Denti, Leif
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Supporting first-line managers in implementing oral care guidelines in nursing homes – a pilot study2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, no 2, p. 87-95Article in journal (Refereed)
    Abstract [en]

    This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate the process. By means of a process evaluation with mixed methods, the context and a three-month leadership program was explored, including activities during and in relation to the program, and the effects in terms of oral care CPG implementation plans. While the managers appreciated the intervention and considered improved oral care to be a priority, their implementation plans mainly focused the dissemination of an oral care checklist. The findings suggest that extended implementation interventions engaging both managers and clinical staff are needed, and that a concise intervention does not facilitate first-line managers to adopt behaviors known to facilitate knowledge implementation.

  • 3. Holde, Gro Eirin
    et al.
    Oscarson, Nils
    Tillberg, Anders
    Marstrander, Peter
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. The Public Dental Health Service Competence Centre of Northern Norway, Tromsø.
    Methods and background characteristics of the TOHNN study: a population-based study of oral health conditions in northern Norway2016In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, article id 30169Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection.

    STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination.

    METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world).

    RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service.

    CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.

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  • 4. Holde, Gro Eirin
    et al.
    Oscarson, Nils
    Trovik, Tordis A
    Tillberg, Anders
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Periodontitis prevalence and severity in adults: A cross-sectional study in Norwegian circumpolar communities2017In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 88, no 10, p. 1012-1022Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study was to describe the prevalence, severity and extent of periodontitis in the adult population of circumpolar communities in Norway using data from the study Tromstannen - Oral Health in Northern Norway.

    METHODS: In this cross-sectional survey, data were collected from a randomized population sample (20-79 years) in Northern Norway. Periodontal conditions were assessed for 1,911 dentate adults with a full-mouth periodontal examination. Probing depth (PD) and bleeding on probing (BoP) were measured at six sites per tooth. Radiographic bone loss (BL) was examined using orthopantomograms.

    RESULTS: According to the CDC/AAP case definition, 49.5% of participants had periodontitis and 9.1% had severe periodontitis. Periodontitis prevalence and severity increased with age. The extent of BL and PD ≥ 4 mm also increased with age, but more rapidly and to a greater extent for BL. The prevalence of periodontitis was higher among men and varied between urban and rural areas. Periodontitis prevalence was positively associated with smoking, lower levels of education and income.

    CONCLUSIONS: This study reveals a high burden of periodontitis among adults living in circumpolar communities in Norway. The results showed sociodemographic disparities regarding periodontitis, and highlights the importance of further investigation of factors influencing periodontal health.

  • 5. Jönsson, Birgitta
    Behavioural medicine perspectives for change and prediction of oral hygiene behaviour: Development and evaluation of an individually tailored oral health educational program2010Doctoral thesis, monograph (Other academic)
  • 6.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hälsosamt beteende2010Conference paper (Other (popular science, discussion, etc.))
  • 7.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Resultat från konsesuskonferens Beteendemedicinsk prevention och behandling2012Conference paper (Other (popular science, discussion, etc.))
  • 8.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Baker, S
    Lindberg, P
    Oscarson, N
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Factors influencing oral hygiene behaviour and gingival outcomes 3 and 12 months after initial periodontal treatment: an exploratory test of an extended Theory of Reasoned Action2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 2, p. 138-144Article in journal (Refereed)
    Abstract [en]

    Aim. The aim was to empirically test the extended Theory of Reasoned Action (TRA) and the prospective direct and indirect role of attitudes, beliefs, subjective norms, self-efficacy, and a cognitive behavioural intervention in adult's oral hygiene behaviour and gingival outcomes at 3- and 12-month follow-up.

    Materials and Methods. Data were derived from an RCT evaluating the effectiveness of oral hygiene educational programs integrated in non-surgical periodontal treatment (n = 113). Before baseline examination, participants completed a self-report questionnaire. Structural equation modelling using maximum likelihood estimation with bootstrapping was used to test the direct and indirect (mediated) pathways within the extended TRA model.

    Results. The extended TRA model explained a large amount of variance in gingival outcome scores at 12 months (56%). A higher level of self-efficacy at baseline was associated with higher frequencies of oral hygiene behaviour at 3 months. Being female was linked to more normative beliefs that, in turn, related to greater behavioural beliefs and self-efficacy. Gender was also related to behavioural beliefs, attitudes and subjective norms. Both frequency of oral hygiene behaviour at 3 months and the cognitive behavioural intervention predicted gingival outcome at 12 months.

    Conclusions. The model demonstrated that self-efficacy, gender and a cognitive behavioural intervention were important predictors of oral hygiene behavioural change.

  • 9.
    Jönsson, Birgitta
    et al.
    Department of Public Health and Caring Services, Uppsala University, Uppsala, Sweden.
    Lindberg, Per
    Department of Public Health and Caring Services, Uppsala University, Uppsala, Sweden.
    Oscarsson, Nils
    Department of Periodontology, Public Dental Health Care, Uppsala, Sweden.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Improved compliance and self-care in patients with periodontitis: a randomized control trial2006In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 4, no 2, p. 77-83Article in journal (Refereed)
  • 10.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Behavioural medicine perspective for change or oral hygiene behaviour in patients with periodontal disease2010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 11.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Dental anxiety before and after non-surgical periodontal treatment2010In: 88th General Session of the International Association for Dental Research and 5th General Session of the Pan European Region of the IADR, Barcelona, Spanien, 2010Conference paper (Refereed)
  • 12.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Competence Ctr Northern Norway TkNN, Publ Dent Hlth Serv, Tromso, Norway.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Evaluation of the effect of nonsurgical periodontal treatment on oral health-related quality of life: estimation of minimal important differences 1 year after treatment2014In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 41, no 3, p. 275-282Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate an individually tailored oral health educational programme on patient-reported outcome compared with a standard oral health educational programme, assess change over time and determine minimal important differences (MID) in change scores for two different oral health related quality of life (OHRQoL) instrument after non-surgical periodontal treatment (NSPT).

    Materials and Methods: In a randomized controlled trial evaluating two educational programmes, patients (n=87) with chronic periodontitis completed a questionnaire at baseline and after 12months. OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI) and the UK oral health-related quality-of-life measure (OHQoL-UK). In addition, patients' global rating of oral health and socio-demographic variables were recorded. The MID was estimated with anchor-based and distributions-based methods.

    Results: There were no differences between the two educational groups. The OHRQoL was significantly improved after treatment. The MID was approximately five for OHQoL-UK with a moderate ES, and three for GOHAI with a Small ES, and 46-50% of the patients showed improvements beyond the MID.

    Conclusion: Both oral health educational groups reported higher scores in OHRQoL after NSPT resulting in more positive well-being (OHQoL-UK) and less frequent oral problems (GOHAI). OHQoL-UK gave a greater effect size and mean change scores but both instruments were associated with the participants' self-rated change in oral health. The changes were meaningful for the patients supported by the estimated MID.

  • 13.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Factors influencing oral hygiene behaviour 12 month after dental hygiene treatment2011In: 2nd North American/Global Dental Hygiene Research Conference, Washington, DC, 2011Conference paper (Refereed)
  • 14. Jönsson, Birgitta
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Self-efficacy scale a useful tool for predicting oral hygiene behavior2009In: 44th meeting of the IADR-Continental European Division with the Scandinavian Division and Israeli Division, Munchen, Tyskland, 2009Conference paper (Refereed)
  • 15.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Stage of Change for Interdental Cleaning in Patients with Peridontitis2013Conference paper (Refereed)
    Abstract [en]

    Objective: In the Transtheoretical model, behavioral change processes through a series of stages (Precontemplation, Contemplation, Preparation, Action and Maintenance). The purpose of the study was to determine if there were an association between decisional balance, self-efficacy and stage of change. A further aim was to assess stage of change for interdental cleaning before and after two different oral hygiene interventions.

    Method: A randomized (n = 104), evaluator-masked, clinical trial, with two different active oral hygiene behavior interventions, was analyzed with respect to stage of change at baseline and 12 months after non-surgical treatment. An individually tailored oral health educational program [ITOHEP] based on social cognitive principles were compared with a standard oral hygiene education program [ST]. A questionnaire consisting of Stage of Change instrument, Decisional balance instrument, and Self-efficacy instrument was used.

    Result: Nearly 36 % was in maintenance stage and 47% in the preparation stage. Individuals in the maintenance stage had significant higher self-efficacy than those in contemplation stage (p<0.001). There were no association between stage of change and decisional balance. Significantly more individuals was in the maintenance stage after treatment than before (p<0.001). At baseline there were no differences between groups. At the 12 month follow-up significantly more individuals in the ITOHEP group was in the maintenance stage (p< 0.05) and significantly more individuals in the ST group was in the preparation stage (p<0.05).

    Conclusion: Individuals with higher self-efficacy were to a greater extent in maintenance stage. Oral hygiene behavior interventions influence patients to move on to the maintenance stage. Patients receiving an individually tailored program were more successful in movement towards maintenance stage compared to patients receiving standard health education.

  • 16.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science. Uppsala University.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, P
    Oscarson, N
    Evaluation of an individually tailored oral health educational programme on periodontal health2010In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, no 10, p. 912-919Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate an individually tailored oral health educational programme (ITOHEP) on periodontal health compared with a standard oral health educational programme. A further aim was to evaluate whether both interventions had a clinically significant effect on non-surgical periodontal treatment at 12-month follow-up.

    Material and Method: A randomized, evaluator-blinded, controlled trial with 113 subjects (60 females and 53 males) randomly allocated into two different active treatments was used. ITOHEP was based on cognitive behavioural principles and motivational interviewing. The control condition was standard oral hygiene education (ST). The effect on bleeding on probing (BoP), periodontal pocket depth, “pocket closure” i.e. percentage of periodontal pocket >4 mm before treatment that were <5 mm after treatment, oral hygiene [plaque indices (PlI)], and participants' global rating of oral health was evaluated. Preset criteria for PlI, BoP, and “pocket closure” were used to describe clinically significant non-surgical periodontal treatment success.

    Results: The ITOHEP group had lower BoP scores 12-month post-treatment (95% confidence interval: 5–15, p<0.001) than the ST group. No difference between the two groups was observed for “pocket closure” and reduction of periodontal pocket depth. More individuals in the ITOHEP group reached a level of treatment success. Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success.

    Conclusions: ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment.

  • 17.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, Per
    Kognitiva beteendestrategier och motiverande samtal för att uppnå långsiktigt goda munhygienvanor vid kronisk parodontit. En randomiserad kontrollerad tvågruppsstudie2009In: Svenska Tandläkarsällskapets 45:e Odontologiska Riksstämma, Stockholm, 2009Conference paper (Refereed)
  • 18.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Lindberg, Per
    Oscarson, Nils
    Cost-effectiveness of an individually tailored oral health educational programme based on cognitive behavioural strategies in non-surgical periodontal treatment2012In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 39, no 7, p. 659-665Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this cost-effectiveness analysis (CEA), performed from a societal perspective, was to compare costs and consequences of an individually tailored oral health educational programme (ITOHEP) based on cognitive behavioural strategies integrated in non-surgical periodontal treatment compared with a standard treatment programme (ST).

    Material and Methods. A randomized (n = 113), evaluator-blinded, controlled trial, with two different active treatments, was analysed with respect to their costs and consequences 12 months after non-surgical treatment. Costs referred to both treatment costs and costs contributed by the patient. Consequences (outcome) were expressed as the proportion of individuals classified as having reached the pre-set criteria for treatment success after non-surgical treatment (“successful-NSPT”).

    Results. More individuals in the ITOHEP group reached the pre-set criteria for treatment success than individuals in the ST group did. The CEA revealed an incremental cost-effectiveness of SEK1724 [€191.09; SEK9.02 = €1 (January 2007)] per “successful-NSPT” case, of which treatment costs represented SEK1189 (€131.82), using the unit cost for a dental hygienist.

    Conclusion. The incremental costs per “successful-NSPT” case can be considered as low and strengthens the suggestion that an ITOHEP integrated into non-surgical periodontal treatment is preferable to a standardized education programme.

  • 19.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden and Dental health care administration in Uppsala County Council, Uppsala, Sweden.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oscarson, Nils
    National Board of Health and Welfare, Stockholm, Sweden.
    Lindberg, Per
    Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden and Department of Psychology, Uppsala University, Uppsala, Sweden.
    An individually tailored treatment programme for improved oral hygiene: introduction of a new course of action in health education for patients with periodontitis2009In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 7, no 3, p. 166-175Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis.

    Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse.

    Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period.

    Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

  • 20. Jönsson, Birgitta
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oscarson, Nils
    Lindberg, Per
    The effectiveness of an individual tailored ora health education programme on oral hygiene behaviour in patients with periodontal disease2009In: Europerio 6, Stockholm, 2009Conference paper (Refereed)
  • 21.
    Jönsson, Birgitta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Science, Uppsala University, Sweden, Dental Health Care Administration in Uppsala County Council, Sweden.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oscarson, Nils
    National Board of Health and Welfare, Stockholm, Sweden.
    Lindberg, Per
    Department of Psychology, Uppsala University, Sweden.
    The effectiveness of an individually tailored oral health educational programme on oral hygiene behaviour in patients with periodontal disease: a blinded randomized-controlled clinical trial (one-year follow-up)2009In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, no 12, p. 1025-1034Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the effectiveness of an individually tailored oral health educational programme for oral hygiene self-care in patients with chronic periodontitis compared with the standard treatment. 

    Material and method: A randomized, evaluator-blinded, controlled trial with two different active treatments were used with 113 subjects (60 females and 53 males) randomly allocated to an experimental or a control group. The individually tailored oral health educational programme was based on cognitive behavioural principles and the individual tailoring for each participant was based on participants' thoughts, intermediate, and long-term goals, and oral health status. The effect of the programmes on gingivitis [gingival index (GI)], oral hygiene [plaque indices (PlI) and self-report], and participants' global rating of treatment was evaluated 3 and 12months after oral health education and non-surgical treatment. 

    Results: Between baseline and the 12-month follow-up, the experimental group improved both GI and PlI more than the control group. The mean gain-score difference was 0.27 for global GI [99.2% confidence interval (CI): 0.16-0.39, p < 0.001] and 0.40 for proximal GI (99.2% CI: 0.27-0.53, p < 0.001). The mean gain-score difference was 0.16 for global PlI (99.2% CI: 0.03-0.30, p=0.001), and 0.26 for proximal PlI (99.2% CI: 0.10-0.43, p < 0.001). The subjects in the experimental group reported a higher frequency of daily inter-dental cleaning and were more certain that they could maintain the attained level of behaviour change. 

    Conclusion: The individually tailored oral health educational programme was efficacious in improving long-term adherence to oral hygiene in periodontal treatment. The largest difference was for interproximal surfaces.

  • 22. Lundgren, A-M
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway.
    Do adolescents who are night owls have a higher risk of dental caries?: A case-control study2016In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 14, no 3, p. 220-225Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits.

    METHODS: A group of 196 adolescents (15 and 16 years old) were divided into two equal groups based on caries risk (case = high risk; and control = low risk). Before their dental examinations, they were asked to complete a questionnaire. The questionnaire included questions on circadian rhythm, dietary and oral self-care habits, and demographic variables. The participants were divided into three circadian types: evening types who are alert in the evening and tired in the morning; morning types who are the opposite; and neutral types who are neither particularly alert in the evening nor extremely tired in the morning.

    RESULTS: The most common sleep-cycle group type was neutral (50%). After this came evening types (37%) and finally morning types (13%). Morning and neutral types reported more frequently than evening types that they had breakfast every morning and brushed their teeth twice a day. More evening types were categorized as at high risk of caries. Circadian rhythm, breakfast habits and toothbrushing frequency were associated with a high risk of caries. The predicted probability of being at high risk of caries was almost four times higher for evening types than for morning types (OR 3.8; 95% CI 1.3-10.9).

    CONCLUSION: Adolescents who belonged to the evening circadian rhythm group brushed their teeth more seldom, ate breakfast less regularly and had a higher risk of caries than morning types. A patient's circadian rhythm should be considered when planning oral health education for adolescents with a high risk of caries.

  • 23.
    Olai, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Implementing oral health-care guidelines in long-term-care: the role and support of managers2015Conference paper (Refereed)
    Abstract [en]

    Aim: There is an essential need to bridge the know-do gap in terms of oral-health-care for frail older people; while there are evidence based guidelines readily available, these guidelines are not altogether implemented in long-term-care (LTC) for older people. Facilitating knowledge translation has been found a complex undertaking, encompassing for example tailoring of evidence in relation to the specific context, considering the barriers and strengths of each setting. While managers and leaders have been found to influence implementation, studies focusing strategies to support the managers have only recently been launched. The aim of this pilot study in Swedish LTC is to support managers in facilitating implementation of evidence-based oral-care guidelines. Methods: Oral-health and knowledge translation experts provided a three month support programme for five managers in four LTC units, including knowledge of national guidelines tailored to LTC, and guidance for the managers on how to collate and execute guideline implementation plans, considering their behaviours, attitudes and actions as leaders in facilitating guideline implementation, underpinned by Gifford’s Model of Leadership. Oral-health measures were collected before and after the intervention, along with managers and staff experience. Results: Although the older people residing in the LTC units mainly had individual care plans for their oral care, and these aligned with the national guidelines, the oral care routines applied varied considerably. The managers were eager to support guideline implementation, and suggested that the intervention programme sustained their ambition. However, unclear roles and urgent everyday issues took its toll, leaving limited opportunities for managers to engage. Conclusions: Implementation of evidence based oral health-care guidelines requires support from primary leaders. Yet, they themselves need to be supported by the context, including top level management as well as staff, and all stakeholders involved in oral care issues need to be engaged.

  • 24. Oscarson, Nils
    et al.
    Espelid, Ivar
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.
    Is caries equally distributed in adults? A population-based cross-sectional study in Norway - the TOHNN-study2017In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 75, no 8, p. 557-563Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the study was to examine the prevalence and distribution of dental caries in an adult population and identify factors associated with being caries free.

    MATERIAL AND METHODS: Data were collected from a randomized population sample in Northern Norway (N = 1932; 988 women; mean age 47.0 years, SD 15.3). The study included a structured questionnaire and a clinical examination. The sum of enamel and dentine caries, DS1-5, formed the main outcome measures for caries prevalence.

    RESULTS: Mean DMFT was 15.1 (95% CI 14.8, 15.4), mean DFT was 12.0 (CI 11.7, 12.2), and mean DT was 1.1 (CI 1.0, 1.2). The mean value for dentine caries (DS3-5) was 0.8 (CI 0.7, 0.9), and mean DS1-5 was 3.8 (CI 3.6, 4.1). Mean DS1-5 was highest in the youngest age group (mean 6.9, 95% CI 6.3, 7.6) and in rural areas (mean 5.0, CI 4.4, 5.6). The most caries-prone 20% in the youngest age group had 52% of the total number of carious lesions compared with 80% in the two oldest age groups. Tooth brushing twice daily (p = .005), drinking sugar containing soft drink (p =.029), and attending dental services every year (p < .001), were associated with being caries free.

    CONCLUSION: Dental caries is still a common condition, particularly in the youngest age group. Living in a rural area, low socioeconomic status, less frequent tooth cleaning and sugar containing soft drinks were associated with a higher prevalence of dental caries. The different caries distribution among adults calls for different preventive strategies at both population and individual levels.

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  • 25.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    A comparison of two questionnaires measuring oral health-related quality of life before and after dental hygiene treatment in patients with periodontal disease2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, p. 9-14Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to compare the usefulness of two different questionnaires assessing oral health-related quality of life (OHRQoL) at the basic examination and after initial dental hygiene treatment (DHtx).

    Methods: A total of 42 patients referred for periodontal treatment completed the Oral Health Impact Profile (OHIP-14) and the General Oral Health Assessment Index (GOHAI) at the basic periodontal examination. They underwent DHtx and completed the questionnaires once again after the treatment.

    Results: No statistically significant differences could be found between the two assessments, neither for the total scores nor for any of the separate items of the OHIP-14 or the GOHAI. However, the GOHAI questionnaire seems to result in a greater variety in the responses indicating that the floor effect is not as pronounced as for the OHIP-14. Those who had rated their oral health as good reported significantly better OHRQoL on both questionnaires. The same pattern was found for patients who reported that they were satisfied with their teeth. After DHtx and necessary extractions, there was a statistically significant correlation between the number of teeth and the total scores on both questionnaires. No other statistically significant correlations with periodontal variables could be found.

    Conclusion: No statistically significant difference could be found after DHtx compared to before in regard to OHRQoL assessed with OHIP-14 and GOHAI. However, there was a greater variety in the responses with the GOHAI questionnaire; it may hereby be more useful for patients with periodontal disease.

  • 26.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life before and after dental hygiene treatment2010In: 88th General Session of the International Association for Dental Research adn 5th General Session of the Pan European Region of the IADR, Barcelona, Spanien, 2010Conference paper (Refereed)
  • 27.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Patient related outcomes of initial periodontal treatment2010In: 18th International Symposium on Dental Hygiene, Glasgow, Skottland, 2010Conference paper (Refereed)
  • 28.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Patient related outcomes of initial periodontal treatment2011In: 2nd North American/Global Dental Hygiene Research Conference, Washington, DC, 2011Conference paper (Refereed)
  • 29.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Patients' experiences of initial periodontal treatment2009In: 87th General Session and Exhibition of the IADR, Miami, USA, 2009Conference paper (Refereed)
    Abstract [en]

    Patients´ experiences of initial periodontal treatment Objective The objective of the present study was to assess the impact of periodontal disease on oral health-related quality of life before and after the initial periodontal treatment (information, instruction, scaling and root planning). Method Patients referred to a specialist clinic in periodontology were invited to participate. A total of 97 (86%) completed the UK oral health-related quality of life questionnaire (OHRQoL-UK) and a check list of questions on their rating and satisfaction with general and oral health before and after initial periodontal treament. Results The patients´ reported an overall improvement in their OHRQoL after the initial periodontal treatment. This was specifically true for the items: general health, well-being and breath odour. They were more satisfied with their general health and their teeth after the treatment. In addition, they rated their oral health higher. Conclusion Initial periodontal treatment improved OHRQoL and patients´ satisfaction with general and oral health, indicating that mechanical infection control is effective assessed by the patients.

1 - 29 of 29
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