Epidemiological studies of the relationship between dental fear, use of dental services, and oral health in different age groups in a common population are scarce. Dental fear and its relationships are usually described in individuals with high dental fear only. The purposes of this study were to describe the prevalence of dental fear in the Norwegian adult population according to age, and to explore differences in oral health, oral hygiene, and visiting habits between individuals with high and low dental fear. For the present study, data from the Trøndelag-94 study were used. The prevalence of dental fear in our study population of adults in Trøndelag, Norway was 6.6%. There was a tendency for individuals with high dental fear to engage in avoidance behavior more frequently than the low dental fear group. Individuals with high dental fear had a statistically significantly higher number of decayed surfaces (DS), decayed teeth, (DT) and missing teeth (MT) but a statistically significantly lower number of filled surfaces (FS), filled teeth (FT), functional surfaces (FSS), and functional teeth (FST). There were no differences in DMFS and DMFT between the groups of high and low dental fear. Since one of the superior aims of the dental profession is to help a patient to achieve a high number of functional teeth throughout life, consequently detecting and treating dental fear should therefore be an important aspect of dental processionals' work.
The focus of this paper is caries in populations. Caries is assessed as a phenomenon and as it occurs in populations. It is observed that in recent literature the notion of causation of caries is restricted to the biological process on the tooth surface. This may be sufficient to explain caries as a phenomenon, but it is argued that a biological causation is insufficient in order to understand caries and its variation in populations. The understanding of the determinants of a population's oral health has been seriously impeded by the absence of a theoretical framework. A framework would be useful to the extent that it would bridge relevant categories for portraying complex causal patterns of caries in populations. An approach to a framework has therefore been outlined, and the idea of such a framework has been confronted with three critical comments. The framework is as yet pragmatic, incomplete, uncertain and fragmented. Yet, even such an approach may invite greater precision in epidemiological concepts about causes of caries than presently prevails. The framework directs attention to health effects of collective phenomena that cannot be reduced to individual attributes. The image proposed in this paper is intended to spur discussion about important aspects of the epidemiology of caries in populations.
This longitudinal study of 231 preschoolchildren from a medium sized Norwegian town had three aims: firstly, to examine the children's early dental behavior, secondly to study the variation of dental health behavior according to mother's education, mother's dental health, and her dental attendance pattern, and thirdly to identify any behavioral or social predictors of dental caries in 36-month-old children. Data were collected at health centers, using precoded questionnaires and examinations, when the children were 6, 18, and 36 months old. Data about the mothers were collected at the maternity ward. At 36 months of age, 80% of the children were caries free. Favorable dental behaviors were related to toothbrushing and use of fluorides. These behaviors were so well established and consistent at all ages that they can be regarded as norms for this community. The most unfavorable and inconsistent behavior was related to sugar consumption. Dental health education could be most usefully applied to this area, where the greatest potential for improvement in behavior exists. A relationship was found between the children's caries experience and the number of missing teeth of the mother, her dental attendance pattern and her level of education. None of the social or behavioral variables tested had a strong enough association with caries experience to justify their use as caries predictors in this age group.
Questionnaire surveys are often used in epidemiology and survey research. However, investigations have shown that the method suffers from biases. If the intention is to examine differences between subgroups in a sample, studies have shown that people tend to give answers to questionnaires more according to a social norm than to the actual situation. This has been called social desirability. The aim of this study was to investigate response bias in subgroups of a sample in a large questionnaire survey (n = 9,200) and to study whether social desirability has an impact on survey results in dental research. The answers were divided into subgroups according to gender, age, and residence and were compared with corresponding data from dental insurance claims. The levels of agreement were found to vary considerably and the differences were highly statistically significant. The variation in agreement showed that bias on the group level increased when the distance from an anticipated social norm was larger. This implies that the divergence from a socially desirable mode of action influences the magnitude of the bias.
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