The causes of mental retardation (MR) were studied as part of a multidisciplinary epidemiological case-control study in 151 mentally retarded patients identified by screening four age cohorts (12,882 children) at 8-9 years of age in the province of Kuopio, Finland. The causes of MR in 77 severely retarded (SD < or = -3 SD) and 74 mildly retarded (-2 > SD > -3) children were divided into pre-, peri-, postnatal and unknown groups according to the probable time of onset. The causes were pre-, peri-, postnatal and unknown in 60%, 9%, 8% and 23%, and 22%, 1%, 3% and 74%, in the two populations, respectively. Genetic causes were found in 28% of all 151 cases; the three most common subgroups were trisomy 21, fragile X syndrome and aspartylglycosaminuria (13%, 4% and 2% respectively). The study design used provided reliable information on the causes of MR and also demonstrated those forms of genetic metabolic diseases typical of Finnish inheritance.

The ideal behavior of dentists and patients has seldom been studied with the aim of determining whether it is similar to the actual behavior of the two groups. Thus, the purpose of this study was to compare whether the ideal behavior of dentists and patients differed from their actual behavior. Thirty-three volunteering dentists and 271 of their patients from the public and private sectors in different parts of Finland participated in the study. The dentists first filled out a questionnaire with 5-scale Likert-type statements about the ideal patient and questions concerning their own background variables. In connection with normal dental practice their dental nurses selected 10 patients, who before treatment filled out a questionnaire containing statements about the desired behavior of an ideal dentist and their own background variables. Immediately after the treatment, both dentists and patients filled out another questionnaire containing similar statements, which this time indicated whether the dentist/patient actually behaved according to the ideal. Differences between each individual and the independent ideal and actual scores were compared by cross-tabulation and percentage agreement. With regard to the ideal behavior that was directly related to the treatment procedure, the expectations of both dentists and patients were usually met. In general, the patients did not disrupt the procedures and the dentists were able to concentrate on the treatment. The discrepancies most often found between the ideal and the actual behavior concerned the level of communication. The patients often would like to have been talked to more and wanted to be encouraged. The dentists were not sure whether their patients were interested in or motivated about the treatment or whether they followed the home care instructions. In general, there evidently is a clear gap in communication between dentists and patients, which may lead to frustration on both sides. It is thus suggested that when dentists are trained, more emphasis be placed on communication skills.

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The aim was to study whether subgroups of lay people and dentists differ in their opinions about the ideal dentist and the ideal patient. This was done by analyzing further a data set containing responses on single statements regarding different aspects of dentist-patient relationship that have been reported previously. A questionnaire containing 124 five-class Likert scale statements and questions about the background of the respondents was sent in November 1988 to a representative sample of lay people and to all dentists in Kuopio and North Karelia Provinces in Finland. To extract areas of interdependence for both dentists and patients, factor analyses were applied to the data and factor scores were calculated for further analyses. Differences in the opinions were studied between dentists and patients as well as among subgroups of patients and dentists. The power of the selected factors in discriminating between dentists and patients, and different subgroups of dentists and patients was evaluated by means of logistic regression analyses. The expectations of dentists and patients were similar about the ideal patient. About the ideal dentist, dentists and patients agreed only on one of the five factors, i.e. communicativeness and informativeness. Differences, especially in the opinions about the ideal patient, were found between following subgroups of patients: non-regular and regular attenders, males and females, old and young, patients with low and high education and different occupational status; and between private practitioners and community dentists.

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