Periodontal health and disease in two adult populations in Sweden
Sammanfattning: This thesis deals with epidemiological data regarding periodontal disease from two different Swedish populations (Jönköping and Skåne). Background The studies focus on periodontal disease, a disease affecting a large part of the adult population. Periodontitis is a complex inflammatory disease, often chronic, which affects the tissues supporting the teeth – the periodontium. The biofilm that adheres to the hard surfaces of the teeth initiate an inflammation in the supporting tissues. In susceptible individuals, the inflammation may cause the destruction of the periodontium (periodontitis). Individuals with severe periodontitis – between 5-15% in different populations – show a range of clinical signs and symptoms, such as bleeding gums, mobile and drifting teeth, the loss of interdental papillae, and eventually the loss of teeth. This may affect the function of the dentition and the aesthetic appearance of the individual. Despite this, the disease is often considered to be silent. Aims The overall aim was to study periodontitis prevalence and severity in two Swedish adult populations, and to describe the changes over time. Further aims were to examine the effect of an individual’s sense of coherence on periodontitis and to analyse the impact of periodontitis on oral health-related quality of life. In order to examine this, a series of four different studies were performed with the following specific aims: I) to investigate the prevalence, severity, extent of marginal bone loss and subject characteristics in the adult population in the county of Skåne, Sweden; II) to assess trends over 40 years regarding the prevalence and severity of periodontitis in an adult Swedish population; III) to investigate the impact of periodontal disease experience on quality of life, in an adult Swedish population, using the OHIP-14 questionnaire; and finally IV). To investigate how an individual’s level of sense of coherence correlates with their periodontitis experience, in two different random samples, ten years apart. Methods One cross-sectional clinical study in Skåne and five cross-sectional clinical studies in Jönköping, repeated every ten years, were performed with random samples of the adult populations. Both study protocols included questionnaires regarding demographic as well as health and oral health-related factors, as well as patient-related outcome measures, such as oral health related quality of life and sense of coherence. Results The prevalence of severe periodontitis experience was eleven percent across the two study populations. There was no difference in periodontitis prevalence according to gender. It was also shown that subjects with severe periodontitis suffered from worse quality of life compared to subjects without periodontitis. Regarding the sense of coherence, no difference could be observed between the different degrees of periodontitis experience. Conclusion The main findings over time were the increase of periodontally healthy individuals and the retention of more teeth among subjects with severe periodontal disease. Also, individuals with advanced periodontitis experience worse quality of life compared to periodontally healthy individuals.
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