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BACKGROUND: Since 1972 The National Child Odontology Registry has collected data on the oral health of most of all Danish children and adolescents. However, comprehensive information on the registry has not previously been available, making it difficult to approach and use the registry for research purposes.METHODS: By combining historical documentation and simple descriptive statistics we provide an overview of major events in the timeline of The National Child Odontology Registry and discuss how they impact the available data. We provide a broad overview of the dental variables in the registry, and how the registration criteria for some of the core dental variables (gingivitis, periodontitis, and dental caries) have changed over time. We then provide examples of how aggregate variables for the core dental diseases, allowing for comparison across registration criteria, can be created.RESULTS: Most of the Danish population born during or after 1965 have a least one entry in the National Child Odontology Registry, with 68% having entries spanning their entire childhood and adolescence. The prevalence of gingivitis and periodontitis seem to increase significantly in the years immediately following changes in how registration criteria for these variables, raising questions as to whether these diseases are generally underreported, or subject to overreporting in the years following the registration changes. The mandatory ages of registration instituted in 2003, do not appear to have had a strong impact on the ages at which registrations are made. For variables not directly comparable across datasets due to changes in registration criteria aggregate variables of measurements can be computed in most cases.CONCLUSIONS: The National Child Odontology Registry provides a unique opportunity to study the impact of childhood oral health on life trajectories, but using the registry is not without issues, and we strongly recommend consulting with experts in

Objective: To investigate the impact of the Covid-19 pandemic on the patient flow and economy as experienced by dental practices in Denmark. Material and methods: A survey regarding experience of patient flow, economical turnover, financial strain and willingness to pay for large treatments during the first year of the Covid-19 pandemic (March 2020 to March 2021), along with information on the characteristics of the practice (specialist practice, ownership, practice operation and size) was distributed to all dental practices in Denmark in March 2021. Results: Of the 1728 practices, 581 (33.6%) answered the survey. A decline in patient flow and a decline in economical turnover were reported by 79% and 84.4% of the practices, respectively. Financial strain was reported by 15.8% and an increased willingness to pay for large treatments was reported by 32.1%. A large decline in turnover and financial strain were associated with non-specialized practices, practices with a single owner and small practices. Logistic regressions showed that practices not receiving referrals had an odds ratio of 2.34 (CI: 1.32-4.14) for having a large decline in economic turnover compared with practices receiving referrals and that small practices had an odds ratio of 1.92 (CI: 1.16-3.19) for reporting financial strain compared with large practices. Conclusions: Reportedly, the Covid-19 pandemic resulted in a decline in both patient flow and economical turnover in Danish dental practices. Large and more specialized practices seem to have managed the economic crisis better.

Objective: To investigate the impact of the Covid-19 pandemic on the patient flow and economy as experienced by dental practices in Denmark. Material and methods: A survey regarding experience of patient flow, economical turnover, financial strain and willingness to pay for large treatments during the first year of the Covid-19 pandemic (March 2020 to March 2021), along with information on the characteristics of the practice (specialist practice, ownership, practice operation and size) was distributed to all dental practices in Denmark in March 2021. Results: Of the 1728 practices, 581 (33.6%) answered the survey. A decline in patient flow and a decline in economical turnover were reported by 79% and 84.4% of the practices, respectively. Financial strain was reported by 15.8% and an increased willingness to pay for large treatments was reported by 32.1%. A large decline in turnover and financial strain were associated with non-specialized practices, practices with a single owner and small practices. Logistic regressions showed that practices not receiving referrals had an odds ratio of 2.34 (CI: 1.32-4.14) for having a large decline in economic turnover compared with practices receiving referrals and that small practices had an odds ratio of 1.92 (CI: 1.16-3.19) for reporting financial strain compared with large practices. Conclusions: Reportedly, the Covid-19 pandemic resulted in a decline in both patient flow and economical turnover in Danish dental practices. Large and more specialized practices seem to have managed the economic crisis better.

Objective: Planning and evaluation of oral healthcare systems rely on monitoring of care patterns. Monitoring periodontal care patterns provide information on the burden and occurrence of periodontitis in the population and on the direct financial cost. The aims of the study were to describe patterns in periodontal care among dental care attenders that might incite subsequent investigation and revised treatment guidelines. Secondly, to estimate the direct societal costs of periodontal care. Material and methods: A retrospective register-based study utilising data from the Danish Public Health Insurance which includes all dental care attenders in 2012–2016, three years before and one year after a national risk-based recall maintenance program was rolled out in Denmark. Results: The 2.7 million yearly dental care attenders corresponded to ∼60% of the eligible population and in the range of 20–24% received periodontal care. Total expenditure for periodontal care in Denmark increased by 13% from 2012 to 2016, from €78 to €88 million. The proportion of total healthcare funding spent on periodontal care was 0.61% in 2016. Conclusions: Patients with periodontitis have large out-of-pocket yearly expenses for periodontal care. Despite small changes in periodontal clinical practice that may indicate improved targeting of patients in need of periodontal care, challenges of reaching non-attenders and non-adherence to care are unsolved. More research into outcomes from periodontal therapy in daily practice, seen from both normative and patient perspectives, would help establish knowledge of the efficiency of existing periodontal care systems and help identify barriers and facilitators for attending care in Denmark.

Udnyttelse af tandplejen defineres som den andel af befolkningen, der modtager tandplejeydelser inden for et givet tidsrum. Individuelle patientbehov afgør, hvad der betragtes som regelmæssig tandpleje. De nordiske landes tandplejesystemer har mange fællestræk, og et grundlæggende princip er, at alle borgere har lige ret til tandpleje. Generelt er udnyttelsesgraden høj i forskellige befolkningsgrupper i alle de nordiske lande, og befolkningerne har god forståelse for nødvendigheden af regelmæssig tandpleje. Når de årlige udnyttelsesgrader er mindre end 100 %, er en del af forklaringen, at tandsundheden generelt er blevet stadig bedre i de nordiske lande, og at der derfor er et stigende antal borgere, der ikke længere har behov for at blive undersøgt hvert år. Der er dog også evidens for, at en række faktorer som fx tandlægeskræk, socio-økonomiske forhold, stor afstand til nærmeste klinik og tandlægernes priser påvirker udnyttelsesgraden. Det er problematisk både fra et etisk og et juridisk synspunkt, at nogle befolkningsgrupper, især de ældre og socialt belastede, ikke i fuldt omfang får gavn af tandplejesystemerne under den nuværende organisering.

Udnyttelse af tandplejen defineres som den andel af befolkningen, der modtager tandplejeydelser inden for et givet tidsrum. Individuelle patientbehov afgør, hvad der betragtes som regelmæssig tandpleje. De nordiske landes tandplejesystemer har mange fællestræk, og et grundlæggende princip er, at alle borgere har lige ret til tandpleje. Generelt er udnyttelsesgraden høj i forskellige befolkningsgrupper i alle de nordiske lande, og befolkningerne har god forståelse for nødvendigheden af regelmæssig tandpleje. Når de årlige udnyttelsesgrader er mindre end 100 %, er en del af forklaringen, at tandsundheden generelt er blevet stadig bedre i de nordiske lande, og at der derfor er et stigende antal borgere, der ikke længere har behov for at blive undersøgt hvert år. Der er dog også evidens for, at en række faktorer som fx tandlægeskræk, socio-økonomiske forhold, stor afstand til nærmeste klinik og tandlægernes priser påvirker udnyttelsesgraden. Det er problematisk både fra et etisk og et juridisk synspunkt, at nogle befolkningsgrupper, især de ældre og socialt belastede, ikke i fuldt omfang får gavn af tandplejesystemerne under den nuværende organisering.

Objectives: A proof-of-concept study has shown that the Added Value for Oral Care (ADVOCATE) Field Studies approach (academic detailing with feedback data) is considered a feasible, useful, and acceptable way to motivate general dental practitioners (GDPs) to reflect on and, if required, change their oral health-care delivery. The aims of this proof-of-principle study were to test whether such results were reproducible and to reach consensus among stakeholders on recommendations for wider implementation. Methods: Eleven groups of GDPs were recruited in 6 countries (Denmark, England Germany, Hungary, Ireland, and The Netherlands). Each group had 3 academic detailing meetings, being stimulated by feedback data. Focus group interviews were held to evaluate the reproducibility of the Field Studies approach. A World Café session explored suggestions for the wider implementation of the approach. Results: Replicable results on feasibility, acceptability, and usefulness of the Field Studies approach were seen; 7 out of 9 themes identified in the proof-of-concept study were validated. Directed content analyses identified that adjustments to procedures to collect and present feedback data were desirable. Overall, the approach can stimulate GDPs to reflect on and change aspects of their oral health-care delivery. Conclusions: The Field Studies approach, after some adjustments to data collection procedures, is ready for further testing in larger studies.

Objectives: A proof-of-concept study has shown that the Added Value for Oral Care (ADVOCATE) Field Studies approach (academic detailing with feedback data) is considered a feasible, useful, and acceptable way to motivate general dental practitioners (GDPs) to reflect on and, if required, change their oral health-care delivery. The aims of this proof-of-principle study were to test whether such results were reproducible and to reach consensus among stakeholders on recommendations for wider implementation. Methods: Eleven groups of GDPs were recruited in 6 countries (Denmark, England Germany, Hungary, Ireland, and The Netherlands). Each group had 3 academic detailing meetings, being stimulated by feedback data. Focus group interviews were held to evaluate the reproducibility of the Field Studies approach. A World Café session explored suggestions for the wider implementation of the approach. Results: Replicable results on feasibility, acceptability, and usefulness of the Field Studies approach were seen; 7 out of 9 themes identified in the proof-of-concept study were validated. Directed content analyses identified that adjustments to procedures to collect and present feedback data were desirable. Overall, the approach can stimulate GDPs to reflect on and change aspects of their oral health-care delivery. Conclusions: The Field Studies approach, after some adjustments to data collection procedures, is ready for further testing in larger studies.

BACKGROUND: To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls.METHODS: Forty-nine patients (42 women, aged 61.0 ± 10.3 years) and 29 healthy age- and gender-matched subjects underwent a standardised questionnaire on general and oral health, assessment of xerostomia, clinical examination, sialometry, mucosal biopsy and contact allergy testing.RESULTS: Nineteen patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ. The patients had higher sIgA levels in unstimulated and chewing-stimulated saliva than the healthy controls. The total protein concentration in saliva was lower in the unstimulated saliva samples whereas it was higher in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy.CONCLUSION: Xerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis, but not associated with salivary gland hypofunction, numbers of systemic diseases or medications, contact allergy, age, or gender. Salivary sIgA levels were higher in patients than in healthy controls, but did not differ between patient groups. The total salivary protein concentration was lower in unstimulated saliva samples and higher in chewing-stimulated saliva samples in patients than in healthy controls, but did not differ between patient groups. Our

Objectives: As part of the “Added Value for Oral Care” (ADVOCATE) project; this subproject aims to construct a preliminary set of indicators of dental clinic service delivery profiles, to be used in a pilot “dashboard.” The dashboard will provide feedback and mirror information about dental care, as one of several steps in constructing a model on how to promote preventive rather than restorative oral health care. Methods: Danish oral health claims data cover the range of dental care services under the National Health Insurance reimbursement scheme. Demographic and dental claims data on Danish adults (age range 18-106 years), who saw a dentist during 2014, n=2,703,442 corresponding to 61% of eligible adults, were obtained from the Danish Health Authority. Approval was granted from the Danish Data Protection Agency. Results: The following indicators of dental clinic service delivery profiles were constructed. See Table 1. Combinations of the indicators gave relative measures of the mutual preventive/diagnostic/treatment profiles. For instance ICPS/extractions =(16%/6%)=2.7. Conclusions: The indicators are considered suitable for use in an electronic feedback system for the individual oral health professional, to compare “own” results with relevant groups of dental clinics locally, on a municipality, regional or national level. The indicators may be, to some degree, either individually or combined, considered suitable for comparison in between countries, because of their relatively simple and universal character. With time the feedback system maybe further developed to adjust for oral health risk status, socioeconomic factors, and patient reported oral health and treatment outcomes, to make the comparisons more relevant. The ADVOCATE project (www.advocateoralhealth.com) has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 635183

BACKGROUND: To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls.METHODS: Forty-nine patients (42 women, aged 61.0 ± 10.3 years) and 29 healthy age- and gender-matched subjects underwent a standardised questionnaire on general and oral health, assessment of xerostomia, clinical examination, sialometry, mucosal biopsy and contact allergy testing.RESULTS: Nineteen patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ. The patients had higher sIgA levels in unstimulated and chewing-stimulated saliva than the healthy controls. The total protein concentration in saliva was lower in the unstimulated saliva samples whereas it was higher in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy.CONCLUSION: Xerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis, but not associated with salivary gland hypofunction, numbers of systemic diseases or medications, contact allergy, age, or gender. Salivary sIgA levels were higher in patients than in healthy controls, but did not differ between patient groups. The total salivary protein concentration was lower in unstimulated saliva samples and higher in chewing-stimulated saliva samples in patients than in healthy controls, but did not differ between patient groups. Our

OBJECTIVE: The purpose of this study was to compare the microbiota of stimulated whole saliva samples from patients with severe hyposalivation to samples from individuals with normal whole saliva flow rates. It was hypothesized that the two groups differ with regard to salivary bacterial profiles.METHODS: This cross-sectional study included 36 participants (24 females and 12 males, mean age 58.5 years) with severe hyposalivation and 36 gender-, age- and geographically-matched participants with normal salivary secretion from the Danish Health Examination Survey (DANHES). The microbiota of stimulated whole saliva samples was characterized by HOMINGS.RESULTS: The two groups had comparable caries experience measured by decayed-missed-filled-surfaces/-teeth and decayed-missed-filled-root surfaces as well as active caries lesions. In addition, no single probe-target was present with a significant difference in frequency or proportional presence between groups. Furthermore, data reduction by principal component analysis and correspondence analysis showed comparable bacterial community profiles between groups.CONCLUSIONS: The results indicate that the salivary bacterial profiles of patients with severe hyposalivation do not differ from those of individuals with normal salivary secretion, when there are virtually no untreated active caries lesions present in the oral cavity. This article is protected by copyright. All rights reserved.

Objectives To describe the pattern of dental services provided to 64–65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence ‘Data on elderly's dental service are scarce, although increased use is seen and more teeth are present in this age group.’ was removed.] Methods A cross-sectional study of all aged 64–65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Results Almost all received restorations, while periodontal treatment was received by <50% during 5 years. Heavy use of dental services was dominated by periodontal services. Periodontal services were most prevalent in the capital and the most affluent areas. Relatively more extractions were related to low income and persons in least affluent areas. Total number of services was highest among women, persons with ≥20 teeth, persons living in the capital, and where the ratio user per dentist was low. Conclusion For future planning of dental care for elderly, dental status, geographical and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services.