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Abstract Background Determining risk indicators behind dental caries is important for identifying children in need of enhanced dental care. The aim of this register-based study was to investigate the association of family-related risk indicators and dental attendance in the development of dental caries in preschool children. Methods The data for this study were collected from the medical records of 206 randomly chosen preschool children who lived in the city of Oulu, Finland, during 2014–2020. Data on challenges in family life, missing appointments and utilization of oral health care were collected. Sum functions were formed of risk indicators. Analyses were carried out for three age groups (1- to 2-, 3- to 4- and 5- to 6-year-olds) born between 2014 and 2018. Results There was a significant association between the number of family-related risk indicators and the prevalence of manifested caries lesions in the age group of 5- to 6-year-olds. All family-related risk indicators and information about health care utilization were associated with dental caries risk. Challenges in a child’s family life were present among 20.3% of the 5- to 6-year-olds. In all age groups, the most common challenges in family life were parental exhaustion and problems in the parents’ relationship or divorce. Conclusion Family-related risk indicators and dental attendance should be considered when determining caries risk. The caries risk indicators investigated here are associated with each other.

Objective: The aims of this study were to assess the accuracy of Cameriere’s and Demirjian’s methods in Finnish children, and compare the findings with those of the Turkish children according to dental age. Material and methods: Dental panoramic tomography (DPT) of children (482 Finnish, 423 Turkish) aged between 5 and 15 years were evaluated. Comparison of mean difference between estimated and chronological age was evaluated. The difference between two means was analysed using paired t-test at 95% confidence interval (CI). Pearson correlation coefficients were used to estimate the correlation between chronological and estimated ages. Results: Demirjian’s method resulted in overestimation in all age groups except for 8-year-old girls. Dental age, however, was found to be underestimated with Cameriere’s method in all age groups but 6-year-old girls and boys. In Northern Finnish children, Demirjian’s method was more suitable for boys while Cameriere’s method led to better estimation in girls. When comparing Finnish and Turkish children, differences between dental ages and chronological ages differed significantly in 10-year-old boys and 8-year-old girls with both methods. Conclusion: Dental age of Turkish children seems higher than that of Finnish children. There is a significant difference between chronological and dental ages in both populations assessed by both methods.

AbstractBackground This study aimed to determine the factors that promote and facilitate rehabilitation as well as challenges and possible barriers perceived by people with spinal cord injury (SCI).Materials and Methods This study was part of a larger, mixed-method Finnish Spinal Cord Injury (FinSCI) study. We interviewed 45 persons with SCI representing participants from the FinSCI study and used a qualitative approach and a deductive-inductive content analysis to analyse the data.Results We identified 28 facilitators and 19 barriers in the rehabilitation process. The majority of the facilitators and barriers were related to the rehabilitation planning phase. There were more barriers than facilitators in applying for and accessing treatment or rehabilitation and during the implementation of rehabilitation. Facilitators consisted of successful, realized, or planned treatments or rehabilitation events; clear goals; multidisciplinary teamwork; support and monitoring in various changing situations; and the rehabilitees’ own capabilities and activities, among other things. The barriers included delays, challenges and deficiencies in the planning and implementation of treatment or rehabilitation; the lack of different skills; and resources of rehabilitation professionals; and different personal factors, which made the rehabilitation process cumbersome.Conclusions Good communication and interaction between stakeholders are crucial for the progress of rehabilitation.

Objectives: Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients’ self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed. Methods: A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new “traffic light” colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants. Results: Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF “traffic light” system. The association between dentists’ and participants’ estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = −0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS. Conclusions: Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Abstract Background Dental fear may lead to avoidance of regular dental treatment. The scope of this long-term practe-based study was to monitor the dental attendance of patients who received chair-side dental and fear treatment. Methods In 2000–2006, patients in the City of Oulu, Finland, received treatment for dental fear in the Clinic for Fearful Dental Patients (CFDP) from primary health care dentists trained on this subject. Of the originally treated patients (n = 163), 152 (93%) with sufficient information in dental records made up the study population. Information on their age and sex was available. The number of dental examinations, emergency visits and missed appointments was collected covering the follow-up period of 10 years 2006–2016. For analyses, data were dichotomized according to age at baseline and preliminary outcome baseline condition of dental fear treatment evaluated in 2006. To investigate association further, Poisson regression as well as binary logistic regression models were conducted. As register keeper, the City of Oulu gave permission for this retrospective data-based study. Results Patients receiving dental fear treatment at younger age (2–10 y) had significantly more dental examinations than those treated at > 10 years. Preliminary success was associated with the number of examinations, but not with emergency visits and missed appointments. Sex was not a significant factor in later dental attendance. There was an association between few dental examinations and dental emergency care need with unsuccessful baseline outcome of dental fear treatment. Conclusions Successful dental fear treatment especially at an early age is beneficial for future dental attendance measured by the number of examinations and consequently, less need for emergency care than in the opposite case. Successful fear treatment has positive impact on later dental care and regular dental attendance.

Objective: To explore work participation and the health-related factors affecting work participation among the Finnish Spinal Cord injury (FinSCI) study population (n = 884). Methods: A cross-sectional explorative observational study in the FinSCI community survey applying Patient-Reported Outcomes Measurement Information System (PROMIS®) forms on Social Health and Global Health. Analyses of socio-demographic and injury-related data were performed. Results: Employment among the study population (n = 452) was 26.5%. Physical, Mental, Social and General Health were better in the employed group compared with work-age persons not working. Logistic regression showed that work participation was related to all health domains, but Physical Health and Ability to Participate in Social Roles and Activities in Social Health were the strongest indicators of likelihood of being at work. Paraplegia and young age were associated with increased likelihood of work participation. Conclusion: The first national survey among people with spinal cord injury in Finland shows low level of employment. The results suggest that pain, physical function, and ability to participate in social roles should be monitored by health and vocational professionals when assessing a person’s likelihood of being in work. Lay abstract The data source for this study was the Finnish Spinal Cord Injury Study (FinSCI), which collected extensive information from people with spinal cord injury about their health and employment status. A total of 452 responders from the FinSCI survey were included in the current study. The employment rate in the FinSCI study population was low (26.5%) and the majority of those not in work (73.5%) were receiving a disability pension. The analysis of health factors showed that all health aspects were better in the employed group compared with the group who were not working. Physical Health, Ability to Participate in Social Roles and Activities, less severe injury, and young age were associated with likelihood of work participation. This study provides up-to-date self-reported data for the spinal cord injury population and health professionals, helping to identify health-related problems that could be barring employment.

Objective: The aims of this study were to assess the accuracy of Cameriere's and Demirjian's methods in Finnish children, and compare the findings with those of the Turkish children according to dental age., Material and Methods: Dental panoramic tomography (DPT) of children (482 Finnish, 423 Turkish) aged between 5 and 15 years were evaluated. Comparison of mean difference between estimated and chronological age was evaluated. The difference between two means was analysed using paired t-test at 95% confidence interval (CI). Pearson correlation coefficients were used to estimate the correlation between chronological and estimated ages.  Results: Demirjian's method resulted in overestimation in all age groups except for 8-year-old girls. Dental age, however, was found to be underestimated with Cameriere's method in all age groups but 6-year-old girls and boys. In Northern Finnish children, Demirjian's method was more suitable for boys while Cameriere's method led to better estimation in girls. When comparing Finnish and Turkish children, differences between dental ages and chronological ages differed significantly in 10-year-old boys and 8-year-old girls with both methods.  Conclusion: Dental age of Turkish children seems higher than that of Finnish children. There is a significant difference between chronological and dental ages in both populations assessed by both methods.

Aim: Treatment under general anaesthesia (DGA) is a rising trend in Finland. There is a great need to investigate the causes leading to it. Our purpose was to examine family-related factors reported by parents, such as the family size and favoring DGA in the family, and their influence on children being treated under DGA. This survey was based on a questionnaire targeted to parents of children whose dental treatment could not be performed in a conventional setting., Materials and Methods: Guardians of 87 healthy children treated under DGA at a municipal health center in the city of Oulu, Finland, between November 2014 and December 2015 answered the questionnaire on family-related background factors and on the respondent's own as well as their child's presumed dental fear., Results: According to most guardians (83.9% of the cases), the reason for DGA was caries. Male gender, vague family structure, large number of siblings (?4), and DGA history in the family were all important family-related background factors leading to DGA. Self-reported parental dental fear was quite common (25.3%). Children's dental fear reported by parents was associated with DGA in almost half of the cases (46.0%)., Conclusions: The survey highlights the role of the entire family in association with children ending up being treated under DGA. It is essential for the success of dental health care to also consider family-related factors when planning the treatment, particularly with children demanding DGA.