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Preserving the outcome of orthodontic treatment is both important and challenging. However, there is insufficient evidence regarding the best way to ensure long-term treatment outcome. The aim of this study was to evaluate a pre-fabricated chain retainer (PFCR) in terms of: ability to maintain satisfactory treatment outcomes; periodontal and dental health; complications; and patient satisfaction. Overall, 130 patients who had completed orthodontic treatment with a fixed appliance during the period 2016–2019 (follow-up time range, 24–55 months) at a specialist orthodontic clinic in Varberg, Sweden and who had a PFCR in the lower jaw were invited to take part in the study. Little's irregularity index (LII) was recorded on dental casts. Caries, gingivitis, calculus, probing pocket depth, and gingival retractions were registered during clinical examinations. Patient satisfaction and retainer complications were evaluated using a questionnaire. In total, 76 patients (58.5%) agreed to participate. All patients, except for one, had their retainer still in place, and the complication rate was 40%. The LII scores were in the range of 0–4 mm (mean, 1.42 mm). At the retainer site, 82% had calculus, 74% had gingivitis, 1% had pocket depth >4 mm, 10.5% had gingival retractions >2 mm, and 0% had caries. All the patients expressed satisfaction with their retainer. PFCRs exhibit characteristics similar to those of traditional bonded retainers in terms of complications, stability, side-effects and patient experience. Therefore, they can be considered a viable alternative to traditional retainers installed in the lower anterior teeth. [ABSTRACT FROM AUTHOR]

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Background The estimate of 0.4-1.0% prevalence of atrial fibrillation in the most recent American guidelines is based mainly on studies including patients with permanent atrial fibrillation ( AF), although recent evidence shows that the stroke risk is similar with paroxysmal and persistent AF. Our objective was to determine the prevalence of AF in Sweden, irrespective of type and to what extent patients with AF receive adequate stroke prophylaxis. Method Retrospective study of patients with a clinical diagnosis of atrial fibrillation between 2005 and 2010 in the national Swedish Patient Register matched with data from the National Prescribed Drugs Register. Results We identified 307 476 individuals with a diagnosis of atrial fibrillation. Of these, 209 141 were still alive on the last day of the inclusion period, signifying a prevalence of clinically diagnosed AF in Sweden of 2.9% of the total adult (≥20 years) population. Only 42% of them had purchased an oral anticoagulant within 6 months of the first presentation with AF during the study period. Those at the highest risk of stroke were those least likely to receive anticoagulant treatment. Undertreatment was common amongst women and individuals >80 years, whilst overtreatment was common amongst young men without risk factors. Conclusion The prevalence of atrial fibrillation is at least 2.9% of the Swedish adult population, not counting 'silent atrial fibrillation'. The official US figures probably underestimate the magnitude of the problem by a factor of 3-5. More than 80% had risk factors motivating anticoagulation therapy. [ABSTRACT FROM AUTHOR]

A model was developed to estimate costs and clinical effectiveness of fondaparinux compared with enoxaparin after hip fracture surgery in Sweden. Outcomes and costs of venous thromboembolism (VTE)-related care from a health care perspective were incorporated, with symptomatic deep-vein thrombosis and pulmonary embolism, recurrent VTE, post-thrombotic syndrome, major haemorrhage and all-cause death being included. Event probabilities were derived from fondaparinux clinical trial data and published data. VTE-related resource use and associated costs as well as costs of prophylaxis were based on local Swedish data. Extended prophylaxis with fondaparinux could avoid an additional 28 symptomatic VTE per 1,000 patients compared with extended prophylaxis with enoxaparin in hip fracture surgery patients. Although the prophylaxis costs were higher in the fondaparinux group, these were offset by the lower costs associated with treating fewer VTE, which thus indicates that extended fondaparinux prophylaxis is the dominant alternative when compared with enoxaparin in hip fracture surgery. [ABSTRACT FROM AUTHOR]

Objective: To test the hypothesis that Swedish dentists schedule more mandibular third molars for prophylactic removal compared with UK dentists and oral surgeons.Design: Clinical and radiographic information relating to a stratified sample of 36 disease-free mandibular third molars (equal distribution of males and females, patients' age, angular position and degree of impaction) was presented to 26 general dental practitioners (GDPs) and 10 oral surgeons in Sweden and 18 GDPs and 10 oral surgeons in Wales who were asked to decide whether or not the third molars should be removed.Results: There was no evidence of any difference in mean number of molars scheduled for removal by the GDPs, but the Swedish oral surgeons scheduled significantly more third molars for removal than oral surgeons in Wales.Conclusion: The less interventionist approach among oral surgeons in the UK may reflect the development and application of authoritative guidelines in the UK and an extensive debate concerning appropriateness of prophylactic removal there. [ABSTRACT FROM AUTHOR]

Objective: To evaluate oral single dose prophylaxis in colorectal surgery. Design: Prospective study. Setting: University hospital, Sweden. Subjects: 24 patients (13 women; 11 men; mean age 57 years, range 27-81) listed for elective colorectal operations. Intervention: At 0630 on the day of the operation all patients were given an oral dose of trimethoprim-sulphamethoxazole (TMP 160 mg and SMZ 800 mg) and metronidazole (2 g). The serum concentrations of TMP and SMZ were analysed in venous samples taken at the start and end of each operation. Results: The earliest operation started at 0830 and the last finished at 1700. The median (range) serum concentrations of TMP were 1.4 (0.7-2.6) mg/L (start) and 1.3 (1.0-2.8) mg/L (end), and of SMZ 35 (15-65) mg/L (start) and 33 mg (13-70) mg/L (end). The individual values were above or equal to the minimal inhibitory concentration (TMP 0.8 mg/L; SMZ 15.2 mg/L) for relevant Gram-negative species. Conclusion: Oral TMP/SMZ in the morning gives satisfactory serum concentrations independently of when the operation is done during the day. The regimen is simple and has the potential for being an effective alternative to intravenous prophylaxis. [ABSTRACT FROM AUTHOR]

During 1974 and 1975 a sample of individuals in Sweden between 20 and 60 years were interviewed about dental care habits. 938 of them were then clinically examined. An estimation of the time needed for treatment of dental caries and periodontitis was based upon the clinical examination. Dental status and the estimated treatment time were then related to the dental care carried out during one period of 18 months and one of 48 months after the clinical examination. For these calculations, information on dental care was acquired from the patient register of the National Social Insurance Board. The results derived from the analyses showed that the requisite time for treating caries related well to the treatment executed. On the other hand the time for treating periodontal disease showed a poorer agreement with what could have been expected from the clinical periodontal status. 1 he treatment time devoted to periodontal disease was considerably higher in the metropolitan areas, with their higher density of dentists, than in other parts of Sweden. Thus, dental care in Sweden between 1974 and 1978 concentrated primarily on restorative procedures while a progression of periodontal disease was largely ignored by dental practitioners. [ABSTRACT FROM AUTHOR]

The article offers information on a three-year study conducted in Sweden in order to determine the effectiveness of the combination of oral hygiene and dental prophylaxis on dental caries and gingivitis. The study involved 197 school children. The test group received a dental prophylaxis. The study has revealed that the combination of oral hygiene and dental prophylaxis reduced tooth decay and gingivitis.

Background Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence.Material and methods We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was carried out using a pre-defined protocol. In the end, one case-control study was included for evaluation of evidence.Results The case-control study included patients with specific cardiac conditions. The study reported a 49% protective efficacy (odds ratio: 0.51) of antibiotic prophylaxis for first-time episodes of endocarditis within 30 days of procedure. This result was not statistically significant. The quality of the evidence was low. No studies were evaluated on patients with other medical conditions. The recommendations included several cardiac and other medical conditions for which there is a lack of evidence or no evidence to support the use of antibiotic prophylaxis.Conclusions There is a lack of evidence to support the use of antibiotic prophylaxis. To avoid the risk of adverse events from antibiotics and the risk of developing resistant bacterial strains, the use of antibiotic prophylaxis should be minimised and recommendations in Sweden should be revised to be more evidence-based. [ABSTRACT FROM AUTHOR]

Examines the costs analysis of prophylaxis with antibiotics to prevent infected knee arthroplasty in Sweden. Use of the price lists of the regional hospital; Side effects of flucloxacillin and cephalexin; Ways of preventing hematogenous infections.

Background Almost all (17/20) Swedish counties have pharmaceutical committees that establish recommendations for the use of antibiotic prophylaxis in oral healthcare.Objective To evaluate the evidence for the use of antibiotic prophylaxis in oral healthcare and the agreement between Swedish recommendations and evidence.Material and methods We conducted a systematic literature search in PubMed and the Cochrane Controlled Trials Register. The MeSH terms 'antibiotic prophylaxis' and 'dentistry' were used in the database search. Abstracts were reviewed according to specific inclusion and exclusion criteria. A total of 186 articles were read in full text by the four authors independently. Data extraction and interpretation of data was carried out using a pre-defined protocol. In the end, one case-control study was included for evaluation of evidence.Results The case-control study included patients with specific cardiac conditions. The study reported a 49% protective efficacy (odds ratio: 0.51) of antibiotic prophylaxis for first-time episodes of endocarditis within 30 days of procedure. This result was not statistically significant. The quality of the evidence was low. No studies were evaluated on patients with other medical conditions. The recommendations included several cardiac and other medical conditions for which there is a lack of evidence or no evidence to support the use of antibiotic prophylaxis.Conclusions There is a lack of evidence to support the use of antibiotic prophylaxis. To avoid the risk of adverse events from antibiotics and the risk of developing resistant bacterial strains, the use of antibiotic prophylaxis should be minimised and recommendations in Sweden should be revised to be more evidence-based. [ABSTRACT FROM AUTHOR]

Objective To test the hypothesis that Swedish dentists schedule more mandibular third molars for prophylactic removal compared with UK dentists and oral surgeons. Design Clinical and radiographic information relating to a stratified sample of 36 disease-free mandibular third molars (equal distribution of males and females, patients' age, angular position and degree of impaction) was presented to 26 general dental practitioners (GDPs) and 10 oral surgeons in Sweden and 18 GDPs and 10 oral surgeons in Wales who were asked to decide whether or not the third molars should be removed. Results There was no evidence of any difference in mean number of molars scheduled for removal by the GDPs, but the Swedish oral surgeons scheduled significantly more third molars for removal than oral surgeons in Wales. Conclusion The less interventionist approach among oral surgeons in the UK may reflect the development and application of authoritative guidelines in the UK and an extensive debate concerning appropriateness of prophylactic removal there. [ABSTRACT FROM AUTHOR]

Objectives: To describe adolescents' experiences of participating in a school-based oral health intervention programme for 2 years containing education about oral health and fluoride varnish treatment at the school clinic., Methods: Sixteen adolescents aged 13-16 were interviewed in three focus group sessions. A phenomenographic approach was used for analysis., Results: The results are presented as three themes and seven descriptive categories. The three themes were 'Seeing the dental hygienist', 'Treatments at the dental hygiene clinic' and 'Education about oral health in class'. The results demonstrate satisfaction with the intervention, such as accessibility, time gain and expanding knowledge. On the other hand, feelings of vulnerability in the treatment sessions were expressed. The fluoride varnish treatment was given both positive and negative reviews. The contact between the participants and the dental hygienist was important, and the opportunity to ask questions about oral health issues was emphasized., Conclusions: Both positive and negative experiences of the programme were found. Adolescence is a transitional period of life, and for this reason, it is important to create a good working alliance between students and the dental hygienist in future school-based oral health interventions., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of the present investigation was to map the presence of prophylactic measures in organized Swedish dental health care systems, focusing on personnel working with children and adolescents. The study was conducted by sending a questionnaire to all public dental clinics in Sweden (830 clinics in all). The results showed that collectively-performed prophylactic measures were given at 66% of the child health centers/ child day care centers and at 63% of the pre-schools. 57% of all clinics replied that they performed some kind of fluoride administration collectively (mainly fluoride varnish application or fluoride mouthrinses). 34% of all clinics used fluoride varnishes at the ages from 6 to 12 years, and collectively-performed fluoride mouthrinsing in schools at these ages was carried out by 16% of the clinics. 26% of all the clinics answered that they aimed at increasing the time spent on prophylactic measures compared to only 2% that were planning to decrease this time. The remaining 72% aimed at maintaining the time spent at the present. Prophylactic measures were performed individually by 49% of the clinics, whereas 50% of the clinics preferred a combination of individually and collectively performed measures. It can be concluded that the preventive measures against dental caries in Swedish public dental care is mainly focused on individually performed prophylaxis.

A simplified dental health program for newly arrived refugees was evaluated. The efficacy of presenting the program in one instructional session or two was compared. 193 Chilean refugees, granted residency in Stockholm in Spring 1981 or in Spring 1982, participated. The subjects were divided into two groups. One group received a dental health program only at the first visit, in conjunction with the baseline examination, and the other group was recalled for a further session 3 months after the baseline examination. Both groups were recalled for evaluation 6 months after the initial visit. At follow-up the groups comprised 94 and 65 subjects respectively. The mean relative reductions in gingivitis (relating GBI reduction to baseline GBI) were 33.2% (95% < I: 29.1 to 37.3%) in the single-visit group and 40.5% (95% < I: 35.9 to 45.8%) in the two-visit group. The reduction in periodontal pocket depth was mainly a reduction of shallow pockets. The maximum effect was attained after one instructional session.

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

An epidemiological study of the prevalence of dental caries and gingivitis in 13-year-olds was carried out in the county of Västerbotten, Sweden, in 1987. Besides providing information on the dental health of this age group, prevalence data were compared with data from earlier surveys of the same age group carried out in 1967 and 1977, covering the same areas and applying the same diagnostic criteria and methods. The results showed a marked decrease in the prevalence of caries and gingivitis. The mean number of DMF surfaces was 4.6, compared to 9.0 in 1977 and 19.0 in 1967. The mean GBI% was reduced from 33% to 21% between 1977 and 1987. In contrast to the results from 1967 and 1977 the differences in mean DMF values between the three areas were nonsignificant in 1987. The decline in dental caries is most probably due to an extended regular dental care with a strong preventive approach. Only slight differences in dental health were found between the three areas in 1987 in contrast to in 1977 and 1967. The most likely reason was probably that larger resources had been allocated to preventive programmes in the rural areas than in the city of Umeå.

An interdisciplinary strategy based on a theoretical model for studying dental health was used to analyze the relevance of social and behavioral factors in the evaluation of dental health care for school children. The study comprised pupils who, after a total period of 5 years, differed in their experience with preventive regimens applying different principles of dental prevention. In 1979-80 social and behavioral data were collected by means of a postal questionnaire from altogether 234 pupils, aged 15-16 years, from two school areas. Clinical data, comprising scores for prevalence of plaque, gingivitis, and caries, were available from examinations in 1974, 1978, and 1979. The analysis of factors influencing the subjects' oral status demonstrated that material factors--the parents' education and employment, type of housing, and line of education--and physical factors--sex and prevalence of plaque, gingivitis, and caries at base line--all were of significance for the results obtained. No significant influence of home care climate (social/political factors), dental knowledge and attitudes, general foresightedness or carelessness (mental factors), or tooth-cleaning and sweet-eating habits (action factors) was found. Social and behavioral factors of significance exerted their influence regardless of the type and scope of the dental health care provided. Gingival health was far more a consequence of the professional tooth-cleaning regimen than dependent on the social and behavioral factors tested. No superior effect on caries status was demonstrated for any of the preventive regimens tested.

The purpose of the investigation was to estimate the relative effect of fluoride on caries in a preventive program based on meticulous plaque control. The material consisted of 82 children; 41 in the test and 41 in the control group. At the start of the study the children were 13-14 years of age. In August 1973 an examination was performed to obtain baseline data for the trial. Prophylactic treatment was given to the children once every second week. A total of 18 treatments were given during a 10-month period. In the control group an abrasive paste was used containing 5% sodium monofluorophosphate (Jodka Fluor Polerpasta). In the test group an abrasive paste was used which was identical with the control paste except that it did not contain any fluoride components. Twelve months after the baseline examination the test and control groups were reexamined. The trial demonstrated that, in children, fortnightly professional cleaning of the teeth combined with meticulous toothbrushing instructions result in (1) a high standard of oral hygiene and (2) only very few new carious surfaces. Though the control group children received fortnightly topical application of F- during the prophylactic sessions and used a fluoridated dentifrice, there was no significant difference between the two groups regarding number of new carious tooth surfaces per child per year.

The present paper reports the effect of a 3-year study of regularly repeated professional toothcleaning on oral hygiene status, gingivitis, and dental caries. At the initiation of the study in 1971, the children were 7-8 years old (Group 1), 10-11 (Group 2) or 13-14 (Group 3). The children were divided into test and control groups. Before the study all the children were examined regarding oral hygiene, state of the gingiva and dental caries. Throughout the 3-year period the controls brushed their teeth with a 0.2% sodium fluoride solution once a month under supervision. During the first 2 years of the trial all the children of the test groups were given professional oral prophylaxis once every second week during the school terms. During the third year the interval between consecutive prophylactic sessions was prolonged to 4 weeks in Groups 1 and 2 and to 8 weeks in Group 3. The results demonstrated that regularly repeated professional cleaning of the teeth combined with fluoride applications and toothbrushing instructions, over a 3-year period in schoolchildren resulted in the establishment and maintenance of excellent oral hygiene standards. Inflammation of the marginal gingiva almost entirely disappeared, and practically no new carious lesions developed.

In a retrospective study, 50 patients over 70 years of age, selected from a private specialist clinic for fixed and removable prosthodontics, were studied. They all had remaining natural teeth and had undergone complete dental treatment at least 5 years before. The age-range was 70-96 and they had been treated 6-25 years before the study. The patients had on average 13.9 teeth. During the five-year observation period, 32 patients developed caries, with a mean number of 5.0 lesions (range 1-22). 79 fillings were made due to other defects than caries. 25 root canal fillings were made, due to caries lesions after loosened fillings or crowns in 5 cases and for other reasons than caries in 20 cases. 4.4% of the natural teeth had to be extracted. 19 crowns, 11 bridges and 1 splint were made. The prophylactic periodontal and cariological care delivered during the 5 years varied from 0 to 350 minutes (mean 89). The time for prophylactic treatment was not significantly correlated to the total number of natural teeth per patient but instead to the number of periodontally severely involved teeth (i.e. with 50% or less marginal bone support). The overall conclusion is that 3.5 times as much chairside treatment time was used for therapeutic measures as for prophylaxis.

Dental research the last two decades has created a basis for understanding the etiology, prevention and treatment of dental diseases. As a consequence, particular interest has been focused on the effect of prophylactic measures, efficiently organized and carried out, for various groups of individuals. However, it has proved difficult to organize systematic integrated preventive dental care for large parts of the population. The present paper describes in detail the development of integrated preventive dental care for children and adolescents in the County of Jönköping. Sweden, from 1973 to 1979. Based on the circumstances that existed before 1973 as regards e.g. personnel and the nature and content of the prophylactic measures, a description is made of the aims, methods, target groups, organization, financing and evaluation of a preventive dental care organization gradually developed for the age groups 0-16 years in the whole county (308,000 inhabitants; 4,000 individuals in each age-group). Important practical information as to the performance of the organization is given as well as examples of both basic preventive dental care programmes and supplementary programmes intended for individuals exhibiting a high prevalence of caries and gingivitis. As an effect of the programme instituted of remarkable improvement in dental health among children and adolescents has been achieved.