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Objective: The aim of this cross-sectional study was to investigate the oral-health-related quality-of-life (OHRQoL) and oral health-care habits in a population of marginalized persons in Copenhagen. Materials and Methods: Patients attending a dental clinic for marginalized persons filled in the 14-item version of the oral-health-impact profile (OHIP-14) regarding their OHRQoL and a questionnaire on their oral health-care habits. Age, gender, smoking habits, need for general and oral health-care, and living conditions were further registered. Results: Of the 212 participants, 72% had not visited a dental clinic within the past two years and in 68% of the cases, the last dental visit was related to dental treatment. Tooth brushing at least once a day was reported by 93%. The mean OHIP-14 score in the participants was 24.9 (SD: 13.6). The most frequent problems were pain, chewing difficulties, being self-conscious, tense, and embarrassed as well as affected life. The mean OHIP-14 score was significantly higher in participants in need of general health-care (29.5, SD: 12.2) than in participants not in need of general health-care (22.8, SD: 13.9). The same applied to participants referred for dental treatment (26.1, SD: 12.7) compared to participants not being referred (20.2, SD: 15.9). Conclusions: The OHRQoL is poor in the population with pain, chewing difficulties and aesthetic issues as the most prominent problems. The participants had low and treatment-oriented use of the dental care system. This indicates a high need for dental care in the population with a focus on including them in the dental care system.

Background: There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. Objective: The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. Methods: We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. Results: We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. Conclusion: Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people. PROSPERO ID: CRD42021231721.

Objective: Addressing social inequality in oral health and access to dental care is a global concern. This study aims to describe the utilization of a public subsidy scheme targeting vulnerable individuals out of labor in Copenhagen municipality (2013–2018) and to identify key characteristics of individuals eligible to apply. Material and Methods: Data from Copenhagen municipality were combined with data from population and health registers. Employing logistic regression analyses, we examined the association between demographic, socioeconomic, and health-related characteristics and (1) having applied, (2) being granted, and (3) using the subsidy. Results: The study included 65,174 individuals aged 18–65. Of these 10,369 (15.9%) applied for subsidies, submitting a total of 18,529 applications. Overall, 83% of the applications were granted and 85% were used. Significantly increased odds of applying for subsidies were observed among individuals receiving social benefits non-stop over the past year versus none (odds ratio [OR] = 15.45, 95% confidence interval [CI] = 14.24–16.76), aged 50–65 versus 18–29 years (OR = 4.41, CI = 4.15–4.69), and having combined indicators of social vulnerability versus none (OR = 2.90, CI = 2.73–3.07). Conclusions: While the utilization of the public subsidy scheme is low, individuals who apply are likely to be granted a subsidy and use it. Vulnerability was associated with greater utilization of the scheme, yet a substantial portion of those at risk of poor oral health did not take advantage of it.

BACKGROUND: The difficulties and challenges faced by people with Parkinson's disease (PD) in performing daily orofacial function are not systematically investigated. In this study, specific orofacial non-motor and motor symptoms and functions were systematically examined in PD patients in comparison to a matched control group.METHODS: The clinical case-controlled study was conducted from May 2021 to October 2022 and included persons with PD and age- and gender-matched persons without PD. The participants with PD were outpatients diagnosed with PD at the Department of Neurology at Bispebjerg University Hospital in Copenhagen, Denmark. The participants underwent a systematic clinical and relevant self-assessment of the orofacial function and temporomandibular disorders (TMD). The primary outcomes were objective and subjective assessments of the general orofacial function, mastication, swallowing, xerostomia and drooling. The secondary outcomes were the prevalence of TMD and orofacial pain. The difference in outcome measures between the two groups was analysed using chi-square and Mann-Whitney U test.RESULTS: The study included 20 persons with PD and 20 age- and gender-matched persons without PD. Both objectively and subjectively, persons with PD had poorer orofacial function than the control group. Persons with PD had also a significantly more severe limitation of jaw mobility and jaw function. The objective masticatory function was also significantly reduced for persons with PD compared to the control group, and 60% of persons with PD found it difficult to eat foods with certain consistencies while 0% of the control group reported that problem. Persons with PD could swallow less water per second and the average swallowing event was significantly longer for PD persons. Even though PD persons reported more xerostomia (58% for persons with PD and 20% for control persons), they also reported significantly more drooling than the control group. Additionall

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.

BACKGROUND: Parkinson's disease (PD) has a negative effect on oral health and orofacial function, but the subjective experience of orofacial symptoms and their impact on the quality of life is not fully investigated. In addition, knowledge of how to improve the subjective oral symptoms is lacking.OBJECTIVES: To assess the self-reported orofacial function and oral health in patients with PD. Furthermore, to investigate the effect of interventions for improvement of oral hygiene and function on oral health related quality of life (OHRQoL).METHODS: A randomised controlled study with delayed intervention was conducted in 29 patients with moderate to advanced PD. Patients were instructed in a standardised exercise program for the jaw and orofacial muscles and given an individualized oral hygiene program. The effect on self-reported orofacial function and OHRQoL was measured after 2 and 4 months using the Nordic Orofacial Test - Screening (NOT-S), the oral health impact profile (OHIP-14), self-reported drooling score and subjective mastication ability.RESULTS: Self-reported oral health and function before the intervention was significantly correlated to the severity and duration of PD. The NOT-S and drooling score were significantly improved by the interventions after 2 months and the OHIP-14 after 4 months.CONCLUSION: The interventions improve the self-reported orofacial function and OHRQoL. These simple interventions can be implemented in the allied multidisciplinary healthcare surrounding the PD patient.

OBJECTIVES: To quantify the patient-reported effect of oral rehabilitation and investigate aspects associated with this.METHODS: The patient-reported effect in participants treated with fixed dental prosthesis (FDP; n = 72) or removable dental prosthesis (RDP; n = 58) was measured using the Oral Health Impact Profile 14 (OHIP-14) and global oral ratings (GOR) of aesthetics, chewing and comfort before and after treatment and global transition judgements (GTJ) of aesthetics, chewing and comfort after treatment. Explanatory variables included gender, age, if a prosthetic replacement was present before treatment, type of prosthetic treatment performed, number of teeth replaced and zone of the teeth replaced.RESULTS: The RDP and FDP treatments both significantly improved the OHIP-14 score with a moderate to large effect and most participants had good patient-reported effect. The effect varied depending on the method used. In the bivariate analyses, the number of participants with good effect was higher in the RDP group than the FDP group when using the OHIP-14 and GOR whereas the effect was higher in the FDP group when using the GTJ. Multiple regression analyses showed that poor chewing ability before treatment was associated with good effect measured by the OHIP-14 and GOR and that poor effect in chewing ability and RDP treatment was associated with poor effect in comfort measured by GTJ. Functional problems after treatment were associated with no/poor effect.CONCLUSIONS: Oral rehabilitation with fixed or removable prostheses in general yields good patient-reported effect. Masticatory aspects highly influence the patient-reported effect and treatment with RDP is associated with poor effect in oral comfort.

OBJECTIVE: The aims of this study were to investigate and describe the Oral Health Related Quality of Life (OHRQoL) in a socially endangered group of people and to compare the OHRQoL to other patient groups.MATERIAL AND METHODS: About 294 socially endangered persons attending a volunteer clinic in Copenhagen Denmark filled in the OHIP-14 questionnaire. The group was compared in mean score and reported problems to a group of patients with tooth loss and about to have a removable dental prosthesis (RDP), a group with tooth loss about to have a fixed dental prosthesis (FDP) and a control group without tooth loss.RESULTS: Significantly higher OHIP-14 score was seen in the socially endangered group (15.5 (SD 12.6)) compared with the control (1.9 (SD 2.7)) and the FDP group (9.4 (SD 8.2)) but not the RDP group (13.1 (SD 10.5)). This difference was not changed after stratifying in age groups. Problems related to psychological disability, social disability, and handicap were more frequent in the social endangered group than for the other groups. The items pain, tense, diet, relax, life, and function stand out as problems in the socially endangered group compared to the other groups.CONCLUSION: The OHRQoL is highly impaired in the socially endangered persons and at least to the level of persons with great tooth loss about to have an RDP. The problems seem to be more handicapping in the socially endangered compared with other patient groups known to have high impairment.

Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients' with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmark, and Malmö, Sweden, respectively, 20 patients with partial edentulism seeking rehabilitation were interviewed in a semistructured qualitative manner. The interviews were transcribed and analysed yielding overall domains. Six themes appeared as overall domains: (i) experienced impairments, (ii) experienced social awareness, (iii) expectation to treatment, (iv) expectation to durability/survival, (v) coping strategies dealing with the tooth loss including explanations of the tooth loss and (vi) modifications to experienced impairment. The impairments were mostly experienced as problems in social settings. Most participants expressed a simple wish to function normally; a fixed solution was preferred. Many Danish participants accepted a removable solution whereas only few Swedish participants did so. The domains 'coping strategies' and 'modifications' were not part of the chosen topics of interest, indicating a high wish of the participants to explain their tooth loss and how they coped with it. In conclusion, a large degree of social impairment was found in the patient group along with several coping strategies. The impairments were modified by a number of factors indicating that highly individualised care and treatment is needed. A state of normality was described as the primary treatment wish with a higher acceptance of removable solutions in Denmark than in Sweden. For final decision-making, surrounding factors seemed to influence the patients' choices., Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients’ with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmark, and Malmö, Sweden, respectively, 20 patients with partial edentulism seeking rehabilitation were interviewed in a semistructured qualitative manner. The interviews were transcribed and analysed yielding overall domains. Six themes appeared as overall domains: (i) experienced impairments, (ii) experienced social awareness, (iii) expectation to treatment, (iv) expectation to durability/survival, (v) coping strategies dealing with the tooth loss including explanations of the tooth loss and (vi) modifications to experienced impairment. The impairments were mostly experienced as problems in social settings. Most participants expressed a simple wish to function normally; a fixed solution was preferred. Many Danish participants accepted a removable solution whereas only few Swedish participants did so. The domains ‘coping strategies’ and ‘modifications’ were not part of the chosen topics of interest, indicating a high wish of the participants to explain their tooth loss and how they coped with it. In conclusion, a large degree of social impairment was found in the patient group along with several coping strategies. The impairments were modified by a number of factors indicating that highly individualised care and treatment is needed. A state of normality was described as the primary treatment wish with a higher acceptance of removable solutions in Denmark than in Sweden. For final decision-making, surrounding factors seemed to influence the patients’ choices