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Mac Giolla Phadraig, C., Healy, O., Fisal, A. A., Yarascavitch, C., van Harten, M., Nunn, J., . . . Krämer, S. (2024). Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management. Community Dentistry and Oral Epidemiology
Open this publication in new window or tab >>Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management
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2024 (English)In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour.

Methods: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.

Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.

Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
Delphi technique, anaesthesia, anxiety management, behaviour management, behaviour sciences, dentistry, sedation, taxonomy
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66512 (URN)10.1111/cdoe.12953 (DOI)001189223600001 ()38516782 (PubMedID)2-s2.0-85189106821 (Scopus ID)
Available from: 2024-03-27 Created: 2024-03-27 Last updated: 2024-04-23Bibliographically approved
Johansson, K., Bokander Matilainen, L., Wiaderny, M., Berlin, H., Klingberg, G., Ghiasi, H., . . . Paulsson, L. (2024). Self-reported pain during different phases of orthodontic treatment with fixed appliance: A multi-centre randomized controlled trial in adolescents with crowding. Orthodontics & craniofacial research
Open this publication in new window or tab >>Self-reported pain during different phases of orthodontic treatment with fixed appliance: A multi-centre randomized controlled trial in adolescents with crowding
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2024 (English)In: Orthodontics & craniofacial research, ISSN 1601-6335, E-ISSN 1601-6343Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: To compare self-reported pain levels across various treatment phases using passive self-ligating (Damon) and conventional (Victory) standardized fixed appliance systems.

MATERIALS AND METHODS: Adolescents (12-17 years old) with crowding and displaced teeth, planned for non-extraction treatment, were recruited from four orthodontic clinics. They were randomized into stratified blocks (1:1 ratio) using concealed allocation to receive Damon Q™ (34 boys, 28 girls) or Victory™ (39 boys, 31 girls). Pain and analgesic intake were assessed on seven different occasions with validated self-report questionnaires using a 10-grade scale.

RESULTS: Of the 132 patients included, six were lost to follow up. Clinically relevant mean pain scores (≥4) were registered in both groups after bonding upper and lower arches and after insertion of 0.019 × 0.025 stainless steel archwire. The highest mean scores were reported on day two after bonding the upper arch (Damon 5.96, Victory 7.18, P = .011). In both groups, at least 40% reported taking analgesics during various treatment phases. The Damon group reported a lower intake of analgesics on days one and two (P = .042 and .037) after treatment initiation. In the entire sample, boys reported significantly higher mean pain scores than girls on the second and third days after bonding (P = .008 and .026, respectively).

CONCLUSIONS: Lower pain levels were reported from the Damon group after bonding. In general, boys reported higher pain than girls did. Clinicians and adolescents need to be aware that clinically relevant pain levels can be expected not only after bonding but also in later phases.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
RCT, adolescent, fixed, orthodontic appliances, pain
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66281 (URN)10.1111/ocr.12771 (DOI)001169625100001 ()38389292 (PubMedID)2-s2.0-85186398132 (Scopus ID)
Available from: 2024-03-08 Created: 2024-03-08 Last updated: 2024-03-28Bibliographically approved
Roxner, R., Hallberg, U., Berlin, H. & Klingberg, G. (2024). Undergraduate dental students' perceptions of dental pain in children - A grounded theory study.. European journal of dental education
Open this publication in new window or tab >>Undergraduate dental students' perceptions of dental pain in children - A grounded theory study.
2024 (English)In: European journal of dental education, ISSN 1396-5883, E-ISSN 1600-0579Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: There is an underuse of pain management strategies in dental care for children, possibly owing to perceived stress and discomfort when treating children, which has also been reported by dental students. The aim of this study was to explore how undergraduate dental students experience and understand pain related to dental treatment in children.

MATERIALS AND METHODS: Interviews were held with 21 Swedish dental students, from 3 dental schools, all in their final 2 years of education. The interviews were transcribed verbatim and analysed according to Grounded Theory.

RESULTS: A core category, seeking guidance to avoid pain, was identified and related to 6 conceptual categories. The students used different strategies to manage pain prevention in child dentistry and to become skilled dentists. They described high levels of stress, as well as having high expectations on themselves when treating children. The stress led to a surface learning approach, something the students were not fully aware of.

CONCLUSION: All children should have the right to be ensured optimal pain prevention in dental care. The basis for this is laid during undergraduate education. Thus, pain management in child dentistry is an area in need of special attention in this respect. The academic staff has an important role in supporting their students in their process to gain an identity as professional dentists. To ensure that students incorporate an understanding of the importance of pain prevention when treating children there is a need to create more integration between theory and clinical training in undergraduate education.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
child, dental education, dental student, paediatric dentistry, pain, procedural pain
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66653 (URN)10.1111/eje.13008 (DOI)001197309800001 ()38581212 (PubMedID)2-s2.0-85189984468 (Scopus ID)
Available from: 2024-04-09 Created: 2024-04-09 Last updated: 2024-05-02Bibliographically approved
Berlin, H., Hallberg, U., Ridell, K., Toft, D. & Klingberg, G. (2023). A grounded theory study on Swedish 10 to 16-year-olds’ perceptions of pain in conjunction with orthodontically indicated tooth extraction. Acta Odontologica Scandinavica, 81(3), 235-240
Open this publication in new window or tab >>A grounded theory study on Swedish 10 to 16-year-olds’ perceptions of pain in conjunction with orthodontically indicated tooth extraction
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 3, p. 235-240Article in journal (Refereed) Published
Abstract [en]

Objective: Children frequently experience pain and/or discomfort during dental treatment. Still, pain research in dentistry has mainly been performed on adults using quantitative methods while research on the child's perspective is scarce. This study aims to explore and describe children's experiences and/or thoughts regarding pain in conjunction with tooth extraction.

Material and methods: Interviews were carried out with twelve Swedish 10-16-year-olds who had recently undergone tooth extractions due to orthodontic reasons. Interviews were transcribed verbatim and analysed according to grounded theory.

Results: A core category was identified and named 'handling the unavoidable unknown'. The informants recalled experiences of pain and discomfort during extractions. However, instead of focussing on pain, they described an urge for more information about the procedure and what to expect in terms of pain and/or discomfort, during and/or after treatment. They stated that the levels of pain/discomfort were manageable, while the lack of information negatively affected their coping abilities, causing feelings of unease.

Conclusions: To improve patients' ability to deal with pain in conjunction with dental extraction, the dental team should ensure better and individually tailored information about the treatment. Thus, the use of psychological techniques is a cornerstone in pain management and must be reflected in clinical guidelines.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Child; adolescent; dental care; grounded theory; pain
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-54805 (URN)10.1080/00016357.2022.2119163 (DOI)000850970700001 ()36070618 (PubMedID)2-s2.0-85137767477 (Scopus ID)
Funder
Region Skåne
Available from: 2022-09-08 Created: 2022-09-08 Last updated: 2023-04-20Bibliographically approved
Kirkinen, T., Naimi-Akbar, A., Cederlund, A., Tranæus, S., Carlson, C. & Klingberg, G. (2023). Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden. Acta Odontologica Scandinavica, 81(8), 615-621
Open this publication in new window or tab >>Accuracy of the Swedish quality registry for caries and periodontal diseases (SKaPa) – evaluation in 6- and 12-year-olds in the region of Värmland, Sweden
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2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 8, p. 615-621Article in journal (Refereed) Published
Abstract [en]

Objectives This study evaluates the agreement of data on dental caries between electronic dental records and data retrieved from the national SKaPa-registry (Swedish Quality Registry for caries and periodontal disease), with special reference to e/M in deft/DMFT.

Methods In a random sample of 500 6- and 12-year-old children having received dental care in 2014 in the county region of Värmland, Sweden, the diagnostic accuracy of data in electronic dental records with corresponding data obtained from the SKaPa-registry was compared by using Cohen’s Kappa and Intraclass correlation coefficient (ICC).

Results For dft/DFT the Kappa was 0.95, and ICC 0.98 (total population). For deft/DMFT in the total population the Kappa was 0.80 and ICC 0.96. For 6-year-olds (deft) the Kappa was 0.89 and ICC 0.99 and for 12-year-olds (DMFT) the Kappa was 0.70, and ICC 0.83. The corresponding figures for Kappa and ICC when excluding individuals without caries (deft/DMFT = 0) were: Total population 0.63 and 0.94; 6-year-olds 0.79 and 0.99; 12-year-olds 0.42 and 0.68.

Conclusion Agreement between data in the dental records and SKaPa was very high for dft/DFT confirming that transfer from the dental records to the SKaPa-registry is safe and correct. As the accuracy of deft/DMFT was considerably lower than for dft/DFT we advise against using deft/DMFT data from SKaPa for research purposes at this point.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
data accuracy, registries, child, dental caries
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-61741 (URN)10.1080/00016357.2023.2235422 (DOI)001032787700001 ()37470405 (PubMedID)2-s2.0-85165443093 (Scopus ID)
Funder
Region Värmland
Available from: 2023-07-26 Created: 2023-07-26 Last updated: 2024-04-08Bibliographically approved
Klingberg, G. & Hallberg, U. (2023). Anhöriga till personer med funktions­nedsättningar (1ed.). In: Gunilla Klingberg; Ulrika Hallberg (Ed.), Stora anhörigboken: (pp. 251-272). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Anhöriga till personer med funktions­nedsättningar
2023 (Swedish)In: Stora anhörigboken / [ed] Gunilla Klingberg; Ulrika Hallberg, Lund: Studentlitteratur AB, 2023, 1, p. 251-272Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023 Edition: 1
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:mau:diva-63012 (URN)978-91-44-15678-1 (ISBN)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2024-03-22Bibliographically approved
Hallberg, U. & Klingberg, G. (2023). Children with Special Needs: An Overview of Knowledge on Disability (1ed.). Cham, Switzerland: Springer
Open this publication in new window or tab >>Children with Special Needs: An Overview of Knowledge on Disability
2023 (English)Book (Other academic)
Abstract [en]

There can be a lack of understanding of the vulnerable situation of children with disabilities and their families, even among professional caregivers whose mission is to protect the health and wellbeing of these children. Their respectful treatment should include knowledge, empathy, humanity, and an open and sympathetic dialogue. This book provides an overview of knowledge and literature review of children and adolescents with special care needs that contribute to the respect and understanding of children with disabilities and their families. It also explains possible reasons for different outcomes in research studies and why there is a lack of knowledge in some areas concerning these children. 

Research on children with disabilities is considerable but often can be difficult to access on many levels, which means it does not always benefit those who need this knowledge. This compact book addresses this by presenting the international research in the field in an understandable way for people who work with children with disabilities and their families. The authors provide a broad picture of the background, reality of life, opportunities for professional help and support, as well as outlook of these children and families. Among the topics covered:

  • The Health and Well-being of Children with Disabilities
  • The Health and Well-being of Relatives
  • Occupation
  • On the Road to Adulthood

Children with Special Needs: An Overview of Knowledge on Disability is pertinent reading for students in all areas of health care (including nursing and psychology), social work, sociology, and education aimed at children and young people. The text also would be of interest to those who practice in these areas and/or encounter children with disabilities in their daily work.

Place, publisher, year, edition, pages
Cham, Switzerland: Springer, 2023. p. 88 Edition: 1
Series
SpringerBriefs in Social Work, ISSN 2195-3104, E-ISSN 2195-3112
Keywords
Children with special care needs, Children with developmental disabilities, Children's rights, International Classification of Functioning Disability & Health, Schooling for children with disabilities, Health in children with disabilities, Parents of children with disabilities, Child abuse, Child-centered approach, Children with intellectual disabilities, Autism, Wellbeing of children with disabilities, Educational opportunities of children with disabilities, COVID-19 pandemic
National Category
Psychiatry Psychology Social Work
Identifiers
urn:nbn:se:mau:diva-59109 (URN)10.1007/978-3-031-28513-4 (DOI)978-3-031-28512-7 (ISBN)978-3-031-28513-4 (ISBN)
Available from: 2023-04-04 Created: 2023-04-04 Last updated: 2023-08-17Bibliographically approved
Klingberg, G., Benchimol, D., Berlin, H., Bring, J., Gornitzki, C., Odeberg, J., . . . Domeij, H. (2023). How old are you?: a systematic review investigating the relationship between age and mandibular third molar maturity. PLOS ONE, 18(5), 1-14, Article ID e0285252.
Open this publication in new window or tab >>How old are you?: a systematic review investigating the relationship between age and mandibular third molar maturity
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 5, p. 1-14, article id e0285252Article, review/survey (Refereed) Published
Abstract [en]

Introduction and objective: Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years.

Methods: The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H).

Results: A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment.

Conclusion: The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-59643 (URN)10.1371/journal.pone.0285252 (DOI)000993222400034 ()37200251 (PubMedID)2-s2.0-85159764106 (Scopus ID)
Available from: 2023-05-23 Created: 2023-05-23 Last updated: 2023-09-05Bibliographically approved
Klingberg, G. & Hallberg, U. (Eds.). (2023). Stora anhörigboken (1ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Stora anhörigboken
2023 (Swedish)Collection (editor) (Other academic)
Abstract [sv]

Stora anhörigboken samlar insikter från en bredd av ledande experter inom området anhörigomsorg. Den belyser anhörigas betydelsefulla roll och den belastning de upplever i sina strävanden att tillhanda­hålla omsorg, kontinuitet och kärlek när samhällets resurser inte räcker till. Boken lyfter fram riskerna för anhörigas egen hälsa, deras ekonomiska utsatthet och sociala stigmatisering samt den betydande överrepresentationen av kvinnor som vårdare. Genom att belysa vikten av ett mer organisera...

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023. p. 488 Edition: 1
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:mau:diva-63011 (URN)9789144156781 (ISBN)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2023-11-23Bibliographically approved
Klingberg, G. (2023). Tandvård för barn med specifika sjukdomar (3ed.). In: Kristensson Hallström, Inger; Derwig, Mariette (Ed.), Pediatrisk omvårdnad: (pp. 411-416). Stockholm: Liber
Open this publication in new window or tab >>Tandvård för barn med specifika sjukdomar
2023 (Swedish)In: Pediatrisk omvårdnad / [ed] Kristensson Hallström, Inger; Derwig, Mariette, Stockholm: Liber, 2023, 3, p. 411-416Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2023 Edition: 3
National Category
Dentistry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-59108 (URN)978-91-47-14601-7 (ISBN)
Available from: 2023-04-04 Created: 2023-04-04 Last updated: 2024-05-20Bibliographically approved
Projects
Health promotion in Collaboration; Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV); Publications
Ramji, R. (2022). Health promotional interventions informed by community-based participatory research in a socially disadvantaged neighbourhood: development, exploration and evaluation. (Doctoral dissertation). Malmö universitet
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1371-8770

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