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Dental fear and anxiety and oral health behaviour in 12-to-14-year-olds born preterm
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0000-0002-1371-8770
2010 (English)In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 20, no 6, p. 391-399Article in journal (Refereed)
Abstract [en]

BACKGROUND: An enhanced frequency of cognitive and behavioural disturbances has been reported in preterm children. It is not known if this affects their perceptions of or behaviour in the dental care situation. HYPOTHESIS: The hypotheses were that preterm (PT) children aged 12-14 years more often exhibit dental fear and anxiety (DFA) than full-term controls (C), while no differences were expected regarding oral health behaviour. METHODS: One hundred and nine PT and 108 C children took part in the present questionnaire study. DFA was assessed using the Children's Fear Survey Schedule - Dental Subscale (CFSS-DS). In addition the questionnaire covered items including satisfaction with received dental care, oral health behaviour and medical health. RESULTS: The children's CFSS-DS scores revealed no differences between the PT and C groups. Regarding oral health behaviour there were no differences, except that PT children more often used dental floss and extra fluoride supplements. PT children reported more medical health problems than C children. CONCLUSIONS: Preterm (PT) children 12- to 14-years-old, as well as C of same age group, seem to be satisfied with their dental care and display low prevalence of DFA. Still, a higher frequency of medical health problems in the PT children suggests that these children should be regarded as potential risk patients for oral health problems.

Place, publisher, year, edition, pages
2010. Vol. 20, no 6, p. 391-399
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-15886DOI: 10.1111/j.1365-263X.2010.01069.xISI: 000283325700003PubMedID: 20642465Scopus ID: 2-s2.0-78751515837Local ID: 11339OAI: oai:DiVA.org:mau-15886DiVA, id: diva2:1419408
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
In thesis
1. The preterm child in dentistry. Behavioural aspects and oral health
Open this publication in new window or tab >>The preterm child in dentistry. Behavioural aspects and oral health
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Allt fler för tidigt födda barn överlever tack vare en avancerad intensivvård, vilket innebär att tandvården möter en ny grupp av patienter som är födda 3 till 4 månader för tidigt. Många av dessa barn riskerar att få bestående fysiska och psykiska problem.

Det finns mycket få studier som utvärderat oral hälsa hos förtidigt födda barn eller hur de klarar sin tandvård. Avhandlingens övergripande mål har varit att analysera olika aspekter av tandvårdsbeteende och oral hälsa hos för tidigt födda barn.

Samtliga barn födda före graviditetsvecka 32 i Malmö Lundssjukvårdsdistrikt ingick i studierna. I delarbete I-III följdes en gruppför tidigt födda barn och matchade fullgångna kontrollbarn frånförskoleålder till tonår. Delarbete IV inkluderade en ny grupp 10-12 år gamla för tidigt födda barn och kontrollbarn.

I delarbete 1 studerades tandvårdsjournaler för 187 tidigt födda barn och 187 fullgångna kontrollbarn vid 3 och 6 år samt under förskoleperioden (3-6 år). Uppgifter om psykologiska behandlingsproblem och karies registrerades. Behandlingsproblem var vanligare bland de för tidigt födda barnen, medan det inte förelåg några skillnader mellan grupperna avseende karies.

I delarbete II intervjuades föräldrar till 153 för tidigt födda barn och153 matchade fullgångna kontrollbarn vid två olika tillfällen med 2års mellanrum (förskoleålder, tidig skolålder). Syftet var att studera föräldrars syn på barnens tandvård, tandhälsa och tandvårdsvanor. Föräldrarna till de för tidigt födda barnen rapporterade mer behandlingsproblem i förskoleåldern, men inte i skolåldern. De rapporterade också mer medicinska problem än föräldrarna till kontrollbarnen.

I delarbete III, när barnen var 12-14 år gamla, deltog 109 för tidigt födda barn och 108 fullgångna kontrollbarn i en enkätstudie. Syftet var att studera upplevelser av tandvård samt förekomst av tandvårdsrädsla, tandvårdsvanor och allmän hälsa. Studien visade inga skillnader mellan grupperna avseende tandvårdsrädsla eller andra faktorer kopplade till tänder och tandvård. De för tidigt födda ungdomarna rapporterade mer flitig användning av tandtråd och extra fluor och hade mer allmänna hälsoproblem än kontrollerna.

I delarbete IV undersöktes kliniskt 82 10-12 år gamla för tidigt födda barn och 82 matchade kontroller avseende emaljavvikelser (MIH), förekomst av plack, gingivit, karies samt psykologiska behandlingsproblem. Studien visade att för tidigt födda barnhade högre förekomst av MIH, hade mer plack och gingivit samtuppvisade mer psykologiska behandlingsproblem jämfört med de fullgångna kontrollbarnen. Tidig födsel och låg födelsevikt ökade risken för MIH. När det gäller kariesförekomst sågs inga skillnadermellan grupperna.

Konklusion och klinisk betydelse

Sammanfattningsvis tyder studierna på att för tidig födsel innebär en större risk för problem av psykologisk art i tandvården och större risk för oral ohälsa. Det är också vanligare med medicinska problem, vilket tycks följa barnen upp i tonåren. Som en följd av detta behöver tandvården tidigt identifiera de för tidigt födda barnen för att utforma rutiner kring prevention och behandling samt för att individualisera det psykologiska omhändertagandet. Vidare krävsett utökat samarbete mellan tandvården och barnhälsovården för att försäkra sig om en god oral hälsa hos för tidigt födda barn.

Abstract [en]

Background: Advancements in medical care have enabled more children born preterm to survive and develop as healthy individuals alongside their full-term peers. However, a higher frequency of medical health problems, cognitive and behavioural disturbances, including problems in school, has been reported. There is limited knowledge about how this affects preterm children (PT) in dentistry, and few studies have evaluated behavioural problems related to dental treatments and oral health in PT as compared with full-term control children (C).

Aims: The overall objective was to investigate behavioural problems related to dental treatments and the oral health in PT born between 23 and32 weeks of gestation as compared with full-term C. Specific aims were to analyze behaviour management problems (BMP), dental fear and anxiety (DFA), prevalence of Molar-Incisor Hypo mineralization (MIH), oral hygiene, gingival health, and dental caries in PT and full-term C.

Materials and methods: The study group comprised all children born between 23 and 32 weeks of gestation in the catchment area of the University hospitals of Lund and Malmö in southern Sweden. The subjects in Papers I-III were PT and matched full-term C, followed from preschool years to adolescence. In Paper IV, a new group of children, living in the cityof Malmö was identified, the subjects being 10-to-12-year old PT and matched full-term C. Information about dental treatment, oral health and oral health related factors were obtained from dental records, interviews, questionnaires and clinical examinations.

Results of the four papers: 

Paper I:  BMP and dental caries was studied in 187 PT and 187 C, based on notes in dental records at 3 and 6 years of age, and during the preschool period (3-6 years). At age 3, but not at age 6, the prevalence of BMP at dental examinations were more common in PT than in C. At various kinds of dental treatments during the preschool period, PT presented more frequently with BMP. No differences were found regarding dental caries. 

Paper II: Parents of 153 PT and 153 C were interviewed on two occasions, two years apart (preschool period and early school years) regarding experience of their child’s dental care, oral health behaviour and medical health. BMP were reported more common in PT than in C during preschool period but not during the early school years. PT also reported more medical health problems than C. 

Paper III: At 12-14 years of age, 109 PT and 108 C took part in a questionnaire study, including, the Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS) to measure the level of DFA, oral health behaviour and medical health. Few PT and C reported DFA. PT reported more daily use of dental floss and use of extra fluoride supplements than C. Further, PT reported more medical health problems than C. 

Paper IV: Eighty-two PT and 82 full-term C, aged 10 to 12 years, were clinically examined regarding the prevalence and severity of MIH as well as their levels of oral hygiene and gingival health. In addition, BMP and dental caries were recorded. MIH was more common in PT than in C. Low gestational age and low birth weight increased the risk of MIH. PT had more plaque and gingival inflammation and presented more BMP than C. No difference in caries prevalence was found. 

Conclusions and clinical implications:

 In 3-to-10-year-old PT and matched full-term C, and based on dental records and parental reports, it was concluded that BMP were more common in PT than in C during the preschool period. The difference decreased with increasing age and during the early school years there were no differences between the groups. However, at clinical examination at the age of 10-12 years, PT presented with BMP more frequently than C. 

During adolescence, based on the youngsters’ own viewpoints, few PT and C reported DFA. 

The clinical examination at 10-to-12 years of age showed that PT had a higher prevalence of Molar-Incisor Hypo mineralization (MIH) than C, and low gestational age and low birth weight increased the risk of MIH. At this age, PT also had less favorable oral hygiene and gingival status than C. 

Problems with toothbrushing were more commonly reported in PT than in C during the preschool period. During adolescence, PT reported more daily use of dental floss and extra fluoride supplements than C. 

Regarding caries prevalence, there were no differences between the groups in either the primary or in the permanent dentition. In contrast, PT had more medical health problems, persisting from preschool period into adolescence than C. 

The results in this thesis indicate more behavioural problems related to dental treatments and more oral health problems in PT than in C. Therefore, PT require special attention from the dental services, with treatment planning and prevention strategies from an early age. Collaboration between medical and dental health care professionals is advocated in order to ensure good oral health in PT.

Place, publisher, year, edition, pages
Malmö University, Department of Paediatric Dentistry, 2010
Series
Swedish Dental Journal : Supplement, ISSN 0348-6672 ; 208
Keywords
preterm, oral health, behaviour management problems
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7671 (URN)10594 (Local ID)91-7104-314-4 (ISBN)10594 (Archive number)10594 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as accepted manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-05Bibliographically approved

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Brogårdh-Roth, SusanneMatsson, LarsKlingberg, Gunilla

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