We used Swedish national registers to analyse dental health care among young adults with childhood experience of out‐of‐home care (OHC), in Cox regression analyses. All 1.7 million Swedish residents born in 1980–1994 were included, of whom 4% had been in OHC. The population was followed up in the Dental Health Register from age 20 to 29, during the period 2009–2014. We found that persons with short or long OHC experience made emergency dental care visits more often than their majority‐population peers: 17–23% versus 9–10%, (adjusted Hazard ratios [HR:s] 1.60–2.02); they more often had tooth extractions, 9–12% versus 3% (HR:s 2.33–3.03); but less regularly visited a dentist for planned check‐ups, 61–77% versus 80–87% (HR:s 0.76–0.78). Since dental health in young adulthood reflects dental health and dental care in childhood, the findings of this study call for improved preventive dental health care for children in OHC.

AIM: Decades of research confirm that children and adolescents in out-of-home care (foster family, residential care) have much greater healthcare needs than their peers. A systematic literature review was conducted to evaluate organizational healthcare models for this vulnerable group. METHODS: A systematic literature search was undertaken of the following databases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomized and non-randomized controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion. RESULTS: No study with low or medium risk of bias was identified. CONCLUSION: In the absence of studies of acceptable quality, it is not possible to assess the impact of organizational models intended to ensure adequate health and dental care for children and adolescents in out-of-home care. Therefore, well-designed follow-up studies should be conducted following the implementation of such models. This article is protected by copyright. All rights reserved.

Background

The Swedish Quality Registry for caries and periodontal disease (SKaPa) automatically collects data on caries and periodontitis from patients’ electronic dental records. Provided the data entries are reliable and accurate, the registry has potential value as a data source for registry-based research. The aim of this study was to evaluate the reliability and accuracy of the SKaPa registry information on dental caries in 6- and 12-year-old children.

Method

This diagnostic accuracy study compared dental caries data registered at an examination with dental health status registered in the patient’s electronic dental records, and with corresponding data retrieved from the SKaPa registry. Clinical examinations of 170 6- and 12-year-old children were undertaken by one of the researchers in conjunction with the children’s regular annual dental examinations where the number of teeth were registered, and dental caries was diagnosed using ICDAS II. Teeth with fillings were defined as filled and were added to the ICDAS II score and subsequently dft/DFT was calculated for each individual. Cohen’s Kappa, the intraclass correlation coefficient (ICC), and sensitivity and specificity were calculated to test the agreement of the ‘decayed and filled teeth’ in deciduous and permanent teeth (dft/DFT) from the three sources.

Results

Cohen’s Kappa of the dft/DFT-values was calculated to 0.79 between the researcher and the patient record, to 0.95 between patient dental record and SKaPa, and to 0.76 between the researcher and SKaPa. Intraclass correlation coefficient (ICC) was calculated to 0.96 between the researcher and the patient journal, to 0.99 between the patient dental record vs. SKaPa, and to 0.95 between the researcher and SKaPa.

Conclusion

The SKaPa registry information demonstrated satisfactory reliability and accuracy on dental caries in 6- and 12-year-old children and is a reliable source for registry-based research.

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.

Objectives: Children in out-of-home care (OHC) are at greater risk of ill health than other children in the community. The aim of this registry-based cohort study was to compare the oral health and dental care needs of children in OHC with those of other children in Sweden, by merging data from different Swedish registries. A further aim was to analyse whether children in OHC received more dental examinations after 2017, following implementation of a law requiring mandatory health evaluations prior to placement.

Methods: We identified an exposed cohort of Swedish children and young people, 0–19 years old, who had been placed in OHC 2010-2018(N=59,348), and an unexposed cohort, five times larger, matched for age, sex and county of residence (N=296,730). Data on dental health, dental care, socioeconomic background and medical diagnoses were retrieved from several registries.

Results: During the study period, children in OHC received relatively fewer regular, scheduled dental examinations (4.35 vs. 4.94; p=0.000). More children entering OHC in 2018 received dental examinations (72,86%) compared with 2016 (66,78%) (p=0.000), but this was still lower than the proportion of controls. Moreover, during the study period, dental caries affected more teeth in children in OHC than in the controls (dft 6-year-olds 1.54 vs. 0.72; p=0.000, and DFT 12-year-olds 1.14 vs. 0.70; p=0.000), more extractions and more emergency dental appointments than children who had never been in OHC. Conclusion:Not only do children in OHC have poorer oral health than other children, they also receive less support from the dental health services. It seems that society has failed in its mission to ensure that children in OHC are not disadvantaged with respect to health and access to comprehensive healthcare. Thus, there is an urgent need for reappraisal of guidelines, legislation, and organizational models for providing dental care to children and adolescents in OHC.