Background: Socioeconomic status and oral health care habits may change throughout adult life. This calls for age-stratified analyses of oral health in the adult population to uncover differences that could be of importance for organizing adequate oral health care services. The aim of the present study was to describe self-reported oral health in different age groups in a general adult population in Norway, and to explore associations between self-reported oral health and age groups, sociodemographic factors, use of dental services, number of teeth and dental caries. Methods: We used data from a cross-sectional study of almost 2000 Norwegian adults, 20–79 years old. The study included both a structured questionnaire and a clinical examination to assess sociodemographic variables, use of dental services, self-reported oral and general health as well as dental caries and number of teeth. For analysis, the participants were divided into three age groups: young adults (20–29 years), middle-aged adults (30–59 years), and senior adults (60 years and older). Differences among groups were analyzed by cross-tabulation, and logistic regression analyses were used to assess associations between variables. Results: Forty-eight percent of the participants rated their oral health as good. Almost half of the participants had at least one carious tooth, with the highest caries prevalence among the young adults. To be caries free was strongly associated with reporting good oral health among the young and middle-aged adults. One third of the senior adults had fewer than 20 teeth, which was associated with reporting moderate or poor oral health. Less than half of the young adults reported regular use of dental services, and 40% of them had postponed dental visits for financial reasons during the past 2 years. Regardless of age group, having to postpone dental visits for financial reasons or having poor-to-moderate general health were associated with high odds for reporting moderate or poor oral health. Conclusions: That there were important age-group differences in self-reported and clinical measures of oral health and in the use of dental health services demonstrates the importance of age-stratified analyses in oral health research. Many adults, especially among the young, faced financial barriers for receiving dental health services, which was associated with poorer self-reported oral health. This argues for a need to revisit the financing of oral health care for adults in Norway.

The extracellular matrix protein nephronectin plays an important regulatory role during embryonic development, controlling renal organogenesis through integrin α8β1 association. Nephronectin has three main domains: five N-terminal epidermal growth factor-like domains, a linker region harbouring two integrin-binding motifs (RGD and LFEIFEIER), and a C-terminal MAM domain. In this review, we look into the domain-related functions of nephronectin, and tissue distribution and expression. During the last two decades it has become evident that nephronectin also plays a role during cancer progression and in particular metastasis. Nephronectin is overexpressed in both human and mouse breast cancer compared to normal breast tissue where the protein is absent. Cancer cells expressing elevated levels of nephronectin acquire increased ability to colonise distant organs. In particular, the enhancer-motif (LFEIFEIER) which is specific to the integrin α8β1 association induces viability via p38 MAPK and plays a role in colonization. Integrins have long been desired as therapeutic targets, where low efficiency and receptor redundancy have been major issues. Based on the summarised publications, the enhancer-motif of nephronectin could present a novel therapeutic target.

Background: Both the incidence and survival rate of head and neck cancer (HNC) is increasing, making quality of life of HNC survivors an important issue. Methods: In this cross-sectional study we compared the oral health related quality of life (OHRQoL) of long-term HNC survivors to that of a general population cohort from the seventh survey of the Tromsø study with the Oral Impact on Daily Performances questionnaire. Comparisons were done with frequency analyses and cross tabulation. We also assessed OHRQoL’s association to sociodemographic and oral health related variables in both cohorts as well as with cancer related variables in the HNC cohort with regression analyses. Results: The HNC survivors had four times the risk of reporting problems with daily performances compared with the general population cohort. The ability to eat and enjoy food was most frequently affected in both cohorts. Moderate-poor self-rated dental health and general health as well as high frequency of dental visits were significantly associated with poorer OHRQoL. To have a history of oral or pharyngeal cancer was associated with more problems than having a history of laryngeal cancer. Conclusions: Our study shows that HNC treatment is associated with a strong and lasting impairment of OHRQoL, highlighting the need to find less toxic, yet effective ways to treat the disease, and to provide easy access to expert dental care at all stages of the disease to minimize morbidity. Given the widespread side effects of cancer treatment, a multidisciplinary approach might be required to improve the OHRQoL of HNC survivors.

English summary: Experiences with economic reimbursement schemes for dental treatment among patient treated for head and neck cancer: Nor Tannlegeforen Tid. 2021; 131: 996-1003. A questionnaire was mailed to members of the Norwegian Head and Neck Cancer Association to explore costs of dental treatment in people treated for head-neck cancer in Norway, and their experiences with the National Insurance reimbursement schemes for dental treatment. We also assessed the increase in the National Insurance’s reimbursement rates for dental treatment between 2015 and 2020 and compared the 2021 rates with the treatment rates in the Public Dental Health Service in Troms and Finnmark County. The questionnaire was answered by 216 previous head- and neck cancer patients of whom half reported costs for dental treatment after their cancer diagnosis. Respondents with poor dental health reported significantly higher costs than did those with good dental health. Among respondents with large expenses, a high proportion had received good help with the financial reimbursements. Our findings indicate that the fee rates of the National Insurance do not reflect the prices for dental treatment of adults in Norway. While the consumer price index increased by 14% between January 2015 and December 2020, the National Insurance Scheme’s reimbursement rates increased by an average of 5-6%, and the 2021 rates were on average 40% below the rates in the Public Dental Health Service of Troms and Finnmark.