Objective: Epidemiological studies of the prevalence of periodontitis over an extended time using the same methodology to investigate and classify periodontitis are sparse in the literature. Smoking and socio‐economic factors have been proven to increase the risk for periodontal disease. The objective of this study was to investigate 30‐year time trends, using the same methodology to classify the prevalence and severity in alveolar bone loss (ABL) and to investigate the influence of tobacco and socio‐economic factors.Methods: Four cross‐sectional epidemiological studies in an adult population were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008 and 2013. Random samples of 787–1133 individuals aged 35–85 who answered a questionnaire about tobacco use and socio‐economic factors were radiographically and clinically examined. A number of teeth, ABL and calculus visible on radiographs were registered. The severity of ABL as detected on radiographs was classified into no bone loss, moderate or severe.Results: The prevalence of moderate ABL decreased from 45% in 1983 to 16% in 2008, but increased to 33% in 2013 (P < 0.05). The prevalence of severe ABL remained the same from 1983 (7%) to 2013 (6%). Calculus visible on radiographs increased from 22% in 2008 to 32% in 2013 (P < 0.05). Socio‐economic factors had limited impact on the severity of ABL.Conclusion: Moderate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.

Objectives: The proportion of older people in the population is increasing rapidly. Along with this comes an increase in the number of people requiring assistance in daily living, including oral care. Swedish law stipulates that care personnel who work with older people should be offered oral health education every year. The aim of this study was to investigate oral health care beliefs among such personnel.Methods: A questionnaire study was conducted among 2167 personnel providing care to older people at special accommodation sites and in home care. Data were collected using the Nursing Dental Coping Beliefs Scale. Descriptive statistics were calculated and logistic regression analysis was performed.Results: Personnel working in home care had lower odds of having an internal locus of control than those working in special accommodation, and personnel with less than 10 years of working experience had lower odds than their more experienced counterparts. Men had higher odds of having an external locus of control than women.Conclusions: It seems important to ensure that home care personnel and less experienced personnel attend oral care educational sessions, and to encourage male staff to focus on oral care work.

Objectives: To investigate the prevalence of dental caries and to identify risk factors for dental caries in an elderly population between 2008 and 2018.Methods: This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions 10 years apart to 273 individuals who were 65 and 75 years of age in 2008. The variables included were prevalence of dental caries as well as socioeconomic and socio‐behavioural factors.Results: The number of teeth decreased in both age groups by a mean of 2 over the 10‐year study period, but the prevalence of dental caries remained stable. Approximately, a quarter of the participants had caries lesions. Toothbrushing once a day or less was the factor most strongly correlated with dental caries lesions (OR: 3.82, 95% CI: 1.68–8.66, p = 0.001), followed by need for homecare (OR: 3.50, 95% CI: 1.55–7.93, p = 0.003) and interproximal cleaning less than once a day (OR: 2.65, 95% CI: 1.36–5.19, p = 0.004).Conclusions: This longitudinal study revealed no increase in the prevalence of dental caries lesions, indicating that good oral health can be preserved among elderly people. The highest risk for dental caries lesions was among participants with inadequate oral hygiene routines (toothbrushing once a day or less and seldom using interproximal devices) and in need of help in daily living, emphasizing the importance of oral hygiene and collaboration between dental services and community‐based health care.

With care dependency, untreated root caries lesions (RCLs) and irregular dental visits are common. RCLs, if left untreated, could lead to pain, tooth loss, difficulties eating, and impact on general health. Therefore, there is a need for prevention and effective treatment for RCLs, and especially in those with care dependency. The aim of this systematic review was to investigate the effect of domiciliary professional oral care on root caries development and progression, in comparison with self-performed or nurse-assisted oral care. A literature search was conducted in four databases in November 2022. Two authors independently screened the literature throughout the review process. Five of the identified studies were found to be relevant. Four of these were assessed as having moderate risk of bias and were included in the review, while one study had high risk of bias and was excluded from further analyses. Due to heterogenicity of the included studies (and of the interventions and outcomes), no meta-analysis or synthesis without meta-analysis (SWiM) was performed. The participation of dental personnel performing mechanical plaque removal and fluoride, or chlorhexidine application seems beneficial for care-dependent older adults with risk of RCLs development and progression. However, future studies are needed.

Objective: To investigate attitudes to dental care, and to assess possible associations with socio‐economic and clinical variables over a period of ten years, and to investigate the association between OHRQoL assessed by oral impact on daily performance (OIDP), and socio‐economic, dental care habits, smoking and oral status.Materials and methods: Cross‐sectional studies performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1,107‐1,115 dentate individuals, aged 30‐85 years, who answered a questionnaire and who were radiographically and clinically examined were included.Results: The importance of preventive treatment, regular recalls and meeting the same caregiver as on previous visits became less important. In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (P<.05). In individuals with manifest caries, information on treatment cost was important, while prevention became less important (P<.05). OIDP was reported by 31% of the individuals in the study, and frequent impact was reported by 10%. Individuals with manifest caries lesions, less than 20 remaining teeth, and temporomandibular disorders (TMD) reported OIDP to a significantly higher degree, compared to orally healthy individuals.Conclusion: Attitudes important in maintaining and improving good oral health, such as preventive care and regular recalls to dentistry, became less important during this period of 10 years. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, individuals with less than 20 remaining teeth, TMD and manifest caries.

Objectives: To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018.Methods: This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65 years and 75 years in 2008.Results: The mean number of teeth decreased significantly over the ten‐year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period.Conclusions: Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.