Top

BMC Oral Health

Published in:

Open Access 01-12-2020 | Periodontal Treatment | Research article

Adults’ dental treatment in 2001–2013 in Finnish public dental service

Authors: J. Linden, E. Widström, J. Sinkkonen

Published in: BMC Oral Health | Issue 1/2020

Abstract

Background

All adults over 17 years of age have access to the Public Dental Service after the Finnish Dental Care Reform in 2001–2002. This study aimed to survey the treatment needs and treatment measures provided for adult patients and changes in these during the period 2001–2013.

Methods

Sing each person’s unique identifier, demographic data on dental visits during the period 2001–2013 were collected from municipal databases in five PDS-units covering 320,000 inhabitants. The numbers of visitors, those in need of basic periodontal or caries treatment (CPI > 2 and D + d > 0) were calculated for three age groups. Treatment provided was also calculated in 13 treatment categories. Trend analyses were performed to study changes during the study period.

Results

Restorative treatments (968,772; 23.6%), examinations (658,394; 16.1%), radiographs taken (529,875; 12.9%) anaesthesia used (521,169; 12.7%) and emergency treatments (348,229; 8.5%) made up 73.8% of all treatment measures during the entire study period. Periodontal treatment (7.8%) and caries prevention (3.9%) made up a small part of the care provided and prosthetics and treatment of TMJ disorders were extremely uncommon (fewer than 1%). Treatments related to caries (restorative treatment, examinations, endodontics, emergencies, anaesthesia and radiographs) made up 60.4% of the dental personnel’s treatment time. During the study period, statistically significant increasing trends were found for radiographs (p < 0.001***), anaesthesia (p = 0.003**) and total number of treatments (p = 0.009**). There was a slight decreasing trend in treatment need among the youngest adults (18–39 years; p = 0.033*).

Conclusion

Compared with the results of national epidemiological studies, insufficient periodontal treatment is provided and prosthetic treatment is almost totally neglected in the PDS. Rather, adults’ dental treatment concentrates on treatment of caries. The unmet needs may be due to tradition, inadequate treatment processes or a lack of resources or failed salary incentives.

Vehkalahti M, Paunio I, Nyyssönen V, Aromaa A, ed. Suomalaisten aikuisten suunterveys ja siihen vaikuttavat tekijät (Abstract in English). Kansaneläkelaitoksen julkaisuja AL:34. Vammalan kirjapaino, Turku 1991. (Oral health of Finnish adults and determinant factors, English summary).

Suominen-Taipale L, Nordblad A, Vehkalahti M, Aromaa A. Eds. Oral health in the Finnish adult population. Health 2000 survey. Publications of the National Public Health Institute (KTL) B25. Hakapaino Oy: Helsinki; 2008.

Koskinen S, Lundqvist A, Ristiluoma N, eds. Terveys, toimintakyky ja hyvinvointi Suomessa 2011 In: THL Raportti 68. Tampere: Juvenes Print - Suomen yliopistopaino Oy; 2012. (Health, functional capacity and welfare in Finland in 2011, English summary.).

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Parodontiitti. Käypähoito-suositus. http://www.kaypahoito.fi/web/english/guidelineabstracts/guideline?id=ccs00082. Accessed 2018 Dec 30. (Finnish Best Practice Guideline for treatment of periodontal diseases, English summary.).

Wahlin Å, Papias A, Jansson H, Norderyd O. Secular trends over 40 years in periodontal health and disease in individuals aged 20–80 years in Jönköping, Sweden: repeated cross-sectional studies. J Clin Periodontol. 2018;45:1016–24. https://doi.org/10.1111/jcpe.12978.CrossRefPubMed

Holt C. Brugen af og betaling for tandpleje i Danmark. Sverige og Norge Nor Tannlegeforen Tid. 2013;123:12–8 https://www.tandlaegebladet.dk/sites/default/files/articles-pdf/20-29.pdf. Accessed 2019 Oct 3.

Jordan AR, Micheelis W. Fünfte Deutsche Mundgesundheitsstudie. Köln: Deutscher Zahnärzte Verlag DÄV; 2016.

Linden J, Widström E, Sinkkonen J. Children and adolescents’ dental treatment in 2001–2013 in the Finnish public dental service. BMC Oral Health. 2019;19:131. https://doi.org/10.1186/s12903-019-0828-z.CrossRefPubMedPubMedCentral

Widström E, Agustdottir H, Byrkjeflot LI, Pälvärinne R, Christensen LB. Systems for provision of oral health care in the Nordic countries. Tandlaegebladet. 2015;119:702–11 https://www.tandlaegebladet.dk/sites/default/files/articles-pdf/TB092015-702-711.pdf. Accessed 2019 Oct 3.

10.

Raittio E. Use of oral health services and perceived oral health after the oral health care reform introduced during 2001–2002. The more comprehensive public coverage of Oral health care, the lower socioeconomic inequalities? Thesis. Kuopio: University of Eastern Finland; 2016.

11.

Widström E, Linden J, Tiira H, Seppälä TT, Ekqvist M. Treatment provided in the public dental Service in Finland in 2009. Community Dent Health. 2015;32:60–4.PubMed

12.

Widström E, Linden J. Treatment provided in the public dental service and by private dentists in Finland. Oral Health Dent Manag. 2018;17:1024 https://www.omicsonline.org/open-access/treatment-provided-in-the-public-dental-service-and-by-private-dentists-in-finland.pdf. Accessed 2019 Oct 3.

13.

Guiney P, Felicia H, Whelton N, Woods H. Analysis of a payments database reveals trends in dental treatment provision. J Dent Res. 2013;92(7 Suppl):63S–9S. https://doi.org/10.1177/0022034513484327.CrossRefPubMed

14.

Guiney H, Felicia P, Whelton H, Woods N. Comparing epidemiologically estimated treatment need with treatment provided in two dental schemes in Ireland. BMC Oral Health. 2012;12:31. https://doi.org/10.1186/1472-6831-12-31.CrossRefPubMedPubMedCentral

15.

Hummel R, Bruers J, van der Galien O, van der Sanden W, van der Hejden G. Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice. BMC Oral Health. 2017;17:125. https://doi.org/10.1186/s12903-017-0410-5.CrossRefPubMedPubMedCentral

16.

WinHit, In Net OY; www.winhit.fi.

17.

Statistics Finland. Population structure. http://www.stat.fi/til/vaerak/index.html. Accessed 2019 Oct 3.

18.

Oral health surveys: basic methods - 5th edition. World health organization. Geneve: WHO press; 2013.

19.

Tarvonen P-L, Ekqvist M, Turunen S, Hiekkanen S, Suominen L. Helsingin terveyskeskuksen suun terveydenhuollon tuotteistushankkeen loppuraportti. Helsingin terveyskeskuksen raportteja 3. Helsinki 2012. (Time used for different dental treatment measures, in Finnish).

20.

Chandler R, Scott M. Statistical methods for trend detection and analysis in the environmental sciences. New Jersey: Wiley; 2011. https://doi.org/10.1002/9781119991571.CrossRef

21.

Hausen H, Kärkkäinen S, Seppä L. Caries data collected from public health records compared with data based on examinations by trained examiners. Caries Res. 2001;35:360–5. https://doi.org/10.1159/000047475.CrossRefPubMed

22.

Linden J, Josefsson K, Widström E. Frequency of visits and examinations in the public dental Service in Finland – a retrospective analysis, 2001–2013. BMC Oral Health. 2017;17:138. https://doi.org/10.1186/s12903-017-0436-8.CrossRefPubMedPubMedCentral

23.

Niiranen T, Widström E, Niskanen T. Oral health care reform in Finland - aiming to reduce inequity in care provision. BMC Oral Health. 2008;28(8):39. https://doi.org/10.1186/1472-6831-8-3.CrossRef

24.

Årsrapport 2017. Svenskt kvalitetsregister för karies och parodontit. (Annual report 2017. The Swedish quality registry for caries and periodontal disease, in Swedish) http://www.skapareg.se/wp-content/uploads/2018/09/%C3%85rsrapport-2017.pdf. Accessed 2019 Oct 3.

25.

Widström E, Komu M, Mikkola H. Longitudinal register study of attendance frequencies in public and private dental services in Finland. Community Dent Health. 2013;30:143–8.PubMed

26.

Rantahakala L, Nihtilä A, Mäntylä P. Terveyskeskuksissa tarvetta parodontologiselle täydennyskoulutukselle, (Periodontal diagnosis and treatment practices in Helsinki’s Metropolitan Public Dental Services). Suomen Hammaslääkärilehti. 2012;1:24–32.

27.

Nihtilä A, Widström E, Elonheimo O. Adult heavy and low users of dental services: treatment provided. Swed Dent J. 2016;40(1):21–32.PubMed

28.

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Karies (hallinta). Käypähoito-suositus, (Finnish Best Practice Guideline for management of caries, English summary). https://www.kaypahoito.fi/hoi50078. Accessed 2019 Oct 3.

29.

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Purentaelimistön toimintahäiriöt (TMD). Käypähoito-suositus, (Finnish Best Practice. Guideline for treatment of temporomandibular disorders, English summary). https://www.kaypahoito.fi/hoi50057. Accessed 2019 Oct 3.

30.

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Hampaan paikkaushoito. Käypähoito-suositus, (Finnish Best Practice Guideline for tooth restoration, English summary). https://www.kaypahoito.fi/hoi50117. Accessed 2019 Oct 3.

31.

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Hammasperäiset äkilliset infektiot ja mikrobilääkkeet. Käypähoito-suositus, (Finnish Best Practice Guideline for use of antimicrobials in acute dentistry, English summary). https://www.kaypahoito.fi/hoi50090. Accessed 2019 Oct 3.

32.

Suomalaisen Lääkäriseura Duodecimin ja Suomen Hammaslääkäriseura Apollonia ry:n asettama työryhmä. Lyhentyneen hammaskaaren hoito. Käypähoito-suositus, (Finnish Best Practice Guideline for treatment of shortened dental arch (SDA), English summary). https://www.kaypahoito.fi/hoi50094. Accessed 2019 Oct 3.

33.

Sipilä R, Lommi M-L. Hoitosuositukset eivät muutu hoitokäytännöiksi Itsestään. (treatment recommendations do not automatically translate into treatment practices, English summary). Duodecim. 2014;130:832–9.PubMed

34.

Alestalo P. Management and leadership in the public dental Service in Finland between 2003 and 2011, thesis. Helsinki: University of Helsinki; 2015. https://helda.helsinki.fi/bitstream/handle/10138/153268/manageme.pdf?sequence=1&isAllowed=y. Accessed 2019 Oct 3.

35.

Ordell S, Söderfeldt B. Understanding politics? Some lessons from Swedish dentistry. Community Dent Health. 2009;26:239–43.PubMed

Title: Adults’ dental treatment in 2001–2013 in Finnish public dental service
Authors: J. Linden
E. Widström
J. Sinkkonen
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Periodontal Treatment
Caries
Published in: BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-020-01091-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Adults’ dental treatment in 2001–2013 in Finnish public dental service

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Emergency and urgent dental visits among Medicaid enrollees from 2013 to 2017

Perception, knowledge, and attitudes towards molar incisor hypomineralization among Spanish dentists: a cross-sectional study

Deep learning-based dental plaque detection on primary teeth: a comparison with clinical assessments

Efficacy of nano-carbonate apatite dentifrice in relief from dentine hypersensitivity following non-surgical periodontal therapy: a randomized controlled trial

Influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain: a systematic review of randomized clinical trials

Correction to: Use of an oxygen planar optode to assess the effect of high velocity microsprays on oxygen penetration in a human dental biofilms in-vitro