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Public Dental Health and Profession in Oral Health Care Research theme at the Faculty of Odontology, Malmö University Clinical research In situ models A holistic view on oral health (Axtelius & Söderfeldt, 2007) Time Stressors NEED FOR RESEARCH Research within the ’Oral health’ profile Oral health care In vitro models Implementation Evaluation Components of ”Oral Health Related Quality of Life” (OHRQOL) – Lalonde 1974, Inglehart & Bagramian 2002, S-O Isacsson 2003). © Faculty of Odontology, Mah Description of oral health, oral treatment need and utilization among the adult population of Skåne, Sweden. Quality of life, role function, social network Biol Psych Ageing Genes setup Destruktive health behaviour Empowerment Health litteracy Form-Function Freedom from pain Caring Prevention Form/Function -chewing -speak -swallow -smile Freedom from pain Dental org Sociol Health-Disease Experienced treatment need Access Quantity Quality Lack of welfare Food habits Drinking habits Tobacco consumption Exercise Low intage of fruits/veg High colesterol High blood pressure Economical welfare Etnicity Democrazy Epidemiology: •Lower birth numbers •Ageing population Questionnaire Clincial study In-depth interviews Project: Good Work in Sweden and Denmark Health-Unhealth The questions in the questionnaire are focused on: Several multidisciplinary research activities are performed within the research theme ”Oral public health and profession”. One important aspect of this research is to better understand the concept of ”health” and the importance of the mouth and the teeth for quality of life. Oral health can only be understood from a multi-level perspective. Traditionally, the evaluation of biological disease processes in the patient has been the dominating perspective on oral health and disease. Today, the opinion of the patient has gained in importance in the evaluation of a disease, and is seen as a complementary view to the professional view and therefore necessary for a holistic perspective on oral health and disease. The importance of the mouth in a social context is obvious, and oral rehabilitation has a tremendous impact on a patient’s life. The development of methodologies för a holistic evaluation of oral health related quality of life is a research area with high priority. Evaluation of clinical assessments and actions in relation to the opinions of the patient is part of this work, but also comparative, international studies of oral health related quality of life in order to understand the importance of the mouth in a social and cultural context. work psychology, public health medicine and oral public health, has proven to be a very fruitful starting point for the understanding of the conditions for the work environment. As an example, we are conducting a series of comparative studies of ”Good Work” environments in Denmark and Sweden. • Positive aspects of the work • Work satisfaction and work fulfillment • Values of the work 2. Oral health and quality of life: Evalutions are made of assessment methods for oral health and quality of life, which are conducted in large epidemiological studies in cooperation with different regional political boards and oral public health organisations. One example is the Värmland study which studies the impact of financial frameworks for oral health related quality of life. Another example is the Scania study which encompass some 6500 questionnaire- and some 450 clinical studies of the population in Skåne. The study aims to make a traditional epidemiological description of oral health and disease, as well of how oral treatment demands and needs develop over time. 3. Oral health in patient groups with special needs: In this reasearch area, oral health analysis is performed on elderly, patients with mental functional disabilities, whiplash accident-related diseases and the children of immigrants. This focused research theme encompasses four research directions: 1. Dentistry as a professional human care organisation: The psychosocial work environment of dentists is problemetic and be related to different organisational models and management doctrines, which have had great impact in dentistry. Within the reasearch area, several in-depth studies are focused on the development of analytical models för human research studies and how the special demands in this context can lead to problems in the work situation. In particular, the intersection between different disciplines such as management theory, • Relation to the patient 4. The clinical encounter: In dentistry, as in other parts of the health care system, difficult and complex decisions must be made. In an analysis of the structure of the clinical decision process, you may gain insight into the complex interplays between the clinician and the patient. The ambition of these studies is to have a multidisciplinary approach where, organisation, financial structure and psychology interplay with biological and technical aspects. In particular, the therapeutical alliance and different aspects of patient-therapist communication is studied. • Organisation • Relations at the work place • Balance between work and free time Oral health related quality of life and financial frameworks This project studies whether Contract dental care or Fee-for-service dental care leads to different outcomes in relation to the patients oral health related quality of life. The questionnaire studied some 2400 patients enrolled in the Public Dental Health Service system in the county of Värmland, 1200 in each finanancial system. A series of statistical regression analyses were made in order to exclude the impact of selection bias of patients to the different health care systems. Patients in the Contract care system experienced better oral health related quality of life than patients in the Fee-for-service care system, independent of e.g. age, education and marital status. It seems there are different causal mechanisms working in the two systems, where economical factors were important for patients in Contract care, and the patient-therapist relation was essential for patients in the Feefor-service care. Co-ordinator: [email protected] Ph.D. students: Researchers: Hanne Berthelsen, Kamilla Bergström, Eva-Karin Korduner, Nina Lundegren, Carina Mårtensson, Birger Narby, Sven Ordell Sigvard Åkerman, Solgun Folke, Karin Hjalmers, Gunvi Johansson, Veronica Johansson, Francesca Sampogna, Elsebet Söderpalm-Andersson, Eva Wolf, Katarina Wretlind