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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