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Tannhelseutvikling på klinikknivå ved ulik forebyggende praksis
Nordic Council of Ministers, Nordic School of Public Health NHV.
2011 (Norwegian)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
Public dental service at three clinics : Preventive profile and oral health results (English)
Abstract [no]

Formål: Denne studien ville undersøke tannhelseeffekt ved et intervensjonsprogram for forebygging av karies på klinikknivå.

 

Metode: Et ex post-facto quasi-eksperimentell design ble anvendt til kvantitativ analyse av

data fra journal programmet i Tannhelsetjenesten i Vest-Agder fylke, Norge. Effekten av et

beskrevet intervensjonsprogram for forebygging av karies ble analysert ved sammenlikning

mellom tre klinikker, og delvis med fylkesgjennomsittet for Vest-Agder. De sosioøkonomiske

forhold i klinikkenes tilhørende bydeler ble beskrevet med indekser ut fra gitte kriterier.

Kalibreringsøvelser med røntgenbetrakting på behandlernivå ble utført post hoc for å få en

formening om mulige målefeil og presisjon i det statistiske materialet.

 

Resultat: Planmessig, nytenkende og godt folkehelsearbeid i undersøkelsesperioden 2004– 2008 med tidlig intervensjon på småbarn og praktisk opplæring i effektiv tannpuss, gav betydelig tannhelsegevinst for 5- åringene.

Resultatene var mindre entydige for 12- og 18-åringene. Klinikken med det forebyggende intervensjonsprogrammet var beliggende i et område med bra sosioøkonomisk indeks, hvilket kan forkludre resultatene. Forskjell i diagosenivå mellom klinikerne, viser hvordan helseresultater kan bli påvirket av behandlervariasjon. Ulik diagnose- og behandlernivå blant klinikerne slik det kommer fram i studien, ser ut for å være en vedvarende utfordring for tannhelsetjenesten. 

 

Konklusjon: Studien understreker betydningen av intensiv og målrettet forebyggende intervensjon fra tidlig alder, og at forebyggende arbeid og tannhelseresultat må ses i et langtidsperspektiv. Ulike sosioøkonomiske forhold i et undersøkt område, reduserte mulighetene for å konkludere om helseresultater i denne quasi-eksperimentelle studien.

Abstract [en]

Purpose: This study aimed to evaluate oral health results at the clinical level of an intervention program for the prevention of dental caries.

 

Method: An ex post facto quasi-experimental design was used for quantitative analysis of data using digital records in the Public Dental Health Service of County Vest-Agder, Norway. The effect of a described intervention program for prevention of caries was analyzed by comparing oral health data from the intervention clinic with two other clinics and also with the county average. The socioeconomic conditions in the neighbourhoods served by the clinics were described with indexes containing known criteria. The test of the treatment criteria of salaried dentists was based on post hoc x-rays to estimate the size of measurement error and precise statistical material.

 

Result: Systematic, innovative, and good public health practices conducted during the 2004–2008 study period provided early intervention treatment for toddlers and trained effective tooth-brushing skills, beneficially affected oral health results among 5-year-old children. However, the results were less clear among 12- and 18- years-old children. The clinic with the best oral health results was located in the best socioeconomic area in the study, possibly confounding the results. An unsatisfactory agreement of the diagnostic level between the clinicians showed that practice variations might influence health effects. Differing diagnostic and treatment levels among clinicians shown in the study, poses an ongoing challenge for dental service.

 

Conclusion: This study emphasizes the importance of initiating and maintaining intensive and targeted preventive dental activities in early childhood, and shows that preventive dental treatment and oral health results require a long-time perspective. Varying socioeconomic conditions in the trial area reduced the possibility of concluding health results in this quasi-experimental study.

Place, publisher, year, edition, pages
2011. , 49 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; 2011:9
Keyword [en]
Dental Results, Treatment Level, Socioeconomic Conditions
Keyword [no]
tannhelseresultater, behandlingssnivå, sosioøkonomiske forhold
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3115OAI: oai:DiVA.org:norden-3115DiVA: diva2:718839
Presentation
2011-09-23, 00:00 (Norwegian)
Supervisors
Note

ISBN 978-91-86739-20-1

Available from: 2014-05-23 Created: 2014-05-22 Last updated: 2014-07-07Bibliographically approved

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