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The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50,65 and 75 answered a questionnaire and were also clinically and radiographically examined. The number of edentulous individuals decreased from 15% in 1983 to 3 % in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15 % in 1983 to 2 % in 2008. Individuals with moderate periodontitis decreased from 45 % in 1983 to 16 % in 2008. Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated. This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

ObjectiveEpidemiological 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. MethodsFour 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. ResultsThe 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. ConclusionModerate ABL and calculus visible on radiographs significantly increased between 2008 and 2013. Smoking was the strongest factor associated with ABL overall.

Objective. The aim of this study was to investigate the prevalence of dental caries in an adult population using four different cross-sectional studies over a 30-year period and to assess its possible associations with socio-economic and socio-behavioral factors. Materials and methods. Four cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 1983, 2003, 2008, and 2013. Random samples of 1012–2243 individuals, aged 20–85 years, who answered a questionnaire about socio-economic and socio-behavioral factors, were radiographically and clinically examined. Results. The proportion of individuals with at least one decayed surface (DS) was 58% in 1983 and significantly lower, 34% in 2008 (p<0.05) and 33% in 2013; the mean number of DS was 2.0 in 1983 and 1.1 in 2013 in the age group 35 to 75 (p < 0.05). In the age group 85, the mean number of DS was 1.2 in 2008 and 2.4 in 2013. Adjusted for age and number of teeth, irregular dental visits, limited financial resources for dental care, smoking, education below university, male gender, daily medication, and single living were positively and statistically associated with manifest caries. Conclusion. The declining trend in the prevalence of manifest caries seems to be broken. In the oldest age group mean number of DS was higher in 2013 compared with 2008, indicating a possible beginning of an increase.  This needs special attention as this group increases in the population, retaining natural teeth high up in age. Manifest caries was found to be associated with socio-economic and socio-behavioral factors.

Objective. The aim of the present study was to investigate attitudes to, and demands of dental care, and to assess possible associations with socioeconomic and clinical variables over a period of ten years. A further aim was to investigate the association between OHRQoL assessed by OIDP, and socioeconomic, dental care habits, smoking and oral status. Materials and methods. Three cross-sectional epidemiological studies were performed in the county of Dalarna, Sweden, in 2003, 2008 and 2013. Random samples of 1542–2244 individuals, aged 30-85 years, who answered a questionnaire about socio-economic, socio-behavioral factors, oral health-related quality of life were radiographically and clinically examined. Results. The importance of preventive treatment, regular recalls, meeting the same caregiver as on previous visits, and information on treatment cost have become less important. Difficulty in booking treatment time was reported by 17% in 2013, compared with 11% in 2003 and 12% in 2008 (p<0.05). In individuals with alveolar bone loss, meeting the same caregiver as on previous visits was important (p<0.05). In individuals with temporomandibular disorder (TMD) and manifest caries, information on treatment cost was important, while prevention became less important (p<0.05). Oral impact on daily performance (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 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, and difficulty in booking treatment time was reported more frequently in 2013. Oral impact was found to be associated with irregular dental visits and limited economy for dental care, less than 20 remaining teeth, TMD and manifest caries.