title: Impact of dental health care on dental health of children with long-term diseases: a nested case-control study.
abstract: The objective was to study dental health among nine-year-old long-term ill and disabled children and their matched controls using DMFT/dmft-indices (decayed-missing-filled-teeth, of both permanent and deciduous teeth); to analyze similarities and differences of their family factors; the children's dental health habits which include dietary factors; to assess capabilities of the health care personnel in the identification of the risk groups and in the provision of services; and finally to investigate family satisfaction with the dental health care services provided. One dentist (M-L M) routinely carried out the clinical examinations of the children using the DMFT(dmft)-index. Only cavities extending to dentin were included in the DMF and dmf indices. X-rays were also used. It was found that less than half of the children (46%) had healthy teeth (DMFT and dmft both = 0), with 41% among the study group and 51% among the controls. The DMFS index of the longterm ill children was slightly, but not significantly greater than that of the controls, and these children used dental health care services more but their families were less satisfied with the services. The long-term ill children had less orthodontic care than the controls although they needed it more frequently, and they had a designated candy day significantly more often than the controls. Special diets were associated with long-term ill children, as were the sociodemographic factors of marital status, divorce, or stepfather present. No significant differences existed between the groups in toothbrushing and the use of fluoride products. In the status and health of teeth as measured with the DMFT/dmft indices, there were no statistically significant differences between the group of the long-term-ill children and healthy controls. Estimation of the focusing of care was considered successful concerning dental health, but resource limitations emerged and contributed to parents not being satisfied with the frequency dental care services offered.
authors.affiliation: Dental Health Care Clinic and Public Health Center of Turku, Department of Public Health University of Turku, Finland. malema@utu.fi
authors.forename: M L
authors.initials: ML
authors.lastname: Mattila
authors.forename: P
authors.initials: P
authors.lastname: Rautava
authors.forename: P
authors.initials: P
authors.lastname: Paunio
authors.forename: L
authors.initials: L
authors.lastname: Hyssälä
authors.forename: H
authors.initials: H
authors.lastname: Helenius
authors.forename: M
authors.initials: M
authors.lastname: Sillanpää
authors.forename: A
authors.initials: A
authors.lastname: Ojanlatva
mesh_terms: D016022:Case-Control Studies; D002648:Child; D003258:Consumer Behavior; D004245:DMF Index; D017742:Dental Care for Chronically Ill; D003731:Dental Caries / Q000453:epidemiology*; D004032:Diet; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008310:Malocclusion / Q000453:epidemiology; D017533:Marital Status; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data; D009909:Oral Health; D010290:Parents; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000706:statistics & numerical data