title: Reliance on social security benefits by Swedish patients with ill-health attributed to dental fillings: a register-based cohort study.
abstract: BACKGROUND
  Some people attribute their ill health to dental filling materials, experiencing a variety of symptoms. Yet, it is not known if they continue to financially support themselves by work or become reliant on different types of social security benefits. The aim of this study was to analyse reliance on different forms of social security benefits by patients who attribute their poor health to dental filling materials.
  
  
  METHODS
  A longitudinal cohort study with a 13-year follow up. The subjects included were 505 patients attributing their ill health to dental restorative materials, who applied for subsidised filling replacement. They were compared to a cohort of matched controls representing the general population (three controls per patient). Annual individual data on disability pension, sick leave, unemployment benefits, and socio-demographic factors was obtained from Statistics Sweden. Generalized estimating equations were used to test for differences between cohorts in number of days on different types of social security benefits.
  
  
  RESULTS
  The cohort of dental filling patients had a significantly higher number of days on sick leave and disability pension than the general population. The test of an overall interaction effect between time and cohort showed a significant difference between the two cohorts regarding both sick leave and disability pension. In the replacement cohort, the highest number of sick-leave days was recorded in the year they applied for subsidised replacement of fillings. While sick leave decreased following the year of application, the number of days on disability pension increased and peaked at the end of follow-up.
  
  
  CONCLUSIONS
  Ill health related to dental materials is likely to be associated with dependence on social security benefits. Dental filling replacement does not seem to improve workforce participation.
authors.affiliation: Division of Dental Biomaterials and Cariology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. aron.naimi-akbar@ki.se
authors.forename: Aron
authors.initials: A
authors.lastname: Naimi-Akbar
authors.forename: Pia
authors.initials: P
authors.lastname: Svedberg
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.forename: Jan
authors.initials: J
authors.lastname: Ekstrand
authors.forename: Gunilla
authors.initials: G
authors.lastname: Sandborgh-Englund
mesh_terms: D000328:Adult; D003723:Dental Amalgam / Q000009:adverse effects; D003764:Dental Materials / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D018582:Sick Leave / Q000706:statistics & numerical data; D012943:Social Security / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology
chemical_list: D003764:Dental Materials; D003723:Dental Amalgam