Background/Objectives: Fear of pain is common in both dental and health care settings and a factor that clinicians have to consider when examining and treating patients. Fear of dental pain has been described as associated with dental anxiety. The aims were to translate the Fear of Dental Pain Questionnaire-short form (s-FDPQ) into Swedish, to add three items, and to analyze the associations between fear of dental pain, dental anxiety and painful experiences of dental treatment. Methods: This cross-sectional study with a translation and validation component of the s-FDPQ, in a dental setting, included 178 adult individuals. Dental anxiety was measured with the Dental Anxiety Scale (DAS), and single questions captured experiences of dental care regarding pain. The analyses included exploratory factor analysis, internal consistency, intraclass correlation (ICC), and regression analysis (GLM). Results: Psychometric analyses revealed a two-factor solution, treatment and examination dimension, and the modified s-FDPQ (ms-FDPQ) had acceptable internal consistency = 0.87 and ICC = 0.93. Validation analyses using fearfulness of painful dental care and dental anxiety showed r = 0.75 and 0.68, respectively. In the GLM model, there were three significant predictors of fear of dental pain: women, dental anxiety and "fear of dental pain makes it more difficult to undergo dental treatment". Conclusions: The ms-FDPQ shows acceptable validity and reliability as an instrument to measure fear of dental pain concerning several common procedures or treatments in routine dental care. However, the ms-FDPQ needs to be tested in other populations and settings. The results indicate that fear of dental pain is prevalent among adults.

Background/Objectives: Valid and reliable measurement of dental anxiety is of importance in both clinical and research settings. The aim of this study was to adapt and evaluate the Swedish child and adolescent version of the index of dental anxiety and fear (IDAF). Methods: A total of 142 dental patients aged 10-15 completed the four-components (IDAF-4C) and stimulus module (IDAF-S). Convergent validity was evaluated by correlating IDAF with CFSS-DS and a single item question on self-reported dental anxiety (SQDA). Reliability was investigated using Cronbach's alpha, test-retest measurements (n = 16) and interviews. Results: IDAF-4C had a high correlation to CFSS-DS (r = 0.72). IDAF-4C convergent validity to SQDA (r = 0.76) was higher than the correlation between CFSS-DS and SQDA (r = 0.62). Convergent validity between IDAF-S and CFSS-DS was high (r = 0.83). Test-retest for IDAF-4C resulted in a moderate ICC of 0.72 (95% CI 0.37-0.89) and a correlation coefficient of 0.74. The difference in skipped items suggests that IDAF has higher usability than CFSS-DS. Conclusions: IDAF-4C provides a reliable estimate of dental anxiety, while IDAF-S provides clinical insights in individual aspects of dental anxiety similar to CFSS-DS. Further research includes evaluating the specific phobia module of IDAF and include more test-retest participants. The Swedish child and adolescent version of IDAF-4C and IDAF-S show good psychometric properties and usability and may be used as a dental anxiety measurement among children and adolescents.

Objective: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women. Design: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline. Subjects: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave +/- 2 weeks around baseline examination; 493 women had complete data on stress exposure. Methods: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity. Results: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment. Conclusion: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.

Background Dental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity. Methods This study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces. Results The High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables. Conclusion The results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.

Dental resin-based composites used as direct restorative treatment show increased water susceptibility depending on the monomer blend and radiant exposure. The current project aimed to investigate the mechanical properties of two contemporary dental resin-based composites with two different monomer mixtures and suboptimal light-curing after 30 and 90 days of water storage. Forty-eight samples of each material were made. Twenty-four samples were made using 5 s of 715 mW/cm2 irradiance (“low-cure” group) and compared to samples that were light-cured for 20 s with 1317 mW/cm2 (“high-cure” group). The samples were stored either in water or air for 30- and 90-days post-cure. After storage, the samples were tested using piston-on-ring biaxial flexure and analysed with differential scanning calorimetry, thermogravimetric analysis, and scanning electron microscopy. Both materials tested showed a reduction in maximal stress at fracture after 90 days compared to the 30 days samples. Furthermore, the “low-cure” sample groups exposed to water for 90 days underwent surface erosion for both materials. For all samples stored in air, the glass transition temperature (fictive temperature) was equal to the storage temperature (37±2 °C), and a hysteresis peak indicated physical ageing. For one of the materials tested, the “low-cure” samples stored in water showed smaller hysteresis peaks and a double glass transition, indicating a difference in curing between the organic filler particles used in the material and the polymer matrix.

Objective To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. Design Prospective population study. Setting Gothenburg, Sweden, with similar to 450,000 inhabitants. Subjects A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years. Main outcome measures Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60. Results Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts. Conclusions Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.

OBJECTIVE:Development of a new questionnaire, Oral Health-Related Quality of Life - Neurosensory Disturbances after Orthognathic Surgery (OHRQL-NDO), designed to measure the effects of neurosensory disturbance (NSD) on patients' oral health-related quality of life (OHRQL) and to evaluate reliability and validity of this questionnaire. MATERIALS AND METHODS:A questionnaire including 11 items was constructed. Thirty patients with NSD affecting the lower lip and/or chin following orthognathic surgery were included. Convergent validity was assessed by comparing OHRQL-NDO with OHIP-14 and two global questions. Test-retest reliability was assessed by asking the patients to complete OHRQL-NDO at two different occasions with an interval of two to three weeks. RESULTS:The internal consistency, measured with Cronbach's alpha, was 0.84. The test-retest reliability, measured with ICC, was 0.89 (95% CI 0.77-0.95). The correlation between the mean sum score for the OHRQL-NDO and the mean sum score for the OHIP-14 was r = 0.75, using Pearson correlation coefficient. The correlations between the mean total score for the OHRQL-NDO and the global questions 1 and 2 were r = 0.74 and r = 0.72, respectively. CONCLUSIONS:The current instrument OHRQL-NDO is a promising test, but needs further development to better capture the different aspects of OHRQL. Further tests of the questionnaire must follow in other samples to finalize the instrument.

Objective To investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80 years of age. Study design In a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3 mm was calculated. Results A normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR for severely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96 mm) and women (2.92 mm), respectively. The OR for cortical thickness < 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately. Conclusions Among old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.

Objective The aim of this study was to describe and analyze oral health, oral health behaviors, and oral health-related quality of life (OHRQoL) in relation to the level of caries disease among caries-active young adults. Material and methods This study presents data from a sample of young adults ( n = 135) with active caries disease who were enrolled in a clinical, randomized controlled trial. The independent variables of sociodemographics, oral health (gingivitis, plaque), oral health behaviors (such as toothbrushing, dental attendance, sugar-containing sweets and drinks), dental anxiety, self-rated oral health, and OHRQoL were collected. Multinomial logistic regression was used to simultaneously evaluate the associations between the independent variables and caries severity. Results Multinominal logistic regression showed that poor OHRQoL and gingivitis were associated with caries severity in a gradient fashion in accordance with caries disease activity. Also, irregular dental care and frequent consumption of sugary soda were significantly associated with very high caries severity. Conclusions The risk factors related to caries severity among young adults were poor OHRQoL, gingivitis, consumption of sugary soda and irregular dental care attendance, indicating the need for a combination of different interventions specifically health behavior change. Furthermore, these findings may contribute to identifying high caries-risk individuals.

Abstract Objective The aim of the present study was to evaluate the effect of a brief version of the behavioral intervention Acceptance and Commitment Therapy (ACT) on reducing gingivitis and plaque levels after 18 weeks. Materials and methods One hundred thirty‐five caries‐active young adults (18–25 years of age), recruited from two public dental clinics, participated in this parallel group randomized control trial (RCT). Participants in the intervention (n = 67) received two ACT sessions in combination with standard information on oral health, and participants allocated to the control group (n = 68) received standard information only. Gingivitis and plaque levels were recorded at baseline and at the 9‐ and 18‐week follow‐ups. The effect of the intervention versus standard information alone was analyzed by intention‐to‐treat and per protocol, applying the General Linear Model (GLM). Exploratory analyses for the intervention and control groups were conducted to evaluate the effect of gender and smoking habits on the gingivitis and plaque outcome. The CONSORT guidelines for RCT were followed. Results A significant decrease in gingivitis and plaque levels was observed over time, irrespective of treatment allocation. However, the ACT intervention was not significantly more effective at reducing gingivitis and plaque scores than standard information alone, even though the intervention participants had maintained their improvement to a greater extent. The exploratory analysis revealed that females improved their gingivitis and plaque levels significantly more than the males in the intervention group (p = 0.025 for gingivitis and p = 0.013 for plaque). Conclusion A brief ACT intervention was not proven to be more effective than standard information alone at improving oral health in a sample of young adults with poor oral health. However, ACT seems to have a positive effect on oral health among females. (TRN ISRCTN15009620).

Þessi grein dregur fram og útskýrir fræðileg hugtök í tengslum við ójöfnuð heilbrigðis ásamt því að fjalla um helstu atriði sem brúa bilið milli þjóðfélagshópa þegar kemur að munn- og tannheilsu. Ójöfnuður heilbrigðis er alþjóðlegt vandamál. Félags- og efnahagslegir þættir á borð við tekjur, menntun og starf hafa mikil áhrif á munn- og tannsjúkdóma hjá fullorðnum. Auk þess hafa áhrif félagslegra þátta á munn- og tannheilsu barna komið fram víða. Kannanir sýna að ójöfnuður munn- og tannheilsu er langvarandi vandamál. Félagsfræðikenningar hafa lagt sitt af mörkum við að auka skilning á félagslegum ójöfnuði. Félagsfræðingar sem aðhyllast átakakenningar (e. conflict sociologists) telja efnahagslega þáttinn vera meginorsök stéttaskiptingar og skorts innan samfélaga. Átakakenning leggur áherslu á vald og tengsl þess við framlegð innan samfélaga. Virkni- eða samstöðukenning (e. functionalist or consensus theory) bendir á upphefðina sem fylgir sterkri þjóðfélagsstöðu, samfélagslegri viðurkenningu og aðdáun annarra. Fjórar meginaðferðir hafa verið notaðar til að greina hugtök eins og stétt eða félags- og efnahagslega lagskiptingu. Samstöðukenning mælir með orðstírsaðferð (e. reputational method), sjálfsmetinni samfélagsstöðu (e. self-location) og aðferð með samsettum stuðli (e. composite index method) en átakakenning hallast að hlutlægri aðferð. Kerfislægir og sálfélagslegir þættir ásamt pólitískum þáttum leiða til ójöfnuðar heilbrigðis. Mismunandi lifnaðarhættir og áhættuhegðun eru mikilvægir miðlunarþættir. Þegar reynt er að skilja hvernig félagslegur ójöfnuður virkar er hægt að nota líkan sem Alþjóða heilbrigðismálastofnunin (WHO) þróaði. Ójöfnuður heilbrigðis er óréttlátt fyrirbæri en með réttri blöndu af stefnumálum stjórnvalda er hægt að draga úr honum. Alþjóða heilbrigðismálastofnunin viðurkennir lýðheilsumarkmið sem lönd þurfa að tileinka sér í því skyni að rjúfa félagslegan ójöfnuð heilbrigðis og lýsir helstu nálgunum sem hægt er að beita til að draga úr ójöfnuði munn- og tannheilsu.

Main topics The oral health impact of social determinants affecting all population groups is known universally. Variations exist by income, education, occupation, ethnic minority groups, environmental conditions, gender, families and children, and generations spanning from children to older people. Inequality in oral health tends to last from early childhood to older age. Social diversities in oral health and general health are comparable due to shared causal mechanisms. The financial burden related to use of private dental health services plays a powerful role in creation of inequality. Structural, psychosocial and political determinants are drivers in creation of inequalities. WHO give emphasis to intervention against social determinants in health; inequalities in health are unfair and can be reduced by the right mix of government policies.

Background The aim of this systematic review was to evaluate the assessment of trabecular bone patterns in dental radiographs, for fracture risk prediction, compared with the current diagnostic methods. Methods The PRISMA guidelines were followed. According to predefined inclusion criteria (PICO), literature searches were focussed on published studies with analyses of trabecular bone patterns on intraoral and/or in panoramic radiographs, compared with Dual X-ray Absorptiometry (DXA) and/or Fracture Risk Assessment Tool (FRAX), with the outcomes; fracture and/or sensitivity and specificity for osteoporosis prediction. The included studies were quality-assessed using the QUADAS-2 tool and the certainties of evidence was assessed using the GRADE approach. Results The literature searches identified 2913 articles, whereas three were found to meet the inclusion criteria. Two longitudinal cohort studies evaluated the use of trabecular bone patterns to predict bone fractures. In one of the studies, the relative risk of fracture was significantly higher for women with sparse bone pattern, identified by visual assessment of dental radiographs, and in the other study by digital software assessment. Visual assessment in the second study did not show significant results. The cross-sectional study of digital analyses of trabecular bone patterns in relation to osteoporosis reported a sensitivity of 0.70 and a specificity of 0.69. Conclusion Based on low certainty of evidence, trabecular bone evaluation on dental radiographs may predict fractures in adults without a prior diagnosis of osteoporosis, and based on very low certainty of evidence, it is uncertain whether digital image analyses of trabecular bone can predict osteoporosis.

The aim was to study general dental practitioners' knowledge and attitudes on pain and pain management in children and adolescents, using a multidimensional questionnaire. There is little information on dentists' views on pain in children. The research question was how attitudes and knowledge may correlate to the dentists' age, sex, years of professional experience, the proportion of working time devoted to treating children and adolescents, as well as being a parent. At the time of the study, 387 general dentists working for the Public Dental Service participated in a web-based, multidimensional validated questionnaire holding the categories (A) views on the care of children in pain, (B) physiology, (C) pain alleviation, (D) medication, (E) sociology/psychology, (F) Pain assessment instruments and methods, (G) non-medication methods of pain alleviation, and (H) documentation of pain management. The age categories were given as; below 25, 25-35, 36-45, 46-55 years, and older than 55 years of age. 71% of the responders were female. The dentists' age cohort, as well as the years of professional experience, tended to make a difference as to the pain interventions in children and adolescents (P < 0.03). The female dentists, in comparison to the male dentists, conveyed different pain treatment strategies (P < 0.03). The proportion of working time devoted to treating children and adolescents, as well as being a parent, did not show significant differences regarding pain strategies. Associations were observed between the age of the dentists studied, the number of years as professionals and the knowledge and attitudes that benefit children's pain treatment. Being a parent was not significant. In this studied group, female dentists displayed significantly more care regarding pain management, than did their male colleagues. Furthermore, the study highlighted the need for a short questionnaire, user-friendly yet with retained multidimensionality.

Dental anxiety and dental phobia are still prevalent among adult individuals and should be considered a dental public health issue. Dental anxiety/phobia is often described as a vicious cycle where avoidance of dental care, poor oral health, and psychosocial effects are common features, often escalating over time. Treatment should include therapy for dental anxiety/phobia and oral diseases. This paper discusses aetiology, prevalence, and diagnosis of dental anxiety/phobia and, in detail, presents a conceptual treatment model at the Dental Fears Research and Treatment Center in Gothenburg, Sweden. In addition, based on systematic reviews, evidence-based treatment for dental anxiety is revealed including the interdisciplinary approach between psychology and dentistry.

OBJECTIVES:The radiographic trabecular pattern on dental radiographs may be used to predict fractures. The aim of this study was to analyze longitudinal changes in the mandibles of 145 females between 1980 and 2005. METHODS:Panoramic radiographs were obtained in 1980 and 2005. On 290 radiographs, regions of interest (ROIs) were selected in the ramus, angle and body. In all ROIs, the orientation was measured in 36 directions with the line frequency deviation method. The effects of ageing were analyzed for the fracture and the non-fracture groups separately. RESULTS:During the follow-up, 61 females suffered fractures of the hip, wrist, spine, leg or arm. The fracture and non-fracture groups displayed dissimilar age changes in each investigated ROI. All significant changes pertained to increasing values of line frequency deviation. With increasing age, the trabecular network in the mandible lost details and the trabeculae became more aligned in their main direction. In the "ramus", the alignment was to the 110-120˚ axis, parallel to the posterior and anterior ramus border. In the "angle", the alignment was to the 135-150˚ axis, parallel to the oblique line, and in the "body" ROI to the 150-175˚ direction, approximately parallel to the occlusal plane and inferior cortex. CONCLUSION:Most changes were consistent with the notion that the bone aged less severely in the non-fracture group. In the fracture group, the findings indicate that bone loss leads to redistribution of the remaining bone tissue in such a way that the trabeculae are accentuated perpendicular to the principal loading.

Purpose The aim of this longitudinal prospective study was to evaluate if schoolchildren with large overjet experience a greater risk of traumatic dental injuries (TDI) compared to children with normal or small overjet. Methods A sample of children aged 6‑13 years was prospectively evaluated after 1 year: from the initial sample, data concerning trauma cases of 1413 children were collected to determine the number and types of injuries, the influence of overjet on the risk of TDI, and the relationships between trauma, age, and gender. Results The observed prevalence of trauma was higher for boys, with the largest frequency between the ages of 8 to 12 years: 67.9% of all injuries were hard tissue injuries and 32.1% subluxation and luxation injuries. Children with an overjet of 6 mm or more showed a statistically increased risk of getting trauma [RR = 3.37 with CI (1.81; 6.27)]. Conclusion In this prospective study, overjet stood out among variables as the most significant risk factor of TDI: an increased overjet of 6 mm or more had a major impact on the risk of trauma, which would speak in favor of early orthodontic correction of an increased overjet to reduce the prevalence of dental trauma

Dental anxiety is a common condition with severe consequences for oral health and health-related quality of life. The aim of this study was to evaluate the recently developed self-report scale Index of Dental Anxiety and Fear (IDAF-4C+) in adults with severe dental anxiety. A sample of 147 adults (age 20-71 yr) with severe dental anxiety completed a questionnaire including the IDAF-4C+ and three other dental anxiety scales. In a clinically assessed subgroup (n = 93), 95% had an International classification of diseases and related health problems 10th version (ICD-10) diagnosis of specific phobia for dentistry. Agreement between the scales was analysed using Spearman's correlation, the Kappa measure of agreement and the intraclass correlation coefficient. The agreement of dental phobia according to the IDAF-4C+ phobia module and the ICD-10 was very low (ĸ = 0.02). The anxiety and fear module of the IDAF-4C+ showed acceptable agreement with the other scales (rs 0.69-0.75; ICC 0.90, 95% CI 0.87-0.93). We conclude that the IDAF-4C+ offers more information to clinicians and researchers than the older dental anxiety scales, but the phobia module needs further development.

The water sorption and solubility of two polymer resin-based dental composite materials were assessed in order to evaluate the effects of immediate post-cure water exposure on the water sensitivity of the composites. Each material was tested with two different light curing setups. The radiant exposure of the two curing setups differed by a factor of 5. After exposure to water and subsequent drying, the Knoop surface hardness was measured. The change in the degree of conversion in both water and air storage medium within the first 24 h after curing was monitored by Raman spectroscopy. No significant differences in the degree of conversion were detected 24 h after curing. Samples exposed to the lower irradiation dose showed higher solubility and a lower surface hardness than the samples exposed to the higher irradiation dose. Early exposure to water did not cause detectable differences in the ongoing polymerization process. Increase in radiant exposure reduced the fraction of unbound constituents and increased the crosslink density, thereby reducing the plasticity of the material.

Background There is a need for effective behavioural interventions in dentistry. This paper presents an innovative behavioural intervention for young adults with dental caries, in an interdisciplinary collaboration between dental personnel and licensed psychologist in general dental care. The intervention has been evaluated in an RCT, with positive effects on oral health behaviour. Method The intervention, Acceptance and Commitment Therapy (ACT), a recent form of cognitive behaviour therapy (CBT), was adapted to young adult patients (18–25 years of age) with high dental caries activity. Results The intervention included two individual sessions, provided by a clinical psychologist at general dental clinics. The rationale for selecting ACT as the theory base is presented, together with the treatment manual and a case illustration. Conclusions ACT may be a promising alternative for behavioural interventions in dentistry for patients with oral diseases, specifically dental caries. Interprofessional collaboration between psychologists and dental personnel opens up for new possibilities to help and treat patients with various health issues in public dental care. Trial registration TRN ISRCTN15009620 www.isrctn.com , retrospectively registered 14/03/2018.