Objective: This study aimed to gain knowledge of general oral health preventive measures with a specific focus on root caries preventive measures for patients ≥65 years old, performed by Norwegian dental hygienists in public and private dental health services. A secondary aim was to investigate differences and challenges in prevention practices. Materials and methods: An electronic survey was conducted among the sample in 2022. A total of 365 dental hygienists were included in the analyses. Chi-square tests were used to analyze differences between private and public dental hygienists regarding preventive measures and perceived challenges. Results: The most frequently reported general oral health preventive measures were oral hygiene instruction, professional tooth cleaning and scaling. Oral hygiene instruction and application of fluoride varnish were the most performed root caries preventive measure, and reduced manual dexterity in patients was the most perceived challenge. Public dental hygienists perceived challenges to a greater extent than private dental hygienists, particularly related to reduced mobility and ergonomic difficulties in patients. Conclusion: This study confirms dental hygienists’ important role in oral health promotion and showed that Norwegian dental hygienists performed a wide range of preventive measures for patients ≥65 years old. However, a number of challenges were identified in the preventive work.

Objectives: The objective of this study was to describe the knowledge, opinions and practices about the defective restoration (DR) management of French general dental practitioners (GDPs). Methods: A cross-sectional, online survey-based study was carried out amongst 378 GDPs -members of the dental practice-based research network in France (ReCOL). Bivariate comparisons were made using Fisher & rsquo;s exact test to assess the association of the respondent characteristics (age, gender...) with the decision to repair DRs, and responses to clinical cases. Results: The response rate was 82.9%. 50.4% of the respondents declared they at least sometimes consider DRs repair in their clinical practice instead of DRs total replacement. For the 89.8% who at least rarely repaired DRs, the main characteristic determining the therapeutic strategy was the defect size (71%, mainly inclined to repair small defects), followed by the defect type (marginal defect or crack for more than 60% of the respondents) and the material of initial restoration (composite for 63.5%). When shown clinical photographs illustrating DRs, most of respondents proposed a replacement with inlay/onlay or crown. Conclusions: This study indicates that a significant proportion of French GDPs do not make sufficient use of DR repair on a routine basis. A lack of knowledge of the concept seems to explain at least part of this situation. Collective and individual efforts from the profession are still needed to promote DR repair and therefore more often apply MinimalIntervention Dentistry. Clinical significance: This survey shows that MID is not yet sufficiently used in routine practice in France regarding DR management. Further efforts (continuing education toward MID, public funding revaluation for MID stra-tegies...) are needed to help GDPs to implement MID into everyday practice.

Introduction: The aim of this cross-sectional study was to explore the degree whereby dentists differentiate between repair versus replacement for failed restorations. A random selection of adult patients from North Norway was chosen from the larger Troms & oslash; 7 study. Methods: A randomized sample of 3,653 persons (11.5% of the total number of individuals invited to the Troms & oslash; 7 study, 51.5% women, aged 40-93 years) were included. Based on FDI's clinical criteria for the evaluation of restorations - 2010, 17 calibrated dentists evaluated patients by clinical and radiographical pictures in a specially designed software developed for this purpose. The dental practitioners' opinions gave rise to the reported treatment decisions. Descriptive statistics and multivariable multilevel mixed-effect logistic regression models (STATA 17/SE) were performed. Results: The participants' DMFT values ranged from 0 (0.9%) to 24 (8.8%) (median DMFT 21.3, mean 20.0). A total of 90.062 teeth (24.7 teeth per patient) were assessed. Re-treatment suggestions were made for 3,006 restorations, i.e., an average of 3.3% re-treatments. Of these, 25.3% (n = 814) were suggested for repair and 74.7% (n = 2,192) for replacement. Dental treatment was suggested for 1,597 patients and varying from 1 to 14 suggestions per patient. Secondary caries (37.6%) and restoration fracture (15.2%) were found to be most frequently used indications for re-treatment, surface properties the least. No significant difference was found between assessing dentists based on sex or age. Clustering by dentist level was checked using intra-class correlation coefficients, demonstrating that 16% of the variance in suggestions for restoration re-treatment was explained at the dentist level. Thus, a wide range of treatment suggestions was noted among the dentists. Conclusion: Need for restoration revision seems low in North Norway. There is a tendency towards larger and more indirect restorations, and the diagnosis of secondary caries is still a matter of uncertainty.

Objective: This study aimed to quantitatively investigate the accumulation of Streptococcus mutans biofilm on enamel and root surfaces and assess the amount of biofilm removal using (1) experimental toothpaste and (2) water, in a closed system of flow chamber. Methods: Eight sound premolars were embedded in epoxy resin and polished with silicon carbide grinding papers to display enamel and root surfaces. To mimic biofilm, cultures of Streptococcus mutans were prepared and grown on the tooth surfaces over night before they were exposed to either 2 liters of Milli Q water or 2 liters of 40% experimental toothpaste in the flow chamber. The amount of biofilm was measured and quantified in Fluorescence microscopy. Mean fluorescence values were recorded and analysed using Microsoft® Excel® (MS Excel 2016). Results: The ability to grow biofilm was equally present at both the enamel and root surfaces. The use of water and 40% experimental toothpaste showed a significant reduction of areas covered with biofilm on both enamel and root dentin in comparison to untreated surfaces (p < 0.01). Significantly more biofilm was removed from enamel compared to root surfaces when treated with either water and toothpaste (p < 0.01). Slightly less biofilm was removed by the use of water compared to toothpaste on both enamel and root dentin surfaces, although the differences were not statistically significant. Conclusion: The results indicate that less biofilm is removed from the root surfaces than enamel by the use of water and 40% experimental toothpaste in flow chamber. Assessing oral biofilm accumulation and monitoring biofilm formation on enamel and root dentin surfaces give oral health professionals important directions that could strenghten the significance of dental caries prevention. Improving older individuals’ oral hygiene practices should therefore be considered an important measure to prevent root caries.

Hovedbudskap For single kroner produsert av laboratorier både i Norge og i utlandet avdekket denne studien store mangler i funksjonelle egenskaper, så vel som kjemisk sammensetning, og hvorvidt samsvarserklæringen var fullstendig eller i det hele tatt inkludert. Det er tannlegenes ansvar å velge egnet legering, og å kontrollere i samsvarserklæringen at de har fått det de har bestilt. Det er viktig at opplysningene som skal være med i samsvarserklæringen er korrekt, og at opplysningene oppbevares i pasientens journal, slik at det kan etterspores hva som er brukt av materialer, i fall det skulle være behov for en utredning av allergi eller andre helsemessige plager. For å sikre at pasientene får trygge og velfungerende materialer er det behov for økt bevissthet både hos tannlegen og tannteknikeren om viktigheten av kvaliteten på den medfølgende informasjonen for tannteknisk arbeid.

Aim: We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents’ own educational plans, the parents’ educational level(s) and tobacco habits were estimated. Methods: In this cross-sectional questionnaire-based study, 1465 patients aged 18–20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. Results: Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. Conclusions: These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents’ influence on their children’s tobacco use.

ObjectiveUse of snus, a moist, smokeless tobacco product, may lead to local changes in the oral mucous membrane in the area where the snus is placed. It can also cause irreversible gingival retraction. This cross-sectional study aimed to investigate the relationship between use of snus, oral mucosal lesions (snus induced lesions) and gingival retractions among adolescents in Norway.Material and MethodsAll 18-20 years olds visiting public dental health clinics in the south-eastern region of Norway between October 2015 and December 2016 were invited to participate. All participants (n = 1363) filled in an electronic questionnaire before a clinical examination. Of these, 216 used snus daily.ResultsSnus induced lesions were observed in 79.2% of daily snus using participants. In adjusted regression analyses, the odds of having a more severe lesion as opposed to a less severe lesion were 1.12 times greater for each additional box of snus used in a month (p < .01). Women were 46% less likely to have a severe lesion than men (p = .03). Gingival retractions were observed in 18.4% of the participants. The odds for dental retraction were significantly higher by 34% for each year of snus use.ConclusionsMost of the adolescents using snus had snus induced lesions, whereas approximately one-fifth had gingival retractions. The severity of the lesion and gingival retraction increased with the amount of snus boxes used and the duration of the snus use, respectively.

Objectives To investigate Finnish dentists' knowledge on and means of recording, detecting and diagnosing erosive tooth wear (ETW). Treatment options and possible differences in treatment decisions between general and specialized dentists were also evaluated. Materials and methods An electronic questionnaire was sent by e-mail to 3664 Finnish dentists. Respondents' gender, age, work experience, field of specialty, and practice location were requested. The questionnaire also included a patient case where the dentists were asked about their choice of treatment. Statistical analyses were performed using means, proportions, and cross tabulations. Results Response rate was 24% (n = 866). Almost all respondents (98.0%) recorded ETW in patient files, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. Use of carbonated beverages (84.3%), energy drinks (57.0%), and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patient's dietary history while 1.9% evaluated saliva secretion rate. When asked about treatment decisions of ETW patients, the differences between general dentists and specialized dentists were not as obvious as hypothesized. Conclusions This study suggests that the Finnish dentists who participated in this survey are able to detect and/or diagnose erosive tooth wear, but there is variation in recording it. The differences in treatment decisions between general dentists and specialized dentists seem to be moderate. The treatment practices for ETW are not established and further research to create clinical guidelines seems to be needed.

The aims of the study were to investigate functional and esthetic properties, the composition of the alloy, and the content of hazardous elements of single dental crowns with metal skeleton and fired porcelain. Epoxy models made from full mouth impressions taken of a patient with a crown preparation of the right maxillary first permanent molar were used for production of identical polyether impressions, which were distributed to dentists in Norway. The dentists sent the impressions to their regular dental laboratories. All 55 crowns collected were anonymized and examined. Of the crowns received, 35 were made in Norway, 12 were imported, and 8 were of unknown origin. The evaluation of functional properties revealed that 50% of the Norwegian, 42% of the imported, and 25% of the unknown-origin crowns were considered unacceptable. The composition of the alloy was not in accordance with that stated by the manufacturer for 17%, 13% and 20% of the crowns, where this information was provided. The lead content of the alloy exceeded the limit set by theISO 22674: 2016for 18% of the crowns in total. The statement that shall follow the work according to EU-regulations was not complete for approximately 75% of the works received.

The aim of this study was to evaluate the dentine bond strength of a novel fast-setting calcium silicate cement (Protooth) versus a calcium hydroxide-based cement (Dycal), a calcium silicate cement (ProRoot MTA), and a glass ionomer cement (Ketac-Molar). Mid-root dentine slices of 1 mm thickness were obtained from human maxillary incisors. After enlarging the lumen of the canal to 1.3 mm, the cavities were randomly filled with test materials. Samples were immersed in physiological-like solution. The push-out bond strength was tested on days 1, 28, and 180 (n = 12). Failure types of bonding were determined using a stereomicroscope. We analysed the data using linear regression. Dycal and day 1 were considered as reference for cement type and assessment time, respectively. Protooth, Ketac-Molar, and ProRoot MTA demonstrated higher push-out bond strength than Dycal. The push-out bond strength in the Protooth group increased on day 28 and 180. The bond strength of Ketac-Molar was significantly reduced on day 28. Dycal showed a significant decrease in bond strength on day 180 compared with that on day 1 and 28. Mixed failure was the dominant failure type. Protooth bonding to dentine was increased with time, in contrast to that of ProRoot MTA, Dycal, and Ketac-Molar, as a function of time.

Dental health care professionals have the opportunity to play a key role in tobacco prevention and cessation among adolescents. Snus use has increased in Norway, especially in the age group 16-24, whereas there has been a decline in smoking. This study investigated attitudes and activities related to snus prevention among dental health care professionals working in the Public Dental Service (PDS) in south-eastern Norway. A web-based survey with a total of 557 dentists and dental hygienists in seven counties in Norway, with a response rate of 53.5%, was carried out in 2017. Dentists' and dental hygienists' activities regarding preventive snus use intervention were analysed using the chi-square test. Intervention was measured with a score (1-5) based on four questions. Bivariate and multivariate linear regression analyses were used to investigate the associations between the explanatory variables of attitudes/activities and the outcome intervention variable. Approximately 87% of the dentists and 58% of the dental hygienists were not familiar with the "minimum intervention method" for tobacco prevention and cessation. Dental hygienists were most active in informing and supporting their patients in prevention and cessation of snus use. The PDS is an underutilized arena for tobacco prevention and cessation among adolescents, and the intervention potential is particularly high among the dentists.

Dental erosive wear (DEW) is common among children and adolescents, and a survey of Icelandic children showed that 30.7% of 15-year-olds were diagnosed with the condition. Objective. To gain knowledge about dental practitioners' experiences, opinions, and treatment decisions. Materials and Methods. A precoded questionnaire, previously used among Norwegian dentists, was sent electronically to all dentists in Iceland (n = 341). Results. The response rate was 64.2%, and 58% of dentists were male. More than half of the clinicians (54%) thought that prevalence had increased the last 10-15 years, and 67% reported it to be more common in male. Most (96%) recorded presence of DEW, but only 4% used a detailed scoring system. Lesions were mostly on occlusal surfaces of first mandibular molars (73%), on palatal in upper anterior teeth (61%), and on occlusal of maxillary first molars (36%). Most dentists (74%) reported a probable cause, e.g., high consumption of carbonated beverages (98%), acidic juices (68%), sport drinks (58%), reflux (54%), and eating disorders (20%). Dietary history was often recorded by 38%, and 65% never measured saliva. Most of the dentists (88%) treated patients themselves, and half of them preferred prevention with high fluoride and resin sealants. While some dentists wanted to restore teeth more invasively, most considered to restore with a filling. Conclusion. Icelandic dentists seem to be well educated for diagnosis and treatment of dental erosion, and dentists are aware of a minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for patients with DEW, both in a short perspective and long perspective. At present, little is known about their knowledge and treatment approach, and there is no standard treatment which can be recommended. Therefore, the present study investigated dental practitioners' treatment decisions, as well as knowledge, experiences, and awareness of DEW.

Objective: To investigate the longevity and reasons for failure of posterior cast Class II gold inlays and onlays among a group of Norwegian adults. The term inlay was used for both inlays and onlays. Methods: A cohort of 138 patients regularly attending a general practice for check-up were examined in 2016. The patients had a total of 391 posterior gold inlays placed in the period 1970-2015. The inlays were categorized as successful, repaired or failed. Reasons for failure were classified as either "secondary caries", "fractures", "lost inlay" or "other". Participation was voluntary and no compensation was given. Results: The mean age of the patients at placement was 50.8 years (SD: 12.7 yr). Most gold inlays were placed in molars (85.9%) and 14.1% in premolars; 49.4% of the inlays were in the maxilla and the 50.6% in the mandibula. Average length of follow-up was 11.6 years (range: 1-46 years, SD: 7.9); 82.9% were classified as successful, 10.7% as repaired and 6.4% as failed. Reasons for failure were secondary caries (41.3%), lost inlay (25.4%), fractures (23.8%) and other (9.5%). Mean annual failure rate (AFR) was 1.69% for repaired and failed inlays combined. However, if repaired inlays were considered as success, the AFR decreased to 0.57%. Multi-level Cox regression analyses identified low age of the patient and high number of restored surfaces as risk factors for failure. Conclusion: The present retrospective clinical study demonstrated an acceptable annual failure rate for Class II cast gold inlays.

Background: The study aimed to explore the variability between the treatment decisions dentists make for MIH-affected teeth.Methods: In 2009, a pre-coded questionnaire was sent electronically to all dentists employed by the Public Dental Service (PDS) in Norway (n = 1061). The questions were related to treatment of MIH-affected teeth, including three patient cases illustrated by photographs and written case descriptions.Results: Replies were obtained from 61.5 % of the respondents after two reminders. In the first case, showing a newly erupted first permanent molar with moderate hypomineralization and no disintegration of the surface enamel, the preferred treatment among the majority of the respondents (53.5 %) was application of fluoride varnish, while 19.6 % would seal the fissure with GIC material. In the second case, showing a severely damaged first permanent molar in a six year old child, more than half of the respondents (57.5 %) would place a conventional glass ionomer restoration and 10.5 % would use a stainless steel crown (SSC). In the third case, showing a severely damaged permanent first molar in a nine year old child, 43.8 % of the dentists would remove only the parts with soft, damaged enamel; while 35.2 % would remove more and 21.0 % would remove all affected enamel and leave the cavity margins in sound enamel.Conclusions: The survey shows that there is a wide disparity between clinicians' views on how MIH affected teeth should be treated. In a severely affected first permanent molar, only a minority of dentists would remove as much tooth substance as needed to get the full benefit of the acid etch pattern in sound enamel.

Objectives: This study aimed to investigate dentists' exposure to curing light and to obtain information about the dentists' knowledge on practical use and technical features of their curing lights as well as their safety awareness.Methods: A pre-coded questionnaire was sent electronically to all dentists (n = 1313) in the Public Dental Service (PDS) in Norway in 2015.Results: The Response rate was 55.8%. The dentists spent on average 57.5% of their working days placing restorations, ranging from 1 to 30 (mean 7.7, SD 3.6) restorations per day. The average length of light curing one normal layer of composite was 27 s. The longest individual mean curing time per day was about 100 times higher than that of the lowest. The mean curing time for lamps of the lower reported irradiances was similar to the time representing exceedance of international guidelines for limit values for blue light to the eyes. Almost one-third of the dentists used inadequate eye protection against blue light. The odds of using adequate eye protection were significantly higher among young dentists (p < 0.01). The majority of the respondents (78.3%) were unaware of the irradiance value of their curing lights, thus rendering the curing time uncertain. More dentists in this group did not perform regular maintenance of their curing lights compared with all respondents (17.1% vs. 3.3%, p < 0.01).Conclusions: This study revealed considerable variations among Norwegian dentists in the Public Dental Service with respect to performance of light curing of restorations, safety awareness and technical knowledge of the curing light.Clinical significance: The questionnaire study identifies specific knowledge gaps among Norwegian dentists with regard to curing lights and use of personal protection. Today's dependence on technology in dentistry necessitates that the operator possesses knowledge of essential technical specifications and safe use of devices and instruments routinely used in dental treatment. (C) 2017 The Author(s). Published by Elsevier Ltd.

Amalgam was banned as a dental restorative material in Norway in 2008 due to environmental considerations. An electronic questionnaire was sent to all dentists in the member register of the Norwegian Dental Association (NTF) one year later, to evaluate dentists' satisfaction with alternative restorative materials and to explore dentists' treatment choices of fractured amalgam restorations. Replies were obtained from 61.3%. Composite was the preferred restorative material among 99.1% of the dentists. Secondary caries was the most commonly reported cause of failure (72.7%), followed by restoration fractures (25.1%). Longevity of Class II restorations was estimated to be ≥10 years by 45.8% of the dentists, but 71.2% expected even better longevity if the restoration was made with amalgam. Repair using composite was suggested by 24.9% of the dentists in an amalgam restoration with a fractured cusp. Repair was more often proposed among young dentists (p < 0.01), employees in the Public Dental Service (PDS) (p < 0.01) and dentists working in counties with low dentist density (p = 0.03). There was a tendency towards choosing minimally invasive treatment among dentists who also avoided operative treatment of early approximal lesions (p < 0.01). Norwegian dentists showed positive attitudes towards composite as a restorative material. Most dentists chose minimally- or medium invasive approaches when restoring fractured amalgam restorations.

Fyldningsterapi udgør stadig en stor del af tandlægers hverdag. Efter at brugen af amalgam er udfaset, er komposit i dag det mest anvendte fyldningsmateriale. Udviklingen af både materialer og metoder har til hensigt at forbedre behandlingsresultaterne. På markedet findes der et bredt udvalg af kompositmaterialer, og udviklingen af nye produkter går hurtigt. Mulighederne for at forudsige resultater i klinikken med in vitro-tests synes imidlertid at være begrænsede. Det er derfor nødvendigt med kliniske studier, som tester materialerne under realistiske forhold. Kliniske undersøgelser af fyldningsmaterialer omfatter randomiserede kontrollerede studier (RCT), retrospektive tværsnitsstudier og praksisbaserede studier, som alle har både styrker og svagheder. Et antal systematiske oversigtsartikler har sammenfattet og vurderet studier om fyldningers overlevelse i den kliniske situation. Sekundær caries og frakturer er de hyppigste årsager til udskiftning af kompositfyldninger. Eftersom det tager tid, før caries og fyldningsdefekter udvikles, må kliniske undersøgelser have lang observationstid for at kunne give pålidelige resultater. Kompositter anses i dag for at have lige så god holdbarhed som amalgam med en Annual Failure Rate (AFR) på 1 - 3 %. Fire hovedfaktorer påvirker fyldningers holdbarhed: materialet, metoden, operatøren og patienten. Dagens kompositter er generelt gode, så fyldningernes holdbarhed er frem for alt afhængig af forhold, som relaterer til patienten og operatøren.