<p>Oral complications and symptoms are common among patients with cancer. The aim of this thesis is to study several aspects of oral status, oral health and its relation to quality of life, and oral care among patients treated with radiotherapy or chemotherapy. Descriptive, comparative and correlational designs were used. </p><p>A series of consecutive patients admitted to a university hospital or a regional hospital to receive radiotherapy for head and neck cancer or chemotherapy for haematological malignancies, were studied prospectively with regard to oral symptoms and their relation to health-related quality of life using interviews and questionnaires, examination of the oral cavity and saliva tests. All nurses and enrolled nurses who worked with these patients or with patients with lung cancer were interviewed about their education and knowledge in oral care and performed oral care. The medical and nursing records on patients with these cancer diseases at the two hospitals were reviewed. </p><p>The results indicate that patients receiving radiotherapy experienced increasing oral symptoms, which remained to a large extent one month after treatment. Patients receiving chemotherapy did not experience oral symptoms to the same extent. The oral symptoms were significantly related to patients' health-related quality of life, particularly among those receiving radiotherapy. Data also indicate that there is a lack of adequate education and continuing education in oral care among nursing staff. All patients were not examined orally before or during treatment, nor did they receive sufficient information or instruction related to oral hygiene. Patient compliance with oral hygiene procedures was acceptable, although some patients reported difficulties. Oral status and oral care were insufficiently documented, particularly in nursing records. The attitudes to oral examination and discussion on oral hygiene differed between nursing staff and patients. Nursing staff objected to examining the oral cavity referring to patient integrity. This was not considered as a hindrance among patients. In conclusion, oral health is related to health-related quality of life, which motivates a multi-disciplinary approach to oral care. </p>

<p>Patient satisfaction is critical for the growth of oral health service and practice. The present study was a descriptive study on patient satisfaction with oral health care provided by a district dental clinic. The aim of the study was to determine whether patients attending the dental clinic of the Lagos State University hospital were satisfied with the care they received.</p>

Oral complications and symptoms are common among patients with cancer. The aim of this thesis is to study several aspects of oral status, oral health and its relation to quality of life, and oral care among patients treated with radiotherapy or chemotherapy. Descriptive, comparative and correlational designs were used. A series of consecutive patients admitted to a university hospital or a regional hospital to receive radiotherapy for head and neck cancer or chemotherapy for haematological malignancies, were studied prospectively with regard to oral symptoms and their relation to health-related quality of life using interviews and questionnaires, examination of the oral cavity and saliva tests. All nurses and enrolled nurses who worked with these patients or with patients with lung cancer were interviewed about their education and knowledge in oral care and performed oral care. The medical and nursing records on patients with these cancer diseases at the two hospitals were reviewed. The results indicate that patients receiving radiotherapy experienced increasing oral symptoms, which remained to a large extent one month after treatment. Patients receiving chemotherapy did not experience oral symptoms to the same extent. The oral symptoms were significantly related to patients' health-related quality of life, particularly among those receiving radiotherapy. Data also indicate that there is a lack of adequate education and continuing education in oral care among nursing staff. All patients were not examined orally before or during treatment, nor did they receive sufficient information or instruction related to oral hygiene. Patient compliance with oral hygiene procedures was acceptable, although some patients reported difficulties. Oral status and oral care were insufficiently documented, particularly in nursing records. The attitudes to oral examination and discussion on oral hygiene differed between nursing staff and patients. Nursing staff objected to examining the oral cavity referring to patient integrity. This was not considered as a hindrance among patients. In conclusion, oral health is related to health-related quality of life, which motivates a multi-disciplinary approach to oral care.

In the past two decades studies have indicated that oral health might be associated with the prevalence for cardiovascular disease (CVD), although the biological link still remains unknown. Bacteria and inflammatory mediators causing periodontal disease have also been suggested to influence the progression of atherosclerosis. The aims of this thesis were to study oral inflammation and associations between different oral health parameters and CVD. Inflammatory mediators such as interleukin-1 (IL-1) as well as bone resorption activity (BRA) were significantly higher in gingival crevicular fluid (GCF) from sites with periodontal disease compared to healthy sites. Treatment resulted in a reduction of BRA as well as the levels of IL-1 for most of the diseased pockets. The levels of IL-1 were not correlated to the amount of BRA. Number of teeth (NT) was consistently associated to CVD and was the only oral health parameter that related to all-cause mortality and mortality in CVD in a dose-dependent manner. Subjects with &lt;10 teeth had a 7-fold increase risk for mortality in coronary heart disease compared to those with &gt;25 teeth. Furthermore, NT was also significantly associated to the levels of leukocytes and to the metabolic syndrome, which consists of a combination of cardiovascular risk factors. Other investigated oral health parameters, such as severity of periodontal disease, number of deepened pockets, and bleeding on probing, were not related to CVD in a consistent way. Oral health parameters as well as myocardial infarction (MI) were related to serum antibody levels against Porphyromonas gingivalis (Pg), indicating that Pg might be a link between oral health and MI. In conclusion, treatment reduced the increased levels of IL-1 and BRA in GCF from sites with periodontal disease. Oral health was associated to CVD with number of teeth being the only oral health parameter that consistently was associated to CVD. Serum antibody levels against P. gingivalis were related to myocardial infarction (MI) as well as to oral health parameters, suggesting that this bacteria could be a link between oral health and CVD.

Kunskaper i oral hälsa har betydelse för att sjuksköterskor på ett tidigt stadium ska kunna upptäcka olika sjukdomstillstånd i munhålan. Bristande kunskap i oral hälsa har rapporterats vara ett problem inom vården och därför behövs det ökad utbildning inom oral hälsa hos sjuksköterskor. Syftet med studien var att jämföra kunskaper inom oral hälsa mellan sjuksköterskestudenter i årskurs 1 och årskurs 3. Undersökningen skedde med användning av en strukturerad enkät som delades ut av studiens författare till sjuksköterskestudenter som gick årskurs 1 (n= 95) och årskurs 3 (n= 57) vid Högskolan Kristianstad. Studenterna ansåg sig ha bra teoretiska och praktiska kunskaper medan det i resultatet av kunskapsfrågorna framkom att det fanns brister. Resultatet visade också att statistiskt signifikanta skillnader fanns i kunskap mellan studenterna i årskurs 1 och årskurs 3 på frågor om svampinfektion, muntorrhet, protes och bedömning av munstatus. I denna studie var kunskaperna låga i flera områden inom oral hälsa hos sjuksköterskestudenterna. Ökad utbildning är önskvärt för att vårdtagare ska få de åtgärder som de är i behov av i munhålan. / Knowledge of oral health is important so registered nurses, at an early stage, can detect various diseases in the oral cavity. Lack of knowledge in oral health has been reported among registered nurses. The purpose of this study was to compare the knowledge in oral health between nursing students in grade 1 and grade 3. The study was based on a questionnaire with fixed response alternatives that were distributed by the author to nursing students in grade 1 and grade 3 at Kristianstad University. The students claimed to have good theoretical and practical knowledge while the survey revealed that there were gaps in knowledge. The results showed also that there was a statistically significant difference in knowledge between students in grade 1 and grade 3 concerning candidiasis, xerostomia, prosthesis and oral health assessments. In this study the knowledge is low in several areas within oral health among the nursing students. Increased education is desirable to ensure adequate oral health procedures among patients in hospital or nursing homes. / nursing students, oral health, knowledge

This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour. Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status. Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour. These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment. / Behavioural medicine perspectives for change and prediction of oral hygiene behaviour

Syftet med denna studie var att undersöka upplevelser av munhälsa hos äldre personer som var medlemmar i olika pensionärsföreningar samt jämföra om det fanns skillnader mellan män och kvinnor. Material och metod: Studien har utförts som en kvantitativ tvärsnittsundersökning och data har samlats in hos olika pensionärsföreningar i nordöstra Skåne. En enkät lämnades ut till 202 pensionärer som deltog i studien. Resultat: De flesta var nöjda med sina tänder. Kvinnor (68 %) uppgav att de tuggade all sorts mat mycket bra i jämförelse med männen (45 %) (p=0, 006P() var stor skillnad istatis är). Det största problem som förekom hos pensionärerna var muntorrhet. Konklusion: De äldre som deltog i denna studie upplevde sin munhälsa positivt. Bland de problem som förekom var muntorrhet vanligast. / Aim: The aims of this study were to investigate the experiences of oral health in elderly individuals who were members in various pensioners' associations, and to compare if there were differences between men and women. Materials and methods: The study was conducted as a quantitative cross-sectional survey in various pensioners' associations in north-eastern Skåne, Sweden. A questionnaire was handed out to 202 pensions who participated in the study. Result: Most of the elderly were satisfied with their teeth. Sixty eight percent of the women indicated that they could chew at all kinds of food very well as compared to 45 % of the men (p = 0. 006). The main oral health problem was dry mouth. Conclusion: The elderly that participated in this study perceived their oral health as being good. A frequent complaint that occurred was dry mouth.

The purpose of this observational cross-sectional study was to assess the oral health of children between the ages of 6 to 18 with neutropenia attending the Marrow Failure and Myelodysplasia Program at The Hospital for Sick Children and compare the results to healthy control patients attending the Children’s Clinic, Faculty of Dentistry, University of Toronto. Fifteen patients with neutropenia and 26 healthy controls participated in this study. Patients with neutropenia reported an increased incidence of mouth sores and bleeding gums while brushing. However, clinical examination showed no statistical differences in the presence of ulcerations, gingival recession, tooth mobility, gingival inflammation or plaque and calculus levels. The dmft/t and DMFT/T scores were lower for the group with neutropenia, but only the dmft/t score was significant. This data suggests that patients with neutropenia that are being treated by a haematologist do not experience any more severe oral problems than healthy dental patients.

The purpose of this observational cross-sectional study was to assess the oral health of children between the ages of 6 to 18 with neutropenia attending the Marrow Failure and Myelodysplasia Program at The Hospital for Sick Children and compare the results to healthy control patients attending the Children’s Clinic, Faculty of Dentistry, University of Toronto. Fifteen patients with neutropenia and 26 healthy controls participated in this study. Patients with neutropenia reported an increased incidence of mouth sores and bleeding gums while brushing. However, clinical examination showed no statistical differences in the presence of ulcerations, gingival recession, tooth mobility, gingival inflammation or plaque and calculus levels. The dmft/t and DMFT/T scores were lower for the group with neutropenia, but only the dmft/t score was significant. This data suggests that patients with neutropenia that are being treated by a haematologist do not experience any more severe oral problems than healthy dental patients.

Munnen är en viktig del av kroppen, men trots det så blir den lätt skild från övriga kroppen och placerad i en egen kategori. Komplikationer kan uppstå om inte munvården sköts och därför är det viktigt att sjuksköterskan har kunskap om munhälsa. Hur människor uppfattar sin munhälsa är individuellt och kan ge bra underlag i omvårdnadsarbetet. Syftet var att beskriva sjuksköterskans och patientens syn på munhälsa och dess påverkan på välbefinnandet. Arbetet genomfördes som en litteraturstudie och 13 artiklar användes till resultatet. Resultatet visade att munvård ofta blev bortprioriterat i omvårdnadsarbetet då andra arbetsuppgifter ansågs som viktigare. Patienter uppfattade sin munhälsa på olika sätt, munproblem påverkade välbefinnandet negativt. Vårdpersonalen och patienterna utvärderade munhälsan olika och om patienten inte hade några uppenbara problem så uppmärksammades den inte. Det behövs mer utbildning för vårdpersonal inom munhälsa. Även mer forskning om munhälsa och munvård behövs för att fördjupa sjuksköterskans omvårdnadsarbete och sjuksköterskor bör vara medvetna om att munnen är ett bortglömt område som behöver lyftas fram.