Eeva Widstrom | UiT The Arctic University of Norway (original) (raw)
Papers by Eeva Widstrom
Sosiaalilaaketieteellinen Aikakauslehti, 2006
Oral health and dental management, 2012
This study aimed to examine how leadership positions in the Public Dental Service (PDS) were dist... more This study aimed to examine how leadership positions in the Public Dental Service (PDS) were distributed between women and men and how the female and male lead dentists perceived themselves as managers or leaders and whether their superiors, the leading doctors and municipal decision makers or their subordinates, the public dentists, found differences between female and male lead dentists as leaders. Gender aspects on the leadership qualities of the lead dentists in the Public Dental Service were evaluated by four professional groups using a questionnaire. The groups surveyed were: lead dentists (in charge of the municipal PDS clinics), leading doctors (lead dentists'line managers), the directors of municipal health boards, and the PDS dentists (subordinates to the lead dentists). Factor analysis, chi-square and non-parametric tests were used to analyse the data gathered. Women made up 50% (96/192) of the lead dentists, 80% (211/263) of the public dentists, 31% (47/152) of the l...
International Dental Journal, Jun 1, 2005
At present the European Union is developing its competence on health and new important issues wil... more At present the European Union is developing its competence on health and new important issues will be taken on board in European health policy. Increasing mobility of people and integration of the applicant countries puts pressure on the current health care provision systems. A mandate for an open co-ordination process in public health is expected to be given by the European Council. The process will start by exchange of information and best practice models. The next step will be the presentation of common targets between member countries, followed by national action programmes and indicators. It is likely that a lot of emphasis will be put on access to health services, comparisons of costs of health care and benchmarking the costs of items of care. In the long run this will mean convergence of the health care systems. If oral health is to be considered an integral part of general health dental professionals need to be aware of and be able to influence the actions to be taken.
Background: In Finland, dental services are provided by a public (PDS) and a private sector. In t... more Background: In Finland, dental services are provided by a public (PDS) and a private sector. In the past, children, young adults and special needs groups were entitled to care and treatment
Tidsskr Norske Laegeforen, 2010
Aims: To assess self-perceived oral health-related quality of life (OHRQoL) in 12-year-olds livin... more Aims: To assess self-perceived oral health-related quality of life (OHRQoL) in 12-year-olds living in two areas in the Barents region: North-West Russia (Arkhangelsk) and Northern Norway (Tromsø). Methods: Sampling was performed according to a stratified cluster design and consisted of 590 Russian and 264 Norwegian 12-year-olds and their parents. After written consent from their parents, 514 Russian (87% attendance) and 124 Norwegian (47% attendance) children entered the study. The study included clinical examination (children) and questionnaires (children and parents). Dental caries and the aesthetic dental appearance were recorded under field conditions. Self-reports on background variables and oral health-related quality of life questions (CPQ11-14) were completed in classroom settings by children and at home by parents. Results: OHRQoL was found to vary depending on country of origin, with higher scores of CPQ11-14 domains among 12-year-olds from Russia. OHRQoL was found to be associated with dental caries, with higher scores among 12-yearolds with caries. Inferior emotional and social well-being were established as having the strongest association with quality of life. Dental caries showed an independent effect on OHRQoL scores, but this effect disappeared when controlling for background variables, with country of origin, family economy, parental education and aesthetic appearance as the most influential (R²=0.14). Conclusions: Norwegian 12-year-olds had better oral health and OHRQoL than their Russian counterparts. The impact of dental caries on OHRQoL was weak and aesthetic dental appearance and socio-economic determinants were found to be more important, probably reflecting the great differences in the standards of living between Northern Norway and North-West Russia.
International dental journal, Jan 14, 2015
The current study addresses the extent to which diversity in dental attendance across population ... more The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries. The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents ≥ 51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use. We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social hea...
Swedish dental journal
Factors affecting the costs of children's free orthodonti... more Factors affecting the costs of children's free orthodontic treatment were studied from patient records of a random sample of 193 successfully treated orthodontic patients, aged 7-14 years at the start of the treatment. They were treated by orthodontic specialists in the health centers of the cities of Joensuu, Oulu, and Vaasa. The statistical analysis was done using advanced regression analysis, two-tailed t-test and chi-square test. The results indicated that the number of appliances used, the patients' ages at the start of treatment, the number of missed appointments, differences between health centers, and the change in PAR (Peer Assessment Rating) Index scores accounted for 78.7% of the variations in treatment costs. The number of appliances used was the most important factor in the regression (R2 = 0.657). The costs of treatment were lowest in one-stage treatments started in the permanent dentition, and were highest in two-stage treatments started in the mixed dentition. Significant differences were found in treatment patterns and costs between the three health centers, reflecting low concern for cost-efficiency aspects.
Tidsskrift for den Norske laegeforening
Oral health & preventive dentistry
There is a number of systems for the provision of oral health care, one of which is the Nordic mo... more There is a number of systems for the provision of oral health care, one of which is the Nordic model of centrally planned oral health care provision. This model has historically been firmly based on the concept of a welfare state in which there is universal entitlement to services and mutual responsibility and agreement to financing them. This study reports and analyses oral health care provision systems and developments in oral health policy in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) since 1990. Descriptions of and data on the oral health care provision systems in the Nordic countries were obtained from the Chief Dental Officers of the five countries, and contemporary scientific literature was appraised using cross-case analyses to identify generalisable features. It was found that in many respects the system in Iceland did not follow the 'Nordic' pattern. In the other four countries, tax-financed public dental services employing salaried dentist...
Oral health & preventive dentistry
This article reports a survey of the systems for the provision of oral healthcare in the 28 membe... more This article reports a survey of the systems for the provision of oral healthcare in the 28 member and accession states of the EU/EEA in 2003. Descriptions of the systems were collected from the principal dental advisers to governments in the individual states. In many states these were the Chief Dental Officers (CDOs). In states without a CDO, descriptions were gathered from CDO equivalents or senior academics. A template (model description) was used to guide all respondents. Additional statistical information on oral healthcare costs and workforce was collected from the Council of European Chief Dental Officers, WHO and World Bank websites. The study showed that in broad terms there were six patterns (Beveridgian, Bismarkian, The Eastern European (in transition), Nordic, Southern European and Hybrid) for the administration and financing of oral healthcare in the expanding EU. The extent and nature of government involvement in planning and coordinating oral healthcare services and ...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2013
To assess oral health and oral health associated factors in 12-year-olds and to establish determi... more To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child's oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p<0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child's dental caries (χ(2)=87; p<0.001). Among parent's variables showing the ...
International journal of circumpolar health, 2010
The first aim was to study how oral health care delivery was organized in member countries and to... more The first aim was to study how oral health care delivery was organized in member countries and to determine whether there were differences across the Barents region. The second aim was to assess the performance of the care provision systems. The Barents region is one of the largest hinterlands in northern Europe. Descriptions of the oral health care provision systems in Norway, Sweden, Finland and Russia were written. Performance of the care provision systems was assessed by evaluating access to and use of services in relation to oral health. National statistics, governmental reports and scientific publications were used as data sources. Data were supplemented by sending questioning to national and local managers and experts. Inter- and intra-country comparisons included dental health status, service availability and restrictions, financial support for oral health care, availability of dental personnel and use of services. In the Barents region, oral health care provision systems, m...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2010
To document the oral health status, to study oral health determinants and oral health-related qua... more To document the oral health status, to study oral health determinants and oral health-related quality of life among 12-year-olds from the Barents Euro-Arctic Region. The study was conducted in Severodvinsk (North-West Russia) and Tromsø (Northern Norway). Two schools representing each region were selected and all 12-year-old pupils having obtained their parents' written consent were included (Severodvinsk n=48, Tromsø n=36). Background factors were collected by questionnaires. Oral health conditions, i.e. caries (DMFT/S), oral hygiene (OHI-S) and satisfaction with their own dental appearance were recorded under field conditions and possible associations between background factors and the children's oral health status were studied. Oral health was better among Norwegian than Russian participants. The most important factors explaining variation in oral health were country of origin and treatment (filling/no filling) received at the last dental visit. Among parental factors, ed...
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 25, 2010
International Journal of Dental Hygiene, 2009
Aim: The aim was to compare the working profiles of Finnish and Norwegian dental hygienists in pu... more Aim: The aim was to compare the working profiles of Finnish and Norwegian dental hygienists in public and private practice. To this end, we compared the procedures performed, the type of patients and the time devoted to different tasks. Subjects and methods: A questionnaire survey was originally conducted among a representative sample of dental hygienists in Finland (n = 595) and all authorized dental hygienists in Norway (n = 1 138) in 2004. The questionnaires collected data on the dental hygienists' age, gender, year of graduation, working experience, work sector (private or public), working time spent on different activities and patient groups. The questionnaire also assessed how frequently the dental hygienists performed 25 different treatment measures. Results: The Norwegian dental hygienists spent 45.4% of their clinical time on check-ups, whereas the Finns spent 49.9% of their time scaling. Dental hygienists in Finland and Norway working in the public sector spent 42.9% and 74.6% of their working time dealing with children and youth respectively. Conclusions: The working profiles of dental hygienists in Finland and Norway were quite similar, although differences in distribution by activities, type of patients and treatment measures do exist. The main activity of the dental hygienists was clinical work. The most commonly practised clinical activity among Finnish dental hygienists was scaling, and among Norwegians, check-ups. Public dental hygienists in both countries dealt mainly with children and youths. Oral hygiene instruction was the most commonly reported treatment measure among both Finns and Norwegians.
International Dental Journal, 2014
Insurance against the cost of preventing and treating oral diseases can reduce inequities in dent... more Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental-care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the USA and various European countries. The analyses relied on 2006-2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and on 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents 51 years of age and older. A series of logistic regression models was estimated to identify disparities in dental coverage. The highest extent of significant insurance differences between various population subgroups was found for the USA. In comparison with southern and eastern European countries, a lower number of significant differences in coverage was found for Scandinavian countries. Countries categorised as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than did countries categorised as not having comprehensive public coverage. The exceptions were Poland and Switzerland. The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and that the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies in order to provide more equitable dental coverage.
Sosiaalilaaketieteellinen Aikakauslehti, 2006
Oral health and dental management, 2012
This study aimed to examine how leadership positions in the Public Dental Service (PDS) were dist... more This study aimed to examine how leadership positions in the Public Dental Service (PDS) were distributed between women and men and how the female and male lead dentists perceived themselves as managers or leaders and whether their superiors, the leading doctors and municipal decision makers or their subordinates, the public dentists, found differences between female and male lead dentists as leaders. Gender aspects on the leadership qualities of the lead dentists in the Public Dental Service were evaluated by four professional groups using a questionnaire. The groups surveyed were: lead dentists (in charge of the municipal PDS clinics), leading doctors (lead dentists'line managers), the directors of municipal health boards, and the PDS dentists (subordinates to the lead dentists). Factor analysis, chi-square and non-parametric tests were used to analyse the data gathered. Women made up 50% (96/192) of the lead dentists, 80% (211/263) of the public dentists, 31% (47/152) of the l...
International Dental Journal, Jun 1, 2005
At present the European Union is developing its competence on health and new important issues wil... more At present the European Union is developing its competence on health and new important issues will be taken on board in European health policy. Increasing mobility of people and integration of the applicant countries puts pressure on the current health care provision systems. A mandate for an open co-ordination process in public health is expected to be given by the European Council. The process will start by exchange of information and best practice models. The next step will be the presentation of common targets between member countries, followed by national action programmes and indicators. It is likely that a lot of emphasis will be put on access to health services, comparisons of costs of health care and benchmarking the costs of items of care. In the long run this will mean convergence of the health care systems. If oral health is to be considered an integral part of general health dental professionals need to be aware of and be able to influence the actions to be taken.
Background: In Finland, dental services are provided by a public (PDS) and a private sector. In t... more Background: In Finland, dental services are provided by a public (PDS) and a private sector. In the past, children, young adults and special needs groups were entitled to care and treatment
Tidsskr Norske Laegeforen, 2010
Aims: To assess self-perceived oral health-related quality of life (OHRQoL) in 12-year-olds livin... more Aims: To assess self-perceived oral health-related quality of life (OHRQoL) in 12-year-olds living in two areas in the Barents region: North-West Russia (Arkhangelsk) and Northern Norway (Tromsø). Methods: Sampling was performed according to a stratified cluster design and consisted of 590 Russian and 264 Norwegian 12-year-olds and their parents. After written consent from their parents, 514 Russian (87% attendance) and 124 Norwegian (47% attendance) children entered the study. The study included clinical examination (children) and questionnaires (children and parents). Dental caries and the aesthetic dental appearance were recorded under field conditions. Self-reports on background variables and oral health-related quality of life questions (CPQ11-14) were completed in classroom settings by children and at home by parents. Results: OHRQoL was found to vary depending on country of origin, with higher scores of CPQ11-14 domains among 12-year-olds from Russia. OHRQoL was found to be associated with dental caries, with higher scores among 12-yearolds with caries. Inferior emotional and social well-being were established as having the strongest association with quality of life. Dental caries showed an independent effect on OHRQoL scores, but this effect disappeared when controlling for background variables, with country of origin, family economy, parental education and aesthetic appearance as the most influential (R²=0.14). Conclusions: Norwegian 12-year-olds had better oral health and OHRQoL than their Russian counterparts. The impact of dental caries on OHRQoL was weak and aesthetic dental appearance and socio-economic determinants were found to be more important, probably reflecting the great differences in the standards of living between Northern Norway and North-West Russia.
International dental journal, Jan 14, 2015
The current study addresses the extent to which diversity in dental attendance across population ... more The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries. The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents ≥ 51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use. We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social hea...
Swedish dental journal
Factors affecting the costs of children&amp;amp;amp;amp;amp;amp;amp;#39;s free orthodonti... more Factors affecting the costs of children&amp;amp;amp;amp;amp;amp;amp;#39;s free orthodontic treatment were studied from patient records of a random sample of 193 successfully treated orthodontic patients, aged 7-14 years at the start of the treatment. They were treated by orthodontic specialists in the health centers of the cities of Joensuu, Oulu, and Vaasa. The statistical analysis was done using advanced regression analysis, two-tailed t-test and chi-square test. The results indicated that the number of appliances used, the patients&amp;amp;amp;amp;amp;amp;amp;#39; ages at the start of treatment, the number of missed appointments, differences between health centers, and the change in PAR (Peer Assessment Rating) Index scores accounted for 78.7% of the variations in treatment costs. The number of appliances used was the most important factor in the regression (R2 = 0.657). The costs of treatment were lowest in one-stage treatments started in the permanent dentition, and were highest in two-stage treatments started in the mixed dentition. Significant differences were found in treatment patterns and costs between the three health centers, reflecting low concern for cost-efficiency aspects.
Tidsskrift for den Norske laegeforening
Oral health & preventive dentistry
There is a number of systems for the provision of oral health care, one of which is the Nordic mo... more There is a number of systems for the provision of oral health care, one of which is the Nordic model of centrally planned oral health care provision. This model has historically been firmly based on the concept of a welfare state in which there is universal entitlement to services and mutual responsibility and agreement to financing them. This study reports and analyses oral health care provision systems and developments in oral health policy in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) since 1990. Descriptions of and data on the oral health care provision systems in the Nordic countries were obtained from the Chief Dental Officers of the five countries, and contemporary scientific literature was appraised using cross-case analyses to identify generalisable features. It was found that in many respects the system in Iceland did not follow the 'Nordic' pattern. In the other four countries, tax-financed public dental services employing salaried dentist...
Oral health & preventive dentistry
This article reports a survey of the systems for the provision of oral healthcare in the 28 membe... more This article reports a survey of the systems for the provision of oral healthcare in the 28 member and accession states of the EU/EEA in 2003. Descriptions of the systems were collected from the principal dental advisers to governments in the individual states. In many states these were the Chief Dental Officers (CDOs). In states without a CDO, descriptions were gathered from CDO equivalents or senior academics. A template (model description) was used to guide all respondents. Additional statistical information on oral healthcare costs and workforce was collected from the Council of European Chief Dental Officers, WHO and World Bank websites. The study showed that in broad terms there were six patterns (Beveridgian, Bismarkian, The Eastern European (in transition), Nordic, Southern European and Hybrid) for the administration and financing of oral healthcare in the expanding EU. The extent and nature of government involvement in planning and coordinating oral healthcare services and ...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2013
To assess oral health and oral health associated factors in 12-year-olds and to establish determi... more To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child's oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p<0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child's dental caries (χ(2)=87; p<0.001). Among parent's variables showing the ...
International journal of circumpolar health, 2010
The first aim was to study how oral health care delivery was organized in member countries and to... more The first aim was to study how oral health care delivery was organized in member countries and to determine whether there were differences across the Barents region. The second aim was to assess the performance of the care provision systems. The Barents region is one of the largest hinterlands in northern Europe. Descriptions of the oral health care provision systems in Norway, Sweden, Finland and Russia were written. Performance of the care provision systems was assessed by evaluating access to and use of services in relation to oral health. National statistics, governmental reports and scientific publications were used as data sources. Data were supplemented by sending questioning to national and local managers and experts. Inter- and intra-country comparisons included dental health status, service availability and restrictions, financial support for oral health care, availability of dental personnel and use of services. In the Barents region, oral health care provision systems, m...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2010
To document the oral health status, to study oral health determinants and oral health-related qua... more To document the oral health status, to study oral health determinants and oral health-related quality of life among 12-year-olds from the Barents Euro-Arctic Region. The study was conducted in Severodvinsk (North-West Russia) and Tromsø (Northern Norway). Two schools representing each region were selected and all 12-year-old pupils having obtained their parents' written consent were included (Severodvinsk n=48, Tromsø n=36). Background factors were collected by questionnaires. Oral health conditions, i.e. caries (DMFT/S), oral hygiene (OHI-S) and satisfaction with their own dental appearance were recorded under field conditions and possible associations between background factors and the children's oral health status were studied. Oral health was better among Norwegian than Russian participants. The most important factors explaining variation in oral health were country of origin and treatment (filling/no filling) received at the last dental visit. Among parental factors, ed...
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 25, 2010
International Journal of Dental Hygiene, 2009
Aim: The aim was to compare the working profiles of Finnish and Norwegian dental hygienists in pu... more Aim: The aim was to compare the working profiles of Finnish and Norwegian dental hygienists in public and private practice. To this end, we compared the procedures performed, the type of patients and the time devoted to different tasks. Subjects and methods: A questionnaire survey was originally conducted among a representative sample of dental hygienists in Finland (n = 595) and all authorized dental hygienists in Norway (n = 1 138) in 2004. The questionnaires collected data on the dental hygienists' age, gender, year of graduation, working experience, work sector (private or public), working time spent on different activities and patient groups. The questionnaire also assessed how frequently the dental hygienists performed 25 different treatment measures. Results: The Norwegian dental hygienists spent 45.4% of their clinical time on check-ups, whereas the Finns spent 49.9% of their time scaling. Dental hygienists in Finland and Norway working in the public sector spent 42.9% and 74.6% of their working time dealing with children and youth respectively. Conclusions: The working profiles of dental hygienists in Finland and Norway were quite similar, although differences in distribution by activities, type of patients and treatment measures do exist. The main activity of the dental hygienists was clinical work. The most commonly practised clinical activity among Finnish dental hygienists was scaling, and among Norwegians, check-ups. Public dental hygienists in both countries dealt mainly with children and youths. Oral hygiene instruction was the most commonly reported treatment measure among both Finns and Norwegians.
International Dental Journal, 2014
Insurance against the cost of preventing and treating oral diseases can reduce inequities in dent... more Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental-care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the USA and various European countries. The analyses relied on 2006-2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and on 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents 51 years of age and older. A series of logistic regression models was estimated to identify disparities in dental coverage. The highest extent of significant insurance differences between various population subgroups was found for the USA. In comparison with southern and eastern European countries, a lower number of significant differences in coverage was found for Scandinavian countries. Countries categorised as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than did countries categorised as not having comprehensive public coverage. The exceptions were Poland and Switzerland. The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and that the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies in order to provide more equitable dental coverage.