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Dental Health of University Students in Finland a


Heikki Murtomaa DDS, PhD, MPH , Jukka Meurman MD, DDS, PhD , Lauri Turtola DDS, PhD & Inkeri Rytömaa DDS, PhD a



Institute of Dentistry at the University of Helsinki , USA


Finnish Student Health Service in Helsinki , USA Published online: 09 Jul 2010.

To cite this article: Heikki Murtomaa DDS, PhD, MPH , Jukka Meurman MD, DDS, PhD , Lauri Turtola DDS, PhD & Inkeri Rytömaa DDS, PhD (1990) Dental Health of University Students in Finland, Journal of American College Health, 39:3, 151-153, DOI: 10.1080/07448481.1990.9936227 To link to this article:

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Dental Health of University Students in Finland

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University students' dental care in Finland was organized within the student health service in 1955. Services are offered to all university students at subsidized prices. Those who do not use the service either pay the whole fee when visiting a dentist or, if they were born in 1961 or later, they may get a refund from the National Sickness Insurance. This study investigated oral health and dental attendance in a group of university students irrespective of whether or not they had used the service.

METHOD Two hundred seventeen Helsinki-born fifth-year students of the University of Helsinki were invited to a free dental examination at the student dental health service. Their average age was 25.4 years. During the clinical examination, we recorded dental caries, using the DMFS index, which counts the number of diseased, missed, or filled tooth surfaces,' and assessed periodontal condition by using the Community Periodontal Index of Treatment Needs (CPITN).2*3 The CPITN takes into account eventual bleeding of gums, Occurrence of calculus, and number of pathological periodontal pockets. We measured the salivary secretion rate and buffering capacity and analyzed salivary lactobacilli and Streptococcus mutans counts by using commercial kits (Orion Diagnostica, Espoo, Finland). We asked each student about the time, place, and reason for his or her last dental visit. The information obtained from the clinical examination and questionnaires was summarized by means of cross-tabulation and correlation analyses. The statistical significance between the groups was tested by t test and chi-square evaluation. ~~~~

Eighty percent of the students bad visited a dentist within 1% years. O f these, 88% had seen the dentist at the student health service (Table 1). The most frequently cited reason for not seeing a dentist was lack of time (35%). Fear (15%) and costs of treatment (18%) were not sizable obstacles to visiting the dentist. We found no statistically significant differences between men and women in how often they said lack of time, fear, or costs kept them from seeing a dentist. Our study showed that the students slightly underestimated the time interval since their last visit when we compared their recollection with the last recorded appointment. Those who did not use the service had significantly worse oral health than those who regularly attended, but there were no statistically significant differences between the sexes in caries and periodontal findings. When hard tissue pathologies other than caries were assessed, 18% of the students were found to have cervical abrasion due to vigorous toothbrushing, and 5 students had erosive changes in enamel. The need for dental treatment was greatest among those with the longest interval since their last dental visit (Table 2). Reduced saliva secretion and poor buffering capacity were seen in 7% of the subjects (salivary flow less than 0.8 mUmin, and buffering end pH less than 4.5, respectively). The microbiological cultivations showed high S mutans counts in 18% of the students and high lactobacillus counts in 41o/o of the subjects (the number of colony-forming units over 106 and 1P per mL saliva, respectively). The S mutans and lactobacillus counts had a highly significant correlation with the diseased tooth surface index (shown as DS in Table 2, p < .001).


Heikki Murtomaa is an associate professor in social dentistry, Jukka Meurman a docent in cariology, and lnkeri Rytomaa an associate professor in cariology; all are at the Institute of Dentistry at the University of Helsinki. Lauri Turtola is the chief dental officer in the Finnish Student Health Service in Helsinki.



DISCUSSION Approximately 300,000 visits are made annually to the Finnish student health service: Every second a p pointment is made to see a dentist. Although students themselves pay only about half of the total costs for the

15 1

COLLEGE HEALTH TABLE 1 Source of Most Recent Dental Service and Reason for Visit of 217 Finnish University Students

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Total Dental service



Source Student health service Private practitioner Community dental health center Total

152 41 24 217

70 19 11 100

Reason for visit Annual check-up on own initiative Subjective treatment need Recall visit Total

111 78 28 217

51 36 13 100

dental services, money was often mentioned when we asked why the students had not recently visited a dentist. It has been shown earlie+ that the best way to assure the use of dental services is to invite the students to a general health examination and to give them the possibility of seeing a dentist at the same time. Those in greatest need of treatment usually take advantage of the opportunity. An annual dental appointment is generally recommended i n Finland. The low incidence of caries found in the present study indicates that dental visits at intervals of 18 to 24 months could be recommended for students rnore than 20 years old. This, of course, calls for special focus o n at-risk groups and those in greater need of treatment. The salivary chemical and microbiological analyses made in this study have been shown to be useful i n early identification of dental risk In our subjects, 18% showed high numbers of salivary S mutans, indicating liability to caries. Only 3% of studenis had a periodontal index value of zero i n all mouth sextants (the sextants extend from the second molars t o the premolars and from canine to canine in both jaws). According to the program of the World Health Organization’s “Health for All by the Year 2000,” 90’/0 of the 18-year-olds should have at least three sextants scoring CPITN-index zero. Based on our findings, the Finnish students have a long way t o go in order tlo reach this objective. To sum up, our study found fairly good coverage for dental care and recall activity at the students’ own initiation. Seventy percent of the students studied had visited their own student health service dentist within 1’/2 years. These students also had significantly better oral health than those who had not used the service. Thus, a systematic dental health plan with subsidized prices inevitably ameliorates oral health in young adults.


Women No. %



77 25 9 111

69 23 8 100

76 16 14 106

72 15 13 100


49 36 15 100

56 37 13 106

53 35 12 100

40 17 111


TABLE 2 The Oral Health Status of 217 Finnish University Students Based on Most Recent Dental Visit %



Women No visit during 18 months Annual check-up on own initiative Subjective treatment need Recall visit

100 21

1.1k2.0 1.7k2.5

1.4k1.4 1.2rt1.2











100 16

1.3k3.0 3.1 f6.2

1.2rt1.6 0.4k0.6










No visit during 18

months Annual check-up on own initiative Subjective treatment need Recall visit


tDS Diseased tooth surfaces. K P I T N = Community Periodontal Index of Treatment Needs; expressed as mean number of healthy sextants in the mouth.

REFERENCES 1. World Health Organization. Oral health survey: Basic methods. Geneva: WH0;1977;68. 2. World Health Organization. Epidemiology, etiology and prevention of periodontal diseases. Technical Report Services Number 621. Geneva: WHO:1978. 3. Ainamo J, Barmes D, Beagrie G, et a]. Development Of the World Health Organization Community Periodontal Index of Treatment Needs (CPITN). Int Dent 1. 1982;32:218-219. 4. Finnish Student Health Service [in Finnish]. Yearbook 7 984- I 985. He1si nki: 1985. 5. Turtola L, Rytomaa I, Murtomaa H, Helminen S, Jauhiainen L. Dental health care of university students. A


FINNISH STUDENTS' DENTAL HEALTH longitudinal study. Publications of the Social Insurance Institution, ML:45. Helsinki:1985. 6. Krasse B. The cariogenic potential of foods-A critical review of current methods of investigation. Int Dent 1. 1985;35: 31-42. 7. Hamada S, Slade HD. Biology, immunology and cariogenicity of Streptococcus rnutans. Microbiol Rec. 1980;41: 331-384. 8. Murtomaa H, Meurman J, Rytomaa I, Turtola L. P e r b dontal status in university students. f Clin Periodontol. 1987; 14462-465.




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Dental health of university students in Finland.

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