From the first study year (2001) to the last (2013), the number of adults having visited the PDS increased by 81.5% from 37,377 to 67,834. The number of patients in the youngest age group (18-39-year-olds) increased only by 6.5% from 25,463 to 27,113. The age group 39-64-years-old increased by 183.5% from 9,760 to 27,666 and the oldest group (65+ years) increased five-fold from 2,154 to 13,055 (Table 1). The total number of adults treated during the 13-year study period was 203,619 (Table 1). This means that about 77.5% of the adult population had visited the PDS on one or more occasions during 2001-2013.
#Table 1 is placed here #
During the study period, the proportion of those in need of basic caries and periodontal treatment (CPI > 2, D+d > 0) decreased slightly. A statistically significant decreasing trend could be found in the youngest age group (18-39 years) from 75% to 68% (p=0.033*). In the age group 40-64 years the decrease was smaller, from 74% to 70% and the trend was not significant (p=0.497). In the oldest age group (65+years) the corresponding figures were from 61% to 55% (p=0.394; Table 1; Table 3).
Altogether, 4,099,050 treatment measures were provided for the adults during the entire study period (Table 1). Almost equal shares were provided for the 18-39-year-olds (1,762,373, 43.0%) and 40-64-year-olds (1,758,359, 42.9%). The 65+ year-olds had had 578,318 (14.1%) treatment measures. The 18-39- year-olds had on average had 14,742, the 40-64- year-olds 23,015 and the 65+ year-olds 17,998 treatment measures per 1000 patients, respectively (Table 3).
Restorative treatment (968,772; 23.6%), examinations (658,394; 16.1%), radiology (529,875; 12.9%) anaesthesia (521,169; 12.7%) and emergency treatment (348,229; 8.5%) made up 73.8% of all treatment measures during the entire study period. Periodontal treatment (7.8%) and prevention (3.9%) made up smaller parts of the care provided and prosthetics, treatment of TMD disorders and orthodontics were extremely infrequent (fewer than 1%; Table 1).
As can be seen from Table 2, a major part of all preventive treatment (43.5%) was provided for the youngest adults and most periodontal treatment (45.5%), restorative treatment (45.8%) and prosthetics (52.0%) was for middle-aged adults. Other treatment categories were more evenly distributed among the age groups.
#Table 2 is placed here #
When treatment measures were converted into time [20], the share of periodontics doubled from 7.8% to 15.2% and endodontics from 5.3% to 11.6% respectively. The prosthetics share tripled from 0.9% to 2.7% but remained low. Radiology decreased from 12.9% to 3.2% and anaesthesia from 12.7% to 4.2%. The share of restorative treatment increased from 23.6% to 28.4% and preventive treatment from 3.9% to 4.8%. The share of examinations decreased slightly from 16.1% to 12.8% (Table 2). Treatments related to caries, restorative treatment (28.4%), examinations (12.8%), endodontics (11.6%) and emergency treatment (9.2%) made up 62.0% of dental personnel’s treatment time (Table 3).
#Table 3 is placed here #
The total number of treatment measures provided increased from 5,402 to 7,057 per 1,000 patients. Among the youngest age category (18-39 years), the mean number of treatment measures increased from 5,207 to 6,781 per 1,000 patients, among the 40-64-year-olds from 5,806 to 7,495 per 1,000 patients and among the oldest (65+ years) from 5,872 to 6,701 per 1,000 patients (Figure 1, Table 3).
#Figure 1 is placed here #
Restorative treatment decreased from 1,520 to 1,428 treatment measures per 1,000 patients, preventive care from 314 to 164 and prosthetics from 89 to 57 treatment measures.
Examinations increased from 917 to 1,182 items per 1,000 patients, radiology from 548 to 1,054 items, anaesthesia from 683 to 939, periodontics from 494 to 537, emergency treatment from 258 to 567 and endodontics from 253 to 362 treatment measures respectively (Table 3).
Preventive treatment measures decreased among the 18-39-year-olds from 245 to 153 among the 40-64-year-olds; from 416 to 130 items and among the 65+ year-olds the decrease was from 659 to 262 treatment measures per 1,000 patients per year.
A statistically significant increasing trend was found in the total number of treatment measures provided from 2001 to 2013 for the youngest age group (18-39 years) (p=0.003**) and for the 40-64-year-olds (p=0.015*). For the oldest group (65+ years), the trend was not statistically significant. The increasing trends in radiology (p < 0.001***), anaesthesia (p = 0.003**) and oral surgery (p = 0.004**) were statistically significant. The decreasing trend in preventive care was statistically significant (p = 0.003**; Table 4).
#Table 4 is placed here #
A statistically highly significant increasing trend was found in radiology for all age groups (p< 0.001***) through the years. When studying treatment profiles over patients’ age categories, there was an increasing trend in examinations provided for the 40-64-years-olds (p=0.010*), in anaesthesia among the 18-39-year-olds (p<0.001***) and the 40-64-year-olds (p=0.002**). A statistically significantly increasing trend was found in endodontic treatment among the 18-39-year-olds (p< 0.001***) and in oral surgery among the 18-39-year-olds (p = 0.002**). The only treatment category having a statistically significantly decreasing trend was preventive care, among the 40-64-year-olds (p=0.009**) and among the 65+ year-olds (p=0.002**; Table 4).
There were on average almost five times (483.5%) more preventive treatment measures per patient among those not in need of treatment compared with those in need of treatment in every age group. In addition, among those in need of treatment there was a decreasing trend in preventive treatment measures per 1,000 patients. Among the 40-64-year-olds from 2,287 to 1,383 (p=0.569) and among the 65+ year-olds from 3,759 to 1,297 treatment measures per patient (p=0.958; Table 3).