Lene Hystad Hove

• Santervas, Leonor Roa; Skovlund, Eva; Ringstad, Ingrid Beate; Kristoffersen, Espen Saxhaug; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 9 contributors for this article] (2026). Frailty in relation to general and oral health-related quality of life among older adults in municipal acute care. Journal of Frailty & Aging (JFA). ISSN 2260-1341. 15(5). doi: 10.1016/j.tjfa.2026.100207. Full text in Research Archive Show summary

  Frailty is associated with poorer health-related quality of life (HRQoL) in older adults, but studies rarely assess general and oral HRQoL concurrently in acute care populations. Objectives: To examine the associations between frailty and general as well as oral HRQoL among older adults admitted to a municipal in-patient acute care (MipAC) unit. Design: Cross-sectional study. Setting: Oslo MipAC unit, Norway. Participants: A total of 382 patients aged 70 years or older admitted to the MipAC unit between January and September 2023. Measurements: Frailty was assessed using the Clinical Frailty Scale (CFS). General HRQoL was measured with the 15D instrument and a single-item global life satisfaction question. Oral HRQoL was assessed using the Oral Health Impact Profile-14 (OHIP 14). Associations between frailty and HRQoL were analyzed using linear, ordinal logistic, and binary logistic regression. Exploratory analyses of 15D and OHIP-14 dimensions were performed using non-parametric trend tests. Results: Increasing frailty was significantly associated with lower 15D scores (adjusted B -0.053, 95% CI -0.061 to -0.045), higher odds of lower life satisfaction (adjusted OR 1.19, 95% CI 1.02 to 1.39), and higher odds of reporting oral health impacts on the OHIP-14 (adjusted OR 1.25, 95% CI 1.05 to 1.48). Most 15D dimensions declined with increasing frailty, except distress. For OHIP-14, significant associations were observed for functional limitation, physical pain, and psychological disability. Conclusions: Frailty assessed with the CFS was consistently associated with reduced general and oral HRQoL in older adults admitted to a MipAC unit. These findings support the clinical relevance of simple frailty assessment during acute admission and suggest that it may help identify patients at risk of poorer quality of life.

• Badian, Reza; Sundling, Vibeke; Jensen, Janicke Liaaen; Hynne, Håvard; Tashbayev, Behzod & Hove, Lene Hystad [Show all 8 contributors for this article] (2026). Meibomian Gland Dysfunction and Sex as Risk Factors of Dry Eye Disease in a Cohort of Norwegian 65-year-Olds: A Cross-Sectional Study. Clinical Ophthalmology. ISSN 1177-5467. 20, p. 1–15. doi: 10.2147/opth.s556305. Full text in Research Archive Show summary

  Purpose: Dry eye disease (DED) is a multifactorial condition characterized by the loss of ocular surface homeostasis, causing discomfort and ocular symptoms. Higher age, female sex, and meibomian gland dysfunction (MGD) are some of the reported risk factors for DED. However, age-specific studies of DED are rare. This study aimed to determine the prevalence of DED and MGD in a cohort of Norwegians in their mid-60s. Additionally, to investigate potential sex-related differences in the prevalence of DED and MGD. Methods: For this cross-sectional study, a random sample of 137 demographically homogeneous Norwegian residents of Oslo in their mid-60s was recruited. Participants completed the Ocular Surface Disease Index (OSDI) dry eye symptom questionnaire and underwent clinical dry eye examinations. DED was defined as OSDI ≥ 13, accompanied by fluorescein break-up time (FBUT) < 10s and/or ocular surface staining (OSS) ≥ 1. The presence of MGD was defined as a score of 1 for both meibum quality (MQ) and meibum expressibility (ME) or a score > 1 for either MQ or ME. Results: The overall prevalence for DED was 20.4% [95% CI: 14.0 to 28.2], and for MGD was 90.5% [95% CI: 84.3– 94.9]. No significant sex differences were observed for either condition. MGD was highly prevalent among both DED and non-DED participants: all individuals with DED (n = 28) had MGD, while among those without DED (n = 109), prevalence was 88.1% (males: 85.7%; females: 90.0%). No significant correlation was found between MGD and sex (rs ([137] = [0.075], p = 0.413). In the whole cohort, OPI and FBUT correlated positively with ME (rs ([132] = [0.437] and rs ([132] = [0.296], both p < 0.001) and negatively with OSS (rs ([132] = [− 0.315] and rs ([132] = [0.423], both p< 0.001) and lid margin abnormality (rs ([130] = [− 0.222], p = 0.011; rs ([132] = [0.234], p = 0.007). FBUT correlated also positively with tear production (rs ([128] = [0.308], p< 0.001). A more frequent use of topical ocular lubricant was found among females (p = 0.043). In the symptomatic group, females had significantly lower OPI and FBUT values (p = 0.046 and 0.027, respectively). Among symptomatic participants, categorized as mild (OSDI 13– 22), moderate (OSDI 23– 32), and severe (OSDI 33– 100), only in the severe group did females show higher OSDI scores (p= 0.042) but lower OSS (p= 0.031) compared to males. Conclusion: In this cohort of Norwegians in their mid-60s, DED and MGD were highly and equally prevalent among both sexes. The high prevalence of these conditions underscores the need to raise awareness of DED and MGD within the young elderly population.

• Ringstad, Ingrid Beate; Skovlund, Eva; Santervas, Leonor Roa; Kersten, Hege; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 9 contributors for this article] (2026). Association Between Anticholinergic Burden and Dry Mouth Severity in Acutely Ill Older Adults. Drugs & Aging. ISSN 1170-229X. 43(4), p. 361–371. doi: 10.1007/s40266-026-01286-w. Full text in Research Archive Show summary

  Background: Dry mouth is a common and burdensome condition in older adults and its severity may increase with use of anticholinergic medications. The aims were to describe anticholinergic medication use among acutely ill older adults, examine the association between anticholinergic burden and dry mouth severity using the composite Dry Mouth Severity Points (DMSP) measure and investigate whether the association differs by sex. Methods: Patients ≥70 years admitted to Oslo municipal inpatient acute care unit were eligible. Anticholinergic burden (ACB) was assessed using the ACB calculator and classified as 0, lower (ACB = 1-2) or high (ACB = ≥ 3). Dry mouth severity was quantified with DMSP, range 0-4, assigning one point for each indicator above cut-off: General Xerostomia Question ≥ 3, Summated Xerostomia Inventory ≥ 11, Clinical Oral Dryness Score ≥ 6 and unstimulated whole saliva secretion rate ≤ 0.1 mL/min. Associations were examined with ordinal logistic regression. Results: Of 382 examined patients, 256 (mean age 84 ± 7 years, 70% women) had complete data. Mean [standard deviation (SD)] ACB score was 2.0 (1.7); 18% had ACB = 0, 50% had ACB = 1-2 and 32% had ACB = ≥ 3. DMSP scores of 0, 1, 2 and ≥ 3 were present in 29%, 36%, 23% and 12%, respectively. Compared with patients with ACB = 0, those with ACB = 1-2 [odds ratio (OR) = 2.06, 95% confidence interval (CI) 1.07-3.97) and ACB = ≥ 3 (OR = 2.25, 95% CI 1.09-4.63) had higher odds of more severe dry mouth. Women had significantly higher ACB and DMSP scores than men. Conclusions: Even lower anticholinergic burden was associated with greater dry mouth severity, highlighting the need for early recognition and proactive management in acutely ill older adults.

• Santervas, Leonor Roa; Skovlund, Eva; Kristoffersen, Espen Saxhaug; Ringstad, Ingrid Beate; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 9 contributors for this article] (2026). Collaborative medication reviews during acute primary care admissions for older adults with polypharmacy: a randomised controlled trial. Age and Ageing. ISSN 0002-0729. 55(2). doi: 10.1093/ageing/afag029. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Santervas, Leonor Roa; Fjeld, Katrine Gahre; Hove, Lene Hystad & Skovlund, Eva [Show all 8 contributors for this article] (2025). Oral Health, Xerogenic Medications, and Frailty in Acutely Ill Older Adults. Journal of The American Geriatrics Society. ISSN 0002-8614. 73(8), p. 2466–2474. doi: 10.1111/jgs.19564. Full text in Research Archive Show summary

  Background Oral health is an essential part of overall health and well-being in older adults and may be influenced by medications and frailty. This study aimed to describe the prevalence of xerostomia and hyposalivation and examine their associations with xerogenic medications and frailty in acutely ill older adults. Methods This cross-sectional study included patients aged ≥ 70 years admitted to the Municipal In-Patient Acute Care unit in Oslo, Norway. General xerostomia was defined as a score ≥ 3 on the General Xerostomia Question (GXQ). Specific xerostomia was measured with the Summated Xerostomia Inventory (SXI). Objective dry mouth measures included unstimulated whole saliva (UWS) secretion rate and the Clinical Oral Dryness Score (CODS), with hyposalivation defined as UWS ≤ 0.1 mL/min. Examination of dentition included numbers of missing teeth and posterior occluding pairs of teeth. Medication data included total drug burden and number of xerogenic medications. Frailty was assessed using the Clinical Frailty Scale (CFS). Associations were analyzed using logistic regression models. Results Among 382 patients (mean age 84 years, 72% women), general xerostomia was present in 30% and hyposalivation in 56%. Mean number (SD) of xerogenic medications was 3.7 (±2.2). The number of xerogenic medications used was significantly associated with general xerostomia in both unadjusted (OR: 1.17, 95% CI: 1.05–1.29) and adjusted models (OR: 1.13, 95% CI: 1.01–1.26). Median UWS declined numerically with increasing number of xerogenic medications. Higher CFS scores were associated with increased subjective xerostomia scores (GXQ and SXI), elevated CODS, more missing teeth, and reduced occlusion, but not with general xerostomia or hyposalivation when predefined cut-off values were applied. Conclusion Xerostomia and hyposalivation were common among acutely ill older adults. General xerostomia was associated with xerogenic medication use and frailty. Our findings highlight the need to incorporate oral health assessments into routine geriatric care and emphasize the importance of interdisciplinary collaborations.

• Tashbayev, Behzod; Badian, Reza; Chen, Xiangjun; Vitelli, Valeria; Lagali, Neil & Dartt, Darlene [Show all 9 contributors for this article] (2025). Comparison of non-invasive and fluorescein tear film break-up time in a 65-year-old Norwegian population: a cross-sectional study. BMJ Open. 15. doi: 10.1136/bmjopen-2024-090305. Full text in Research Archive Show summary

  Objectives Measurement of tear film stability is central in dry eye disease (DED) diagnosis. In this study, we aimed to compare the performance of two methods of tear film stability measurement: non-invasive tear break-up time (NIBUT) and fluorescein tear film break-up time (FTBUT). Design Cross-sectional study. Setting and participants The study involved 132 subjects of 65-year-old inhabitants of the Oslo region who were not seeking ophthalmic care. Interventions The participants underwent a battery of DED tests, including NIBUT measured on Oculus Keratograph 5M and a traditional method using fluorescein drops (FTBUT). Oculus Keratograph 5M measures two types of NIBUT:; appearance time of the first dry spot (NIBUTFirst) and average NIBUTAvg. Results 74 participants (56%) were female and 58 were male (44%). Subjects presented with varying degrees of DED signs and symptoms. Mean values of NIBUTFirst and FTBUT from all the participants were significantly different (6.2±4.9 s vs 8.6±6.2 s, p<0.0001). There was also a significant difference between NIBUTFirst and NIBUTAvg values (6.2±4.9 s vs 8.3±5.5 s, p<0.0001). In contrast, no difference was observed between FTBUT and NIBUTAvg values (8.6±6.2 s vs 8.3±5.5 s, p=0.655). The receiver operating characteristic curve analysis was performed to compare NIBUT and FTBUT in regards to other clinical tests (Ocular Surface Disease Index, ocular surface staining, blink interval, eye redness, corneal sensitivity, lid debris, Schirmer I test, tear osmolarity, meibum quality, meibum expressibility, lid hyperemia, tear meniscus height,. irregular lid margin, conjunctival hyperaemia, margin telangiectasia, lipid layer and meibomian gland drop-out). While FTBUT demonstrated results with area under the curve>0.6, neither NIBUTFirst nor NIBUTAvg showed significant results. Conclusion NIBUTFirst was shorter than FTBUT. Low correlation between NIBUT and FTBUT indicates that these diagnostic tests are not interchangeable. Other DED tests had correlation, though low, while NIBUT did not demonstrate correlation.

• Sødal, Anne Thea Tveit; Diep, My Tien; Skudutyte-Rysstad, Rasa; Singh, Preet Bano; Young, Alix & Jensen, Janicke Liaaen [Show all 9 contributors for this article] (2024). Oral helse blant 65-åringer i Oslo. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 12(134). doi: 10.56373/2024-12-5. Full text in Research Archive
• Frigaard, Julie Mari; Hynne, Håvard; Randsborg, Karoline; Mellin-Olsen, Tonje; Hofgaard, Anne Kristine & Young, Alix [Show all 10 contributors for this article] (2023). Exploring oral health indicators, oral health-related quality of life and nutritional aspects in 23 medicated patients from a short-term psychiatric ward. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1083256. Full text in Research Archive Show summary

  Background Patients suffering from psychiatric disorders face many difficulties due to their condition, medications and lifestyle. Oral health and nutrition may be affected, further complicating their lives. Our aim was to provide in-depth information on oral health and nutritional factors in a small group of patients in short-term psychiatric ward. Methods Twenty-three patients (mean age 36, average medications five) were recruited during short-term hospitalization in a psychiatric ward. Inclusion criteria: anxiety, psychosis and/or depression, and use of at least one antidepressant or anxiolytic/antipsychotic drug with xerostomia as a known side effect. Subjective oral dryness was evaluated using the Shortened Xerostomia Inventory (SXI). Oral examination included Clinical Oral Dryness Score (CODS), secretion of unstimulated (UWS) and stimulated whole saliva (SWS), and evaluation of dental, gingival, and periodontal status. Self-reported complaints of oral disorders were recorded. The Oral Health Impact Profile-14 (OHIP-14) was used to explore oral health-related quality of life. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and diet quality was assessed using the Mediterranean diet score (KIDMED). Results Compared to healthy controls, the patients had significantly higher SXI scores and CODS, and SWS secretion was lower. Complaints of dysgeusia and halitosis were significantly more frequent among patients. Gingivitis was more common in patients. OHIP-14 scores were much higher in the patients, and they reported significantly poorer oral and general health. Most patients lacked a regular meal pattern. Very low diet quality was observed in five patients, while improvements were needed in twelve. “ Dry mouth ” and “ No appetite, just did not feel like eating ” were the most common symptoms preventing patients from eating enough. The PG-SGA-SF symptoms component score showed a strong negative correlation with self-reported oral health, and a strong positive correlation with OHIP-14. Conclusion This relatively small group of patients in short-term psychiatric ward had both reduced oral health and poor oral health-related quality of life. Furthermore, their nutritional intake was affected by their oral health problems. Although larger groups need to be studied, these findings indicate that oral health and nutrition should be evaluated and adjusted in these patients to improve their overall care.

• Ottersen, Margareth Kristensen; Larheim, Tore Arne; Hove, Lene Hystad & Arvidsson, Linda Zamoline (2023). Imaging signs of temporomandibular joint osteoarthritis in an urban population of 65-year-olds: A cone beam computed tomography study. Journal of Oral Rehabilitation. ISSN 0305-182X. doi: 10.1111/joor.13547. Full text in Research Archive
• Diep, My Tien; Skudutyte-Rysstad, Rasa; Sødal, Anne Thea Tveit; Young, Alix & Hove, Lene Hystad (2023). Caries experience and risk indicators of having decayed teeth among 65-year-olds in Oslo, Norway: a cross-sectional study. BMC Oral Health. 23(1). doi: 10.1186/s12903-023-03432-x. Full text in Research Archive Show summary

  Background Meeting the oral health needs of the increasing population of older adults presents a major challenge in dental care. Knowledge about the oral health status in the young-elderly age group is essential for the planning of future oral health education and prevention programs. The aims of the present study were therefore to investigate the caries experience among 65-year-olds in Oslo, Norway, and to explore associations between having decayed teeth and sociodemographic, behavioural, and biological factors. Methods A random sample of 65‑year‑olds in Oslo answered a questionnaire and underwent clinical and radiographic examinations (n = 457, 52% men and 48% women) at the Research Clinic, Faculty of Dentistry, University of Oslo, between February and December 2019. Primary- and secondary coronal and root caries lesions, root remnants, and missing and restored teeth were recorded. Decayed teeth (DT) were defined as teeth with coronal- and root caries lesions that had progressed into dentine and root remnants, and the DMFT/S scores were calculated. Results The mean number of teeth was 25 (SD: 4) and the mean DMFT was 19.4 (SD: 4.7). Thirty seven percent of the individuals had at least one decayed tooth (DT > 0), and the mean number of filled teeth (FT) was 16.1 (SD: 5.4). Multivariable logistic regression analysis showed that male gender (OR: 1.8, 95% CI: 1.2–2.8), basic level of education (OR: 1.9, 95% CI: 1.2–2.9), irregular dental attendance (OR: 2.2, 95% CI: 1.0-4.8), and hyposalivation (OR: 2.1, 95% CI: 1.0-4.4) were significant risk indicators for having decayed teeth (DT > 0) (p < 0.05). Conclusions In conclusion, 65-year-olds in Oslo had a low average number of decayed and missing teeth, and a high number of restored teeth. Irregular dental attendance and hyposalivation were the strongest risk indicators for having decayed teeth. Based on the present results, it will be important to ensure access to regular dental care and to increase the emphasis on caries preventive measures for individuals with hyposalivation in this age group.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2023). Identification and susceptibility testing of oral candidiasis in advanced cancer patients. BMC Oral Health. 23(1). doi: 10.1186/s12903-023-02950-y. Full text in Research Archive Show summary

  Background Patients with advanced cancer are prone to develop different opportunistic oral infection due to anti-cancer treatment or the malignancies themselves. Studies of oral fungal samples show an increased prevalence of non-Candida albicans species in mixed oral infections with Candida albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azoles, which may have implications for treatment. This study aimed to assess the diversity and antifungal susceptibility of Candida species detected in the oral cavity. Methods An observational study with microbiological analysis was conducted. Clinical fungal isolates were collected from patients in a hospice unit in 2014–2016. Isolates were re-grown on chromID® Candida plates in 2020. Single colony of each species was re-cultivated and prepared for biochemical identification with a VITEK2® system and verified by gene sequencing. Etest was performed on RPMI agar, and the antifungals fluconazole, amphotericin B, anidulafungin and nystatin were applied. Results Fifty-six isolates from 45 patients were identified. Seven different Candida species and one Saccharomyces species were detected. The results of biochemical identification were confirmed with sequencing analysis. Thirty-six patients had mono infection, and nine out of 45 patients had 2–3 different species detected. Of C. albicans strains, 39 out of 40 were susceptible to fluconazole. Two non-C. albicans species were resistant to fluconazole, one to amphotericin B and three to anidulafungin. Conclusion C. albicans was the predominant species, with a high susceptibility to antifungal agents. Different Candida species occur in both mono and mixed infections. Identification and susceptibility testing may therefore lead to more effective treatment and may prevent the development of resistance among patients with advanced cancer. Trail registration The study Oral Health in Advanced Cancer was registered at ClinicalTrials.gov (#NCT02067572) in 20/02/2014.

• Henni, Silje Havrevold; Ansteinsson, Vibeke Elise; Mamykina, Lena; Hovden, Ewa Alicja Szyszko; Hove, Lene Hystad & Hellesø, Ragnhild (2023). Factors influencing home health care providers' performance of oral health care for older people: A qualitative study. International Journal of Older People Nursing. ISSN 1748-3735. p. 1–10. doi: 10.1111/opn.12561. Full text in Research Archive Show summary

  Aim To examine factors that affect the performance of oral health care (OHC) for older people receiving nursing care at home. Background Oral health is often neglected by health care providers caring for older people. Research shows that health care providers' provision of OHC may be influenced by various factors (barriers and facilitators). When this research was conducted, health care providers from home healthcare services (HHCS) and nursing homes were grouped together despite setting differences; therefore, this study focuses on the performance of OHC by home health care providers (HHCPs) as a single group. Design Explorative design with a qualitative approach. Methods The managers of four HHCS units recruited 17 HHCPs to participate in focus group interviews. One interview was conducted per unit, and there were four to five participants in each interview. The analysis of interviews was based on theoretical thematic analysis and the PRECEDE constructs in the PRECEDE–PROCEED model. Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used in reporting this study. Findings The analysis resulted in two themes with predisposing factors (HHCPs' professional responsibilities, older people's attitude), five themes with enabling factors (knowledge and skills, older people/carer trust, available time, available equipment and collaboration with public dental service (PDS)), and two themes with reinforcing factors (routines and OHC focus on the workplace) that affect the provision of OHC. The factors were categorised as individual, organisational and collaboration factors. Conclusions In addition to individual factors found in previous studies, factors related to the organisation of services and communication between HHCPs and PDS seem to affect HHCPs' provision of OHC for adults receiving HHCS. Implications for Practice This study provides in-depth knowledge that can contribute to increasing HHCPs' provision of OHC and thereby prevent oral and dental disease among older people receiving HHCS.

• Sødal, Anne Thea Tveit; Hove, Lene Hystad; Diep, My Tien; Skudutyte-Rysstad, Rasa & Koldsland, Odd Carsten (2022). Periodontal conditions in a 65-year-old population and prevalence of periodontitis according to three different bone level thresholds. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02276-1. Full text in Research Archive Show summary

  Aims The aims of this cross-sectional study were to describe the prevalence and severity of periodontal disease in a 65-year-old population in Oslo, Norway, and to investigate to what extent the radiographic bone level threshold for periodontitis case definition influences the prevalence. Materials and methods A random sample of 454 subjects underwent a clinical and radiographic examination and answered a questionnaire regarding general health, medications, and smoking habits. Clinical periodontal parameters (periodontal pocket depths, bleeding on probing, mobility, and furcation involvement) and radiographic bone loss were used to identify periodontitis cases and to assess periodontal stage and grade. Results Of the 454 participants, 52.6% were defined as “periodontitis cases”. Of the total study population “unstable cases of recurrent periodontitis” were present in 38.1%, 16.5% of the participants were assigned to stage II, 32.8% to stage III, and 3.3% to stage IV. When lowering the radiographic bone loss cutoff from > 3 mm to > 2 mm or > 1 mm the prevalence of periodontitis increased to 91.9% and 99.6%. Conclusions Periodontitis was common among 65 year-olds living in Oslo, and in the majority of those with periodontitis, the disease was recurrent and unstable. This study also shows that the choice of bone loss cutoff for defining a periodontitis case affects the prevalence estimates to a large extent. In addition, this study addresses weaknesses in the use of the consensus report of the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions for epidemiologic studies in its current form.

• Sødal, Anne Thea Tveit; Skudutyte-Rysstad, Rasa; Diep, My Tien; Koldsland, Odd Carsten & Hove, Lene Hystad (2022). Periodontitis in a 65-year-old population: risk indicators and impact on oral health-related quality of life. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02662-9. Full text in Research Archive Show summary

  Aims The aims of the present study were to investigate socioeconomic and behavioral risk indicators for severe periodontitis in a 65-year-old Norwegian population, and to investigate how periodontitis impacts oral health-related quality of life. Material and methods A sample of 65-year-old residents in Oslo, born in 1954, was randomly selected for this study. The participants answered a questionnaire regarding country of birth, education, diabetes, smoking habits, dental attendance pattern, and tooth-brushing habits. In addition, oral health-related quality of life (OHRQoL) was assessed by the Oral Health Impact Profile-14 questionnaire (OHIP-14). Negative impact on OHRQoL was defined as responding “fairly often” or “very often” to at least one of the OHIP-14 items. The diagnosis of periodontitis was based on clinical and radiographic periodontal measurements and classified based on the consensus report from the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Results Of 796 eligible participants, 460 individuals agreed to participate in the present study (response rate 58%). Seven participants were excluded from the analyses due to < 2 remaining teeth (n = 3) or missing questionnaire (n = 4), resulting in a study sample of 453 individuals (233 men and 220 women). An association was found between non-western country of birth, diabetes type 2, lower education, smoking, non-regular dental visits, and severe periodontitis (stage III or IV, n = 163) in bivariate analyses (Chi-square test). However, in the multiple logistic regression model, only non-western country of birth, diabetes type 2 and smoking (former and current), were associated with higher odds of severe periodontitis. The overall mean OHIP-14 total score was 3.6 (SD: 6.1). Participants with stage III or IV periodontitis reported a significantly higher OHIP-14 total score (mean: 4.7, SD: 7.4), indicating a lower OHRQoL, compared to non-periodontitis participants (mean: 2.9, SD: 4.9). Conclusions In the present study, non-western birth country, diabetes type 2, and smoking were found as significant risk indicators for severe periodontitis. Overall, results indicate a good OHRQoL among 65-year-olds in Oslo, however, a tendency of reduced OHRQoL with increasing severity of periodontitis was observed.

• Hynne, Håvard; Tashbayev, Behzod; Diep, My Tien; Sødal, Anne Thea Tveit; Badian, Reza & Chen, Xiangjun [Show all 10 contributors for this article] (2022). The relationship between ocular and oral dryness in a cohort from the 65-year-old population in Norway. Scientific Reports. 12(1). doi: 10.1038/s41598-022-13985-6. Full text in Research Archive Show summary

  In the present study, the relationship between dry eyes and dry mouth was explored in 150 65-year-old subjects randomly selected from the general population in Oslo, Norway. The number of drugs, including xerogenic drugs, and current and previous systemic diseases were recorded. Ocular parameters recorded were the McMonnies Dry Eye Questionnaire, the Ocular Surface Disease Index, the Schirmer I Test, tear film break-up time and ocular surface staining. The oral parameters were xerostomia frequency, Summated Xerostomia Inventory, Clinical Oral Dryness Score, and unstimulated and stimulated whole saliva. The participants with current or previous systemic diseases had significantly more ocular and oral symptoms and significantly more oral clinical findings than the participants without a history of disease. Moreover, correlation and factor analyses demonstrated an association between subjective ocular and oral parameters. A significant correlation between the total number of drugs and the presence of ocular and oral symptoms was also noted. When the participants were categorized based on their ocular symptoms, poorer values were found for the oral parameters among the participants more troubled with dry eyes. The results in the present study call for increased awareness and an interdisciplinary approach in matters related to dry eyes and dry mouth.

• Chen, Xiangjun; Badian, Reza; Hynne, Håvard; Tashbayev, Behzod; Hove, Lene Hystad & Jensen, Janicke Liaaen [Show all 7 contributors for this article] (2022). Morphology of Meibomian Glands in A 65‐Year‐Old Norwegian Population without Dry Eye Disease. Journal of Clinical Medicine. 11(3). doi: 10.3390/jcm11030527. Full text in Research Archive Show summary

  Analyses of meibography may help in the diagnosis, prevention, and management of meibomian gland dysfunction (MGD). However, there is currently a paucity of data regarding meibography analyses in the young elderly populations in the Nordic countries. In the current study, meibography of the upper and lower eyelids of 117 65-year-old residents in Oslo, Norway, who did not fulfil the diagnosis of dry eye disease (DED) were analysed. Meibomian gland (MG) dropout and tarsal areas were measured semi-automatically using ImageJ software. The relationship between morphological features of the MGs and clinical dry eye tests was examined. The median percent MG dropout was 26.1% and 40.7% in the upper and lower eyelids, respectively. There was no significant difference between males and females. None of the MG morphological parameters demonstrated significant values in discriminating abnormal dry eye symptom loads or MGD diagnosis from the normal loads. We therefore concluded that moderate MG atrophy was common among the Norwegian population of 65-year-olds without DED and showed no sexual differences. Meibography alone cannot discriminate MGD from non-MGD; thus, both morphological and functional MG tests are necessary when screening for MGD.

• Høvik, Hedda; Kolberg, Marit; Gjøra, Linda; Nymoen, Line Cathrine; Skudutyte-Rysstad, Rasa & Hove, Lene Hystad [Show all 8 contributors for this article] (2022). The validity of self-reported number of teeth and edentulousness among Norwegian older adults, the HUNT Study. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02116-2. Full text in Research Archive Show summary

  Background Number of teeth is an established indicator of oral health and is commonly self-reported in epidemiological studies due to the costly and labor-intensive nature of clinical examinations. Although previous studies have found self-reported number of teeth to be a reasonably accurate measure, its accuracy among older adults ≥ 70 years is less explored. The aim of this study was to assess the validity of self-reported number of teeth and edentulousness in older adults and to investigate factors that may affect the accuracy of self-reports. Methods This study included two different samples of older adults ≥ 70 years drawn from the fourth wave of the Trøndelag Health Study (the HUNT Study), Norway. Sample 1 (n = 586) was used to evaluate the validity of self-reported number of teeth and sample 2 (n = 518) was used to evaluate self-reported edentulousness. Information on number of teeth and background variables (education, smoking, cognitive function, and self-perceived general and oral health) were self-reported in questionnaires, while clinical oral health examinations assessed number of teeth, number of teeth restored or replaced by fixed prosthodontics and edentulousness. Spearman and Pearson correlation coefficients, Bland–Altman plot, chi-square test and kappa statistics were used to assess the agreement between self-reported and clinically recorded number of teeth. Results The mean difference between self-reported and clinically recorded number of teeth was low (− 0.22 teeth), and more than 70% of the participants reported their number of teeth within an error of two teeth. Correlations between self-reports and clinical examinations were high for the total sample (0.86 (Spearman) and 0.91 (Pearson)). However, a lower correlation was found among participants with dementia (0.74 (Spearman) and 0.85 (Pearson)), participants having ≥ 20 teeth (0.76 (Spearman) and 0.67 (Pearson)), and participants with ≥ 5 teeth restored or replaced by fixed prosthodontics (0.75 (Spearman) and 0.77 (Pearson)). Self-reports of having teeth or being edentulous were correct in 96.3% of the cases (kappa value 0.93, p value < 0.001).

• Diep, My Tien; Hove, Lene Hystad; Ørstavik, Dag Solmund; Skudutyte-Rysstad, Rasa; Sødal, Anne Thea Tveit & Sunde, Pia Titterud (2022). Periapical and endodontic status among 65-year-old Oslo-citizens. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02406-9. Full text in Research Archive Show summary

  Aim This cross-sectional study aimed to investigate the prevalence of apical periodontitis (AP) and root-filled teeth in a 65-year-old population in Oslo, Norway, and to investigate associations of pathosis and endodontic treatment with selected individual risk indicators and technical quality of root fillings. Material and methods A random sample of 450 65-year-olds in Oslo answered a questionnaire and underwent a clinical and radiological examination (52% men and 48% women). Periapical radiographs were taken of all root-filled teeth and of teeth with apical radiolucency, and periapical status was evaluated using the Periapical Index. Apex-to-filling distance and homogeneity were assessed for all root fillings. Analyses on individual level and tooth level were performed. The outcome variables were ‘non-root-filled tooth with AP’ (‘untreated AP’), ‘root-filled tooth’, and 'root-filled tooth with AP’. The explanatory variables were gender, education, dental attendance pattern, smoking, remaining teeth (n), tooth group, and root filling quality. Chi-square test and logistic regression analyses were used to assess the associations between outcome variables and explanatory variables. The level of significance was set to p < 0.05. Results The mean number of remaining teeth was 26 (SD: 4). AP was present in 45% of the individuals. Sixteen percent of the individuals had untreated AP and 38% had at least one root-filled tooth with AP. Sixty-six percent of the individuals had one or more root-filled teeth. Untreated AP was significantly associated with a decreasing number of remaining teeth and smoking. All the outcome variables were significantly more prevalent in molars compared with premolars and anterior teeth. Thirty-five percent of the root-filled teeth had AP, and AP was more prevalent in teeth with too short apex-to-filling distance (53%) or unsatisfactory homogeneity (46%). Conclusions The remaining number of teeth was high, and AP and root-filled teeth were prevalent in the present young-elderly population. A notable amount of untreated AP was observed, especially in smokers. The findings in the present study indicate a substantial need for dental care associated with endodontic conditions in the future elderly.

• Diep, My Tien; Jensen, Janicke Liaaen; Skudutyte-Rysstad, Rasa; Young, Alix; Sødal, Anne Thea Tveit & Petrovski, Beata [Show all 7 contributors for this article] (2021). Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway. European Journal of Oral Sciences. ISSN 0909-8836. 129(1), p. 1–11. doi: 10.1111/eos.12757. Full text in Research Archive Show summary

  This study aimed to describe the prevalence and associated factors for xerostomia and hyposalivation in a young-elderly population. A random sample of 460 65-yr-old people living in Oslo, Norway, answered a questionnaire and underwent a clinical examination (237 men and 223 women; response rate 58%). Ten percent of respondents reported xerostomia. The median Summated Xerostomia Index was 6 (interquartile range [IQR]: 5–7) and the median Clinical Oral Dryness Score was 2 (IQR: 1–3). The median unstimulated whole saliva (UWS) secretion rate was 0.34 (IQR: 0.20–0.53) mL min–1 and the median stimulated whole saliva (SWS) secretion rate was 1.74 (IQR: 1.24–2.38) mL min–1. In 8% of the study participants the UWS secretion rate was ≤0.1 mL min–1 and in 4% the SWS secretion rate was ≤0.7 mL min–1. Three percent of the study participants had both xerostomia and hyposalivation with respect to UWS. Xerostomia was significantly associated with medication use, having rheumatic disease, and having received radiation therapy to the head/neck region. Hyposalivation with respect to UWS and SWS was significantly associated with medication use and type II diabetes. Even though xerostomia and hyposalivation were not prevalent conditions in this population, clinicians should be especially aware of the salivary conditions in patients taking four or more medications, patients diagnosed with type II diabetes, and those who have undergone radiation therapy to the head/neck region.

• Young, Alix; Hove, Lene Hystad; Stevning, Karen; Løvik, Sara-Emilie & Hjortsjö, Carl (2021). Kan tannpasta gjøre tennene mer sårbare? En in vitro pilotstudie om endring i fukting av emalje uttrykt ved kontaktvinkelmålinger. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 131(9), p. 796–801. Full text in Research Archive
• Sødal, Anne Thea Tveit; Singh, Preet Bano; Skudutyte-Rysstad, Rasa; Diep, My Tien & Hove, Lene Hystad (2021). Smell, taste and trigeminal disorders in a 65-year-old population. BMC Geriatrics. doi: 10.1186/s12877-021-02242-6. Full text in Research Archive Show summary

  Background Smell, taste and trigeminal disorders likely have a substantial impact on human daily life. However, data regarding the prevalence of these disorders in Norway are scarce. The aim of this study was to investigate the prevalence of smell, taste, trigeminal disorders and associated factors in a 65-year-old population in Oslo, Norway. Methods A random sample of 223 individuals (123 men, 100 women) participated in the study. Medical history was obtained, and unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected to determine salivary secretion rates. Sniffin`n Sticks and Taste Strips (Burghart Messtechnik GmbH, Wedel, Germany) were used for quantitative testing of olfactory and gustatory function. In addition, the participants’ self-reported perceptions of smell and taste, and burning mouth sensation were investigated. Results The results showed that 34 % of the participants had reduced smell (28 % hyposmia and 6 % anosmia) and 28 % had reduced taste perception (21 % hypogeusia and 7 % ageusia). 13 % of the partcipants had a combination of smell and taste disorders. Dysgeusia was reported by 5 % and burning mouth sensation (syndrome) by 3 % of the participants. Hyposmia, hypogeusia and ageusia were significantly more prevalent among men. Significant associations were found between taste disorders and previous history of cerebral hemorrhage and heart attack, and between burning mouth sensation and gastrointestinal disorders. Disturbances in olfactory, gustatory and trigeminal function were significantly related to medication use. Ageusia and burning mouth sensation were significantly more prevalent among smokers. Except from higher prevalence of ageusia among participants with hyposalivation with respect to SWS, no significant associations were found between salivary secretion rate and chemosensory or trigeminal disorders in the present study. Conclusions The present study revealed that one-third of 65-year-old individuals had impaired smell and more than one-fourth had impaired taste function. The prevalence of dysgeusia and burning mouth sensation was very low. Reduced smell and taste perception were more common among men than women. Furthermore, some diseases and medications were associated with chemosensory and trigeminal disorders. Ageusia was associated with SWS hyposalivation.

• Westgaard, Kristine Løken; Hynne, Håvard; Amdal, Cecilie Delphin; Young, Alix; Singh, Preet Bano & Chen, Xiangjun [Show all 12 contributors for this article] (2021). Oral and ocular late effects in head and neck cancer patients treated with radiotherapy. Scientific Reports. 11:4026, p. 1–11. doi: 10.1038/s41598-021-83635-w. Full text in Research Archive Show summary

  A broader understanding of oral and ocular late effects in head and neck cancer (HNC) patients who underwent intensity-modulated radiotherapy (IMRT) may provide valuable information in follow-up and improve quality of life. Twenty-nine HNC patients treated at least 6 months earlier and 30 age-matched controls were recruited. After completing several questionnaires: Oral Health Impact Profile-14 (OHIP-14), Shortened Xerostomia Inventory (SXI), Ocular Surface Disease Index (OSDI) and McMonnies Dry Eye questionnaire (MDEQ), participants underwent oral and ocular examinations. Oral examination included clinical oral dryness score (CODS) and secretion rates of unstimulated and stimulated saliva (UWS, SWS). Ocular examination included tear film break-up time, Schirmer test and ocular surface staining. The patients had more problems related to dry mouth than controls based on CODS and SXI, and more complaints of dry eye disease based on OSDI and MDEQ. UWS and SWS rates and oral health related quality of life were significantly lower in the patient group. Subjective oral dryness (SXI) correlated significantly with subjective ocular dryness (OSDI and MDEQ). Our study demonstrates that HNC patients treated with IMRT experience late effects in terms of xerostomia and ocular dryness underlining the importance of interdisciplinary approach in the evaluation and follow-up of HNC patients.

• Svensberg, K.; Kalleberg, Birgitte Grøstad; Rosvold, E.O.; Mathiesen, Liv; Wøien, H. & Hove, L.H. [Show all 11 contributors for this article] (2021). Interprofessional education on complex patients in nursing homes: a focus group study. BMC Medical Education. 21(1). doi: 10.1186/s12909-021-02867-6. Full text in Research Archive Show summary

  Background An ageing population leads up to increasing multi-morbidity and polypharmacy. This demands a comprehensive and interprofessional approach in meeting patients’ complex needs. This study describes graduate students’ experiences of working practice based in interprofessional teams with complex patients’ care needs in nursing homes. Method Students from advanced geriatric nursing, clinical nutrition, dentistry, medicine and pharmacy at the University of Oslo in Norway were assigned to groups to examine and develop a care plan for a nursing home patient during a course. Focus groups were used, 21 graduate students participating in four groups. Data were collected during spring 2018, were inductively analysed according to a thematic analysis method (Systematic Text Condensation). An analytical framework of co-ordination practices was applied to get an in-depth understanding of the data. Results Three themes were identified: 1) Complex patients as learning opportunities- an eye-opener for future interprofessional collaboration 2) A cobweb of relations, and 3) Structural facilitators for new collective knowledge. Graduate university students experienced interprofessional education (IPE) on complex patients in nursing homes as a comprehensive learning arena. Overall, different co-ordination practices for work organization among the students were identified. Conclusions IPE in nursing homes facilitated the students’ scope from a fragmented approach of the patients towards a relational and collaborative practice that can improve patient care and strengthen understanding of IPE. The study also demonstrated the need for preparatory teamwork training to gain maximum benefit from the experience. Something that can be organized by the education institutions in the form of a stepwise learning module and as an online pre-training course in interprofessional teamwork. Further, focusing on the need for well thought through processes of the activity by the institutions and the timing the practice component in students’ curricula. This could ensure that IPE is experienced more efficient by the students.

• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Malterud, Karl Egil [Show all 11 contributors for this article] (2021). A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: A randomized controlled trial. Supportive Care in Cancer. ISSN 0941-4355. doi: 10.1007/s00520-021-06021-2. Full text in Research Archive Show summary

  Background: Few clinical studies evaluate interventions to reduce oral discomfort among patients in palliative care. Aim: This study examines the efficacy of a Salvia officinalis (SO) based herbal mouth rinse compared to conventional normal saline (NS) in order to improve oral health. Design: A block-randomized controlled trial. Data were collected before and after a 4-day intervention with either SO (n=44) or NS (n=44). Numerical rating scales (NRS, 0-10) and 12 items from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Oral Health 17 (EORTC QLQ-OH17) measured patient-reported oral symptoms. An oral examination was performed before and after the intervention. Setting/participants: This study included adult patients with late-stage cancer in an inpatient hospice unit. Results: Of the 88 patients included (mean age=63.9 years, SD=10.6), 73 (83%) completed the study. At baseline, 78% reported dry mouth on the EORTC QLQ-OH17, and 80% rated dry mouth ≥4 on the NRS. Total oral health scores based on the 12 EORTC QLQ-OH17 items improved similarly in both groups (p

• Aqrawi, Lara A.; Chen, Xiangjun; Hynne, Håvard; Amdal, Cecilie Delphin; Reppe, Sjur & Aass, Hans Christian Dalsbotten [Show all 14 contributors for this article] (2020). Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways. Cells. 9(9). doi: 10.3390/cells9092050. Full text in Research Archive Show summary

  Although radiotherapy is a common form of treatment for head and neck cancer, it may lead to tissue damage in the salivary and lacrimal glands, possibly affecting cytokine expression in the gland fluid of treated individuals. Cytokine profiles in saliva and tear fluid of 29 radiated head and neck cancer patients and 20 controls were screened using a multiplex assay. Correlations between cytokine expression and clinical oral and ocular manifestations were examined, and cellular pathways influenced by these cytokines were assessed using the Functional Enrichment Analysis Tool. Significantly elevated cytokines identified in patient saliva were CCL21, IL-4, CX3CL1, CCL2, CXCL1 and CCL15. Many of these cytokines correlated positively with objective signs of oral dryness, and reduced saliva production in the patients. Although CCL21 and IL-4 levels were significantly lower in patient tear fluid, they correlated with subjective ocular symptoms. These increased salivary cytokines affected pro-inflammatory and apoptotic cellular pathways, including T cell signalling, several interleukin signalling pathways, TNF and TGF-β receptor signalling, and the apoptotic p53 pathway. In conclusion, the upregulated salivary cytokines identified suggest an interplay between innate and adaptive immunity, affecting immunoregulatory cellular pathways. Whether this is due to late effects of radiotherapy or tissue repair remains to be investigated.

• Tashbayev, Behzod; Garen, Torhild Oddveig; Palm, Øyvind; Chen, Xiangjun; Herlofson, Bente Brokstad & Vik, Alix Rosslyn Young [Show all 13 contributors for this article] (2020). Patients with non-Sjögren's sicca report poorer general and oral health-related quality of life than patients with Sjögren's syndrome: a cross-sectional study. Scientific Reports. 10(2063). doi: 10.1038/s41598-020-59078-0. Full text in Research Archive Show summary

  Understanding the impact of the disease on quality of life is crucial in patient management. In this cross-sectional study, general and oral health-related quality of life questionnaires, and thorough examinations of oral and ocular dryness were performed in age- and sex-matched patients with primary Sjögren’s syndrome (pSS group), non-Sjögren’s syndrome sicca (non-SS group) and healthy controls. General and oral health-related quality of life were investigated with the 36-Item Short Form Health Survey and the 14-Item Oral Health Impact Profle questionnaires, respectively. Subjective symptoms of xerostomia and ocular dryness were recorded using the Summated Xerostomia Inventory and Ocular Surface Disease Index, respectively. Clinical examinations included evaluation of clinical oral dryness scores, candida counts, unstimulated and stimulated saliva secretory rates, tear osmolarity, tear flm break-up time, Schirmer I test and ocular surface staining. Both patient groups had pronounced signs and symptoms of xerostomia and ocular dryness. Even though the non-SS patients had less severe clinical signs than the pSS patients, they demonstrated much poorer general and oral health-related quality of life. In conclusion, non-SS patients require more attention in order to improve their quality of life.

• Singh, Preet Bano; Young, Alix; Homayouni, Amin; Hove, Lene Hystad; Petrovski, Beata & Herlofson, Bente Brokstad [Show all 9 contributors for this article] (2019). Distorted Taste and Impaired Oral Health May Affect Nutritional Status in Patients with Sicca Complaints. Nutrients. 11(2). doi: 10.3390/nu11020264. Full text in Research Archive Show summary

  Senses of smell and taste, saliva flow, and dental status are considered as important factors for the maintenance of a good nutritional status. Salivary secretory rates, chemosensory function, burning mouth sensation, halitosis and dental status were investigated in 58 patients with primary Sjögren’s syndrome (pSS), 22 non-Sjögren’s syndrome sicca (non-SS) patients, and 57 age-matched healthy controls. A significantly greater proportion of patients with pSS and non-SS had ageusia, dysgeusia, burning mouth sensation, and halitosis compared to controls. Patients with pSS had significantly lower olfactory and gustatory scores, and significantly higher caries experience compared to controls. Patients with pSS and non-SS patients had significantly lower unstimulated and stimulated whole saliva secretory rates compared to controls. The findings indicated that several different aspects of oral health were compromised in both, patients with pSS and non-SS, and this may affect their food intake and, hence, their nutritional status. Although non-SS patients do not fulfill Sjögren’s syndrome classification criteria, they have similar or, in some cases, even worse oral complaints than the patients with pSS. Further studies are needed to investigate food preferences, dietary intake, and nutritional status in these two patient groups in relation to their health condition.

• Chen, Xiangjun; Aqrawi, Lara Adnan; Utheim, Tor Paaske; Tashbayev, Behzod; Utheim, Øygunn Aass & Reppe, Sjur [Show all 12 contributors for this article] (2019). Elevated cytokine levels in tears and saliva of patients with primary Sjögren's syndrome correlate with clinical ocular and oral manifestations. Scientific Reports. 9(1). doi: 10.1038/s41598-019-43714-5. Full text in Research Archive Show summary

  Investigating cytokines in tear fluid and saliva may offer valuable information for understanding the pathogenesis of primary Sjögren’s syndrome (pSS). Cytokine profiles in both tear fluid and saliva of pSS patients, non-Sjögren’s syndrome (non-SS) subjects with sicca symptoms, and healthy controls without sicca complaints were analysed. Furthermore, relationships associating the severity of clinical ocular and oral manifestations with the upregulated cytokines were assessed. In tear fluid, pSS patients showed elevated levels of IL-1ra, IL-2, IL-4, IL-8, IL-12p70, IL-17A, IFN-γ, IP-10, MIP-1b, and Rantes compared to non-SS subjects and healthy controls. The increased cytokine levels (except IP-10) correlated significantly with reduced tear production, less stable tear film, and greater ocular surface damage. In saliva, pSS patients had a higher IP-10 level, which correlated with higher candida score; and an elevated MIP-1a level, which correlated significantly with lower unstimulated and stimulated whole saliva secretion rates. The upregulated cytokines identified in tear fluid and saliva of pSS patients show a clear interplay between innate and adaptive immune responses that may contribute to disease pathogenesis. The increase of IP-10 and MIP in both tears and saliva further emphasises the essential role of macrophages and innate immunity in pSS.

• Diep, My Tien; Sødal, Anne T. Tveit; Skudutyte-Rysstad, Rasa & Hove, Lene Hystad (2018). Rutiner for oral helse på sykehjem: En undersøkelse blant sykehjemsledere. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 118(9), p. 694–699. Full text in Research Archive
• Nesvold, Marianne Bakke; Jensen, Janicke Liaaen; Hove, Lene Hystad; Singh, Preet Bano; Young, Alix & Palm, Øyvind [Show all 9 contributors for this article] (2018). Dietary intake, body composition and oral health parameters among female patients with primary Sjögren’s syndrome. Nutrients. 10:866(7), p. 1–12. doi: 10.3390/nu10070866. Full text in Research Archive Show summary

  There is limited knowledge about dietary intake and body composition among patients with primary Sjögren’s syndrome. We assessed dietary intakes with 24-h recalls and body composition with anthropometry and bioelectrical impedance in 20 female patients. Various scoring tools were used to assess oral health. The patients had a lower energy percentage (E%) from carbohydrates (p = 0.02) and a higher E% from fat (p = 0.01) compared to a reference group. The lower intake of carbohydrates was due to a lower bread intake (p = 0.04), while the higher intake of fat was due to a higher intake of butter, margarine, and oil (p = 0.01). The patients ate more than twice (p = 0.02) as much fish as the reference group. The compliance to recommended intakes of macro- and micronutrients was good. Forty-percent of the patients were overweight/obese. Increased intake of beverages was observed in patients with severe xerostomia and/or low oral health-related quality of life, whereas reduced fat intake was found in hyposmic patients. In conclusion, the dietary intake among the patients was not much different from the reference group and complied with recommendations. Most oral health parameters were not associated with nutrient intakes. Specific dietary guidelines are probably not needed to ensure adequate nutrition among such patients.

• Fjeld, Katrine Gahre; Eide, Hilde; Mowe, Morten; Hove, Lene Hystad & Willumsen, Tiril (2017). Dental hygiene registration: development, and reliability and validity testing of an assessment scale designed for nurses in institutions. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 26(13-14), p. 1845–1853. doi: 10.1111/jocn.13452. Full text in Research Archive Show summary

  Abstract Aims and Objectives To develop and test the Dental Hygiene Registration (DHR), a dental hygiene assessment scale for nurses working in institutions. Background Removal of dental plaque is a key factor in preventing oral health related diseases. A simple, but reliable dental hygiene assessment scale that enables nurses to monitor residents’ dental hygiene on a daily basis, will improve monitoring oral hygiene status and quality of dental health care. Design Descriptive study on the development and evaluation of a dental hygiene registration instrument. Methods The DHR was developed and tested over several stages during the period of 2011–2014. DHR consists of a five-point-plaque score scale. The score indicates whether measures are needed. A reference group comprising both medical and dental personnel designed DHR. Dental plaque was used as a measure of dental hygiene. A pictorial series of teeth with varying amounts of plaque was used to achieve intra-examiner agreement. DHR assessments were scored fifty times to assess inter-examiner reliability between one dental hygienist and one clinical nurse. DHR was validated against the plaque index score of the Oral Hygiene Index (OHI-S). The Regional Ethics Committee approved the study (2011/915). Results Estimates for intra-examiner agreement on plaque score were good for the dental hygienist (kappa=0.7) and very good for the clinical nurse (kappa=0.8). Estimates for inter-examiner reliability for DHR between the dental hygienist and the clinical nurse was moderate (kappa=0.4). DHR corresponded significantly with OHI-S (Spearman's correlation coefficient=0.8, p<0.001) indicating good validity. Conclusion The developed DHR appears to be reliable and valid. This article is protected by copyright. All rights reserved.

• Tashbayev, Behzod; Rusthen, Shermin; Young, Alix; Herlofson, Bente Brokstad; Hove, Lene Hystad & Singh, Preet Bano [Show all 13 contributors for this article] (2017). Interdisciplinary, comprehensive oral and ocular evaluation of patients with primary Sjögren's syndrome. Scientific Reports. 7:10761, p. 1–9. doi: 10.1038/s41598-017-10809-w. Full text in Research Archive Show summary

  A comprehensive evaluation of oral and ocular symptoms and findings in primary Sjögren’s syndrome (pSS) patients may provide valuable information for management. Medical history was obtained from female pSS patients, and sex- and age-matched non-SS patients with sicca symptoms (non-SS sicca controls) as well as healthy subjects without sicca complaints (healthy controls). Oral (Summated Xerostomia Inventory, SXI) and ocular (McMonnies Dry Eye questionnaire, MDEIS, and Ocular Surface Disease Index, OSDI) subjective complaints were recorded. Objective findings including clinical oral dryness scores (CODS), unstimulated and stimulated saliva secretion rates (UWS/SWS), Schirmer I test, tear osmolarity, tear film break-up time (TFBUT), and ocular surface staining (OSS) were determined. The pSS and non-SS sicca controls were extensively troubled by subjective dryness, while the pSS group had higher CODS, significantly lower saliva and tear secretion, shorter TFBUT and higher OSS than both control groups. Furthermore, candida counts were significantly higher in the pSS patients. In the pSS group, subjective oral dryness significantly correlated with ocular dryness (MDEIS: r = 0.5, OSDI: r = 0.413) and SWS was significantly correlated with Schirmer I (r = 0.419). The findings imply that interdisciplinary subjective and objective evaluation of patients with xerostomia and xerophthalmia not only have implications for patient care, but also may guide clinicians in differentiating between pSS and non-SS sicca patients.

• Rusthen, Shermin; Young, Alix; Herlofson, Bente Brokstad; Aqrawi, Lara Adnan; Rykke, Morten & Hove, Lene Hystad [Show all 9 contributors for this article] (2017). Oral disorders and oral health-related quality of life in patients with primary Sjögren’s Syndrome. European Journal of Oral Sciences. ISSN 0909-8836. 125(4), p. 265–271. doi: 10.1111/eos.12358. Full text in Research Archive
• Hove, Lene Hystad; Stenhagen, Kjersti Refsholt; Mulic, Aida; Holme, Børge & Tveit, Anne Bjørg (2015). May caries-preventive fluoride regimes have an effect on dental erosive wear? An in situ study. Acta Odontologica Scandinavica. ISSN 0001-6357. 73(2), p. 114–120. doi: 10.3109/00016357.2014.956146. Full text in Research Archive Show summary

  Objective. High and low concentration NaF regimes have shown caries protective properties, but the preventive effect against erosive/abrasive wear is unclear. Aim. To measure the inhibiting effect on enamel wear of low and highly concentrated sodium fluoride (NaF) toothpastes and a stannous (SnF2) fluoride gel in a single-blind, randomized in situ study, using a White Light Interferometer. Materials and methods. Sixteen human molars were each divided into four specimens, mounted on acrylic mouth appliances and worn by eight volunteers for 9 days. Experimental procedures were performed in the laboratory. The enamel specimens were brushed every day with fluoride-free toothpaste. Treatments; group 1: no fluoride treatment (control), group 2: SnF2 gel 2500 ppm F (5 min) every third day, group 3: NaF toothpaste 5000 ppm F 5 min every third day and 2 min the other days, group 4: NaF toothpaste 1450 ppm F (2 min) every day. In order to mimic gastric reflux/vomiting, the specimens were etched with 0.01 M HCl for 2 min twice a day. Results. The mean step height (µm) for the control specimens was −32.9 (SD = 6.8). The mean values for the other groups were −22.2 (SD = 8.4) (group 2), −30.8 (SD = 7.8) (group 3) and −31.4 (SD = 7.7) (group 4). Compared with the control, the SnF2 treated specimens showed significantly lower wear. The NaF toothpastes gave no significant protective effect. Conclusions. Application of SnF2 gel every third day gave protection against erosive–abrasive challenges. Daily application of both low concentration and high concentration NaF toothpaste provided no protection.

• Hove, Lene Hystad; Stenhagen, Kjersti Refsholt; Holme, Børge & Tveit, Anne Bjørg (2014). The protective effect of SnF2 containing toothpastes and solution on enamel surfaces subjected to erosion and abrasion in situ. European Archives of Paediatric Dentistry. ISSN 1818-6300. 15(4), p. 237–243. doi: 10.1007/s40368-013-0107-7. Full text in Research Archive Show summary

  Background: Stannous fluoride solutions have shown promising protective effect against erosion/abrasion, but the effect of SnF2 toothpastes is uncertain. Aim: The aim of the study was to test the inhibiting effect of two SnF2 toothpastes and a SnF2 solution against erosive/abrasive wear in a single-blind, randomised in situ study, using a white light interferometer. Methods: Sixteen human molars were each divided into four specimens, mounted on mouth appliances and worn by 8 volunteers for 9 days. Specimens were brushed with toothpaste twice each day for 30 s either with fluoride-free toothpaste or toothpastes including SnF2. Toothpaste was left on the surface for 90 additional seconds. Group 1, fluoride-free toothpaste; Group 2, toothpaste A (0.4 % SnF2, Solidox); Group 3, toothpaste B (0.454 % SnF2, Oral-B®); Group 4, brushed with fluoride-free toothpaste (30 s) and treated for 2 min with a 0.4 % SnF2 solution (1,000 ppm F). To mimic gastric reflux/vomit, specimens were etched for 2 min twice a day (0.01 M HCl). Procedures were performed extra-orally. Results: The mean enamel wear (in μm) for the control specimens was: −29.2 ± SD 10.5; for group 2 −14.5 SD ± 9.3; for group 3 −33.3 SD ± 7.4, and for group 4 +0.4 SD ± 1.3. The specimens treated with SnF2 solution and toothpaste A showed significantly lower enamel wear than the control group. Toothpaste B gave no significant reduction in enamel wear. Conclusions: The SnF2 solution fully protected the enamel surface against erosive and abrasive challenges. The SnF2 toothpaste A (Solidox) showed less, but significant protection of the enamel, while no statistically significant protection was demonstrated by SnF2 toothpaste B (Oral-B® Pro-Expert).

• Austin, Rupert; Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Tveit, Anne Bjørg; Moazzez, Rebecca & Bartlett, David (2014). The effect of single-application fluoride treatment on simulated gastric erosion and erosion-abrasion of enamel in vitro. International Journal of Prosthodontics. ISSN 0893-2174. 27(5), p. 425–426. doi: 10.11607/ijp.3956. Full text in Research Archive
• Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Holme, Børge & Tveit, Anne Bjørg (2013). Enamel erosion depths measured on impressions by a white light interferometer. Acta Odontologica Scandinavica. ISSN 0001-6357. 71(3-4), p. 398–403. doi: 10.3109/00016357.2012.690527. Full text in Research Archive Show summary

  Abstract Objective. To investigate if measurements of the step heights on an impression of eroded enamel surfaces may give reliable values of the etching depths measured directly on the enamel. Materials and methods. Twelve human enamel specimens, with one circular amalgam reference surface in each, were mounted on an epoxy block and ground flat. Baseline images were taken by a White Light Interferometer (WLI) followed by 12 min etch by 0.01 M HCl, pH 2.2. The mean etch depth on each specimen was calculated from three repeated measurements, both on the specimen surfaces and on the silicone polymer impressions of the surfaces. Paired samples t-test was used when comparing the precision of measurements on enamel vs on impression. Results. The mean lesion depths after 12 min etch measured on the 12 enamel surfaces and impressions were 9.9 µm and 10.6 µm, respectively. The direct and indirect measurements correlated well (r (2) = 0.95), with 7% higher mean etch depth measured on the impressions (p < 0.05). The reliability of three repeated measurements on enamel and impressions expressed by Intra Class Correlation (ICC) were 0.98 and 0.99, respectively. The average relative precisions of three repeated measurements on the 12 tooth and impression surfaces were (0.5 ± 0.1)% and (0.1 ± 0.02)%, respectively (p < 0.05). The accuracies were 0.4% and 7%, respectively. Conclusion. WLI gave reliable but slightly higher etch depth measurements on impressions compared to enamel surfaces.

• Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Holme, Børge & Tveit, Anne Bjørg (2013). The Effect of Daily Fluoride Mouth Rinsing on Enamel Erosive/Abrasive Wear in situ. Caries Research. ISSN 0008-6568. 47(1), p. 2–8. doi: 10.1159/000342619. Full text in Research Archive Show summary

  It is not known whether application of fluoride agents on enamel results in lasting resistance to erosive/abrasive wear. We investigated if one daily mouth rinse with sodium fluoride (NaF), stannous fluoride (SnF(2)) or titanium tetrafluoride (TiF(4)) solutions protected enamel against erosive/abrasive wear in situ (a paired, randomised and blind study). Sixteen molars were cut into 4 specimens, each with one amalgam filling (measurement reference surface). Two teeth (2 × 4 specimens) were mounted bilaterally (buccal aspects) on acrylic mandibular appliances and worn for 9 days by 8 volunteers. Every morning, the specimens were brushed manually with water (30 s) extra-orally. Then fluoride solutions (0.4% SnF(2) pH 2.5; 0.15% TiF(4) pH 2.1; 0.2% NaF pH 6.5, all 0.05 M F) were applied (2 min). Three of the specimens from each tooth got different treatment, and the fourth served as control. At midday, the specimens were etched for 2 min in 300 ml fresh 0.01 M hydrochloric acid and rinsed in tap water. This etch procedure was repeated in the afternoon. Topographic measurements were performed by a white-light interferometer. Mean surface loss (±SD) for 16 teeth after 9 days was: SnF(2) 1.8 ± 1.9 µm, TiF(4) 3.1 ± 4.8 µm, NaF 26.3 ± 4.7 µm, control 32.3 ± 4.4 µm. Daily rinse with SnF(2), TiF(4) and NaF resulted in 94, 90 and 18% reduction in enamel erosive/abrasive wear, respectively, compared with control (p < 0.05). The superior protective effect of daily rinse with either stannous or titanium tetrafluoride solutions on erosive/abrasive enamel wear is promising.

• Hove, Lene Hystad; Mulic, Aida; Tveit, Anne Bjørg; Stenhagen, Kjersti; Skaare, Anne B & Espelid, Ivar (2013). Registration of dental erosive wear on study models and intra-oral photographs. European Archives of Paediatric Dentistry. ISSN 1818-6300. 14(1). doi: 10.1007/s40368-012-0004-5. Full text in Research Archive
• Mulic, Aida; Tveit, Anne Bjørg; Hove, Lene Hystad & Skaare, Anne B (2011). Dental erosive wear among Norwegian wine tasters. Acta Odontologica Scandinavica. ISSN 0001-6357. 69(1), p. 21–26. doi: 10.3109/00016357.2010.517554. Full text in Research Archive
• Austin, Rupert; Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Dunne, Stephen; Moazzez, Rebecca & Bartlett, David [Show all 7 contributors for this article] (2011). A qualitative and quantitative investigation into the effect of fluoride formulations on enamel erosion and erosion-abrasion in vitro. Journal of Dentistry. ISSN 0300-5712. 39(10), p. 648–655. doi: 10.1016/j.jdent.2011.07.006. Full text in Research Archive
• Hove, Lene Hystad; Holme, Børge; Stenhagen, Kjersti Refsholt & Tveit, Anne Bjørg (2011). Protective effect of TiF(4) solutions with different concentrations and pH on development of erosion-like lesions. Caries Research. ISSN 0008-6568. 45(1), p. 64–68. doi: 10.1159/000324155. Full text in Research Archive
• Mulic, Aida; Tveit, Anne Bjørg; Hove, Lene Hystad & Skaare, Anne B (2010). Dental erosive wear among Norwegian winetasters. Acta Odontologica Scandinavica. ISSN 0001-6357. 69(1), p. 21–26. doi: 10.3109/00016357.2010.517554. Full text in Research Archive
• Mulic, Aida; Tveit, Anne Bjørg; Wang, Nina Johanne; Hove, Lene Hystad; Espelid, Ivar & Skaare, Anne B (2010). Reliability of Two Clinical Scoring Systems for Dental Erosive Wear. Caries Research. ISSN 0008-6568. 44(3), p. 294–299. doi: 10.1159/000314811. Full text in Research Archive
• Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Holme, Børge; Taxt-Lamolle, Sebastien Francis Michel & Tveit, Anne Bjørg (2010). Comparing Different Methods to Assess Erosive Lesion Depths and Progression in vitro. Caries Research. ISSN 0008-6568. 44(6), p. 555–561. doi: 10.1159/000321536. Full text in Research Archive

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• Sødal, Anne Thea Tveit; Skudutyte-Rysstad, Rasa; Diep, My Tien & Hove, Lene Hystad (2026). Risk Indicators for Irregular Dental Attendance Among 65-Year-Olds in Oslo. Full text in Research Archive
• Maroufi, Sada; Milanovic, Blagica; Hove, Lene Hystad; Høyvik, Ann Catrin; Torgersen, Gerald R. & Fjeld, Katrine Gahre (2025). SimSamBot – Development of an AI-Based Training Robot Assisting Students in Communication with Dementia Patients. Full text in Research Archive Show summary

  Background The increasing prevalence of dementia presents unique challenges for dental professionals, particularly in communication and patient management. Effective communication is critical to providing compassionate, patient-centered care, yet dental students often lack the necessary training to interact confidently with dementia patients. Aims and Objectives This project aims to equip dental students with the skills and knowledge required to communicate effectively with dementia patients. Specific objectives include: 1 Developing a communication training module tailored to dementia care; 2 Enhancing students’ ability to recognize and adapt to the needs of patients with cognitive decline; and 3 Promoting empathy and understanding through experiential learning approaches. Materials and Methods A large language model (LLM) acting as communication robot is supplied with data on the patient groups it simulates. Information is collected through literature reviews and audio recordings of clinical consultations with dementia patients, with consent from the healthcare provider, patient and relatives if needed. Recordings are anonymized and transcribed immediately after consultations, with the original recordings subsequently deleted. Only anonymized data is used in the robot. Results While full implementation is forthcoming, anticipated outcomes include improved student confidence in communicating with dementia patients, enhanced empathy, and better preparedness for clinical practice. Discussion and Conclusion This initiative addresses a critical need in dental education by preparing students for the complexities of dementia care. By fostering effective communication skills, this project aligns with ADEEʼs vision of reimagining education to meet evolving societal needs. The outcomes will contribute to improved oral health care for dementia patients while advancing the pedagogical standards of dental education globally.

• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Exploring Associations Between Medication Use, Frailty and Oral Health in Acutely Ill Older Adults. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Dry Mouth, Frailty and Polypharmacy in Acutely Ill Older Adults. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Preliminary data from the COOP II study - exploring oral and general health among older people in need of acute care. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Preliminary data from the COOP II study – exploring oral and general health among older people in need of short-time acute care. Full text in Research Archive
• Santervas, Leonor Roa; Wyller, Torgeir Bruun; Skovlund, Eva; Kristoffersen, Espen Saxhaug; Ringstad, Ingrid Beate & Jensen, Janicke Cecilie Liaaen [Show all 9 contributors for this article] (2024). Frailty and Health-Related Quality of Life in Older Adults Admitted to Oslo Municipal In-Patient Acute Care Unit. Full text in Research Archive
• Santervas, Leonor Roa; Wyller, Torgeir Bruun; Skovlund, Eva; Jensen, Janicke Liaaen; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 11 contributors for this article] (2024). Cooperation across healthcare service levels for medication reviews in older people with polypharmacy admitted to a municipal in-patient acute care unit (The COOP II Study): study protocol for a randomized controlled trial. Trials. 25(1). doi: 10.1186/s13063-024-08442-w. Full text in Research Archive Show summary

  Background: Polypharmacy and inappropriate drug use are associated with adverse health outcomes in older people. Collaborative interventions between geriatricians and general practitioners have demonstrated effectiveness in improving clinical outcomes for complex medication regimens in home-dwelling patients. Since 2012, Norwegian municipalities have established municipal in-patient acute care (MipAC) units, designed to contribute towards reducing the number of hospital admissions. These units predominantly serve older people who typically benefit from multidisciplinary approaches. The primary objective of this study is to evaluate the effect of cooperative medication reviews conducted by MipAC physicians, supervised by geriatricians, and in collaboration with general practitioners, on health-related quality of life and clinical outcomes in MipAC patients ≥ 70 years with polypharmacy. Additionally, the study aims to assess the carbon footprint of the intervention. Methods: This is a randomized, single-blind, controlled superiority trial with 16 weeks follow-up. Participants will be randomly assigned to either the control group, receiving usual care at the MipAC unit, or to the intervention group which in addition receive clinical medication reviews that go beyond what is considered usual care. The medication reviews will evaluate medication appropriateness using a structured but individualized framework, and the physicians will receive supervision from geriatricians. Following the clinical medication reviews, the MipAC physicians will arrange telephone meetings with the participants’ general practitioners to combine their assessments in a joint medication review. The primary outcome is health-related quality of life as measured by the 15D instrument. Secondary outcomes include physical and cognitive functioning, oral health, falls, admissions to healthcare facilities, and mortality. Discussion: This study aims to identify potential clinical benefits of collaborative, clinical medication reviews within community-level MipAC units for older patients with polypharmacy. The results may offer valuable insights into optimizing patient care in comparable municipal healthcare settings. Trial registration: The study was registered prospectively on ClinicalTrials.gov 30.08.2023 with identifier NCT06020391.

• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). What happens to oral health when multimorbidity, polypharmacy and frailty comes along? Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). Oral Health in Times of Frailty and Polypharmacy. Full text in Research Archive
• Ringstad, Ingrid Beate; Fjeld, Katrine Gahre & Hove, Lene Hystad (2023). Gerodontologiske vurderinger og behandlinger anno 2023. Full text in Research Archive
• Frigaard, Julie Mari; Hynne, Håvard; Randsborg, Karoline; Mellin-Olsen, Tonje; Young, Alix & Rykke, Morten [Show all 10 contributors for this article] (2022). Oral health indicators, oral health-related quality of life and nutritional aspects in medicated patients suffering from anxiety, psychosis, and/or depression. Frontiers in Public Health. Full text in Research Archive
• Frigaard, Julie Mari; Hynne, Håvard; Young, Alix; Hove, Lene Hystad; Rykke, Morten & Singh, Preet Bano [Show all 7 contributors for this article] (2022). Do medicated psychiatric patients differ from other dry mouth patients? Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Orale soppinfeksjoner - mer enn Candida albicans: mikrobiologiske analyser av prøver fra alvorlig syke pasienter med kreft. Full text in Research Archive Show summary

  Bakgrunn Pasienter med alvorlig kreftsykdom er utsatte for orale soppinfeksjoner, grunnet sykdommen, kreftbehandling og/eller svekket immunforsvar. Orale soppinfeksjon påvirker pasienters matlyst, ernæringstilstand og livskvalitet. Candida albicans er en vanlig soppart i munnhulen, men forekomst av non-albicans Candida-arter, og i kombinasjon med C. albicans, er økende. Artene har varierende toleranse for antimykotiske midler, det kan gi behandlingsutfordringer. Hensikten med studien var å identifisere og resistensteste Candida sopparter i munnhulen til alvorlig syke pasienter med kreft. Metode Sopprøver tatt under studien Oral Health in Advanced Cancer i perioden 2014 – 2016, ble analysert høsten 2020. Pasientprøvene ble re-dyrket ved Institutt for oral biologi, Universitetet i Oslo. Soppartene ble identifisert biokjemisk og ved DNA sekvensering, og resistenstestet for antimykotiske legemidler: fluconazole, amphotericin B, anidulafungin og nystatin. Resultat Vi analyserte totalt 56 isolater fra 45 pasienter og identifiserte syv Candida arter og en Saccharomyces. Til sammen hadde 36 pasienter oppvekst av én soppart, og 9 pasienter hadde 2 til 3 ulike sopparter i munnhulen. Av C. albicans artene var 39 av 40 følsomme for fluconazole. To Candida parapsilosis og en Candida tropicalis var resistent mot anidulafungin. En C. tropicalis var resistent mot anidulafungin. En Candida glabrata var resistent mot fluconazole. Konklusjon Studien viste at forskjellige Candida arter forekommer både i monoinfeksjoner og blandingsinfeksjoner. C. albicans var dominerende med høy følsomhet for antimykotiske midler. Blandingsinfeksjoner kan komplisere behandlingen og forårsake gjentagende infeksjoner. Mikrobiologiske prøver og analyser med identifisering og resistenstesting, bør være en del av utredningen hos pasienter med alvorlig og tilbakevendende orale soppinfeksjoner.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Identification and susceptibility testing of oral candidiasis in advanced cancer patients – an important diagnostic tool. Full text in Research Archive Show summary

  Background: Candida albicans is the most common fungal species detected in the oral cavity. Studies of oral fungal samples have shown an increased prevalence of non-C. albicans species in mixed infection with C. albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azole. This may have implications for treatment, due to acquired antifungal resistance. Aims: To assess the diversity and susceptibility of detected Candida species in the oral cavity in patients with advanced cancer. Methods: Clinical fungal isolates sampled in 2014-2016 from 45 patients in a hospice unit were analyzed. A total of 56 isolates were grown on chromID Candida plates. After phenotypic identification by colour of the colonies, one single colony of each species was re-cultivated and prepared for identification on a VITEK2® system. Susceptibility testing with E-test was performed on RPMI agar, and the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 Candida isolates were identified. The diversity of Candida species was dominated by C. albicans at 89%, followed by C. glabrata 11%, C. parapsilosis 7%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Thirty-six patients had monoculture, and nine patients had 2-3 different species detected. Almost all C. albicans strains (97.5%) were susceptible to fluconazole. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. Conclusion: C. albicans was the most prevalent Candida species in our sample. Variation in susceptibility was observed in patients with both C. albicans and C. glabrata. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment and accelerate the development of resistance.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Oral candidiasis in advanced cancer – identification and susceptibility testing of detected Candida species. Full text in Research Archive Show summary

  Introduction: Candida albicans is the most common fungal species in the oral cavity. Increased prevalence of non-C. albicans are detected, and co-infection with C. albicans may have implications for treatment, due to antifungal resistance. The aim of the study was to assess the diversity and susceptibility of oral yeasts in patients with advanced cancer. Methods: Clinical fungal isolates were sampled in 2014-2016 from 45 patients in a hospice unit. Totally 56 isolates were grown on chromID Candida plates, prepared for biochemical identification, and controlled with DNA sequencing. E-test was performed with the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 isolates were identified. Candida species was dominated by C. albicans at 71%, followed by C. glabrata 9%, C. parapsilosis 5%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Nine patients had 2-3 different species. C. albicans strains were susceptible to fluconazole in 97.5%. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. The sequencing confirmed the biochemical identification. Conclusion: C. albicans was the most prevalent species. Variation in susceptibility was observed in patients with mixed colonies. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment.

• Hynne, Håvard; Aqrawi, Lara A.; Chen, Xiangjun; Amdal, Cecilie Delphin; Reppe, Sjur & Aass, Hans Christian Dalsbotten [Show all 14 contributors for this article] (2021). Cytokine profiling, clinical oral and ocular manifestations post radiotherapy. Full text in Research Archive
• Young, Alix; Jensen, Janicke Liaaen; Hove, Lene Hystad; Fjeld, Katrine Gahre & Blich, Carl Christian (2021). Et smil uten smerter? Full text in Research Archive
• Fjeld, Katrine Gahre; Hove, Lene Hystad; Shamsolebad, Hoda & Kroglund, Sara (2021). Individuell munnstellboks kan hjelpe eldre med den orale hygienen. Sykepleien.no. Full text in Research Archive
• Diep, My Tien; Jensen, Janicke Liaaen; Sødal, Anne Thea Tveit; Young, Alix; Skudutyte-Rysstad, Rasa & Hove, Lene Hystad (2020). Are Xerostomia and Hyposalivation Common Problems Among 65-Year-Olds? Caries Research. ISSN 0008-6568. 54(4), p. 449–450. doi: 10.1159/000511860. Full text in Research Archive
• Sødal, Anne Thea Tveit; Singh, Preet Bano; Diep, My Tien & Hove, Lene Hystad (2020). Prevalence of Smell, Taste, Trigeminal Disorders and Quality of Life Among 65-Year-Olds in Oslo. Caries Research. ISSN 0008-6568. 54(4), p. 449–449. doi: 10.1159/000511860. Full text in Research Archive
• Fjeld, Katrine Gahre; Hove, Lene Hystad; Bargbidi, Mitra; Abrahamsen, Siren & Heggestad, Anne Kari Tolo (2019). Eldre som ikke koopererer-etiske aspekter. Aktuell Nordisk odontologi. ISSN 1902-3545. Full text in Research Archive
• Jensen, Janicke Liaaen & Hove, Lene Hystad (2019). Eldres munnhelse: La oss fortelle historien om Berit. Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Saghaug, Elisabeth [Show all 10 contributors for this article] (2019). A comparison of normal saline mouth rinse and mouth rinse based on Salvia officinalis in palliative care: A randomized controlled trial. Full text in Research Archive
• Young, Alix; Singh, Preet Bano; Hynne, Håvard; Westergaard, Kristine Løken; Hove, Lene Hystad & Rykke, Morten [Show all 10 contributors for this article] (2019). Oral Investigations in Head and Neck Cancer Patients after Radiotherapy. Full text in Research Archive Show summary

  Objectives: To investigate oral complaints and findings in head and neck cancer (HNC) patients who had received radiotherapy and compare them with controls. Methods: As part of a larger study, 30 HNC patients (14 female, age 64.2±9.6y) and 26 age- and sex-matched controls (13 female, 62.9±12.9y, p=0.850) were examined at the Dry Mouth Clinic, Faculty of Dentistry, Oslo. Oral health-related quality of life (OHRQoL) was assessed using the short form Oral Health Impact Profile (OHIP-14: high score-low OHRQoL). Self-reported dysgeusia (yes/no) and sense of taste (10-point VAS: high score-good smell sense) were recorded. Taste scores were recorded using taste strips (high score-good taste function). Oral candida counts were determined from cheek and tongue swabs (0=no growth, 1=minimal, 2=moderate, 3=severe). Volatile sulphur compounds (VSC) in mouth air samples were determined by gas chromatography and related to perceptive threshold-levels (H2S≤112ppb, CH3SH≤26ppb). Between-group comparisons were performed using Mann-Whitney U test and Chi-square test. Results: The HNC patients reported significantly poorer OHRQoL than controls (OHIP sum-score: 18.4±12.4 vs 1.2±2.0, p<0.001). They reported significantly poorer sense of taste compared to controls (6.4±2.4 vs 7.8±1.9, p=0.018), and more often dysgeusia (26.7% vs 7.7%, p=0.087). The measured gustatory scores (20.4±6.4 vs 22.3±4.6, p=0.315) were similar for both groups. Candida scores were significantly higher in the patient group (1.6±1.3 vs 0.7±0.9, p=0.024). The percentage of HNC patients who had oral H2S above the threshold level was significantly lower than for the controls (0% vs 27%, p<0.05). This was not the case for CH3SH (5.5% vs 27%, p=0.105). Conclusion: After radiotherapy, these HNC patients experienced negative oral consequences of the treatment. They reported poorer OHRQoL, and had reduced taste sensation and higher oral candida counts. However, the underlying reason for less problems with halitosis in HNC patients than in controls is worth further exploration.

• Jensen, Janicke Liaaen; Chen, Xiangjun; Hynne, Håvard; Westgaard, Kristine Løken; Hove, Lene Hystad & Young, Alix [Show all 14 contributors for this article] (2019). Sjögren’s versus irradiated head-neck cancer patients: oral and ocular investigations. Full text in Research Archive
• Hynne, Håvard; Westgaard, Kristine Løken; Herlofson, Bente Brokstad; Amdal, Cecilie Delphin; Hove, Lene Hystad & Young, Alix [Show all 10 contributors for this article] (2019). Oral and Ocular Findings in Radiated Head-and Neck Cancer Patients. Full text in Research Archive
• Homayouni, Amin; Tashbayev, Behzod; Rusthen, Shermin; Hove, Lene Hystad; Rykke, Morten & Singh, Preet Bano [Show all 9 contributors for this article] (2018). Can saliva secretion affect oral malodour and oral health-related quality of life? Full text in Research Archive Show summary

  The aim of this study was to investigate the relationship between saliva secretion, halitosis and oral health-related quality of life (HRQoL). Informed consent was obtained from 65 participants including 24 patients with primary Sjögren’s Syndrome (pSS, 53±12y), 17 patients with dry eyes and dry mouth not fulfilling the classification for pSS (non-SS-sicca, 53±11y), and 24 healthy controls (49±11y). Unstimulated (UWS) and stimulated (SWS) whole saliva secretion rates were recorded as low (hyposalivation: SWS <0.7 ml/min, UWS <0.1 ml/min) or normal (SWS >0.7 ml/min, UWS >0.1 ml/min). Volatile sulfur compounds (VSC: hydrogen sulphide-H2S, methylmercaptan-CH3SH) in mouth air were measured by gas chromatography. HRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Mann-Whitney test was used in data analysis (p<0.05). In general, for UWS, subjects with hyposalivation had significantly higher mean CH3SH-levels than those with normal salivation (27.339.3 vs 9.913.6 ppb). For SWS, subjects with hyposalivation had significantly higher mean H2S-levels (184.5464.8 vs 43.964.1 ppb) and CH3SH-levels (27.237.4 vs 6.58.9 ppb). Within the non-SS patient group, those with hyposalivation had significantly higher H2S-levels than those with normal salivation. In general, there were no significant differences in OHIP-scores based on VSC levels. However, within the non-SS group, those with high H2S-levels (>112 ppb) reported significantly more often that they had “difficulties relaxing due to oral problems”, and that “life has been less satisfactory due to oral problems”, than those with low H2S-levels (<112 ppb). In conclusion, hyposalivation was generally associated with increased levels of oral VSC, indicating oral malodour. Surprisingly, patients with dry eyes and dry mouth who did not fulfill the classification for pSS seemed to be more affected in their daily life than patients who fulfilled the criteria.

• Langeland, Øystein; Tashbayev, Behzod; Rusthen, Shermin; Young, Alix; Herlofson, Bente Brokstad & Hove, Lene Hystad [Show all 14 contributors for this article] (2018). Comparative Ocular and Oral Findings in Sicca Complex. Full text in Research Archive
• Rosvold, Elin Olaug; Svensberg, Karin; Kalleberg, Birgitte; Mathiesen, Liv; Hellesø, Ragnhild & Hove, Lene Hystad (2018). SamPraks Research Project at UiO. Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Saghaug, Elisabeth; Tollisen, Anita & Fjeld, Katrine Gahre [Show all 10 contributors for this article] (2018). Rekruttering av pasienter til en klinisk intervensjonsstudie i et Hospice. Full text in Research Archive
• Tashbayev, Behzod; Chen, Xiangjun; Utheim, Øa; Rusthen, Shermin; Young, Alix & Herlofson, Bente Brokstad [Show all 14 contributors for this article] (2018). Primary Sjögren´s Syndrome and Non-Sjögren´s Sicca Syndrome Patients; unexpected differences in symptoms and findings of dry eye disease, dry mouth, and oral health related quality of life. Full text in Research Archive
• Hynne, Håvard; Tashbayev, Behzod; Young, Alix; Herlofson, Bente Brokstad; Hove, Lene Hystad & Rykke, Morten [Show all 14 contributors for this article] (2018). Evaluation of Dry Eye Disease, Oral Dryness and Inflammatory Cytokines in Primary Sjögren´s Syndrome. Full text in Research Archive
• Hove, Lene Hystad; Young, Alix; Hjortsjø, Carl; Stevning, Karen & Løvik, Sara Emilie (2017). Effect of Whitening Toothpastes on Dental Enamel In Vitro. Full text in Research Archive
• Tashbayev, Behzod; Rusthen, Shermin; Chen, X; Utheim, Tor Paaske; Utheim, Øygunn Aass & Young, Alix [Show all 12 contributors for this article] (2017). Dry Mouth and Dry Eye Examinations of a Norwegian Cohort of Primary Sjögren´s Syndrome Patients. Full text in Research Archive
• Jensen, Janicke Liaaen; Herlofson, Bente Brokstad & Hove, Lene Hystad (2017). Spyttet vårt er livsviktig. Full text in Research Archive
• Jensen, Janicke Liaaen; Herlofson, Bente Brokstad; Young, Alix; Hove, Lene Hystad & Galtung, Hilde (2017). Verdien av spytt. Full text in Research Archive
• Gay, Caryl; Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 11 contributors for this article] (2017). Oral health symptoms that interfere with eating and drinking among hospice patient. Full text in Research Archive
• Rusthen, Shermin; Young, Alix; Preet, Bano; Tashbayev, Behzod; Garen, Torhild Oddveig & Aqrawi, Lara A. [Show all 11 contributors for this article] (2017). Is Health-related Quality of Life Correlated to Oral Status in Primary Sjögren’s Syndrome Patients? Full text in Research Archive
• Singh, Preet Bano; Rusthen, Shermin; Aqrawi, Lara A.; Young, Alix; Rykke, Morten & Hove, Lene Hystad [Show all 9 contributors for this article] (2016). Chemosensory disorders, burning mouth sensation, and halitosis in patients with Sjögren’s syndrome. Full text in Research Archive
• Rusthen, Shermin; Singh, Preet Bano; Young, Alix; Aqrawi, Lara Adnan; Rykke, Morten & Hove, Lene Hystad [Show all 9 contributors for this article] (2016). Oral quality of life, salivary, gustatory and olfactory status in patients with primary Sjögren’s syndrome. Full text in Research Archive
• Young, Alix; Rusthen, Shermin; Aqrawi, Lara Adnan; Rykke, Morten; Hove, Lene Hystad & Herlofson, Bente Brokstad [Show all 9 contributors for this article] (2016). Dental health status of patients diagnosed with primary Sjögren's Syndrome. Full text in Research Archive Show summary

  This clinical study aims to assess some oral health parameters in patients diagnosed with primary Sjögren’s Syndrome (pSS), and is part of a larger project studying groups of patients suffering from dry mouth. Material and methods: Twenty female pSS patients (mean age 54±12.7y) and 32 healthy controls (mean age 50±12.4y), were recruited to the study and examined at a newly established Dry Mouth Clinic at the Faculty of Dentistry, University of Oslo, after giving written consent. A questionnaire was filled out and clinical and radiological examinations were performed. Differences between the patient and control groups were calculated using t-test or Chi-squared tests. Results: Approximately 1/3 of patients considered their general and oral health as ‘poor’ or ‘very poor’. No controls considered their general health as ‘poor’ or ‘very poor’, and only 1 control considered their oral health as ‘poor’ or ‘very poor’. Ninety percent of patients and 75% of controls had visited the dentist within the last year. There was no between-group difference in the mean number of teeth present (patients 25.5±2.7; controls 26.1±3.8). The patients had higher mean caries experience: DMFT (patients: 18.0±6.45; controls 12.9±7.26, p=0.014), FT (patients: 15.35±5.77; controls 11.28±6.10, p=0.02), and D3-5T (patients: 0.60±0.94; controls: 0.28±0.58, p=0.136). Visible plaque was observed in 30% of patients and 9.4% of controls (p=0.056). Signs of gingivitis were observed in 25% of patients and 6% of controls (p=0.054). Conclusion: Compared to controls, pSS patients reported poorer general and oral health. They had significantly higher dental caries experience, and a tendency to more plaque and gingivitis. However, the pSS patients reported visiting their dentist more regularly than the controls, suggesting an awareness of the oral consequences of reduced salivary function.

• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tallang, Oddveig Utheim [Show all 10 contributors for this article] (2016). Munntørrhet hos palliative pasienter - en randomisert kontrollert studie i en hospiceenhet. Full text in Research Archive
• Hove, Lene Hystad; Aqrawi, Lara Adnan; Rusthen, Shermin; Young, Alix; Rykke, Morten & Herlofson, Bente Brokstad [Show all 10 contributors for this article] (2016). Establishment of a Dry Mouth Clinic at the Faculty of Dentistry, University of Oslo, Norway. Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tollissen, Anita [Show all 8 contributors for this article] (2015). Munnskylling med te av Salvia Officinalis som del av palliativ behandling - fra gode erfaringer til en klinisk forskningsstudie. Full text in Research Archive
• Hove, Lene Hystad; Stenhagen, Kjersti Refsholt; Holme, Børge & Tveit, Anne Bjørg (2013). The protective effect of SnF2 containing toothpastes and solution on enamel surfaces subjected to erosion and abrasion in situ. Full text in Research Archive
• Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Holme, Børge & Tveit, Anne Bjørg (2012). The effect of daily fluoride mouth rinse against enamel erosive/abrasive wear in situ. Full text in Research Archive
• Hove, Lene Hystad; Stenhagen, Kjersti Refsholt; Mulic, Aida; Holme, Børge & Tveit, Anne Bjørg (2012). Protective effect of fluoride toothpastes or fluoride gel against erosive/ abrasive wear, an in-situ study. Full text in Research Archive
• Stenhagen, Kjersti Refsholt; Austin, Rupert; Hove, Lene Hystad; Tveit, Anne Bjørg; Festy, Fred & Moazzezz, Rebecca [Show all 7 contributors for this article] (2011). The Effect of Topical Fluorides on Enamel Volume Loss from Erosion and Erosion-Abrasion in vitro. Full text in Research Archive
• Hove, Lene Hystad; Stenhagen, Kjersti Refsholt; Holme, Børge & Tveit, Anne Bjørg (2011). Enamel erosion depths measured on impressions by a White Light Interferometer. Full text in Research Archive
• Stenhagen, Kjersti Refsholt; Hove, Lene Hystad; Tveit, Anne Bjørg & Kvam, Ketil (2010). Appearance of natural enamel after topical fluoride treatments and abrasion in vitro. Full text in Research Archive
• Hove, Lene Hystad; Tveit, Anne Bjørg; Stenhagen, Kjersti Refsholt & Holme, Børge (2010). Protective effect of TiF4 solution with different concentrations and pH on development of erosion-like lesions. Full text in Research Archive
• Hove, Lene Hystad; Holme, Børge; Stenhagen, Kjersti Refsholt & Tveit, Anne Bjørg (2009). Comparing four techniques for analyzing erosive tooth loss and progression in vitro. Full text in Research Archive
• Mulic, Aida; Tveit, Anne Bjørg; Wang, Nina Johanne; Hove, Lene Hystad; Espelid, Ivar & Skaare, Anne B (2009). Testing the Reliability of Two Clinical Scoring Systems for Dental Erosion. Full text in Research Archive
• Hove, Lene Hystad; Tveit, Anne Bjørg & Øgaard, Bjørn (2008). The inhibiting effect of TiF4, SnF2 and NaF on erosion-like lesions in-vitro and in-situ. Universitetet i Oslo. ISSN 9788249703081. Full text in Research Archive

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