Tiril Willumsen

• Saanum, Mariann; Storå, Bent Schøgren & Willumsen, Tiril (2026). Oral health status and treatment needs among adults seeking dental anxiety treatment in general practice - a cross-sectional study. Acta Odontologica Scandinavica. ISSN 0001-6357. 85, s. 520–527. doi: 10.2340/aos.v85.46516. Fulltekst i vitenarkiv
• Sørbø, Marie Flem; Sun, Yi-Qian; Kvist, Therese; Rønneberg, Anne; Myran, Lena & Havnen, Audun [Vis alle 10 forfattere av denne artikkelen] (2025). Associations between adverse childhood experiences and oral health in Norwegian adults, and the impact of social support and adulthood revictimization. The HUNT4 Survey. European Journal of Public Health. ISSN 1101-1262. doi: 10.1093/eurpub/ckaf229. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Adverse childhood experiences (ACEs) increase the risk of various health issues, including oral problems. ACEs also heighten the risk of revictimization, though the impact of adulthood revictimization on oral health is less understood. Conversely, positive influences, such as a trusted adult in childhood, may buffer these effects. This study examines how different dimensions of adversity relate to oral health. This cross-sectional study included 37 559 adults from the HUNT4 Survey, a general population study in Norway. We examined distinct ACE exposures: (i) specific ACEs (i.e. sexual, physical and psychological abuse, bully victimization, parental divorce, and death of a parent), (ii) cumulative ACE, (iii) combined exposure of ACE and adult support, and (iv) adversity trajectories identified by group-based trajectory modelling of ACE and adulthood sexual, physical and psychological abuse. Associations with oral health were assessed by logistic regression, estimating odds ratios with 95% confidence intervals. Most ACE types were associated with poorer adult oral health outcomes, exhibiting a dose–response gradient, where one-unit ACE increase indicated a higher likelihood of self-reported poor dental health (28%), dental fear (31%), and no dental visit in the last 2 years (10%). Combined exposure of ACE and adult support showed that those with high support had lower odds of reporting poor oral health. The revictimized trajectory exhibited the strongest association with impaired oral health outcomes. Our findings support that ACEs are linked to poor oral health later in life, especially among those revictimized as adults, whilst supportive childhood relations may buffer this effect.

• Myran, Lena; Sun, Yi-Qian; Dahllöf, Göran; Willumsen, Tiril; Rønneberg, Anne & Havnen, Audun [Vis alle 9 forfattere av denne artikkelen] (2025). Associations of adverse childhood experiences with dental fear, and the mediating role of dental fear on caries experience: the Young-HUNT4 Survey. BMC Oral Health. 25(1). doi: 10.1186/s12903-025-06486-1. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background Adverse childhood experiences (ACEs) may contribute to dental fear, which can negatively affect long-term oral health. We aimed to examine associations between specific and cumulative ACEs and dental fear in adolescents, investigate possible sex differences, and explore the potential mediating role of dental fear in the relationship between ACEs and caries experience. Methods This cross-sectional study included 5882 Norwegian adolescents aged 13–17 years from the Young-HUNT4 Survey in Norway. Self-reported ACEs (i.e., physical and sexual abuse, witnessing violence, parental divorce, parental alcohol problems, and bully victimisation) and dental fear were combined with clinical measures of caries experience. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between ACEs and dental fear. Effect modification by sex was assessed using the likelihood ratio test. A counterfactual-based mediation analysis was conducted to estimate a potential mediating effect of dental fear on the relationship between ACEs and caries experience, with results presented as ratios of means (RMs) with bias-corrected 95% CIs. Results All specific ACEs were associated with higher odds of reporting dental fear, compared to those not reporting the given ACE. Adolescents reporting any ACE had a 74% higher likelihood of reporting dental fear compared to those without ACEs (OR 1.74, 95% CI 1.29–2.33). A dose-response relationship was observed, with a one-unit increase in ACE exposure associated with higher odds of reporting dental fear (OR 1.25, 95% CI 1.15–1.36). There was evidence of effect modification by sex, with the associations between any ACE and dental fear being more pronounced in females. Further, dental fear accounted for 5.9% of the total effect in the association between any ACE and caries experience. Conclusions Specific and cumulative ACEs were associated with dental fear among adolescents, with a stronger association in females. Our findings indicate a partial mediating role of dental fear in the association between ACEs and caries experience. This study highlights the value of incorporating ACEs and dental fear into patient assessment.

• Dahllöf, Göran; Sørbø, Marie Flem; Feuerherm, Astrid Jullumstrø; Myran, Lena; Havnen, Audun & Willumsen, Tiril [Vis alle 10 forfattere av denne artikkelen] (2025). Associations between childhood adversity and adult oral health-related quality of life, the HUNT4 Survey. BMC Public Health. 25(1). doi: 10.1186/s12889-025-23365-0. Fulltekst i vitenarkiv
• Aardal, Vilde Eika; Hol, Caroline; Rønneberg, Anne; Neupane, Sudan Prasad & Willumsen, Tiril (2025). Who requires dental treatment under general anesthesia due to pain and severe dental anxiety? Findings from panoramic X-ray images and anamnesis. Acta Odontologica Scandinavica. ISSN 0001-6357. 84, s. 78–85. doi: 10.2340/aos.v84.42895. Fulltekst i vitenarkiv
• Nermo, Hege; Goll, Jeppe Bjørnskov; Isaksen, Simen; Trondsen, Sigurd Eggen; Rognmo, Kamilla & Thimm, Jens [Vis alle 9 forfattere av denne artikkelen] (2025). Associations between cumulative exposure to potentially traumatic events and self-reported oral health in the Tromsø Study: Tromsø7. BMC Oral Health. 25(1). doi: 10.1186/s12903-025-06005-2. Fulltekst i vitenarkiv Vis sammendrag

  Background Potentially Traumatic Events (PTEs), such as accidents, childhood neglect or abuse, can affect mental and physical health. The study investigated the association between PTEs and self-reported oral health (SROH), focusing on cumulative exposure to multiple events, the types of events, and the timing of exposure. Methods Data were collected from the seventh survey of the Tromsø Study, which invited all residents over 40 in Tromsø, Norway. A total of 21,069 participants took part, comprising 47,5% male and 52,5% female respondents, who completed assessments of PTEs and SROH. Chi-square (Χ²) tests evaluated unadjusted associations, and a series of logistic regression models were employed to investigate the association of PTEs with poor SROH, controlling for sociodemographic variables, emotional distress, and oral health-related behaviours. Findings The likelihood of reporting poor SROH was higher among those who experienced more PTEs, and this relationship persisted after adjusting for sex, age, socioeconomic status, oral health-related behaviour, dental anxiety, emotional distress and adverse dental events. Subsequent analyses differentiated the associations by type and timing (before and after age 18) of events. Interpersonal events involve direct interactions with others (e.g., abuse, bullying), while impersonal events refer to broader circumstances (e.g., accidents, natural disasters). Adverse dental events, classified as impersonal events, demonstrated the strongest association with poor SROH. The associations between interpersonal events and poor SROH varied more depending on covariates than impersonal events. The association strengthened when adjusting for sociodemographic factors but weakened when accounting for oral health behaviours, dental anxiety, and emotional distress. Notably, impersonal events occurring before age 18 were consistently associated with poor SROH across all models. Conclusions Experiencing multiple PTEs throughout life is associated with poor SROH. Among the various PTEs, adverse dental events showed the strongest association with poor SROH, emphasising the importance of addressing dental care’s emotional and psychological aspects, particularly in paediatric settings, to support long-term oral health outcomes. Clinical trial number Not applicable.

• Høyvik, Ann Catrin; Willumsen, Tiril; Lie, Birgit & Hilden, Per Kristian (2024). Torture victims’ perspective on dental treatment: “Every sign you make, every move you take” – A qualitative study. European Journal of Oral Sciences. ISSN 0909-8836. s. 1–11. doi: 10.1111/eos.13007. Fulltekst i vitenarkiv Vis sammendrag

  Torture victims struggling with post-traumatic stress often experience elements in the dental treatment situation that may trigger trauma-related reactions. The aim of the study was to explore intervention strategies that will enable dental health workers to adapt dental treatment to the needs of torture survivors. Exploratory interviews were conducted with 10 torture-exposed resettled refugees with dental treatment experience in Norway. The data was analyzed using qualitative content analysis, which suggested that to minimize trauma-reactions, dental personnel should focus on creating a safe therapeutic space and strengthening the patient's sense of control. Four main categories of clinical advice were proposed: (i) Acquire knowledge about psychology, consequences of torture, cultural differences, trauma-informed care, and the patients’ individual needs; (ii) Recognize the trigger-potential of busyness or delays; (iii) Avoid surprises, such as sudden moves or actions and explore triggers individually, but make sure not to evoke images of interrogation, and; (iv) Provide overview both with respect to visibility in the clinical room, and to predictability regarding the dental treatment. Although undergoing dental treatment may be challenging for torture-exposed individuals, it is possible to reduce the predicaments considerably by making feasible adaptions to the treatment and adopting a trauma-informed approach.

• Aardal, Vilde Eika; Willumsen, Tiril & Evensen, Kjersti Berge (2024). Differences in anxiety, depression, and oral health-related quality of life among dental anxiety patients with and without reported abuse experience. European Journal of Oral Sciences. ISSN 0909-8836. doi: 10.1111/eos.12976. Fulltekst i vitenarkiv Vis sammendrag

  This study aimed to explore the differences in anxiety, depression, and oral health-related quality of life between people with dental anxiety who reported abuse experience (n = 60) and people with dental anxiety who did not report abuse experience (n = 97). Both groups attended a dental service focused on the treatment of dental anxiety intended for people with a history of physiological or psychological trauma, or odontophobia. The participants responded to a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), Oral Impacts on Daily Performance (OIDP), and the Index of Dental Anxiety and Fear (IDAF-4C+). The differences between groups were tested for statistical significance using Welch's T-tests, and linear regression was used to adjust for gender. The participants with reported abuse experience expressed greater psychological symptoms of anxiety and poorer oral health-related quality of life. The participants with reported abuse experience also expressed a higher fear of losing control, as well as feeling shame and disgust. This study shows that individuals with dental anxiety and a history of abuse may face more complex challenges than those with dental anxiety and no history of abuse.

• Hauge, Mariann Saanum; Willumsen, Tiril & Storå, Bent Olav (2023). Changes in symptoms of anxiety, depression, and PTSD in an RCT-study of dentist-administered treatment of dental anxiety. BMC Oral Health. 23(1), s. 415–415. doi: 10.1186/s12903-023-03061-4. Fulltekst i vitenarkiv Vis sammendrag

  Background Educating dentists in treatment methods for dental anxiety would increase the patients’ access to treatments that are important to their oral health. However, to avoid adverse effects on comorbid symptoms, involvement by a psychologist has been considered necessary. The objective of the present paper was to evaluate whether a dentist could implement systematized treatments for dental anxiety without an increase in comorbid symptoms of anxiety, depression or PTSD. Methods A two-arm parallel randomised controlled trial was set in a general dental practice. Eighty-two patients with self-reported dental anxiety either completed treatment with dentist-administered cognitive behavioural therapy (D-CBT, n = 36), or received dental treatment while sedated with midazolam combined with the systemized communication technique “The Four Habits Model” (Four Habits/midazolam, n = 41). Dental anxiety and comorbid symptoms were measured pre-treatment (n = 96), post-treatment (n = 77) and one-year after treatment (n = 52). Results An Intention-To-Treat analysis indicated reduced dental anxiety scores by the Modified Dental Anxiety Scale (median MDAS: 5.0 (-1,16)). The median scores on the Hospital Index of Anxiety and Depression (HADS-A/D) and the PTSD checklist for DSM-IV (PCL) were reduced as follows: HADS-A: 1 (-11, 11)/HADS-D: 0 (-7, 10)/PCL: 1 (-17,37). No between-group differences were found. Conclusions The study findings support that a general dental practitioner may treat dental anxiety with Four Habits/Midazolam or D-CBT without causing adverse effects on symptoms of anxiety, depression or PTSD. Establishing a best practice for treatment of patients with dental anxiety in general dental practice should be a shared ambition for clinicians, researchers, and educators. Trial registration The trial was approved by REC (Norwegian regional committee for medical and health research ethics) with ID number 2017/97 in March 2017, and it is registered in clinicaltrials.gov 26/09/2017 with identifier: NCT03293342.

• Hauge, Mariann Saanum; Høyvik, Ann Catrin; Strøm, Kjetil & Willumsen, Tiril (2023). Norske tannlegers kompetanse og behandling av tannbehandlingsangst. Norsk tannlegeforening Tidende. doi: 10.56373/2023-4-3. Fulltekst i vitenarkiv
• Myran, Lena; Sen, Abhijit; Willumsen, Tiril; Havnen, Audun; Kvist, Therese & Rønneberg, Anne [Vis alle 8 forfattere av denne artikkelen] (2023). Associations of adverse childhood experiences with caries and toothbrushing in adolescents. The Young-HUNT4 Survey. BMC Oral Health. 23(1). doi: 10.1186/s12903-023-03492-z. Fulltekst i vitenarkiv Vis sammendrag

  Background Adverse childhood experiences (ACEs) are associated with poor oral health. Using a life course theoretical framework, this study explored the associations of specific and cumulative ACEs with caries and toothbrushing frequency in a Norwegian adolescent population. Methods Participants were adolescents (n = 6351) age 13–17 years from The Young-HUNT4 Survey. Clinical data were retrieved from dental health records. Oral health outcomes were toothbrushing frequency, dentine caries experience (Decayed, Missing, and Filled Teeth – DMFT), and enamel caries. ACE exposure variables were physical abuse, sexual abuse, witness to violence, parental separation/divorce, parental alcohol problems, and bully victimization. Negative binominal regression models (incident rate ratios, IRRs; 95% confidence intervals, CIs) were used to determine the associations of the various ACEs with caries; logistic regression analyses (odds ratios, ORs; 95% CIs) were used to estimate associations with toothbrushing frequency. Potential effect modification by age was assessed using likelihood ratio test. Results Adolescents exposed to physical abuse by others, sexual abuse by peers, parental separation/divorce, bullying, or who had witnessed violence, were more likely to report non-daily toothbrushing compared with those with no exposure to the given ACEs. Each cumulative increase in ACE exposure was associated with a 30% higher likelihood of non-daily toothbrushing (OR 1.30, 95% CI 1.19–1.42). Similarly, increasing number of adversities were associated with both higher dentine caries experience (IRR 1.06, 95% CI 1.02–1.09) and higher enamel caries (IRR 1.07, 95% CI 1.03–1.11). This effect was modified by age (13–15 vs. 16–17 years) for dentine caries experience. Furthermore, there was evidence of effect modification by age with bully victimization for both toothbrushing frequency (Pinteraction = 0.014) and dentine caries experience (Pinteraction < 0.001). Specifically, bully victimization was associated with a higher likelihood of non-daily toothbrushing (OR 2.59, 95% CI 1.80–3.72) and higher dentine caries experience (IRR 1.30, 95% CI 1.14–1.50) among 16–17-year-olds. Conclusions Several specific ACEs were associated with non-daily toothbrushing and a higher caries experience among Norwegian adolescents in the Young-HUNT4 Survey.

• Aardal, Vilde; Evensen, Kjersti Berge; Willumsen, Tiril & Bull, Vibeke Hervik (2022). The complexity of dental anxiety and its association with oral health-related quality of life: An exploratory study. European Journal of Oral Sciences. ISSN 0909-8836. doi: 10.1111/eos.12907. Fulltekst i vitenarkiv Vis sammendrag

  This study aimed to explore the factors associated with oral health-related quality of life (OHRQoL) in a sample with high dental anxiety. Data were obtained from 107 patients attending a therapeutic treatment program for people who have experienced abuse and for those with dental phobia in Norway. Patients completed questionnaires, including the Index of Dental Anxiety and Fear, the Anxiety subscale of the Hospital Anxiety and Depression Scale, and the Oral Impacts on Daily Performance scale, measuring OHRQoL prior to treatment. The various measurement instruments were evaluated psychometrically, and the variables associated with OHRQoL were explored using hierarchical multiple regression. Symptoms of dental anxiety and general anxiety were high, while OHRQoL was poor. Dental anxiety, higher age, higher number of years since the last dental treatment, and higher general anxiety were discernibly associated with lower OHRQoL. The strongest association was found between general anxiety and OHRQoL. In conclusion, several factors were associated with OHRQoL in a sample with high dental anxiety, suggesting a complex picture of dental anxiety. When treating patients with high dental anxiety, dental practitioners should be aware that there may be factors complicating the therapeutic setting, such as general anxiety.

• Hauge, Mariann Saanum; Stora, Bent & Willumsen, Tiril (2022). Dental anxiety treatment by a dentist in primary care: A 1-year follow-up study. European Journal of Oral Sciences. ISSN 0909-8836. 130(4). doi: 10.1111/eos.12872. Fulltekst i vitenarkiv Vis sammendrag

  In an earlier randomized controlled trial of dental anxiety treatments (n = 96) we compared the effects of dentist-administered cognitive behavioural therapy (D-CBT) and dental treatment supplemented with the Four Habits communication model plus midazolam sedation. Both treatments, applied in a general dental practice, were associated with a clinically relevant decrease in dental anxiety. In this follow-up study, 52 of the 82 treatment completers responded to an online questionnaire 1 year post-treatment. Reduction in dental anxiety persisted for both treatment groups. From baseline to 1 year post-treatment the Modified Dental Anxiety Scale was reduced by 7.8 [SD: 4.4; Cohen's d effect size: 1.2 (CI: 0.8–1.7)] and 7.8 [SD: 4.2; Cohen's d: 1.4 (0.9–1.8)] in the D-CBT and Four Habits/midazolam groups, respectively. Most patients (74% for D-CBT, 80% for Four Habits/midazolam) continued with dental treatment. Nine patients in the D-CBT and seven in the Four Habits/midazolam groups received additional CBT treatment from a psychologist/dentist team. Both methods tested should be accessible to interested dentists who receive adequate training. Effective first-line treatments for dental anxiety in general dental practice can generate more accessible care pathways for patients with dental anxiety. Evidence-based dental anxiety treatment programmes should be included in the dental curriculum and established as best practice for dentists.

• Toft, Julie; Myhre, Arne Kristian; Sun, Yi-Qian; Willumsen, Tiril & Rønneberg, Anne (2022). Oral health history in children referred to a child advocacy center in Norway. International Journal of Child Abuse & Neglect. ISSN 0145-2134. 132. doi: 10.1016/j.chiabu.2022.105789. Fulltekst i vitenarkiv Vis sammendrag

  Background Some suspected child victims of physical or sexual abuse undergo dental forensic examinations at child advocacy centers (CACs) in Norway. Their oral health history has not previously been studied. Objective This study aimed to compare oral health history of CAC children to matched children. Additionally, the oral health history of children exposed to sexual abuse was compared to children exposed to physical abuse. Participants and setting The CAC cohort included 100 children, 3–16 years. The matched cohort, with no known history of abuse, included 63 children. Methods The retrospective study analyzed registered data in the children's dental records. Results CAC children were more likely than matched children to have caries experience in both primary and permanent teeth, with incidence rate ratio (IRR) 1.50 (95 % CI 1.01–2.25) and 1.92 (1.11–3.30). “Was Not Brought” to dental appointments was more than twice as likely, IRR 2.25 (1.31–3.86), in the CAC cohort. There were no significant differences in reports to the Child Protection Services or dental traumas. Suspected victims of sexual abuse had more caries, IRR 4.28 (2.36–7.77), and fillings, IRR 4.83 (2.55–9.16), in permanent teeth compared to suspected victims of physical abuse. Conclusions CAC children were more likely to have caries experience and not show up for dental appointments than the matched children. Sexual abuse suspected had four times more caries experience than physical abuse suspected. This study supports the need for addressing oral health in risk evaluations concerning child abuse, and provides valuable information to dental professionals and prosecuting authorities.

• Hauge, Mariann Saanum; Storo, Bent; Vassend, Olav Mandt; Hoffart, Asle & Willumsen, Tiril (2022). Tannlegeadministrert kognitiv atferdsterapi versus «Fire gode vaner» – bruk av midazolam: En randomisert kontrollert studie av behandling av tannbehandlingsangst i primær tannhelsetjeneste. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(8), s. 626–636. doi: 10.56373/2022-8-4. Fulltekst i vitenarkiv
• Muhoozi, Grace Kyamazima Mehangye; Li, Kelvin; Atukunda, Prudence; Skaare, Anne B; Willumsen, Tiril & Enersen, Morten [Vis alle 11 forfattere av denne artikkelen] (2022). Child saliva microbiota and caries: a randomized controlled maternal education trial in rural Uganda. Scientific Reports. 12(1). doi: 10.1038/s41598-022-11979-y. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Undernutrition is a public health challenge in sub-Saharan countries, including Uganda. In a previous randomized controlled trial (RCT) with a nutrition, hygiene and stimulation education intervention among mothers of 6 months’ old children, we found less caries in the intervention group when the children were 36 months of age. We now examined the effects of (i) the intervention on the microbiota, (ii) microbiota on caries, and (iii) the intervention and microbiota on caries. The original RCT comprised 511 mother/child pairs whereas in the current study we had access to data from 344/511 (67%) children aged 36 months. The saliva microbiota was determined using 16S rRNA gene sequencing. Carious lesions (a proxy for dental health) were identified using close-up intra-oral photographs of the upper front teeth. Statistical models were used to determine host-microbiota associations. The intervention had a significant effect on the microbiota, e.g. an increase in Streptococcus abundance and decreases in Alloprevotella and Tannerella . Significant associations between the microbiota and dental caries were identified: Positive associations of Capnocytophaga and Tannerella suggest that these taxa may be deleterious to dental health while negative associations of Granulicatella , Fusobacterium , and Abiotrophia suggest taxa potentially beneficial or benign contributors to dental health. Based on taxonomic profiles, the effects of the intervention and microbiota on dental health may be independent of one another. Educational interventions with emphasis on nutrition and oral hygiene may provide a feasible strategy to decrease progression of childhood caries in low-resource settings.

• Rogers, Adam Austin; Willumsen, Tiril; Strømme, Hilde & Johnsen, Jan-Are Kolset (2022). Top-down self-regulation processes as determinants of oral hygiene self-care behaviour: A systematic scoping review. Clinical and Experimental Dental Research. 8, s. 807–826. doi: 10.1002/cre2.548. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Understanding the psychological mechanisms that moderate oral hygiene self‐care behavior is anticipated to benefit efforts to change such behavior. Top‐down self‐regulatory (TSR) processes represent one group of relatively unexplored, yet potentially influential, moderating factors. This systematic scoping review aims to explore whether there is evidence that TSR processes moderate oral hygiene self‐care engagement within the current literature.<p> <p>Methods: CINAHL, The Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched up to April 2020 for articles that compared measures of TSR processes (such as self‐monitoring, inhibitory control, and task switching) to oral hygiene self‐care behavior, or tested interventions that aimed to change or support TSR processes.<p> <p>Results: The search returned 6626 articles, with 25 included in the final sample. Weak evidence supported both the role of TSR processes as moderators of interdental cleaning and the value of interventions targeting self‐monitoring of interdental cleaning behavior. Overall, methodological limitations rendered the findings somewhat inconclusive, with an absence of objective assessments of TSR capacity, and little focus on TSR processes as moderators of intervention effects.<p> <p>Conclusions: The inconclusive, but reasonably promising, findings point to the value of continuing to apply TSR processes within studies of oral hygiene behavior. Exploring why interdental cleaning appears more reliant on TSR processes than toothbrushing, employing objective neuropsychological assessment, and measuring TSR constructs within interventions targeting TSR processes, are encouraged. As a scoping review, the study hopes to generate interest and serve as a starting point for further investigation.

• Hauge, Mariann Saanum; Stora, Bent; Vassend, Olav; Hoffart, Asle & Willumsen, Tiril (2021). Dentist-administered cognitive behavioural therapy versus four habits/midazolam: An RCT study of dental anxiety treatment in primary dental care. European Journal of Oral Sciences. ISSN 0909-8836. s. 1–12. doi: 10.1111/eos.12794. Fulltekst i vitenarkiv Vis sammendrag

  The study aimed to test the effectiveness of cognitive behavioural therapy (CBT) administered by a general dental practitioner (GDP) in a general dental practice. In a two-arm parallel randomised controlled trial, the experimental group received a short dentist-administered CBT-intervention (D-CBT). A best-practice control group (FHM) received dental treatment during sedation with midazolam combined with an evidence-based communication model (The Four Habits Model). Ninety-six patients with self-reported dental anxiety were allocated to the treatment arms at a 1:1 ratio. Modified Dental Anxiety Scale (MDAS) scores spanned from 12 to 25, and 82 patients (85%) had a score of 19 or more, indicating severe dental anxiety. In both treatment arms, scores on MDAS and Index of Dental Anxiety and Fear (IDAF-4C) decreased significantly, but no differences were found between treatment arms. Mean reductions were: MDAS scores: −6.6 (SD = 0.5); IDAF-4C scores: −1.0 (SD = 1.1). In conclusion, local GDPs in general dental practices with proper competence have the ability for early detection of dental anxiety and, with the use of a manual-based D-CBT or FHM treatment, GDPs could offer efficient first-line treatment suitable for dental anxiety of varying severities.

• Nermo, Hege; Willumsen, Tiril; Rognmo, Kamilla; Thimm, Jens; Wang, Catharina Elisabeth Arfwedson & Johnsen, Jan-Are Kolset (2021). Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study—Tromsø 7. BMC Oral Health. 21. doi: 10.1186/s12903-021-01968-4. Fulltekst i vitenarkiv Vis sammendrag

  Objective The objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population. Method The study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015–2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety. Results High dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms. Conclusions The prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression.

• Høyvik, Ann Catrin; Willumsen, Tiril; Lie, Birgit & Hilden, Per Kristian (2021). The torture victim and the dentist: The social and material dynamics of trauma re-experi-encing triggered by dental visits. Journal on Rehabilitation of Torture Victims and Prevention of Torture. ISSN 1018-8185. 31(3), s. 70–83. doi: 10.7146/torture.v32i3.125290. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The flow of refugees towards Europe over the past decade has placed increased demands on the health care services. A significant proportion of refugees have been subjected to torture involving their mouth or teeth, still the importance of oral health challenges is often overlooked or underestimated in the rehabilitation of torture victims. In this qualitative study, we set out to explore the processes that complicate torture victims’ ability to engage in and tolerate dental procedures.&#x0D; Methods: Ten resettled refugees with experience of torture were recruited among patients affiliated with specialized clinics for oral health rehabilitation in Norway. Data were collected through semi-structured exploratory interviews, and analyzed using a qualitative content analysis approach.&#x0D; Results and discussion: We present an exploration of what we have called the social and material anatomy of the triggering event; the process through which trauma-related reactions are produced in torture victims in the course of undergoing dental treatment. All professionals who work with torture survivors should be aware that these individuals often suffer from oral health problems that may affect both their physical and their psychological quality of life. However, although dental treatment is essential, it may still represent a major challenge. Our data suggest, we propose, that dental treatment often involves an experience being suspended, albeit temporarily, in an objectified position, acted on by subjects capable of producing deeply undesirable mental, emotional or bodily states. Three main categories emerged as the most prominent factors with such an agentic capacity: 1) pain, 2) traumatic memories and 3) the dentist. Submitting to dental treatment hence requires the patient’s willingness to give in to the actions of these factors, and avoiding treatment may therefore, in this situation, represent a means of retaining control.

• Varvin, Therese; Søftestad, Siri; Kranstad, Vibeke & Willumsen, Tiril (2020). Preparing for attack and recovering from battle: Understanding child sexual abuse survivors' experiences of dental treatment. Community Dentistry and Oral Epidemiology. ISSN 0301-5661. 48(4), s. 317–327. doi: 10.1111/cdoe.12536. Fulltekst i vitenarkiv Vis sammendrag

  Objective The aim of this paper was to explore child sexually abused survivors' experiences of dental treatment in order to obtain a deeper understanding of them as dental patients. Methods Data were drawn from qualitative semi‐structured interviews with 16 adult informants recruited from four different Centres against Sexual Abuse in Norway. Data analysis was developed according to the principles of grounded theory suggested by Charmaz. Results A conceptual framework was generated, and a core concept was constructed from the informants' reports of their experiences of dental treatment: Preparing for attack and recovering from battle based on four main categories: (a) Expecting danger, (b) Battling anxiety, (c) Reliving abuse and (d) Struggling with the aftermath. Conclusions The analyses increase the understanding of how child sexual abuse survivors prepare before—battle during—and recover after dental treatment. This study revealed child sexual abuse survivors' experiences of extensive anxiety, triggered by sensory stimuli such as sensations, movement, muscles, touch, sight, sound, smell and taste, associated with dental procedures per se, but also sensory stimuli similar to previous traumatic experiences. The findings suggest that child sexual abuse survivors' dental anxiety is primarily trauma‐driven and possibly being one of the long‐term effects of child sexual abuse. This may be an important contribution to the understanding of CSA survivors and should affect the approach of clinicians treating dental patients with such a history.

• Kranstad, Vibeke; Søftestad, Siri; Fredriksen, Therese Varvin & Willumsen, Tiril (2019). Being considerate every step of the way: a qualitative study analysing trauma‐sensitive dental treatment for childhood sexual abuse survivors. European Journal of Oral Sciences. ISSN 0909-8836. 127(6), s. 539–546. doi: 10.1111/eos.12661. Fulltekst i vitenarkiv Vis sammendrag

  This qualitative study aimed to obtain a deeper understanding of what makes adult dentistry possible for child sexual abuse survivors. Sixteen adult informants were recruited from four Centres against Sexual Abuse and interviewed. Qualitative analysis of the transcribed interviews was conducted consecutively until thematic saturation was reached at 16 informants. A conceptual framework was generated, and informants’ experiences of what makes dental treatment achievable were summed as the dentist working in a trauma‐sensitive way, captured by the core category: Being considerate every step of the way. The underlying categories are: (i) offering a good start; (ii) being competent; (iii) being aware of the influence of staff behaviour; (iv) building a safe relationship; (v) arranging a secure treatment situation; and (vi) exploring individual triggers. The findings revealed that dental staff should have adequate competence to build secure relationships and explore individual triggers in dental treatment situations when treating child sexual abuse survivors. Dentists should have a trauma‐sensitive approach to all patients. When treating child sexual abuse survivors, dentists should demonstrate utmost consideration every step of the way, building long‐term solid relationships, and discussing and testing coping strategies individually adapted to the specific needs of the child sexual abuse survivors, in a safe environment.

• Strøm, Kjetil; Skaare, Anne B & Willumsen, Tiril (2019). Dental anxiety in 18-year-old Norwegians in 1996 and 2016. Acta Odontologica Scandinavica. ISSN 0001-6357. 78, s. 13–19. doi: 10.1080/00016357.2019.1637933. Fulltekst i vitenarkiv
• Søftestad, Siri; Kranstad, Vibeke; Varvin, Therese & Willumsen, Tiril (2019). Invading Deeply into Self and Everyday Life: How Oral Health-Related Problems Affect the Lives of Child Sexual Abuse Survivors. Journal of Child Sexual Abuse. ISSN 1053-8712. doi: 10.1080/10538712.2019.1682096. Fulltekst i vitenarkiv
• Rønneberg, Anne; Szyszko, Ewa Alicja; Bie, Thea Martine Granvoll; Willumsen, Tiril & Køpp, Unni Mette (2019). Klinisk rettsodontologiske undersøkelser ved Statens Barnehus - veier til tverrprofesjonell samhandling til barnets beste. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 129, s. 884–892. Fulltekst i vitenarkiv
• Haugen, Hilde Kjærnet; Myhrer, Trude & Willumsen, Tiril (2019). Nedsatt livskvalitet og oral funksjon etter hjerneslag. En kvalitativ studie. Sykepleien Forskning. ISSN 1890-2936. doi: 10.4220/Sykepleienf.2019.79355. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Det foreligger sparsomt med informasjon om oral helse etter hjerneslag i Norge. Lammelser og nedsatt motorikk, tygge- og svelgefunksjon gjør at pasienten ikke merker mangelfull munnhygiene eller klarer å utføre munnstell selv. Forskning viser at munnstell har vært lite prioritert i akutt- og rehabiliteringsfasen etter hjerneslag. Tverrfaglig kunnskap om at oral patologi og tanntap kan oppstå som følge av lammelser og munntørrhet, synes mangelfull innen helseprofesjonene som behandler slagrammede i akutt- og rehabiliteringsfasen. Hensikt: Intensjonen med denne studien er å belyse generell og oral livskvalitet hos personer som har erfart hjerneslag. Vi ønsket også å undersøke hvordan nedsatt oral funksjon påvirker den slagrammedes livskvalitet sosialt og funksjonelt. Metode: Vi gjennomførte 16 kvalitative personintervjuer med hjemmeboende eldre i Norge (70–85 år). Informantene ble plukket ut blant respondenter fra en tidligere spørreundersøkelse (2), som også samtykket til å delta i denne oppfølgingsstudien. Resultat: Fire informanter fortalte at de anser sin egen reduserte tannstatus som en direkte følge av manglende oral oppfølging (6 måneder–2 år) etter hjerneslaget. Som følge av lammelser og nedsatt tygge- og svelgefunksjon trenger ni informanter fortsatt lengre tid til måltidet, foretrekker myk lett-tygget mat oppdelt i små biter og/eller hjelp til å skjære opp maten. Aksept for disse omstendighetene er en forutsetning for at informantene skal oppleve måltidet som hyggelig. Informanter med fastsittende, funksjonelle tenner har best oral livskvalitet. Informanter med avtakbare tannproteser er minst fornøyd med sin orale livskvalitet. Konklusjon: Senskader etter slag kan påvirke tygge- og svelgefunksjonen, føre til munntørrhet og tap av tenner. Kombinasjonen hjerneslag og oral helse ser ut til å redusere både den generelle og den orale livskvaliteten. Redusert protesefunksjon og/eller tyggefunksjon oppleves stigmatiserende i sosiale sammenhenger, fører til redusert matinntak og kan gi ytterligere komplikasjoner av helsetilstanden. Tannhelsefaglig kompetanse bør involveres tidlig i rehabiliteringen. Mer tverrfaglig forskning og oppmerksomhet på systematisk oppfølging av denne pasientgruppen er hensiktsmessig.

• Rønneberg, Anne; Nordgarden, Hilde; Skaare, Anne B & Willumsen, Tiril (2019). Barriers and factors influencing communication between dental professionals and Child Welfare Services in their everyday work. International Journal of Paediatric Dentistry. ISSN 0960-7439. 29(6), s. 684–691. doi: 10.1111/ipd.12507. Fulltekst i vitenarkiv Vis sammendrag

  Background Among various health professionals, general dental professionals (GDPs) screen children frequently, giving them a unique opportunity to act upon suspicion of child maltreatment. The dental team has received considerable attention regarding safeguarding children. Aim The aims of this study were to explore whether GDPs have mutual collaboration and communication with the Child Welfare Services (CWS), and potential barriers for reporting child maltreatment. Design An electronically pre‐coded questionnaire was sent to all GDPs (n = 131) in the Public Dental Health Service (PDHS) in Oslo. Frequency distributions and statistical analysis were carried out by chi‐squared statistics and multivariate logistic regression analysis. Results The response rate was 75%. Ninety per cent of GDPs had received requests from CWS to provide a child's dental chart. General dental professionals reported child maltreatment frequently (71%), but CWS only gave feedback in 55% of the cases. Uncertainty was the most common reason for not reporting and 33% of the GDPs had chosen not to send a report despite suspicion. Using guidelines increased frequency of reporting (OR 3.6). Conclusions Mutual collaboration and communication should be improved in the task of safeguarding children. Uncertainty and lack of guidelines may act as barriers for not reporting to the CWS.

• Fjeld, Katrine Gahre; Eide, Hilde; Mowe, Morten; Sandvik, Leiv & Willumsen, Tiril (2018). A 1-year follow-up of a randomized clinical trial with focus on manual and electric toothbrushes’ effect on dental hygiene in nursing homes. Acta Odontologica Scandinavica. ISSN 0001-6357. 76(4), s. 257–261. doi: 10.1080/00016357.2017.1416166. Fulltekst i vitenarkiv Vis sammendrag

  Objective: A 2-month randomized clinical trial (RCT) study comparing electric and manual toothbrushes used by residents in nursing homes showed significant reduction in plaque score for both groups. The aim of this follow up study was to study if the effect sustained in a longer perspective when toothbrushes were used according to resident’s own preference. Materials and methods: One year after baseline of the RCT-study, 100 participants were re-examined. The simplified oral hygiene index (OHI-S) was used as outcome measure on dental plaque. Results: The mean age was 86.6, 78.1% had three or more medical diagnoses and 52.2% had moderate to severe cognitive impairment. The mean number of natural teeth was 18.8. After 1 year, mean plaque scores was significantly reduced within the population, from 1.2 to 0.7 (p < .001). A total of 46 participants preferred to use an electric toothbrush and 54 preferred manual. No significant difference in plaque score was found between electric and manual toothbrushes. Conclusion: After 1 year, the improvement in dental hygiene from the RCT study sustained for users of both electric and manual toothbrush. Focus upon tooth brushing seems to be efficient and both manual and electric toothbrushes should be available in nursing homes.

• Høyvik, Ann Catrin; Lie, Birgit; Grjibovski, Andrei M. & Willumsen, Tiril (2018). Oral Health Challenges in Refugees from the Middle East and Africa: A Comparative Study. Journal of Immigrant and Minority Health. ISSN 1557-1912. s. 1–8. doi: 10.1007/s10903-018-0781-y. Fulltekst i vitenarkiv Vis sammendrag

  The aim was to explore and compare oral health and need for dental treatment in newly arrived refugees from the Middle East and Africa to Norway. Oral examination and structured interviews were performed with attending interpreters. Associations between origin and measures for oral health were studied with multiple linear regression. Half of the refugees (n = 132) reported oral impacts on daily performances (OIDP) and mean number of decayed teeth (DT) was 4.3 (SD 3.5). Refugees from the Middle East had more DT (1.38, p = 0.044), higher sum of decayed, missing and filled teeth (DMFT) (3.93, p = 0.001) and lower OIDP-score (− 3.72, p = 0.026) than refugees from Africa. Refugee oral health is generally poor, with more extensive challenges in refugees from the Middle East. However, few missing teeth, and manageable caries-gradient at the time of registration indicate that most refugees have the prerequisites for a good dentition, provided they get the necessary treatment.

• Høyvik, Ann Catrin; Lie, Birgit & Willumsen, Tiril (2018). Dental anxiety in relation to torture experiences and symptoms of post-traumatic stress disorder. European Journal of Oral Sciences. ISSN 0909-8836. s. 65–71. doi: 10.1111/eos.12592. Fulltekst i vitenarkiv Vis sammendrag

  Torture victims often show symptoms of dental anxiety when receiving dental care, but little systematic research is available. The purpose of this study was to explore torture experiences, symptoms of post‐traumatic stress disorder (PTSD), and dental anxiety in refugees in Norway and to test the hypothesis that refugees with torture experiences are more prone to dental anxiety than refugees with no such experiences. A total of 173 refugees were interviewed shortly after an oral examination. The Modified Dental Anxiety Scale (MDAS) and the Harvard Trauma Questionnaire‐PTSS16 were administered verbally through attending interpreters. Among torture victims (47%, n = 81), the prevalence of torture experiences involving mouth or teeth was 35% and 23%, respectively. Harvard Trauma Questionnaire mean sum scores were statistically significantly higher in torture victims (34.3 vs. 24.8). Torture survivors report a larger number of symptoms of PTSD, and dental anxiety shows a higher prevalence in refugees reporting PTSD symptoms than in refugees who do not report such symptoms. When analysed using logistic regression models, the data showed the odds of high levels of dental anxiety being 6.1 times higher in refugees with torture experiences compared with other refugees and 9.3 times higher in torture victims with PTSD symptoms. Oral health professionals should be aware of these associations when providing dental care to refugees. The hypothesis that tortured refugees are more prone to dental anxiety is supported.

• Espelid, Ivar✝; Simonsen, Kristian Anton; Skaare, Anne B; Willumsen, Tiril; Straand, Jørund & Gjelstad, Svein [Vis alle 9 forfattere av denne artikkelen] (2018). Forskningsnettverk med leger og tannleger: et pilotprosjekt med datauttrekk fra elektronisk pasientjournal. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), s. 8–14. Fulltekst i vitenarkiv
• Skaare, Anne B; Simonsen, Kristian Anton; Espelid, Ivar✝; Straand, Jørund; Gjelstad, Svein & Klock, Kristin [Vis alle 9 forfattere av denne artikkelen] (2018). Medikamentelt utløst munntørrhet hos to pasientgrupper: Et pilotprosjekt blant leger og tannleger basert på data fra elektroniske pasientjournaler og spørreskjema. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), s. 16–23. Fulltekst i vitenarkiv
• Muhoozi, Grace Kyamazima Mehangye; Atukunda, Prudence; Diep, Lien My; Mwadime, Robert; Kaaya, Archileo & Skaare, Anne B [Vis alle 9 forfattere av denne artikkelen] (2018). Nutrition, hygiene, and stimulation education to improve growth, cognitive, language, and motor development among infants in Uganda: A cluster-randomized trial. Maternal & Child Nutrition. ISSN 1740-8695. 14(2). doi: 10.1111/mcn.12527. Fulltekst i vitenarkiv
• Espelid, Ivar; Simonsen, Kristian Anton; Skaare, Anne B; Willumsen, Tiril; Straand, Jørund & Gjelstad, Svein [Vis alle 9 forfattere av denne artikkelen] (2018). Forskningsnettverk med leger og tannleger. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(1), s. 8–14. Fulltekst i vitenarkiv
• Nermo, Hege; Willumsen, Tiril & Johnsen, Jan-Are Kolset (2018). Prevalence of dental anxiety and associations with oral health, psychological distress, avoidance and anticipated pain in adolescence: a cross-sectional study based on the Tromsø study, Fit Futures. Acta Odontologica Scandinavica. ISSN 0001-6357. 77(2), s. 126–134. doi: 10.1080/00016357.2018.1513558. Fulltekst i vitenarkiv Vis sammendrag

  <i>Objective</i>: To describe the prevalence of dental anxiety (DA) among adolescents in Tromsø and Balsfjord region in northern Norway and present a multivariate logistic regression model to predict high dental anxiety scores (DASs) among these adolescents.<p> <p><i>Materials and methods</i>: We used self-report questionnaires and clinical dental examination data from adolescents registered in upper secondary school (15–18 years of age) in this region (<i>n</i> = 986). Logistic regression was used to estimate odds ratios and their 95% confidence intervals (CI) when using Corah’s DAS as a dichotomous dependent variable.<p> <p><i>Results</i>: Twelve percent of the respondents reported a DAS score ≥13, indicating high DA. The strongest predictors for reporting high DA were anticipated pain at the dentist, ‘external control belief’, avoidance, low social motivation on oral health behaviour and sex. In this population, dental caries (DMFS), symptoms of psychological distress (HSCL-10) and self-motivation concerning oral health behaviour did not differ significantly between those reporting high DA (DAS ≥13) and those that reported low DA (DAS ≤12).<p> <p>Conclusions: Severe DA in adolescence is a dental public health challenge and this study shows that DA is a hindrance to seeking dental treatment irrespective of dental status. Dental anxiety should have a higher focus on preventive oral health strategies and have a higher priority in public dentistry to avoid this problem to escalate into adulthood.<p>

• Nermo, Hege; Willumsen, Tiril & Johnsen, Jan-Are Kolset (2018). Changes in dental anxiety among 15‐ to 21‐year‐olds. A 2‐year longitudinal analysis based on the Tromsø study: Fit futures. Community Dentistry and Oral Epidemiology. ISSN 0301-5661. s. 1–7. doi: 10.1111/cdoe.12434. Fulltekst i vitenarkiv Vis sammendrag

  <i>Objective</i>: Identify predictive variables related to the development and continuation of high dental anxiety among young people over 2 years and assess differences between youth experiencing increased, decreased or unchanged dental anxiety scores over time.<p> <p><i>Methods</i>: An observational panel study of 15‐to 21‐year‐old people in Tromsø and Balsfjord region followed students from their first to their last year of upper secondary school (2010/11‐2012/13). Logistic regression was used to estimate odds ratios and their 95% confidence intervals (CI) of possible predictive variables assessed at baseline when using dental anxiety score from the second wave as a dichotomous dependent variable. Variables measured at baseline: Sex, Dental Caries Experiences (DMFS index), Dental Anxiety (Corah's Dental Anxiety Scale/DAS), Psychological Distress (Hopkins Symptom Checklist/HSCL‐10), Avoidance of dental treatment, Pain Estimation at the dentist and motivational questions related to tooth brushing and caries (Self and Social Motivation). Wilcoxon signed‐rank tests and Kruskal‐Wallis tests were used to test whether changes in DAS score between waves were associated with changes in Pain Estimation between waves and HSCL‐10 scores at baseline.<p> <p><i>Results</i>: Hopkins Symptom Checklist, DMFS and DAS scores at baseline predicted high dental anxiety scores after 2 years. Sex, motivation related to oral hygiene and avoidance due to fear at baseline did not contribute significantly to our model. DMFS and HSCL‐10 were higher among young people who reported a substantial change in DAS score (2.0>Interquartile range/IQR), irrespective of the direction of change. Pain Estimation changed consistently with a change in DAS score.<p> <p><i>Conclusion</i>: Mental health symptoms, pre‐existing dental anxiety and dental health status are important contributors to the development of dental anxiety in youth. Estimations of pain at the dentist are central when it comes to changes in dental anxiety over time in this study.

• Muhoozi, Grace Kyamazima Mehangye; Atukunda, Prudence; Skaare, Anne B; Willumsen, Tiril; Diep, Lien My & Westerberg, Ane Cecilie [Vis alle 7 forfattere av denne artikkelen] (2018). Effects of nutrition and hygiene education on oral health and growth among toddlers in rural Uganda: follow-up of a cluster-randomised controlled trial. Tropical medicine & international health. ISSN 1360-2276. 23(4), s. 391–404. doi: 10.1111/tmi.13036. Fulltekst i vitenarkiv
• 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), s. 1845–1853. doi: 10.1111/jocn.13452. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Vanberg, Karin Elisabeth; Husby, Iselin Elise; Stykket, Liv; Young, Alix & Willumsen, Tiril (2016). Tannhelse blant et utvalg injiserende heroinmisbrukere i Oslo :. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 126(7), s. 528–534. Fulltekst i vitenarkiv
• Mehl, Astrid Engan; Ellingsen, Øivind Grønnerud; Kjeksrud, Joakim & Willumsen, Tiril (2016). Oral healthcare education of future nursing personnel and auxiliary nurses. Gerodontology. ISSN 0734-0664. 33(2), s. 233–239. doi: 10.1111/ger.12147. Fulltekst i vitenarkiv
• Larsen, Pedersen Veronicha; Strand, Nina; Willumsen, Tiril & Rønneberg, Anne (2015). Tannhelsetjenestens rolle ved barnemishandling. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 125(4), s. 320–326. Fulltekst i vitenarkiv
• Rønneberg, Anne; Strøm, Kjetil; Skaare, Anne B; Willumsen, Tiril & Espelid, Ivar (2015). Dentists’ self-perceived stress and difficulties when performing restorative treatment in children. European Archives of Paediatric Dentistry. ISSN 1818-6300. 16(4), s. 341–347. doi: 10.1007/s40368-014-0168-2. Fulltekst i vitenarkiv
• Strøm, Kjetil; Rønneberg, Anne; Skaare, Anne B; Espelid, Ivar & Willumsen, Tiril (2015). Dentists’ use of behavioural management techniques and their attitudes towards treating paediatric patients with dental anxiety. European Archives of Paediatric Dentistry. ISSN 1818-6300. 16(4), s. 349–355. doi: 10.1007/s40368-014-0169-1. Fulltekst i vitenarkiv
• Saltnes, Solfrid Sørgjerd; Storhaug, Kari; Borge, Christine Råheim; Enmarker, Ingela & Willumsen, Tiril (2015). Oral health-related quality-of-life and mental health in individuals with chronic obstructive pulmonary disease (COPD). Acta Odontologica Scandinavica. ISSN 0001-6357. 73(1), s. 14–20. doi: 10.3109/00016357.2014.935952. Fulltekst i vitenarkiv
• Matri, Kristine Lindstad; Willumsen, Tiril & Fjeld, Katrine Gahre (2015). Nye evidensbaserte tiltak for å bedre oral helse hos eldre siste 10 år. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 125(10), s. 872–877. Fulltekst i vitenarkiv
• Myhrer, Trude; Haugen, Hilde Kjærnet; Willumsen, Tiril & Bergland, Astrid (2014). Tannhelse og livskvalitet hos personer etter hjerneslag. Sykepleien Forskning. ISSN 1890-2936. s. 116–125. doi: 10.4220/sykepleienf.2014.0085. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Mennesker som har erfart hjerneslag antas oppleve økte orale problemer som følge av lammelser i ansikt, munn, tunge, og redusert førlighet til å betjene spisebestikk og tannbørste. Det er mangelfullt med forskning på tannhelse, oralfunksjon og livskvalitet hos eldre slagrammede. Hensikt: Hensikten med studien er å kartlegge selvopplevd tannhelse, oral funksjon, generell og oral livskvalitet hos eldre slagrammede, samt å se på mulige sammenhenger mellom oral funksjon, generell livskvalitet og oral helserelatert livskvalitet. Metode: En kvantitativ tverrsnittsstudie ble gjennomført ved en spørreundersøkelse blant medlemmer av Norsk forening for slagrammede. Svarprosent 46 % (N=293). Studien omfattet sosiodemografiske variabler, generell livskvalitet (HUNT-5), tannhelserelatert livskvalitet (OIDP) og selvopplevd tannhelse, munntørrhet, matkonsistens, samt tidsbruk og trygghet i spisesituasjonen. Data ble analysert med SPSS. Resultater: Resultatene viser at kun 5 % av de slagrammede ble informert om tannstell i rehabiliteringsperioden etter hjerneslag. En tredjedel opplever redusert tannhelse etter slaget. Slagrammede med færre enn 19 tenner og/eller brukere av tannprotese hadde signifikant dårligere oral helserelatert livskvalitet sammenlignet med de uten tannprotese og med flere enn 20 egne tenner. Den enkeltfaktoren som påvirker opplevelsen av livskvalitet mest, er graden av munntørrhet. Konklusjon: Informasjon om tannstell og munnhygiene må fokuseres sterkere i rehabiliteringen etter hjerneslag. Tannhelsepersonell må inngå i oppfølgingen av slagpasienters tannhelse på et tidlig stadium for å redusere muligheten for dårligere tannhelse og forringelse av livskvalitet. Nøkkelord: tannhelse, eldre, hjerneslag, livskvalitet, tverrsnittstudie

• Seim, Arnhild Sunde; Kveen, Ellen; Jakobsen, Henrik N.; Olsen, Roy Heine & Willumsen, Tiril (2014). Tannhelse og pasienter med hjemmetjenester : en pilotstudie i Hedmark. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 124(9), s. 712–717. Fulltekst i vitenarkiv
• Myhrer, Trude; Haugen, Hilde Kjærnet; Willumsen, Tiril & Bergland, Astrid (2014). Tannhelse og livskvalitet hos personer etter hjerneslag. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 124, s. 890–897. doi: 10.4220/sykepleienf.2014.0085. Fulltekst i vitenarkiv
• Fjeld, Katrine Gahre; Mowe, Morten; Eide, Hilde & Willumsen, Tiril (2014). Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes. European Journal of Oral Sciences. ISSN 0909-8836. 122(2), s. 142–148. doi: 10.1111/eos.12113. Fulltekst i vitenarkiv
• Kersten, Hege; Molden, Espen; Willumsen, Tiril; Engedal, Knut Arne & Wyller, Torgeir Bruun (2013). Higher anticholinergic drug scale (ADS) scores are associated with peripheral but not cognitive markers of cholinergic blockade. Cross sectional data from 21 Norwegian nursing homes. British Journal of Clinical Pharmacology. ISSN 0306-5251. 75(3), s. 842–849. doi: 10.1111/j.1365-2125.2012.04411.x. Fulltekst i vitenarkiv
• Debelian, Gilberto Jirair; Døving, Lars M; Gerner, Nina Wiencke; Lange, Erik; Pedersen, Ingela & Ulstad, Johan [Vis alle 8 forfattere av denne artikkelen] (2013). Endodontisk sykdom hos pasienter som oppsøker allmenntannleger i Norge. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 123(4), s. 254–257. Fulltekst i vitenarkiv
• Zuluaga, Dairo Javier Marin; Ferreira, Jenny Carol Roman; Montoya, José A Gil & Willumsen, Tiril (2012). Oral health in institutionalised elderly people in Oslo, Norway and its relationship with dependence and cognitive impairment. Gerodontology. ISSN 0734-0664. 29(2), s. E420–E426. doi: 10.1111/j.1741-2358.2011.00490.x. Fulltekst i vitenarkiv
• Solemdal, Kirsten; Sandvik, Leiv; Willumsen, Tiril; Mowe, Morten & Hummel, Thomas (2012). The Impact of Oral Health on Taste Ability in Acutely Hospitalized Elderly. PLOS ONE. 7(5). doi: 10.1371/journal.pone.0036557. Fulltekst i vitenarkiv
• Solemdal, Kirsten; Sandvik, Leiv; Willumsen, Tiril & Mowe, Morten (2012). Taste ability in hospitalised older people compared with healthy, age-matched controls. Gerodontology. ISSN 0734-0664. 31(1), s. 42–48. doi: 10.1111/ger.12001. Fulltekst i vitenarkiv
• Willumsen, Tiril; Karlsen, Line; Næss, Richard & Bjørntvedt, Sissel (2012). Are the barriers to good oral hygiene in nursing homes within the nurses or the patients? Gerodontology. ISSN 0734-0664. 29(2), s. E748–E755. doi: 10.1111/j.1741-2358.2011.00554.x. Fulltekst i vitenarkiv
• Marin-Zuluaga, Dairo-Javier; Sandvik, Leiv; Gil-Montoya, José-Antonio & Willumsen, Tiril (2012). Oral health and mortality risk in the institutionalised elderly. Medicina Oral. ISSN 1698-4447. 17(4), s. E618–E623. doi: 10.4317/medoral.17632. Fulltekst i vitenarkiv
• Solemdal, Kirsten; Sandvik, Leiv; Møinichen, Christina Blymke; Skog, Karina; Willumsen, Tiril & Mowe, Morten (2012). Association between oral health and body cell mass in hospitalised elderly. Gerodontology. ISSN 0734-0664. 29(2), s. E1038–E1044. doi: 10.1111/j.1741-2358.2011.00607.x. Fulltekst i vitenarkiv
• Fjæra, Brit; Willumsen, Tirill & Eide, Hilde (2010). Eldre og tannhelse tannhelse hos eldre pasienter i hjemmesykepleien : en tverrsnittsstudie. Sykepleien Forskning. ISSN 1890-2936. 5(2), s. 100–108. doi: 10.4220/sykepleienn.2010.0065. Fulltekst i vitenarkiv Vis sammendrag

  SAMMENDRAG Bakgrunn: Dårlig oral helse hos eldre kan få store konsekvenser for deres livskvalitet og helse. I dag har eldre en tannstatus preget av kroner, broer og implantater og dette vil stille store krav til godt munnstell hos de grupper eldre som på grunn av svekket helse ikke selv kan ivareta tann og munnhygiene. Hensikt: Hensikten med prosjektet er å kartlegge risiko hos pasientene og hindringer i pasientenes miljø som kan bidra til mangelfullt tannstell og oral sykdom. Metode: Studien er en tverrsnittsstudie med kvantitativ tilnærming. Utvalget besto av 137 pasienter fra 12 bydeler i Oslo. Sykepleierstudenter i 2. året ved bachelorutdanningen ved Høgskolen i Oslo intervjuet pasientene med bruk av strukturert spørreskjema som en del av sin praksis i eldreomsorg. Risikofaktorer, hindringer og sykepleieansvar ble kartlagt. Resultater: Tegn på risiko for tannsykdom var til stede hos 85 % av utvalget. Ingen av pasientene var blitt inspisert i munnhulen av hjemmetjenestens ansatte. Konklusjon: Denne studien viser at de fleste eldre i hjemmesykepleien i Oslo har egne tenner og dermed har et stort behov for forebyggende tiltak og klinisk odontologisk behandling. Tannhelse bør få et mer systematisk og tydeligere fokus i hjemmetjenesten. Sykepleiere må endre holdninger og øke sin kompetanse, fordi tannhelse hos eldre er et sykepleieansvar.

• Willumsen, Tiril; Fjæra, Brit & Eide, Hilde (2010). Oral health-related quality of life in patients receiving home-care nursing: associations with aspects of dental status and xerostomia. Gerodontology. ISSN 0734-0664. 27(4), s. 251–257. doi: 10.1111/j.1741-2358.2009.00344.x. Fulltekst i vitenarkiv
• Haugbo, Helena Oladottir; Storhaug, Kari & Willumsen, Tiril (2010). Rusavhengighet, psykiatri og oral helse : rapport fra et sykehusprosjekt i Oslo. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 120(13), s. 912–917. Fulltekst i vitenarkiv
• Preza, D; Olsen, I; Willumsen, T; Grinde, Bjørn & Paster, BJ (2009). Diversity and site-specificity of the oral microflora in the elderly. European Journal of Clinical Microbiology and Infectious Diseases. ISSN 0934-9723. 28(9), s. 1033–1040. doi: 10.1007/s10096-009-0743-3. Fulltekst i vitenarkiv
• Willumsen, Tirill; Fjæra, Brit & Eide, Hilde (2009). Oral health –related quality of life in patients receiving home care nursing: associations with aspects of dental status and xerostomia. Gerodontology. ISSN 0734-0664. doi: 10.1111/j.1741-2358.2009.00344.x. Fulltekst i vitenarkiv
• Preza, D; Olsen, I; Willumsen, T; Boches, SK; Cotton, SL & Grinde, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2009). Microarray analysis of the microflora of root caries in elderly. European Journal of Clinical Microbiology and Infectious Diseases. ISSN 0934-9723. 28(5), s. 509–517. doi: 10.1007/s10096-008-0662-8. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Aas, Jørn Arne; Willumsen, Tiril; Grinde, Bjørn & Paster, Bruce J (2008). Norsk-amerikansk forskergruppe oppdager nye bakterier ved rotkaries hos eldre. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 118, s. 381–381. Fulltekst i vitenarkiv
• Preza, D; Olsen, I; Aas, JA; Willumsen, T; Grinde, Bjørn & Paster, BJ (2008). Bacterial profiles of root caries in elderly patients. Journal of Clinical Microbiology. ISSN 0095-1137. 46(6), s. 2015–2021. doi: 10.1128/JCM.02411-07. Fulltekst i vitenarkiv

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• Willumsen, Tiril; Lein, Jostein Paul Årøen; Gorter, Ronald C. & Myran, Lena (2022). Oral Health Psychology. Springer. ISBN 9783031042478. 345 s. Fulltekst i vitenarkiv
• Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (2018). Odontologisk psykologi. Gyldendal Akademisk. ISBN 9788205510791. 276 s. Fulltekst i vitenarkiv
• Willumsen, Tiril; Wenaasen, Marianne; Armingohar, Zahra & Ferreira, Jenny (2008). Sykepleie og oral hesle Guide til godt munnstell hos pasienter med funksjonesvikt. Gyldendal Akademisk. ISBN 9788205379954. 99 s. Fulltekst i vitenarkiv

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• Høyvik, Ann Catrin; Tønnesen, Espen Andreas & Willumsen, Tiril (2025). Oral helse hos flyktninger og asylsøkere: Status, utfordringer og tilrettelegging av tannbehandling ved psykologiske traumer. Aktuel Nordisk Odontologi. ISSN 1902-3545. doi: 10.18261/ano.50.1.3. Fulltekst i vitenarkiv Vis sammendrag

  The influx of refugees to the Nordic countries entails an increasing need for oral health services to a population with more oral health challenges than the host population. Regardless of originating country, refugees present with high degree of caries, periodontitis, and tooth loss, followed by oral pain, infections and impaired oral health-related quality of life. Knowledge about prevention of oral health diseases varies, and information must therefore be culturally adjusted and translated to relevant languages. Psychologically traumatized refugees experience more oral health challenges and are more prone to dental anxiety. It is possible to help these refugees master the dental treatment situation provided the dental practitioner 1) acquires relevant trauma knowledge, 2) spends enough time /avoids signaling stress, 3) avoids surprising the patient with sudden triggers, and 4) provides overview of the consultation step by step.

• Rønneberg, Anne; Wigen, Tove Irene; Strøm, Kjetil; Jacobsen, Arne Eldor Tvedt & Willumsen, Tiril (2023). Tannbehandling ved hjelp av lystgass-sedasjon. Aktuell Nordisk odontologi. ISSN 1902-3545. 48(1), s. 186–201. doi: 10.18261/ano.48.1.13. Fulltekst i vitenarkiv Vis sammendrag

  Lystgass er svært egnet som sedasjonsmiddel ved tannbehandling til kooperative pasienter. Det kan titreres individuelt, effekten kommer raskt og kort etter avsluttet behandling er lystgassen ute av kroppen. Sedasjon med lystgass skal utføres i kombinasjon med psykologiske teknikker, med fokus på pasientmedvirkning, kontroll og god kommunikasjon samt adekvat smertekontroll. Lystgass demper uro, gir bløtvevsanalgesi og er et nyttig hjelpemiddel ved forebygging av angstinduserte opplevelser, behandling av pasienter med tannbehandlingsangst, brekninger og/eller ufrivillige muskelsammentrekninger samt for multimorbide pasienter med fare for legemiddelinterraksjoner ved bruk av benzodiazepiner. Følgelig er lystgass et utmerket verktøy i dagens odontologiske praksis med søkelys på smertefri tannbehandling samt forebygging og behandling av tannbehandlingsfrykt, -angst og -fobi.

• Johnsen, Jan-Are Kolset; Rogers, Adam Austin; Bergdahl, Jan & Willumsen, Tiril (2022). Basic oral health-related psychology, Oral Health Psychology. Springer. ISSN 9783031042478. s. 3–23. doi: 10.1007/978-3-031-04248-5_1. Fulltekst i vitenarkiv
• Rønneberg, Anne; Harris, Jenny; Fredriksen, Therese Varvin & Willumsen, Tiril (2022). Chap.10 Family violence and Child Maltreatment, Oral Health Psychology. Springer. ISSN 9783031042478. s. 147–164. Fulltekst i vitenarkiv
• Høyvik, Ann Catrin; Weie, Ingrid Volden; Tveter, Karianne & Willumsen, Tiril (2019). Are dentists familiar with the rights of torture survivors? Fulltekst i vitenarkiv
• Strøm, Kjetil; Willumsen, Tiril & Rønneberg, Anne (2019). Trenger tannleger utdanning i odontologisk psykologi? Aktuell Nordisk odontologi. ISSN 1902-3545. 44, s. 34–46. doi: 10.18261/ISSN.2058-7538-2019-01-04. Fulltekst i vitenarkiv
• Skaare, Anne B & Willumsen, Tiril (2018). Medication-induced dry mouth in two selected patient groups: A pilot study among general practitioners and dentists based on data collected from electronic patient records. Den norske tannlegeforenings Tidende. ISSN 0029-2303. Fulltekst i vitenarkiv
• Torper, Jorun; Strøm, Kjetil; Høyvik, Ann Catrin & Willumsen, Tiril (2018). Pasientkommunikasjon. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 53–71. Fulltekst i vitenarkiv
• Rønneberg, Anne & Willumsen, Tiril (2018). Familievold og omsorgssvikt. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 153–161. Fulltekst i vitenarkiv
• Willumsen, Tiril; Agdal, Maren Gry Lillehaug & Vika, Margrethe Elin (2018). Frykt og angst for tannbehandling. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 101–113. Fulltekst i vitenarkiv
• Johnsen, Jan-Are Kolset; Willumsen, Tiril & Bergdahl, Jan (2018). Grunnleggende psykologi. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 13–35. Fulltekst i vitenarkiv
• Kvist, Therese; Willumsen, Tiril & Rønneberg, Anne (2018). Våld i nära relationer- tandvårdens roll. Aktuell Nordisk odontologi. ISSN 1902-3545. 1(43), s. 114–125. Fulltekst i vitenarkiv
• Hauge, Mariann Saanum; Storå, Bent Olav & Willumsen, Tiril (2018). Tannlegeadministrert kognitiv atferdsterapi. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 179–192. Fulltekst i vitenarkiv
• Trine, Anstorp; Nupen, Åshild Karin & Willumsen, Tiril (2018). Traumesensitiv tannbehandling - hva trengs? I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 227–248. Fulltekst i vitenarkiv
• Willumsen, Tiril; Myran, Lena; Hauge, Mariann Saanum & Storå, Bent Olav (2018). Tannbehandlingsangst - tilvenning til tannbehandling. I Willumsen, Tiril; Myran, Lena & Lein, Jostein Paul Årøen (Red.), Odontologisk psykologi. Gyldendal Akademisk. ISSN 9788205510791. s. 165–178. Fulltekst i vitenarkiv
• Høyvik, Ann Catrin; Lie, Birgit & Willumsen, Tiril (2017). Are refugees with torture experience more prone to dental fear? Fulltekst i vitenarkiv
• Høyvik, Ann Catrin; Shahnavaz, Shervin & Willumsen, Tiril (2016). Flyktninger og tannhelse. Aktuell Nordisk odontologi. ISSN 1902-3545. 41, s. 86–97. Fulltekst i vitenarkiv
• Kirkengen, Anna Luise; Stavdal, Anna; Rønneberg, Anne; Schei, Edvin; Ulvestad, Elling & Hetlevik, Irene [Vis alle 14 forfattere av denne artikkelen] (2016). På tide med en oppdatert helseforståelse. Morgenbladet. ISSN 0805-3847. Fulltekst i vitenarkiv
• Strøm, Kjetil & Willumsen, Tiril (2015). Dental anxiety and its effect on the life of dentally anxious adolescents (16-18 years). Fulltekst i vitenarkiv
• Rønneberg, Anne; Skaare, Anne B; Willumsen, Tiril & Espelid, Ivar (2015). Norwegian dentists` approach to severe caries in preschool children. Fulltekst i vitenarkiv
• Strøm, Kjetil; Rønneberg, Anne; Skaare, Anne B; Espelid, Ivar & Willumsen, Tiril (2014). Dentists’ education and their use of behavioural management techniques. Fulltekst i vitenarkiv
• Strøm, Kjetil; Rønneberg, Anne; Skaare, Anne B; Espelid, Ivar & Willumsen, Tiril (2014). Dentists’ attitudes towards treating patients with dental anxiety. Fulltekst i vitenarkiv
• Rønneberg, Anne; Strøm, Kjetil; Skaare, Anne B; Willumsen, Tiril & Espelid, Ivar (2014). Dentists' self-reported stress during dental treatment. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Cotton, J.S.; Boches, S. & Grinde, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2009). Microarray and 16S rRNA clonal sequencing analysis of the root caries microbiota. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Boches, S; Cotton, SL & Grinde, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2008). Microarray of the microbiota of root caries. Fulltekst i vitenarkiv
• Willumsen, Tirill; Fjæra, Brit & Eide, Hilde (2008). Elderly Receiving Home Care Nursing Risk Factors for Dental Caries. Fulltekst i vitenarkiv
• Willumsen, Tiril; Eide, Hilde & Fjaera, Brit (2008). Elderly receiving home care nursing–risk factors for dental caries. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Grinde, Bjørn; Boches, S & Cotton, SL [Vis alle 7 forfattere av denne artikkelen] (2008). Microbial profiles in root caries of the elderly. Journal of Dental Research. ISSN 0022-0345. 87. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Aas, Jørn Arne; Birkeland, Torunn & Grinde, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2007). The bacterial profiles of root caries in the elderly. Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Aas, Jørn Arne; Grinde, Bjørn & Paster, Bruce J (2007). Microbiology of root caries in elderly (Prisen for beste orale presentasjon). Fulltekst i vitenarkiv
• Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Aas, Jørn Arne; Grinde, Bjørn & Paster, Bruce J (2007). Root caries biofilm in a cohort of elderly Norwegians studied by molecular genetic methods. Fulltekst i vitenarkiv
• Aardal, Vilde Eika & Willumsen, Tiril (2026). The Complexity of Dental Anxiety: Exploring Variables Associated with Oral Health-Related Quality of Life, Abuse, and Psychological, Somatic, and Dental Health. Universitetet i Oslo. ISSN 9788283271089. Fulltekst i vitenarkiv Vis sammendrag

  Denne avhandlingen undersøker kjennetegn ved pasienter med alvorlig tannbehandlingsangst. Siden tannhelsepersonell ofte møter denne pasientgruppen, er kunnskap om deres utfordringer viktig for klinisk praksis. Avhandlingen består av tre studier som utforsker ulike aspekter ved alvorlig tannbehandlingsangst. Den første studien undersøkte oral helserelatert livskvalitet og faktorer som påvirker denne. Den andre studien sammenlignet personer med tannbehandlingsangst som rapporterte å ha vært utsatt for overgrep, med personer som ikke rapporterte overgrep. Den tredje studien beskrev pasienter som hadde behov for tannbehandling i narkose. På tvers av studiene hadde deltakerne høy grad av både tannbehandlingsangst og generell angst, samtidig som de rapporterte at deres orale helse hadde en sterk negativ påvirkning på hverdagen, altså dårlig oral helserelatert livskvalitet. Faktorer som var forbundet med dårligere oral helserelatert livskvalitet, var tannbehandlingsangst, alder, tid siden siste tannlegebesøk og grad av generelle angstsymptomer. Sammenlignet med personer uten rapportert overgrepserfaring hadde de som rapporterte overgrep mer uttalte generelle angstsymptomer, dårligere oral helserelatert livskvalitet og høyere grad av angst knyttet til tap av kontroll og følelsen av skam. Blant pasienter med alvorlig tannbehandlingsangst som trengte tannbehandling i narkose, ble det funnet svært dårlig tannstatus, høy forekomst av psykiske og somatiske helseutfordringer samt hyppig bruk av legemidler. Psykiske lidelser og somatiske helseutfordringer var vanligere blant dem som rapporterte overgrepserfaringer enn blant dem som ikke gjorde det. Dette understreker behovet for tilpassede behandlingstilbud. Tannbehandlingsangst opptrer altså ofte sammen med redusert oral helserelatert livskvalitet og betydelige psykiske og somatiske helsebelastninger, særlig hos personer som har opplevd overgrep. For noen pasienter er tilgang til tannbehandling i narkose nødvendig for å kunne behandle alvorlige tannproblemer som ellers ikke lar seg håndtere. Samlet sett viser resultatene at tannbehandlingsangst er et komplekst og sammensatt fenomen som tannhelsepersonell bør ha kjennskap til.

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