Oral health in the indigenous Sámi population in Norway – the dental health in the North study

Figures & data

Figure 1. Map of Norway. The municipalities included in the survey are marked in blue (Nesseby, Tana, Prosanger, Karasjok and Kautokeino).

Table 1. List of self-reported information collected in the questionnaire.

Theme	Description
Background characteristics	Country of birth and childhood [21] and ethnicity [23]
Socioeconomics	Education and employment [23], income [18]
Use of dental health care services	Frequency of dental visits, public of private dental services and influence of costs on dental treatment [21]
General health and health behavior	Self-perceived health and smoking [23]
Diet	Frequency of sugary foods and drinks, including alcohol [24]
Oral hygiene behaviour	Frequency of brushing, oral hygiene aids and fluoride [21]
Subjective norms, normative beliefs and self-efficacy	Questions about brushing behaviour developed from Theory of Planned Behaviour [25,26]
Attitudes towards oral health	Importance of oral hygiene and oral health [21]
Q36 Oral health-related quality of life (OHIP-14)	Perception regarding discomfort and dysfunction caused by oral conditions [27]
Q37 Dental anxiety scale	Dental Anxiety Scale describing imagined dental situations [28]
Other	Use of traditional healer

Table 2. Overview of clinical parameters.

Disease/clinical parameters	Description to the parameter in patient-records	Description of parameters in post-clinical measurements
Teeth (max n)	Permanent teeth when third molar excluded [28]	Premolar and molar when third molar excluded [16]
Periodontitis
Bleeding on probing (BOP)	Bleeding from gingival sulcus on gentle probing. Assessed at six sites per tooth
Periodontal probing depth (PPD)	Distance from the bottom of a pocket to the gingival margin. Measured in nearest millimetre
Furcation involvement (FI)	Grade I: Horizontal loss of periodontal support not exceeding one-third of the width of the tooth Grade II: Horizontal loss of periodontal support exceeding one-third of the width of the tooth, but not encompassing the total width of the furcation area. Grade III: Horizontal ‘trough-and-trough’ destruction of the periodontal tissues in the furcation area	Furcation that was clearly visible on Bitewing radiographs. Radiolucency in between the roots in molars.,i.e. grades 2 and 3
Alveolar bone level (ABL)		Distance from CEJ to AR. Measured to the nearest 0.5 mm
Caries
Decade Teeth (DT)/surface (DS)	Tooth or surface with caries grades 3–5 included secondary caries	Tooth with caries grades 3–5, included secondary caries
Missed Teeth (MT)/surface (MS)	Missing tooth or surface because of caries or periodontitis, included implants	All missing teeth, included implants
Filled Teeth (FT)/surface (FS)	Tooth or surface with permanent filling, on lay or crown	Tooth or surface with temporary or permanent filling, on lay or crown
Decayed Missed Filled Teeth (DMFT) Decayed Missed Filled Surfaces (DMFS)	Sum of DT, MT, FT Sum of DS, MS, FS	Sum of DT, MT, FT Sum of DS, MS, FS

Figure 2. Flowchart of the study sample and participation.

Table 3. Participation by municipality.

	Filled in questionnaire	No responders	Crude response rate	Final sample
Municipality	n	n	%^a	n (%)
Kautokeino	515	14	96.8	500 (24.6)
Karasjok	508	26	95.1	485 (23.8)
Porsanger	476	198	70.6	404 (19.9)
Tana/Seida	640	47	93.2	563 (27.7)
Nesseby	96	0	100	82 (4.0)
Totalt	2235	285	88.7	2034 (100)

^a 100× Invited/filled in questionnaire.

Table 4. Selected characteristics for the study sample n = 2034^b.

	n	(%)
Age (years)
18–37	505	24.8
38–56	898	44.2
57–75	631	31.0
Daily smoking
Yes	434	21.6
No	1572	78.4
Gender
Females	1158	56.9
Men	876	43.1
Gross income^a
<150,000	68	3.5
150,000-300,000	201	10.4
301,000-450,000	443	22.9
451,000-600,000	327	16.9
601,000-750,000	322	16.7
751,000-900,000	283	14.6
>900,000	289	15.0
Education (years)
<7	23	1.1
7–9	217	10.7
10–12	532	26.2
13–16	734	36.1
>16	528	26.0
Income source status
Fulltime	1092	53.7
Part time	181	8.9
On welfare	201	9.9
Retired	143	7.0
Student	79	3.9
Other	338	16.6
Last visit to dental clinic (years)
<1	1127	55.9
1–2	708	35.1
3–5	116	5.8
>5	65	3.2
Childhood residence in Finnmark at 10 years
Yes	1751	86.1
No	283	13.9
Ethnicity
Sámi	981	48.2
Mixed Sámi/Norwegian	400	19.7
Norwegian	653	32.1

^a Norwegian currency, NOK.

^b Subgroups may not total to 2034 due to missing variables.

Figure 3. Distribution of sub-populations among participants with Sámi affiliation: The Dental Health in the North Study. ¹ Sámi affiliation is defined as Sámi language being spoken at home by at least one of the grandparents, parents or the respondent, or Sámi ethnic background reported for respondent or a parent, or that the respondent considers himself/herself as Sámi (n = 1381). ² Self-perceived Sámi is defined as yes to the question: I consider myself Sámi (n = 1283). ³ Sámi ethnic background is defined as yes to the question: My ethnic background is Sámi (n = 1301). ⁴ Sámi as home language is defined as yes to the question: My home language is Sámi (n = 1044). ⁵ Answered yes to all three questions in footnote: 2, 3 and 4 (n = 981). ⁶ ‘Mixed Sámi/Norwegian’ is defined as yes to one or two of the question(s) in footnote 2 or 3 or 4 (2*+3*+4*+2∧3 + 2∧4 + 3∧4) (n = 400). 2*: Reported only self-perceived Sámi (n = 48). 3*: Reported only Sámi ethnic background (n = 53). 4*: Reported only Sámi as home language (n = 14). 2∧3: Reported Sámi ethnic background and self-perceived Sámi (n = 236). 2∧4: Reported self-perceived Sámi and Sámi as home language (n = 18). 3∧4: Reported Sámi ethnic background and Sámi as home language (n = 31).

Table 5. Self-reported ethnicity, self-perceived ethnicity and language at home according to our ethnic definition.^a

	Sámi %^b	Kven %^b	Norwegian %^b	Other %^b
Self-reported ethnicity (Based on the question: ‘What is your ethnic background’)
Sámi	100.0	1.6	9.6	1.0
Mixed Sámi/Norwegian	80.0	14.2	58.0	6.3
Norwegian	–*	6.1	93.9	1.7
Self-perceived ethnicity (Based on the questions: ‘I consider myself’)
Sámi	100.0	1.1	13.1	0.6
Mixed Sámi/Norwegian	75.5	8.0	66.3	3.5
Norwegian	–*	6.0	96.5	0.9
Language at home (Based on the questions: ‘My home language is’)
Sámi	100.0	0.5	16.3	1.0
Mixed Sámi/Norwegian	15.8	2.0	87.8	3.0
Norwegian	–*	3.5	97.5	1.8

Sámi was defined as answering YES to all three following questions: ‘I consider myself Sámi’, ‘My ethnic background is Sámi’ and ‘My home language is Sámi’.

Mixed Sámi/Norwegian was defined as answering Yes to minimum one (one or two) of the three following questions: ‘I consider myself Sámi’, ‘My ethnic background is Sámi’ and ‘My home language is Sámi’, but not Yes to all three questions.

Norwegian: Manly Norwegians, including Kven affiliation (n = 99) and Sámi without subjective Sámi criteria (n = 165). Those respondents reported use of the Sámi language or ethnicity for grandparents and/or parents, but did not consider themselves to be Sámi or personally consider they were having a Sámi ethnic background or had Sámi as home language.

All three questions had the available responses were Sámi, Norwegian, Kven or Other (specify).

^a Row percent’s add up to more than 100% due to the possibility of answering more than one category.

^b The response options: ‘Norwegian’, ‘Sámi’, ‘Kven’ or ‘Other’ in questionnaire for the following ethnicity questions.

* 0.0%.

Adekoya SM, Brustad M. Oral health of adults in northern Norway – a pilot study. Nor J Epidemiol. 2012;22:31–38.

 Google Scholar

Lund E, Melhus M, Hansen KL, et al. Population based study of health and living conditions in areas with both Sámi and Norwegian populations-the SAMINOR study. Int J Circumpolar Health. 2007;66:113–128.

 PubMed Web of Science ®Google Scholar

Brustad M, Hansen KL, Broderstad AR, et al. A population-based study on health and living conditions in areas with mixed Sami and Norwegian settlements – the SAMINOR 2 questionnaire study. Int J Circumpolar Health. 2014;73:23147.

 PubMed Web of Science ®Google Scholar

Doring N, Hansson LM, Andersson ES, et al. Primary prevention of childhood obesity through counselling sessions at Swedish child health centres: design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial. BMC Public Health. 2014;14:335.

 PubMed Web of Science ®Google Scholar

Ajzen I. The theory of planned behaviour: reactions and reflections. Psychol Health. 2011;26:1113–1127.

 PubMed Web of Science ®Google Scholar

Buunk-Werkhoven YA, Dijkstra A, van der Schans CP. Determinants of oral hygiene behavior: a study based on the theory of planned behavior. Community Dent Oral Epidemiol. 2011;39:250–259.

 PubMed Web of Science ®Google Scholar

Dahl KE, Wang NJ, Skau I, et al. Oral health-related quality of life and associated factors in Norwegian adults. Acta Odontol Scand. 2011;69:208–214.

 PubMed Web of Science ®Google Scholar

Kvale G, Berg E, Raadal M. The ability of Corah’s Dental Anxiety Scale and Spielberger’s State Anxiety Inventory to distinguish between fearful and regular Norwegian dental patients. Acta Odontol Scand. 1998;56:105–109.

 PubMed Web of Science ®Google Scholar

Holde GE, Oscarson N, Tillberg A, et al. Methods and background characteristics of the TOHNN study: a population-based study of oral health conditions in northern Norway. Int J Circumpolar Health. 2016;75:1–7.

 Web of Science ®Google Scholar