National guidelines
for dental care
Summary1

Summary
Most children and adults in Sweden receive dental care on aregular basis. Caries (cavities, or tooth decay) and periodontal
disease (gum disease, which can lead to tooth loss) are among themost common non-communicable diseases in the world. They affectour overall health and well-being, and are associated with greatcosts to both society and the adult patient. Caries and periodontal
diseases, however, are largely preventable.
The 2021 guidelines from the Swedish National Board of Healthand Welfare contain 377 dental care recommendations on theprevention, diagnosis, and treatment of oral diseases. The guidelines also contain 43 indicators that can be used nationally andregionally to evaluate and follow up results in dental care.
National guidelines for adult dental care were first published in
2011. The 2021 guidelines contain many of the recommendations
from the 2011 release, some of them have been updated. New
recommendations, such as on dental care for children and forindividuals with special needs due to impaired function, have also
been added.
These guidelines are primarily intended for policy makers who areresponsible for allocation of resources in dental care. The guidelines are also useful for dental care professionals.

Assessing risk and treating cause
are top priorities
Efficient use of resources requires that dental staff work systematically. For example, they should assess the risk of developing various oral diseases and record any damage, such as tooth erosion.
They are also expected to investigate the underlying causes ofthese risks and tooth damage in collaboration with the patient. In
this way, treatment can target cause and, when necessary, consider alleviating symptoms. Causal treatment is not yet as widespreadas it should be, especially in the treatment of caries.

2NATIONAL GUIDELINES FOR DENTAL CARE
THE NATIONAL BOARD OF HEALTH AND WELFARE

Systematic working methods allow patients to be called for acomprehensive oral health examination on an individual basis,
according to their identified risks. Thus, patients with a high riskof poor oral health should be examined more often (once every
1–1.5 years) than patients with a low risk (once every 2–3 years).
High-risk patients will then have better access to dental care, withexpected improved oral health over time, while patients with lower
risk will save time and money.

Dental care helps prevent poor healthGood oral health is important for our overall health and wellbeing. Among other things, our mental health and nutritional intake
as well as the risk of infectious and inflammatory conditions areaffected by the state of our oral health.
Thus, a primary aim of dental care is to promote and preserve oral
health by measures aiming at strengthening salutogenic factors
as well as reducing risk factors. Many of the risk factors, such as
unhealthy diets and smoking, are common to both oral diseases
and other chronic diseases. Thus, measures against them will affectboth oral and general health.
Some dental staff have special training in the support of behavioral
changes, such as in general counselling or in specialized therapeutic approaches, and can offer support for changing unhealthy
habits and promoting a healthy behavior. This is an essential partof promoting oral health, which also may improve general health.

Dental care must collaborate
more with other actorsDental care must expand their collaboration with other actors, suchas adult and pediatric (child) medical care, schools, and social
services in order to raise the level of oral health in the population.
This requires that dental care be included in the overall policy workof improving coordination between the various branches of healthcare.

NATIONAL GUIDELINES FOR DENTAL CARE
THE NATIONAL BOARD OF HEALTH AND WELFARE

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Oral health influences general health, and coordinating pediatric
medical clinics, schools, and dental care would allow these actors
to reach all children with similar messages. Similar messages
through lectures and activities on healthy eating and oral hygiene
habits, like daily tooth brushing with fluoride toothpaste, would
spread common knowledge throughout the population. Suchcollaboration would be particularly important for areas where poor
oral health among the residents and a high incidence of caries inchildren are more common than in other parts of the population.
Initiatives in these areas are necessary to reduce health inequalities
in the population.
Dental care should also strive to be included in the network ofhealthcare services surrounding a patient. For example, the needfor both professional dental treatment and daily oral care should
be identified when a patient is moved from hospital to municipal
care.
Furthermore, individuals with special needs due to impaired function may need dental care on site, for example, at a care or nursing home. The staff of such accommodations need dental-oriented
education and training so that they can support residents in their
daily oral care and recognize when professional dental treatment
is needed.

Equity in oral health and dental caremust be improved
Oral health and dental care in Sweden vary, for different reasons.
For example, people with low income, low education, or disabilities generally have poorer oral health than other groups in the population. A similar pattern occurs in the population’s general health.
There are also geographical differences in the availability of dental
care and the range of dental services offered.
These guidelines are designed to form the basis for promoting
equity in oral health and dental care. We report regularly on thereach and outcome of dental care throughout the population; thus,
compliance with these guidelines is being continually evaluated.

Art. nr 2022-1-7749