Sense of coherence and oral health-related quality of life among southern Brazilian male adolescents

This study evaluated the association between sense of coherence (SoC) and oral health-related quality of life (OHRQoL) among conscripts of the Brazilian Army, in two cities of southern Brazil. A cross-sectional study included all 18-19-year-old adolescents who joined the Brazilian Army as draftees for mandatory military service in the cities of Itaqui, RS, and Santiago, RS (n = 505). Data collection was conducted from 2019 to 2021, and included the application of questionnaires and a clinical oral examination to record gingivitis, malocclusion, and dental caries. OHRQoL was collected through the Brazilian short version of the Oral Health Impact Profile (OHIP), composed of 14 questions. The adolescents' SoC was assessed using the validated Brazilian version of the SOC-13 scale. The primary outcome of this study was OHRQoL, modeled as a discrete variable (OHIP-14 scores). The main predictor variable was SoC, categorized as low, moderate, or high. The association between predictor variables and OHRQoL was assessed by Poisson regression models using a hierarchical approach. Unadjusted and adjusted rate ratios (RR), and 95% confidence intervals (CI) were estimated. All the analyses were performed using STATA software version 14.2. Adolescents with a moderate and high SoC had 27% (RR = 0.73, 95%CI = 0.64-0.84) and 51% (RR = 0.49, 95%CI = 0.41-0.58) lower mean OHIP-14 scores, respectively, than those with a low SoC score, after the inclusion of behavioral and clinical variables. This study showed a significant association between SoC and OHRQoL among 18-19-year-old southern Brazilian adolescents. Strengthening the SoC as a psychosocial resource may improve the well-being and OHRQoL of adolescents.

Sense of coherence in a general adult population in Northern Norway and its associations with oral health

BACKGROUND

Sense of coherence (SOC) is a global orientation to life that may affect a person's way of acting and living within his or her life context, which can have an impact on general and oral health. The aims of this study were (i) to describe the distribution of SOC in a general adult population; (ii) to explore whether sociodemographic characteristics, oral health-related behaviours, self-reported oral health, and clinical oral status were associated with SOC; and (iii) to explore whether SOC was associated with self-reported oral health, controlling for sociodemographic characteristics, oral health-related behaviours, and oral clinical status.

METHODS

This study was based on data from the cross-sectional population-based study Oral Health in Northern Norway (N = 1819 individuals, 923 women, mean age 47.1 ± 15.2 years). Data were collected between October 2013 and November 2014 in Troms County. Participants answered a questionnaire that included items on SOC, sociodemographic characteristics, oral health-related behaviours, and self-reported oral health. Clinical oral status (number of teeth, dental caries, and periodontal status) was determined through oral and radiographic examination. Linear regression analysis was used to examine factors associated with SOC. Logistic regression analysis was used to examine SOC and its association with self-reported oral health adjusted for sociodemographic characteristics, behaviours, and clinical oral status.

RESULTS

The mean SOC score was 68.5 (standard deviation 10.5). The younger age groups (20-29 and 30-39 years) had mean SOC scores of 64.0 (95% CI: 62.7,65.3) and 67.2 (95% CI: 66.0,68.5), respectively, and the older age groups (40-79 years) had mean SOC scores between 69.8 and 70.1 (95% CI: 68.2,71.3). A higher mean SOC score was associated with older age, higher education level, higher income (all p < 0.001), being married/cohabiting (p = 0.005), and toothbrushing ≥ 2 times/day (p = 0.008). Approximately 49% of participants reported good oral health. SOC was positively associated with self-reported good oral health in the adjusted model (odds ratio:1.03 [95% CI: 1.02,1.05] p < 0.001).

CONCLUSIONS

SOC was associated with sociodemographic characteristics and toothbrushing habits. There was no significant association between SOC and clinical oral status; however, SOC was positively associated with self-reported good oral health. This indicates that a person's SOC might have an impact on how an individual perceives their oral health, independent of sociodemographic characteristics and the presence of oral diseases.

Prevalence of negative behaviour in the dental setting and association with sociodemographic, oral health-related and psychosocial factors amongst Brazilian preschool children

PURPOSE

To investigate the prevalence of negative behaviour in preschool children attending dental clinics and its association with sociodemographic, oral health-related and parental psychosocial factors.

METHODS

A cross-sectional study was carried out with 145 parents/guardians and their children aged 4-6 years attending paediatric dentistry training programmes in a capital city of Midwest Brazil. Data were obtained from children's dental records, interviews, and questionnaires for parents/guardians. The outcome was negative child behaviour, based on the dentists' use or indication of behavioural control measures during the dental appointments, as registered in the children's dental records. Covariates were sociodemographic, clinical and parent/guardian psychosocial factors religiosity (DUREL index) and Sense of Coherence (SOC-13 scale). Bivariate analyses and Poisson regression with robust variance were performed.

RESULTS

The prevalence of negative behaviour was 24.1% (95% CI = 17.9-31.7). In the bivariate analyses, the variables initially selected for the regression models (p < 0.25) were the parent/guardians' number of children and religiosity, and the children's dental pain and caries status in deciduous teeth. After adjustment, the prevalence of negative behaviour was 2.12 higher in children with teeth extracted due to caries.

CONCLUSION

The prevalence of negative behaviour was high and associated with the presence of missing teeth due to caries, regardless of sociodemographic, psychosocial, and other oral health factors.

Direct relations between sense of coherence and oral health-related quality of life in adolescents

OBJECTIVE

To verify the relations between sense of coherence (SOC) and dental caries on oral health-related quality of life (OHRQoL) of adolescents.

SUBJECT AND METHODS

A cross-sectional sample of 768 adolescents nested in a cohort study was evaluated. SOC was measured using Antonovsky's scale. Dental caries was collected considering the decayed, missing, and filled teeth index (DMFT). OHRQoL was collected through the Child Perception Questionnaire. Demographic, socioeconomic, and use of service variables were also collected. The mediation effects between variables were tested by structural equation modeling.

RESULTS

The average age of the individuals was 17.5 years. Individuals with high SOC scores had a positive impact on OHRQoL (β-coefficient = -0.573, p < 0.00). Individuals with high DMFT (β-coefficient = 0.080, p = 0.034) and dental pain (β-coefficient = 0.079, p = 0.039) negatively impacted OHRQoL. Still, adolescents who had dental pain (β-coefficient = 0.112, p = 0.005), mothers with lower education levels (β-coefficient = -0.114, p = 0.004), lower household income (β-coefficient = -0.131, p = 0.003), and those who visited the dentist (β-coefficient = 0.109, p = 0.005) exhibited a higher DMFT index.

CONCLUSIONS

SOC and dental caries had a direct effect on OHRQoL, indicating that oral conditions and psychosocial characteristics are important contributors to OHRQoL.

Evaluation of the predictors of oral health-related quality of life among 3-5-year-old children with dental trauma

This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann-Whitney U tests, Kruskal-Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

Structural validity of the Brazilian version of the Sense of Coherence scale (SOC-13) in oral health research: exploratory and confirmatory factor analysis

Background

The Sense of Coherence (SOC) construct has been used worldwide in oral health research, but rigorous factor analyses of the scale are scarce. We aim to test the dimensional structure of the Brazilian short version of the SOC scale with 13 items.

Methods

This study is a secondary analysis of four independent cross-sectional Brazilian studies on oral health, using the 13-items SOC scale. Sample 1 was conducted on 1760 mothers and 1771 adolescents. Sample 2 comprised 1100 adults. Sample 3 had 720 adults and older individuals. Sample 4 comprised 664 adolescent students. Confirmatory Factor Analysis (CFA) was conducted on sample 1 to compare two models: 3-factor versus 1-factor. Because they were refuted, Exploratory Factor Analysis was implemented in samples 2 and 3. Modified models were tested in sample 4 using CFA. All analyses were conducted with MPlus version 7.11.

Results

CFA of sample 1 resulted in an unacceptable fit (RMSEA = 0.12;CFI = 0.78; TLI = 0.73; and WRMR = 3.28) for 1-factor model and 3-factor (RMSEA = 0.10; CFI = 0.87; TLI = 0.84; and WRMR = 2.50). The EFA on samples 2 and 3 showed, respectively, two eigenvalues greater than 1 (4.11 and 1.56) and (4.32 and 1.42), but the scale items soc1, soc2 and soc3 formed an uninterpretable second factor. Another CFA, using sample 4, showed acceptable model fit after removing those three items and also soc11 (RMSEA = 0.05; CFI = 0.98; TLI = 0.99; and WRMR = 0.71).

Conclusion

The results indicate that the SOC-13 scale needs further adjustments. The one-factor model with nine items showed a good statistical fit, but the implications of excluding items should be further investigated, considering the scale's content validity, cross-cultural adaptation and theoretical background.

Relationship between sense of coherence and health-related behaviours in adolescents and young adults: a systematic review

Background

The sense of coherence is developed through the learning process and contributes to the positioning of individuals in the health-disease continuum, facilitating successful and adaptive personal outcomes. Health-related behaviours represent a health determinant of utmost importance for public health and the development of adolescent and youth health promotion policies, as they are related to the main risk factors and problems of morbidity and mortality in our society. Previous studies have analysed the relationship between sense of coherence and only some individual health outcomes such as oral health, the relationship of sense of coherence with smoking and alcohol consumption, concluding that salutogenic factors are related to quality of life and preventive behaviours. The aim of this systematic review was to describe the relationship of sense of coherence with different health-related behaviours investigated so far in the adolescent and youth population.

Methods

A systematic review was carried out in databases (PubMed, CINAHL, Scopus and PsycInfo) and in the bibliographies of the retrieved articles, without limitation of time or language. Associations between sense of coherence and health-related behaviours have been assessed.

Results

A total of 1214 investigations were reviewed and 21 of them were included in this systematic review. The relationship between sense of coherence and eight health-related behaviours were identified (alcohol use, physical activity, tobacco use, eating habits, rest periods, use of illegal substances, behaviours related to oral health and time spent in games on the computer).

Conclusions

Our results increase the available evidence and support the solid relationship of the sense of coherence with health behaviours both as a protective factor against risk behaviours and for its positive association with preventive and health promoting behaviours of adolescents, young adults and university students.

Sense of coherence and dental fear/dental anxiety: A systematic review and meta-analysis

AIM

The aim of this systematic review and meta-analysis was to evaluate the association between sense of coherence (SOC) and dental fear/dental anxiety.

METHODS

Computerized searches were performed in six databases. Gray literature and manual searches were also conducted. Study selection, risk of bias assessment, and meta-analyses were performed. The results of meta-analyses were reported in odds ratio (OR), mean difference (MD), and confidence interval (CI).

RESULTS

After removing duplicates, 131 references were retrieved and the full texts of 12 were evaluated. Nine references met the eligibility criteria and were included. The results of meta-analyses demonstrated that individuals with a weaker SOC had a score in the dental anxiety/dental fear scale 6.04 times higher than individuals with a stronger SOC (OR = 6.04, CI = 2.62-13.91). Individuals with no dental anxiety/dental fear had a mean score of the SOC scale higher than individuals with dental anxiety/dental fear (MD = 5.39, CI = 2.21-8.56). Sensitivity analysis demonstrated that the result of a higher mean score of the SOC scale among individuals with no dental anxiety/dental fear remained (MD = 7.38, CI = 3.79-10.98). Risk of bias ranged from low to high. The certainty of evidence was very low.

CONCLUSION

Individuals with stronger SOC have lower levels of dental fear/dental anxiety.

Salutogenesis in oral health research in preschool children: A scoping review

BACKGROUND

Oral health research in children has focused both on identifying the risk factors for dental caries and on the impact the disease has on children's life.

AIM

Identifying studies that used the salutogenic theory to investigate positive aspects to promote a healthy condition in preschool children.

DESIGN

A literature scoping review was conducted to answer the question: 'What has been produced in scientific literature about children's oral health with a salutogenic theoretical reference?' The checklist preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) was applied. The research was conducted on the databases PubMed, Scopus, and Web of Science with no language, design, country or date restrictions. Three independent reviewers selected the studies to be included in the research, extracted data, and assessed the studies' contribution to the review.

RESULTS

Among the 38 studies retained, 10 were included, those were published between 2009 and 2018: five in Brazil, two in the United States of America, and one in Canada, China and India, respectively. All articles were published in English language. Nine studies investigated the relation between the parents'/caretakers' sense of coherence and aspects related to the children's oral health condition. One study investigated health factors among the parents of caries-free children.

CONCLUSION

Salutogenic orientation must be included in oral health research, so that salutary and risk factors may coexist, contributing to a new perspective for oral health promotion among children.

Parental perspectives on early childhood caries: A qualitative study

BACKGROUND

Early childhood caries (ECC) affects about 621 million children worldwide, causing chronic pain, infections, sleeping disorders, and tooth extraction.

AIM

To determine perspectives of parents and caregivers of preschoolers regarding ECC.

DESIGN

Three focus groups were conducted with attendees of the Clinics of Paediatric Dentistry from the Bauru School of Dentistry. The meetings were video- and audio-recorded, and the contents were transcribed verbatim. Then, textual passages were examined and coded using the software NVivo 12 Plus.

RESULTS

The participants associated the presence of dental caries lesions with negative consequences for children, such as problems for permanent dentition, discrimination, and psychological damages. Although regular oral hygiene and healthy diet were recognized as important factors for the prevention of ECC, specific doubts about feeding, toothpaste usage, oral hygiene, and dental eruption were detected among parents. Additionally, they declared that their children brush teeth alone, intake fermentable carbohydrates frequently, and sleep during breastfeeding without dental plaque removal, because uncooperativeness, permissiveness, and convenience.

CONCLUSIONS

Based on these results, parents and caregivers understand the unfavourable effects of ECC on children's quality of life; however, their attitudes against the disease seemed to be inaccurate, influenced by their daily routines, doubts, and beliefs.