Freire, MDCM; (1999) Oral health and a sense of coherence: A study among Brazilian adolescents and their mothers. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Several models have been proposed to explain the causes of oral diseases. However, a full explanation has not yet emerged. The salutogenic model of health, operationalized as a Sense of Coherence (SOC), seeks to explain factors that promote health. It suggests that the stronger the SOC of individuals and groups, the better they will cope with life stressors, and hence maintain their health. Nevertheless, there is no evidence of its application to oral health. The aim of this study was to investigate the relationship between SOC and oral health on a sample of 664 15 year-olds and their mothers. It was hypothesized that adolescents with better oral health have higher levels of SOC and have mothers with higher levels of SOC. In addition, oral health and SOC are influenced by socioeconomic status. The study was conducted in Goiania-GO, Brazil, and data were collected through questionnaires and clinical dental examinations. Multiple logistic and polytomous ordered regression were used in the data analysis. Adolescents' SOC was associated with their caries experience in anterior teeth, but the relationship did not remain significant after controlling for other factors. Adolescents with higher SOC were more likely to visit the dentist mainly for checkups, and to have a better self-assessment of oral health, compared with those with lower SOC. Other measures of oral health status and behaviours were not significantly associated with SOC. Mothers' SOC was strongly associated with children's oral health. Adolescents whose mothers had higher levels of SOC had better dental caries and periodontal status and a better self-assessment of oral health, than those whose mothers had lower SOC. Mother-child similarities in dental caries status were also found. Socioeconomic status influenced both SOC and oral health. It was concluded that SOC is an important determinant of adolescents' oral health, particularly via mothers' SOC.

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