Oral health-related resources - a salutogenic perspective on Swedish 19-year-olds

Some young adults can maintain good oral health despite socioeconomic challenges

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19-23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was 'Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health', comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

Common resilience factors among healthy individuals exposed to chronic adversity: a systematic review

OBJECTIVE

To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.

MATERIALS AND METHODS

The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).

RESULTS

A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.

CONCLUSIONS

Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.

Adolescents' experiences of a theory-based behavioural intervention for improved oral hygiene: A qualitative interview study

OBJECTIVES

Adequate oral hygiene, that is self-performed infection control, is crucial to prevent periodontal disease. Epidemiological studies reveal poor oral hygiene conditions among Swedish adolescents and indicate a need for more effective prevention programs. The aim of the current study was to analyse adolescents' experiences of a person-centred, theory-based, oral health education program for improved oral hygiene.

METHODS

Data were obtained by interviewing 19 adolescents treated by dental hygienists in accord with the person-centred education program in a preceding clinical field study (ClinicalTrials.gov NCT02906098). Study participants were selected to reflect a variation of male and female adolescents, treated at clinics in areas with various socio-demographic profiles within Region Västra Götaland, Sweden. Interviews were audio-taped, transcribed verbatim and analysed with qualitative content analysis.

RESULTS

A main theme was identified: 'Adolescents on a guided and challenging journey towards beneficial oral hygiene behavior'. The results elucidate the importance of a person-centred approach in therapy. The adolescents described insight on a personal level about the importance of improved oral hygiene as fundamental for behavioural change. Planning and monitoring of the behaviour, with guidance and support by the dental hygienist, was considered to facilitate change and encouraged further behavioural efforts. However, the adolescents expressed a need of reminders and support to keep up oral hygiene routines over time.

CONCLUSIONS

The study brings knowledge on factors of importance in educational interventions to increase beneficial health behaviours among adolescents and emphasize areas for further improvements of such interventions.

Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study

OBJECTIVE

This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness.

MATERIAL AND METHOD

Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework.

RESULTS

Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness.

CONCLUSION

This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.

Patient-based outcomes and quality of life

Patient-based outcomes complement clinical data with patients' self-evaluation of their physical, psychological, and social well-being, and as such facilitate clinical decision-making, assessing the quality of care provided, and evaluating practices and policies. Some validated generic oral health-related quality of life measures used in recent research indicated a high performance. There is a proportional relationship between the quality of life and periodontitis, ie, the higher the level of periodontitis, the poorer the oral health-related quality of life. This relationship is heightened by the presence of symptoms such as bleeding, halitosis, and mobility. On the other hand, periodontal treatment has demonstrated the capability to improve quality of life substantially. Future research should focus on questionnaires that are able to explain the interlinked pathways between periodontal conditions, approaches to treatment approaches, and patients' well-being. The acquisition of new knowledge in the field is essential for the whole community, as we treat people not millimeters.

Factors associated with good health among older persons who received a preventive home visit: a cross-sectional study

Background

The ageing population is increasing worldwide, and this trend is bringing challenges both for the older person and for society. In order to meet the challenges a comprehensive approach is needed involving both health promotion and risk prevention. The preventive home visit is a public health intervention used around the world with the purpose of promoting health and preventing risk among older persons. However, most preventive home visits are focused on questions asking about risks. In order to strengthen the health promotion perspective during the preventive home visits, factors associated with good health need to be identified. The aim of this study was therefore to determine which factors were associated with good self-rated health among older persons who received preventive home visit.

Methods

This was a register study with a cross-sectional design, including older persons (≥75 years old), living in their own homes, and that had received preventive home visit. Data were collected during a period of 9 months, in two municipalities in the south of Sweden. A questionnaire covered mental, physical and lifestyle factors were used at home visit. Binary logistic regression was used to analyse the data.

Results

In total, 619 older persons were included in the study; 55.4% were women, and the mean age was 80.6 years (standard deviation 2.2 years). The following items were significantly associated with good health (after adjustment for age and gender): being able to do things that make one feel valuable, having no physical problems affecting participation in social activities, not feeling sad, not having reduced energy, and not having impaired endurance.

Conclusions

The main conclusion of this study is that questions focusing on risks could be seen from a health promotion perspective and could thus be turned into assets with a positive impact on older persons’ health. Furthermore, the mental and physical factors identified in the results as associated with good health have implications for the person’s ability to feel valuable and participate in social activities. The results suggest that issues regarding both health promotion as well as risk prevention must be brought up during the preventive home visit.

The validity and reliability of the Sense of Coherence scale among Indian university students

Background:

The importance of salutogenesis, with the focus of what creates health rather than what causes diseases, has been highlighted for a long time. This has been operationalized by Aaron Antonovsky as the Sense of Coherence (SOC-13) scale. The aim of this study was to further examine the psychometric properties of the SOC-13 in India.

Methods:

The present study was carried out among second-year degree students at three randomly chosen institutions at Mangalore University. Investigators assessed the appropriateness, relevance, comprehensiveness and understandability of the scale. Further, the scale was assessed by five subject experts. The SOC-13 was then pretested by administering it to peers, individuals and a few of the study subjects. Internal consistency was assessed by Cronbach’s alpha and split-half reliability. Test-retest reliability was assessed by administering the instrument to the same study participants after two weeks. Confirmatory factor analysis employing varimax rotation was employed.

Results:

The SOC-13 revealed a Cronbach’s alpha value of 0.76. Split-half reliability and Guttman split-half reliability were found to be 0.71 and 0.70, respectively. Test-retest reliability was found to be 0.71 ( p < 0.01). Factor analysis revealed a three-factor solution explaining 40.53% of the variation in SOC.

Conclusions:

SOC-13 was found to be a reliable and valid instrument for measuring SOC in an Indian context. The present study contributes to health promotion in an Indian context, and could be useful even in other developing countries and for further research in India.

Impact of Sense of Coherence on Oral Health Behaviors: A Systematic Review

Objectives

The aim of this review was to critically analyze the empirical evidence on the association between Sense of Coherence (SOC) and oral health behaviors through a systematic approach.

Methods

A systematic search up to April 2015 was carried out using the following electronic bibliographic databases: PubMed, Ovid MEDLINE; ISI Web of Science; and Ovid PsychInfo. Studies were included if they evaluated the relationship between SOC and oral health behaviors including tooth cleaning, fluoride usage, dietary habits, dental attendance, and smoking. We excluded studies that only assessed the relationship between oral health status and SOC without evaluating oral health behaviors. The New Castle Ottawa (NOS) quality assessment checklist was employed to evaluate the methodological quality of included studies.

Results

Thirty-nine potential papers met the preliminary selection criteria and following a full-text review, 9 papers were finally selected for this systematic review. Results provided by the included studies indicated different levels of association between SOC and oral health behaviors. The most frequent behaviors investigated were tooth brushing and dental attendance pattern. The impact of SOC on performing positive oral health behaviors, to some extent, was related to demographic and socio-economic factors. In addition, mothers’ SOC influenced children’s oral health practices.

Conclusions

A more favorable oral health behavior was observed among those with a stronger SOC suggesting that the SOC can be a determinant of oral health-related behaviors including tooth brushing frequency, daily smoking, and dental attendance.