Enhancing Oral Health via Sense of Coherence: an RCT

Background: Psychological factors may influence oral health. One factor, Sense of coherence (SOC) has been related to general and oral health, oral health behaviours and oral health related quality of life (OHRQoL) in observational research with adults and children. Thus improving SOC may be a way to improve OHRQoL in children. Objectives: To evaluate the effect of an intervention to enhance SOC on OHRQoL in children. Methods: Cluster randomised trial in twelve primary schools in Khonkaen, Thailand with 257 grade 5 students. Six schools were allocated randomly to the study and control groups. Data included sociodemographic and clinical data. Self-report questionnaires assessed OHRQoL (measured with the child perceptions questionnaire, CPQ) and SOC. Data were collected at three time points; at baseline, two weeks after the intervention had finished and at 3 month follow up. Intervention: Seven one hour sessions over two months, focusing on children's participation and empowerment. The first four sessions were classroom activities and included a mixture of didactic teaching, discussion, activities and games. The last three involved working on healthy school projects. The intervention was delivered by trained teachers who received an intensive one day course. Results: The two groups were similar for all variables at baseline. The intervention group had significant improvements in SOC and CPQ scores at two week and three month follow up. Mean SOC scores were 64.50 (SD=11.58) and 62.68 (10.04) and CPQ scores were 21.98 (15.45) and 18.53 (13.95) in the intervention group. In the control group mean SOC scores were 58.21 (10.11) and 58.79 (9.49) and CPQ scores were 27.03 (17.95) and 24.32 (16.72). Conclusions: As well as providing experimental evidence that OHRQoL is determined by SOC. These data show that school-based interventions to enhance SOC may be a useful way to improve oral health related quality of life.