Children’s sense of coherence as a determinant of oral health 

Objective: Sense of coherence (SOC) is a central construct in salutogenic theory and has been proposed as an important health-promoting factor in relation to childrens oral health. The aim of the present study was to investigate whether SOC was related to childrenÕs oral health quality of life (OHQoL) over time. Methods: The sample for the present analysis consisted of data from three longitudinal studies conducted in Thailand and Malaysia with 1019, 9-14 year olds (mean age 11.3; 485 boys, 534 girls). Baseline and follow-up data were collected through questionnaires, including the short version of Antonovskys SOC scale (SOC-13) and a measure of OHQoL (Child Perceptions Questionnaire-37) and demographics (sex, age), together with a clinical dental examination (dmft). The direct and indirect (mediated) relationships between these variables were examined using structural equation modelling. Results: The model was an excellent fit to the data (chi-square = 1.63, p = .65, CFI = 1.00, RMSEA = .00 (95% CIs = .00-.04), SRMR = .01). Both clinical status (dmft) and SOC at baseline significantly predicted childrenÕs OHQoL at 3- or 6-month follow-up with less decay and a stronger SOC associated with fewer impacts of oral health on their daily lives. Older age was also significantly predictive of worse OHQoL at follow-up; whilst there was no difference between boys and girls. Interestingly, the effect of age on childrens OHQoL was mediated through their level of SOC. Conclusion: The data indicate that SOC is an important psychological determinant of childrenÕs OHQoL over time, independently of clinical status and demographic factors. In line with salutogenic theory, these findings suggest that interventions to improve oral health of young people should take into account their SOC.