Sense of Coherence and Oral Health in an Adolescent Population

Objective: To determine the association between the central construct of the salutogenic model used to explain factors that promote health - the Sense of Coherence (SOC), and the oral health of a South African adolescent population. Methods: This study involved all 8th Graders from 3 randomly selected schools in the North of Pretoria. Of the 690 learners targeted, 586 (84.9%) consented to participating. Data was collected through a questionnaire, which included the short-version of Antonovsky’s SOC scale, followed by oral examination. Outcome variables selected for analysis of oral health included dental caries experience (DMFS), oral cleanliness, and self-reported frequency of bleeding-gums on brushing. Health-risk behaviours also recorded included use of tobacco and/or alcohol, dental attendance patterns, frequency of daily tooth brushing and daily sugar-intake. Bivariate correlation and multivariable logistic regression was used in the data analysis, with p <0.05. Results: The mean age of the learners was 14yrs. Mean DMFS was 0.91 and 61.9% were caries-free. Of the respondents, 24.8% reported consistently brushing twice or more per day, 55.9% were categorised as having poor oral hygiene; and 41.4% reported frequent bleeding-gums. Significant predictors of poor oral hygiene were smoking (Odds ratio [OR]=1.93) and mother’s highest education of Grade 12 or less (OR=1.54). Learners with weak to moderate SOC were at significantly greater risk for frequent bleeding-gum (OR=1.96), smoking (OR=2.94) and binge-drinking (OR=2.14), when compared to those with strong SOC. SOC did not show significant association with risk for caries, but caries experience was associated with frequent experience of bleeding-gums (OR=1.79) and dental attendance pattern of visits only when in pain (OR=2.2). Conclusions: Adolescents’ SOC level is a common-risk factor for oral and general health in the studied population. Future oral health promotion interventions should include providing adolescents with life-skills that would further develop their ability to cope with life stressors.