A salutogenic perspective to oral health : sense of coherence as a determinant of oral and general health behaviours, and oral health-related quality of life
1University of Oulu, Faculty of Medicine, Institute of Dentistry, Department of Oral and Maxillofacial Surgery
2University of Oulu, Faculty of Medicine, Department of Periodontology and Geriatric Dentistry
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|Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in Auditorium 1 of the Institute of Dentistry, on November 11th, 2005, at 12 noon
Professor Heikki Murtomaa
Docent Sakari Suominen
Dental diseases such as dental caries and periodontal disease could well be seen as being behaviour-related. The high prevalence of periodontal disease in the Finnish adult population mirrors the need for improving oral health behaviours in a comprehensive manner. Thus far, scant attention has been drawn to the underlying psycho-social factors that could, in part, explain oral health and oral health behaviours. Deficiencies in oral health behaviour may also be indicative of an individual’s poor health behaviour in general. The aim of this study was to introduce the salutogenic approach, called sense of coherence, into the domain of oral health and health behaviour.
The present study uses data from the nationally representative Health 2000 survey carried out in 2000–2001 by the National Public Health Institute of Finland. The subjects of this study numbered 4175 in article I, 4131 in article II, 4039 in article III, and 4096 in article IV, and were 30- to 64-year-old dentate men and women. The cross-sectional data was collected via home interviews, self-administered questionnaires, or clinical examinations.
Sense of coherence was positively associated with oral health behaviours, such as dental attendance and tooth-brushing frequency. In addition to tooth-brushing frequency, sense of coherence was also positively associated with the level of oral hygiene. The association between sense of coherence and level of oral hygiene weakened only marginally after controlling for tooth-brushing frequency. A strong sense of coherence was strongly associated with a positive oral health-related quality of life (OHIP). Sense of coherence was also associated with all of the OHIP sub-scales, and the association was most evident in the psychological discomfort, psychological disability and handicap sub-scales. Among males, health behaviours seemed multidimensional, whereas they tended to be unidimensional among females. A strong sense of coherence was a common determinant of healthy behaviours in general, as well as of a good subjective health status.
The present study recognizes the sense of coherence as a common health-promoting determinant of oral and general health behaviours, good oral health, and a good oral health-related quality of life. The results thus suggest that the role of psycho-social factors should not be underestimated in health promotion.
Acta Universitatis Ouluensis. D, Medica
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