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

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          Abstract

          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.

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          Most cited references30

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          Emerging theories into the social determinants of health: implications for oral health promotion.

          In recent years public health research has increasingly focused upon exploring the social determinants of health. This interest has partly arisen through an acknowledgement of the limitations of educational preventive approaches in improving population health and reducing health inequalities. Many health education interventions have been influenced by health behaviour research based upon psychological theories and models. These theories focus at an individual level and seek to explore cognitive and affective processes determining behaviour and lifestyle. Current psychological theories have only a limited value in the development of public health action on altering the underlying social determinants of health. New theoretical approaches have however, emerged which explore the relationship between the social environment and health. This paper aims to review and highlight the potential value to oral health promotion of three important public health theoretical approaches: life course analysis, salutogenic model and social capital. It is important that an informed debate takes place over the theoretical basis of oral health promotion. As the field of oral health promotion develops it is essential that it is guided by contemporary and appropriate theoretical frameworks to ensure that more effective action is implemented in the future.
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            The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks.

            Oral epidemiological research into the social determinants of oral health has been limited by the absence of a theoretical framework which reflects the complexity of real life social processes and the network of causal pathways between social structure and oral health and disease. In the absence of such a framework, social determinants are treated as isolated risk factors, attributable to the individual, having a direct impact on oral health. There is little sense of how such factors interrelate over time and place and the pathways between the factors and oral health. Features of social life which impact on individuals' oral health but are not reducible to the individual remain under-researched. A conceptual framework informing mainstream epidemiological research into the social determinants of health is applied to oral epidemiology. The framework suggests complex causal pathways between social structure and health via interlinking material, psychosocial and behavioural pathways. Methodological implications for oral epidemiological research informed by the framework, such as the use of multilevel modelling, path analysis and structural equation modelling, combining qualitative and quantitative research methods, and collaborative research, are discussed. Copyright Blackwell Munksgaard, 2005.
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              Sense of coherence and mortality in men and women in the EPIC-Norfolk United Kingdom prospective cohort study.

              This study tested the hypothesis that a personality disposition defined by a strong sense of coherence is associated with a reduced risk of mortality. The authors prospectively examined, for < or =6 years, the relation between a strong sense of coherence and mortality due to all causes, cardiovascular disease, and cancer among 20,579 participants aged 41-80 years from the European Prospective Investigation into Cancer (EPIC)-Norfolk Study in the United Kingdom. Data were collected in 1996-2002. Participants were recruited by post from general practice age-sex registers and subsequently completed a postal assessment of their sense of coherence. During follow-up, 1,024 deaths were recorded. A strong sense of coherence was associated with a 30% reduction in mortality from all causes (rate ratio=0.69, p<0.0001), cardiovascular disease (rate ratio=0.70, p=0.001), and cancer (rate ratio=0.74, p=0.003), independent of age, sex, and prevalent chronic disease. These associations were consistent by sex, except that no association was observed for cancer mortality in women. The association for all-cause mortality remained after adjustment for cigarette smoking history, social class, body mass index, systolic blood pressure, cholesterol, hostility, and neuroticism (rate ratio=0.76, p=0.002). Results suggest that a strong sense of coherence may confer some resilience to the risk of chronic disease.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                14 August 2015
                2015
                : 10
                : 8
                : e0133918
                Affiliations
                [1 ]Division of Pediatric Dentistry, School of Dentistry, University of Alberta, Edmonton, Canada
                [2 ]Pediatric Graduate Program, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
                [3 ]Visiting Researcher, School of Dentistry, University of Alberta, Edmonton, Canada
                [4 ]Orthodontic Graduate Program, School of Dentistry, University of Alberta, Edmonton, Canada
                National Cardiovascular Center Hospital, JAPAN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: ME HS CF MA. Performed the experiments: ME LGA PB. Analyzed the data: ME LGA PB. Contributed reagents/materials/analysis tools: ME LGA PB. Wrote the paper: ME HS CF MA.

                Article
                PONE-D-15-10630
                10.1371/journal.pone.0133918
                4537196
                26275064
                1ae0bfbb-76cb-469b-8842-5fe8b826661b
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 11 March 2015
                : 2 July 2015
                Page count
                Figures: 1, Tables: 4, Pages: 16
                Funding
                The authors have no support or funding to report.
                Categories
                Research Article
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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