Title: Evidence of the multifactorial etiology with influence of social determinants (sense of coherence) on the dental caries experience
Abstract:
New perspectives on the etiology of dental caries have been addressed. In this context the study on the influence of social determinants on this disease are essential. In order to clarify more about this relationship I present the following study. The objective of this study was to investigate the relationship between the dental caries experience and the Sense of Coherence (SOC) of mothers and adolescents. A case-control study nested in the cross-sectional study was conducted in the city of Itabira, Brazil, with a sample of 1038 adolescents aged 13 to 15 years, enrolled in schools in the city of Itabira and their mothers. Of these, 346 of them were classified as cases, due to the experience of dental caries and 692 were classified as controls, without dental caries experience. Cases and controls were matched by gender and age. The data were collected through a questionnaire on economic aspects, the short version of the SOC scale (SOC-13) that was applied to both (mothers and adolescents) and oral clinical examination to diagnose the experience of dental caries and presence of dental plaque. The association between dental caries experience and independent variables was performed through descriptive analysis, Mc Nemar test and univariate and multivariate conditional logistic regression. Univariate and multivariate regression models were constructed. In the second model, the independent variables that were significantly associated with the dependent variable in the first model were included individually. Adolescents with low maternal SOC (OR = CI 12.52, 95%: 5.14-30.47, p≤0.001) and low adolescent SOC (OR = 6.60, 95% CI: 3.22- 13.51, p≤0.001) had a higher chance of presenting dental caries experience. It was concluded that, despite not defining the temporal relationship between the association, the data indicate that SOC of adolescents and maternal SOC are independently associated with the dental caries experience in adolescents. Furthermore, this is the first study that describes this association through a case-control and shows the influence of social determinants on the dental caries experience. These findings show how important it would be to invest in interventions aimed at increasing SOC as a way to improve oral health, as new studies consolidate this association. Moreover, as the results contradict some studies and resemble others, it suggests that a better understanding of the SOC of the adolescents and their mothers in relation to the dental caries experience is still necessary, since this relationship is not yet well elucidated in the literature. The interaction between environmental and social factors and how they affect oral health is the way to reduce inequalities found in the oral health of the population. Due to this, through the knowledge of the influence of the social determinants identified here, such as SOC in the adolescent dental caries experience, specific strategies that go beyond intervention, should be considered as a form of Health Promotion and an alternative to which the Individuals remain free of dental caries.
