Dental caries and psychosocial factors: Testing a conceptual model in adolescents.

OBJECTIVES: A conceptual model was designed to examine interrelations among psychosocial factors, oral health behaviour, and dental caries in a sample of adolescents. METHODS: This cross-sectional study design of 531 Greek families included an oral examination and a survey completed by adolescents, and a survey completed by mothers. The outcome measure was dental caries experience. Additionally, dental sealants were recorded. The participants provided information which comprised the Sense of Coherence (SoC) scale and 11 psychosocial and behavioural variables that formed 6 composite variables (life-course experiences, socio-economic status, perceived parental support, perceived parental punishment, preventive measures, sugar intake frequency). The composite variables of preventive measures and sugar intake formed the latent variable of oral health behaviour. The interrelations of the above factors were included in a conceptual model and tested using a Structural Equation Modelling analysis. RESULTS: Data fit the proposed conceptual model (χ2  = 23.338, df = 14, P = .055, RMSEA = 0.036). Among psychosocial variables, adolescent's SoC was the best predictor of both dental caries (Standardized Regression Coefficient - Std. RC ± Standard Error (SE) = -0.178 ± 0.04) and oral health behaviour (Std. RC ± SE = -0.378 ± 0.09). All psychosocial factors were associated with SoC (Std. RCs ± SE between -0.162 ± 0.04 and 0.211 ± 0.04) and via SoC with oral health behaviour (Std. RCs ± SE between -0.080 ± 0.03 and 0.061 ± 0.02). CONCLUSIONS: A conceptual model was tested that integrated SoC with the psychosocial factors theoretically shaping it and clarified all factors' predictive abilities on dental caries via oral health behaviour.

Psychosocial factors and traumatic dental injuries among adolescents.

OBJECTIVES: To examine the association of traumatic dental injuries (TDI) and psychosocial factors in adolescents and to identify psychological profiles associated with TDI. METHODS: A cross-sectional study was conducted involving 531 students aged 13-16 years. Data were collected through oral examination and a structured interview with the adolescents, in conjunction with a questionnaire answered by their mothers. Associations between TDI and independent variables were analysed using a model-based approach, while an exploratory data analysis was applied to identify homogenous clusters of adolescents in relation to their sense of coherence (SoC), perception of parental support and their mothers' SoC. These clusters were examined further for associations with TDI and psychosocial variables. RESULTS: The prevalence of TDI was 15.8%. Adolescents with high TDI prevalence were males, nonfirstborns, or those frequently engaging in physical activity. In addition, both their own SoC and that of their mother were low and they reported low parental support. They were also prone to complaining about the behaviour of their peer group. The hierarchical cluster analysis (HCA) demonstrated three homogenous clusters. The cluster with the highest scores for all psychological variables included adolescents with low TDI prevalence, low paternal punishment, spacious home environment, high Family Affluence Scale (FAS) score, good school grades, few complaints about schoolmates and higher maternal education. CONCLUSIONS: Psychosocial factors appear to influence an adolescent's risk of TDI. High parental support, high own and maternal SoC and a higher socioeconomic status (SES) are typical of adolescents with low TDI experience.

Family structure is associated with oral pain in 12-year-old Greek schoolchildren.

OBJECTIVE: To determine the prevalence, associated correlates and impact of oral pain in 12-year-old schoolchildren in Stayroypoli, Greece. DESIGN AND METHOD: Cross-sectional survey of all schoolchildren attending the last year of government primary schools using self-administered questionnaires. Approval was granted by the Greek Ministry of Education and Religion. Cooperation was obtained from the schools. Children whose parents did not refuse their participation were invited to complete a questionnaire. Oral pain prevalence was estimated and association with sociodemographic/economic factors tested. Associations between pain experience and impact on daily activities were examined. RESULTS: Of the 296 children registered, 225 (76.0%) were present on the days data were collected. Usable questionnaires were completed by 187 children (83.1%). Oral pain in the previous 4 weeks, reported by 70 (37.4%), was more likely to affect children living with one parent/other people (OR 3.0, 95% CI = 1.2-7.4, P = 0.013) and those who brushed less than twice a day (OR 2.8, 1.5-5.2, P = 0.001). Impact on daily activities was reported by 64 children (91.4%). The most commonly stated impacts were eating (40.0%), cleaning teeth (25.7%) and sleeping (18.6%). CONCLUSIONS: Oral pain prevalence was high in 12-year-old schoolchildren in Stayroypoli, is associated with family structure, and impacts substantially on daily activities.