Table 3.
The evidence table of the included studies. Note-the coloured boxes are the studies that evaluate the effect of SOC as mediator
| Author Year | Country | Participants Age/sex/number | Scale of SOC | Primary outcome | Secondary outcome | Results | Conclusion |
|---|---|---|---|---|---|---|---|
| E. Bernabé1 2012 | Finland | 944 dentate adults (426 men and 518 women) Mean age: 48.6 years (SD: 11.9, range: 30-89) |
SOC-13 scale, 7-point (1=very often and 7=very seldom or never | DT, DT increment | - | Dependent: DT Baseline: Unadjusted (RR: 0.74 [0.6-0.91], P<0.01). After adjustment for age, sex (Model 1): RR: 0.72, 95% CI: 0.59-0.87, P<0.01 After adjustment for age, sex, education (Model 2): RR: 0.72, 95% CI: 0.59-0.87, P<0.01 After adjustment for age, sex, education, oral health behavior (Model 3): 0.81 (0.68-0.97) P<0.05 |
The number of decayed teeth decreased by 28% for every unit increase in SOC |
| E. Bernabé1 2012 | Finland | 944 dentate adults (426 men and 518 women) mean age: 48.6 years (SD: 11.9, range: 30-89) | SOC-13 scale, 7-point (1=very often and 7=very seldom or never) | DT, DT increment | - | After 4 years Dependent: DT unadjusted (RR: 0.81 [0.65-1.01], NS). After adjustment for age, sex (Model 1), (RR: 0.78, 95% CI: 0.63-0.97, P<0.05) After adjustment for age, sex, education (Model 2): (RR: 0.79, 95% CI: 0.63-0.98, P<0.05) After adjustment for age, sex, education, oral health behavior (Model 3): (0.81 [0.64-1.02] NS) |
SOC was a predictor of 4-year incidence of tooth decay, irrespective of subjects’ sociodemographic background. Each higher point in the SOC score was associated with around 20% decrease in the risk of having tooth decay |
| Renata Magalh~aes Cyrino 2016 | Brazil | 202 Brazilian males and 74 females mean age: 37.36±12.05 years | SOC-13 (5-point Likert scale) sum from 13 to 65, (weak=24-46), moderate (47-51), strong (52-65) | PI, perceived oral health | - | Logistic reg: Dependent: General perceived oral health Weak SOC OR (4.63; 95% CI: 1.59-3.51, P=0.005) Moderate SOC OR (1.31; 95% CI: 0.34-5.04, P=NS) Strong SOC reference, P=0.001 |
Weak SOC was significantly associated with poor perceived general oral health, But not associated with Clinical periodontal health outcomes such as PI |
| Bernabe´E2011 | Finland | 5401 dentate adults (2538 men and 2863 women) mean age=49.6 years (SD: 12.8, range: 30-99 | SOC-13 scale | Role of adult SOC as a mediator of the relationship between childhood SEP (parental education), and tooth retention | Adult oral health behavior | Childhood SEP with tooth retention directly: (standardized path: 0.06, P: <0.001) indirectly via adulthood SEP: (0.07, P: <0.001), via adulthood SEP and oral health-related behaviors (0.10, P<0.001), and via SOC and oral health-related behaviors (0.01, P=0.001). indirect effects via SOC (−0.002, P=0.081) and via oral health-related behaviors (−0.004, P=0.692) SOC with oral health-related behavior: (0.18, P<0.0001) SOC with tooth retention only indirectly via oral health-related behaviors (0.06, P: <0.001) |
SOC is associated only indirectly with tooth retention through oral health-related behaviours, but may contribute little to the relationship between childhood SEP and tooth retention in adult life. These findings were consistent across sexes and age groups |
| Lindmark U2011 | Sweden | 525 individuals, 261 men and 264 women, aged 20-80 years | SOC-13 levels of SOC (low<66, intermediate: 67-75, high: >76) | . | Oral health-related behaviour | Sweat drinks SOC low (ref) SOC intermediate (OR=1.25; 95% CI: 0.62-2.54, P=NS) SOC high (OR=0.88; 95% CI: 0.42-1.8, P=NS) Frequency of snacks between meals SOC low (ref) SOC intermediate (OR=2; 95% CI: 1.17-3.43, P=0.011) SOC high (OR=1.9 95% CI: 1.1-3.29, P=0.021) Tooth brushing Frequency SOC low (ref) SOC intermediate (OR=2.62 95% CI: 1.01-6.82, P=0.048) SOC high (OR=1.24 95% CI: 0.55-2.82, P=NS) |
Subjects with High SOC 1.90 times more chance of having fewer snacks and drinks between meals and 2.62 times more chance of being included in the group who brushed their teeth twice a day or more, compared with individuals with lower SOC scores |
| A. WENNSTRÖM2013 | Sweden | Women in Gothenburg, aged 38 and 50 years, from the survey in 2004 to 2005 n=493 | SOC-13 | Oral health status (number of teeth, self-reported oral health) | - | Regressions Model I: Number of teeth as dependent (0-25/26-32) and SOC, education, marriage independent: Odds of SOC: 1.02 (1.00-1.04, P=0.018) Model 2: Self-rated oral health (poor/good) as dependent and SOC, education, marriage independent: Odds of SOC: 1.03 (1.01-1.05, P=0.001) |
An increase by 10 SOC points predicts a 20% and 30% greater likelihood of having more teeth and better perceived oral health, respectively |
| CAROLINA FREITAS LAGE 2016 | South eastern Brazil | 1195 adolescents and their mothers The female gender: 55.9% mean age: 13.84 years (SD: 0.717 years) | SOC-13, 5-likert SOC>46 SOC≤46 |
Dental caries experience | - | Dependent: Dental caries Unadjusted bivariate adolescent’s SOC (≤46 as reference,>46 OR: 0.38 (0.32-0.46, P<0.001) Multivariate model: Adjusted for age, economic status SOC>46 versus≤46: OR 0.46 (0.39-0.55, P<0.001) |
SOC is associated with dental caries in adolescents; adolescents with high frequency of dental caries had a lower SOC |
| Neiva da Silva2016 | Brazil | 190 women age 26-63 years (mean 37.5, SD 7.2) | SOC-13 | Dental caries | Tooth brushing frequency, dental floss use | SOC scores with number of decayed teeth (ρ=−0.003, P>0.05) | SOC moderates the relationshipbetween untreated dental caries and dental pain |
| Freire MCM 2001 | middle west Brazil | 664 adolescent 15 years | SOC-13 | DMFS, plaque index, and dental caries | Pattern of dental attendance, Daily frequency of sugar intake, Daily between meals frequency of sugar intake, daily tooth brushing frequency | Simple regression DMFS (OR=0.98; CI: 0.87-1.15, NS; P=0.795) Plaque index (OR=0.98; CI: 0.8-1.19, NS, P=0.810) Cries experience anterior teeth (OR=0.81 scale; 95% CI=0.66-0.98, P: 0.029). Pattern of dental attendance (OR=0.83; CI: 0.71-0.98, P=0.020) Sugar intake (OR=0.89; CI: 0.67-1.19, NS P=0.425) |
Adolescents with higher SOC were less likely to have caries experience in anterior teeth than those with lower SOC scores (after adjusting for all important variables, caries experience in anterior teeth was not associated with SOC) |
| Between meals frequency of sugar intake (OR=0.86 CI: 0.71-1.02, NS P=0.074) Tooth brushing frequency (OR=0.91 CI: 0.76-1.09, NS P: 0.304 Multiple regression Dependent (caries experience in anterior teeth) when adjusted just for social class (OR=0.81; 0.66-0.99, P=0.03), adjusted for all variable (above+dental attendance, sport, mothers dental health, mothers education) OR=0.88 (CI: 0.7-1.09, NS, P=0.22) Dependent (pattern of dental attendance) when adjusted just for social class (OR=0.84, CI: 0.84-1.04, P=0.02), adjusted for above+mothers education): OR=0.85 (CI 0.73-1, NS, P=0.04) |
In the final model, adolescents with higher SOC scores had less probability of attending the dentist when in trouble and were therefore more likely to attend for check-ups than those with lower SOC scores | ||||||
| Bernabe´E2010 | Finland | 5401 dentate adults (2538 men and 2863 women) mean age: 49.6 years (range: 30-99 years) | Slightly abbreviated version of the Finnish SOC-13 scale | Dental plaque and decayed teeth, perceived oral health | - | Linear reg Dependant (number of teeth) when adjusted just for age, sex, marriage and urbanization SOC was significant estimate=0.68, 95% CI: 0.44-0.92, P<0.001 when adjusted just for above and education and income SOC was significant estimate=0.46; 95% CI: 0.23-0.68, P<0.001 when adjusted just for above and oral health behavior SOC was significant estimate=0.29; 95% CI: 0.08-0.51, P=0.007 Dependant (number of decayed teeth) when adjusted just for age, sex, marriage and urbanization SOC was significant estimate=−0.22; 95% CI: −0.3-−0.14, P<0.001 when adjusted just for above and education and income SOC was significant estimate=−0.19; 95% CI: −0.27-−0.11, P<0.001 when adjusted just for above and oral health behavior SOC was significant estimate=−0.13 95% CI: −0.2-−0.06, P<0.001 Logistic reg: Dependant (poor perceived oral health) when adjusted just for age, sex, marriage and urbanization SOC was significant estimate=0.73; 95% CI: 0.67-0.79, P<0.001 when adjusted just for above and education and income SOC was significant estimate=0.76; 95% CI: 0.7-0.83, P<0.001 when adjusted just for above and oral health behavior SOC was significant estimate=0.8; 95% CI: 0.73-0.87, P<0.001 |
SOC was positively associated with various aspects of adult oral health such that adults with a strong SOC had more teeth, fewer decayed teeth, less periodontal pockets and better perceived oral health |
| Mojtaba Dorri 2010 | Iran | 1054 grade 6 Iranian student age 11-16 mean age: 12.4 (SD=0.7) | SOC-13 | - | Frequency of toothbrushing behaviours | Dependent: Frequencies of tooth brushing Univaraite: OR 1.022; 95% CI: 1.001-1.031 (P=0.01) Multivariate: OR 1.021; 95% CI: 1.001-1.032 (P=0.01) adjusted for sex, fathers education |
This study highlights the importance of SOC as a factor influencing toothbrushing behaviours in adolescents |
| Mojtaba Dorri 2010 (paediatric) | Iran | 1132 sixth grade students average age: 12.4 (SD=0.8) | SOC-13 | - | Oral hygiene behaviors | Structural SOC and peer social networks were positively associated with oral hygiene behaviors. B: 0.144, P<0.01 and B: 0.175, P<0.01 |
Sociodemographic factors, sex and education influence hygiene behaviours in adolescents through their impact on sense of coherence and peer social networks |
| ULRIKA LINDMARK2011 | Sweden | 525 individuals, 261 men and 264 women, aged 20, 30, 40, 50, 60, 70 and 80 years | SOC-13, low<66, intermediate 67-75, high>76 | Oral health status | - | Model I linear Reg: Unadjusted, dependent Frequency of DFS (r2=0.026, B=0.167, P<0.000), DS (r2=0.020, B=−0.14, P=0.008), FS (r2=0.010, B=0.177, P=0.053) and teeth with calculus (r2=0.008, B=−0.1 P=0.00). Number of teeth (r2=0.001, B=−0.027, P=NS) After adjusting for age, gender, marital ststus, income, education, occupation level (Model II), dependent Frequency of DFS (r2=0.584, B=0.013 P=NS), DS (r2=0.135, B=−0.051, P=NS), FS (r2=0.608, B=−0.038, P=NS) and teeth with calculus (r2=0.012, B=−0.089, P=NS). number of teeth (r2=0.42, B=-0.015, P=NS) logistic Regression adjusting for age, gender, marital status, income, education, occupation level DFS low (one third low/one third high) intermediate SOC: OR: 053; 95% CI; 0.13-2.22 P=NS, high SOC: OR: 0.85 (95% CI: 0.24-2.97 P=NS), DS(<6/>6 sites) (intermediate SOC: OR: 1.61 (95% CI: 0.71-3.61 P=NS, High SOC : OR: 1.6 (95% CI: 0.65-3.92, P=NS), FS (one third low/one third high) (intermediate SOC: OR : 0.52 (95% CI: 0.09-2.98, P=NS, High SOC: OR: 0.77 (95% CI: 0.16-3.82 P=NS) and teeth with Calculus (<20%/>20%) (intermediate SOC: OR: 0.79; 95% CI 0.45-1.39 P=NS, High SOC: OR: 0.72; 95% CI: 0.4-1.27 P=NS) Number of teeth (>20/<20) (intermediate SOC: OR: 1.02; 95% CI: 0.42-2.5, P=NS, high SOC: OR: 0.67; 95% CI: 0.27-1.66 P=NS) PLI (<20%/>20%) (intermediate SOC: OR: 0.67; 95% CI: 0.4-1.12 P=NS, high SOC: OR: 0.58; 95% CI: 0.34-0.98 P=04) |
Higher mean SOC scores were statistically significantly associated with more decayed and filled tooth surfaces and filled tooth surfaces, fewer decayed tooth surfaces, fewer teeth with calculus and periodontal health |
| Ayo-Yusuf OA-2009 | Limpopo Province, South Africa | Between 12 and 19 years old, mean (SD) age: 14.4 (SD 1.5) years (n=1025) | SOC-13 At baseline and 18 months later |
- | Tooth-brushing frequency, dental attendance, change brushing behaviour | Logistic reg: Dependent: Frequent brushing Model 2 Adjusted for smoking (NS)/depression/live with mother: SOC development OR: 1.02 (CI: 1.01-1.04, P<0.05) SOC baseline OR 1.03 (0.99-1.06, P=NS) Model 3 adjusted for above plus dental visit and reason for brushing: SOC development OR: 1.03 (CI: 1.01-1.05, P<0.05) SOC baseline OR 1.03 (CI: 1-1.06, P<0.05) Model 4 adjusted for above plus stage of change: SOC development OR: 1.03 (CI: 1.01-1.05, P<0.05) SOC baseline OR 1.02 (CI: 0.99-1.06, P=NS) |
Children’s psychological predispositions (SOC, depression) and family environment (living with mother) might significantly influence their tooth-brushing behaviour, and subsequently their oral health (in model 2, 3, 4 beside other factors. SOC was significantly effective with almost the same OR) |
| Jarno J. Savolainen-2005 | Finland | 4131 30-64-year-old individuals (1928 males and 2203 females) | SOC-13 SOC2=low=58.8-64.8) SOC5=high=74.2-84 |
Oral hygiene: PLI | Tooth brushing frequency | Logistic reg: (1) Independent: SOC Dependent: Tooth brushing frequency Model A (unadjusted): SOC2, OR: 1.3 (95% CI: 101-107) SOC5, OR 2.2 (1.7-207) Model B (adjusted for gender, age, education, marital status, smoking, number of teeth): SOC2, OR 1.3 (1-1.6) SOC5, OR 1.9 (1.5-2.5) (2) Independent: SOC Dependant: Level of oral hygiene Model A: SOC2: OR 1.5 (1.2-1.9) SOC5: OR 1.9 (1.6-2.4) >Model B (adjusted for gender, age, education, marital status, smoking, number of teeth): SOC2: OR 1.4 (1.2-1.8) SOC5: OR 1.7 (1.4-2.1) |
A weak sense of coherence increases both the probability of having a poorer level of oral hygiene and a tooth brushing frequency of less than once a day. A strong sense of coherence seems to associate with both higher frequency and quality of toothbrushing |
| Bernabe´2009 | Finland | 8028 subjects, 30 years of age and over | Abbreviated version of the Finnish SOC-13 scale | - | Pattern of dental attendance, tooth brushing frequency, sugar intake frequency, their intake frequency of six di?erent sweets and snacks | Logistic reg: Dependent: Dental attendance adjusted for income and education: OR 1.2 (95% CI: 1.11-1.28, P<0.001) Dependent: Tooth brushing frequency adjusted for income and education: OR 1.22 (95% CI: 1.12-1.32, P<0.001) Dependent: Sugar intake frequency adjusted for income and education: OR 0.9 (95% CI: 0.83-0.97, P=0.006) |
SOC was positively associated with visiting a dentist regularly for check-ups and brushing teeth twice or more often a day as well as being negatively associated with daily smoking and sugar-intake frequency |
SD=Standard deviation, SOC=Sense of coherence, PI=Plaque Index, SEP=socioeconomic position, DMFS=Decayed- Missed-Filled surfaces , PLI=Plaque Index