The Determinants of oral health related quality of life in adults

Objectives: Weak and indirect relationships between oral clinical status and oral health related quality of life (OHQoL) suggest individual and environmental factors might intervene in this relationship. Therefore, the aim of this research was to identify clinical and psychosocial determinants of OHQoL in adults. Methods: Prospective cohort study of 495 adult employees of an automobile parts manufacturer in India. Measures of OHQoL, general health perceptions, overall QoL, individual factors [sense of coherence, social support, stress, oral health beliefs, dental behaviours and subjective SES] and environmental factors [SES and social network] were collected at baseline and three month follow-up, together with a clinical examination at baseline. Analysis using lagged structural equation modelling (SEM) was guided by the Wilson and Cleary model linking clinical variables to quality of life. Results: Participants’ mean age was 33.12 years (18-72), 96% were males and mean DMFT was 2.13. The final SEM model was an excellent fit to the data accounting for 10%, 26% and 24% of the variance (prospectively) in OHQoL, GHP and Overall QoL respectively. Clinical status (decayed teeth) at baseline (β = 0.14, p < 0.01) had a direct effect on OHQoL at follow-up. Baseline individual characteristics: social support (β = 0.12, p < 0.05), SOC (β = 0.12, p < 0.05) and stress (β = 0.14, p < 0.01) had direct effects on OHQoL at follow-up. SES and social network indirectly predicted OHQoL through the individual characteristics. Conclusion: The findings offer longitudinal evidence that clinical and psychosocial factors may determine OHQoL, GHP and overall QoL in adults and suggest routes by which environmental factors such as SES might influence them. These factors might provide avenues for health promotion interventions and should be accounted for when evaluating clinical treatment to improve OHQoL.