Background: Psychological factors may influence oral health. One factor, sense of coherence (SOC) has been related to general and oral health, clinical status, oral health behaviours and oral health related quality of life (OHRQoL) in observational research with adults and children. Thus, improving SOC may be a way to improve OHRQoL.
Aims of the study: To evaluate the effect of an intervention to enhance SOC on OHRQoL in children.
Methods: Cluster randomised trial in twelve primary schools in Khonkaen, Thailand with 257 grade 5 students. Six schools were allocated randomly to the study and comparison groups respectively. Data included socio-demographic and clinical data. Self-report questionnaires assessed OHRQoL using the child perceptions questionnaire, CPQ11-14 and SOC with the 13-item SOC scale. Data were collected at three time points; at baseline, two weeks after the intervention and at 3 month follow up.
Intervention: Seven 40-60 minute sessions over two months, focusing on child participation and empowerment. The first four sessions were classroom activities and included a mixture of didactic teaching, discussion, activities and games. The last three involved working on healthy school projects. The intervention was delivered by trained teachers who received an intensive one day course.
Results: The two groups were similar for all variables at baseline. The intervention group had significant improvements in SOC and CPQ11-14 scores representing better OHRQoL at two weeks after the intervention and 3 month follow-up. SOC had a direct effect on symptoms and indirect effect on OHRQoL via symptoms.
Conclusions: As well as providing experimental evidence that OHRQoL is determined by SOC, these data show that school-based interventions to enhance SOC may be a useful way to improve OHRQoL.
