Exploring the Relationship Between Oral Health and Well-being: A Qualitative Approach to Conceptualisation and Measurement

Background
The shift toward a psychosocial model of oral health emphasises the need for a more comprehensive approach to understanding its broader implications, where the ultimate aim is to enhance well-being. Well-being includes both hedonic (pleasure, satisfaction) and eudaimonic (purpose, meaning) aspects. Oral health impacts daily life, and its effect on oral health-related quality of life is well documented. This impact overlaps with hedonic well-being, although the exact nature and extent of this relationship require further clarification. However, much less is known about how oral health affects eudaimonic well-being.
Aim
This thesis investigates the relationship between oral health and well-being.
Methods
This study employed a multi-method approach to investigate the oral health-well-being relationship. Part A conducted a literature review, and a 7-year scoping review examining well-being conceptualisation in dental research. Part B performed narrative and framework analyses of interviews with 20 UK denture wearers (11 males, 9 females; aged 22-86 years), analysing tooth loss experiences through hedonic and eudaimonic perspectives to develop a novel oral health-related well-being measurement tool. The tool was refined through pretesting with 8 participants.
Results
The scoping review revealed limited and inconclusive evidence, with most studies suggesting weak or no association between oral health and well-being. However, in this thesis participants’ narratives highlighted the integration of oral health challenges into daily life, uncovering four key themes: socioeconomic inequality, masking oral functioning, accepting vulnerability and fear of social judgement. These themes demonstrated the multifaceted nature of oral health’s impact on personal, social and emotional realities. Mapping participant interviews onto well-being domains revealed heterogeneous experiences, with hedonic impacts ranging from none to severe disruption and eudaimonic impacts, both explicit and contextual.
Conclusion
This study highlights the ongoing, complex and unique impact of oral health on well-being, illustrating how subjective experiences are shaped by personal, societal and contextual factors. To address this a draft measurement tool to measure oral health’s impact on subjective well-being was developed and pre-tested.