Savolainen Jarno J, Suominen-Taipale Anna-Liisa, Uutela Antti K, Martelin Tuija P, Niskanen Mirka C, Knuuttila Matti L E
Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland.
J Periodontol. 2005 Jun;76(6):1006-12. doi: 10.1902/jop.2005.76.6.1006.
Antonovsky's salutogenic theory seeks to find general health-promoting factors in individuals as distinct from characteristics that function as risks for specific diseases. A central construct of the theory is sense of coherence (SOC). Individuals with a strong SOC have the ability to define events as less stressful (because of comprehensibility); to mobilize resources to deal with encountered stressors (manageability); and to possess the motivation, desire, and commitment to cope (meaningfulness). Our aim is to investigate whether SOC, self-reported toothbrushing frequency, and objectively assessed levels of oral hygiene are related.
The sample of the present study consisted of 4,131 30- to 64-year-old dentate Finns belonging to a large nationally representative sample. The questionnaire and home interview included information about socioeconomic and demographic factors, behavioral variables, such as oral health behaviors (toothbrushing frequency), and a 12-item SOC scale, used here as a unidimensional measure categorized into quintiles. The level of oral hygiene was measured during clinical oral examination. Chi-square test, ordinal, and ordinary logistic regression analyses were used.
Subjects belonging to the strongest SOC quintile were found to be significantly more often two, or more, times a day brushers compared to those with less strong SOC. After controlling for toothbrushing frequency, sociodemographic and socioeconomic factors, smoking habits, and number of teeth, both strong and moderate levels of SOCs were also found to be related to a good level of oral hygiene compared with moderate and poor levels of oral hygiene. Furthermore, subjects within the weakest SOC quintile were found to have significantly more often than others poor levels of oral hygiene.
Our results suggest that a weak sense of coherence increases both the probability of having a poor level of oral hygiene and a frequency of toothbrushing of less than once a day. This and the theory concerning the development of SOC suggest that sense of coherence may be taken as a determinant of both the frequency and the quality of toothbrushing.
安托诺夫斯基的健康生成理论旨在寻找个体中普遍的促进健康因素，以区别于那些作为特定疾病风险的特征。该理论的一个核心概念是连贯感（SOC）。具有强烈连贯感的个体有能力将事件定义为压力较小（由于可理解性）；能够调动资源来应对遇到的压力源（可管理性）；并且拥有应对的动机、愿望和承诺（有意义性）。我们的目的是调查连贯感、自我报告的刷牙频率和客观评估的口腔卫生水平之间是否存在关联。
本研究的样本包括4131名30至64岁有牙的芬兰人，他们来自一个具有全国代表性的大样本。问卷调查和家庭访谈包括社会经济和人口统计学因素、行为变量，如口腔健康行为（刷牙频率），以及一个12项的连贯感量表，在此用作分为五分位数的单维测量。口腔卫生水平在临床口腔检查期间进行测量。使用卡方检验、有序和普通逻辑回归分析。
与连贯感较弱的人相比，属于最强连贯感五分位数的受试者每天刷牙两次或更多次的情况明显更常见。在控制了刷牙频率、社会人口统计学和社会经济因素、吸烟习惯以及牙齿数量后，与口腔卫生水平中等和较差相比，较强和中等水平的连贯感也与良好的口腔卫生水平相关。此外，发现最弱连贯感五分位数内的受试者口腔卫生水平较差的情况比其他人明显更常见。
我们的结果表明，连贯感较弱会增加口腔卫生水平较差以及每天刷牙频率少于一次的可能性。这一点以及关于连贯感发展的理论表明，连贯感可能被视为刷牙频率和质量的一个决定因素。
