Oral Health–related Beliefs, Behaviors, and Outcomes through the Life Course

Abstract

Complex associations exist among socioeconomic status (SES) in early life, beliefs about oral health care (held by individuals and their parents), and oral health-related behaviors. The pathways to poor adult oral health are difficult to model and describe, especially due to a lack of longitudinal data. The study aim was to explore possible pathways of oral health from birth to adulthood (age 38 y). We hypothesized that higher socioeconomic position in childhood would predict favorable oral health beliefs in adolescence and early adulthood, which in turn would predict favorable self-care and dental attendance behaviors; those would lead to lower dental caries experience and better self-reported oral health by age 38 y. A generalized structural equation modeling approach was used to investigate the relationship among oral health-related beliefs, behaviors in early adulthood, and dental health outcomes and quality of life in adulthood (age, 38 y), based on longitudinal data from a population-based birth cohort. The current investigation utilized prospectively collected data on early (up to 15 y) and adult (26 and 32 y) SES, oral health-related beliefs (15, 26, and 32 y), self-care behaviors (15, 28, and 32 y), oral health outcomes (e.g., number of carious and missing tooth surfaces), and oral health-related quality of life (38 y). Early SES and parental oral health-related beliefs were associated with the study members' oral health-related beliefs, which in turn predicted toothbrushing and dental service use. Toothbrushing and dental service use were associated with the number of untreated carious and missing tooth surfaces in adulthood. The number of untreated carious and missing tooth surfaces were associated with oral health-related quality of life. Oral health toward the end of the fourth decade of life is associated with intergenerational factors and various aspects of people's beliefs, SES, dental attendance, and self-care operating since the childhood years.

Income Trajectories and Oral Health of Young People in a Life Course Study

“…Oral health behaviors, practices, and knowledge are embedded in the patterns of everyday life and are socially determined, assuming different patterns according to social hierarchy. Some individuals can change the social position in which they were born, either for better or worse, but most remain with their habits, beliefs, behaviors, and the environment in which they were born [Thomson, 2012;Muirhead et al, 2013;Broadbent et al, 2016].…”

“…Factors that cause inequalities lead to more vulnerability to unhealthy behaviors and dental self-care [Blas and Kurup, 2010;Marmot and Bell, 2011;Pitts et al, 2011;Thomson, 2012;Broadbent et al, 2016], that is, oral hygiene habits are sensitive to the socioeconomic conditions in which people live in childhood [Nicolau et al, Caries Res 2019;53:347-355 DOI: 10.1159/000495038 2003Broadbent et al, 2016]. Peres et al [2007] found that adolescents who have always been poor brushed their teeth less and had less access to fluoride.…”

Qualidade de vida e percepção estética da cárie dentária

“…Esse vínculo entre saúde e os resultados socioeconômicos pode ser explicado pelo fato da renda familiar ter um efeito direto sobre a capacidade de acesso a bens, serviços e outros recursos que promovem a saúde além dos impactos nos recursos psicossociais e psicológicos (4) .…”

“…O autocuidado desde os anos da infância implica em uma melhor saúde bucal na vida adulta e menor impacto bio-psicossocial (4) beliefs about oral health care (held by individuals and their parents . Somadas ao exame clínico, a avaliação da Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) (5) e a avaliação da percepção estética (6) mensuram os impactos funcionais e psicossociais das doenças bucais, auxiliando os profissionais na compreensão integral do paciente.…”

“…Na avaliação da QVRSB, aspectos como o impacto funcional, os sintomas orais, o bem-estar social e o bem-estar emocional são avaliados (5) , e a literatura aponta uma forte associação da presença da cárie dentária com impactos na qualidade de vida em crianças (6,7) , principalmente na presença de lesões de cárie não tratadas (4) beliefs about oral health care (held by individuals and their parents e em situação de vulnerabilidade social (7,8) .…”