Exploring salutogenic factors supporting oral health in the elderly

Abstract

Aim: To explore associations between salutogenic factors and selected clinical outcome variables of oral health in the elderly, combining Antonovsky's salutogenic theory and the Lalonde Health Field concept.

Methods: The subjects comprised 146 individuals, aged 60 years and older, who had participated in a population-based epidemiological study in Sweden, 2011-2012, using questionnaire and oral examination data. A cross-sectional analysis used the selected outcome variables, such as number of remaining teeth, DMFT-index and risk assessment, and salutogenic factors from the questionnaire, clustered into domains and health fields, as artifactual-material, cognitive-emotional and valuative-attitudinal. This selection was based on findings from our previous analysis using a framework cross-tabulating two health models. The purpose was to facilitate analysis of associations not previously addressed in the literature on oral health. Bivariate and Multiple Linear Regression analyses were used.

Results: Numerous salutogenic factors were identified. Significant associations between outcome variables and salutogenic factors previously unreported could be added. Regression analysis identified three contributing independent factors for 'low DMFT'.

Conclusions: This study supports the usefulness of a salutogenic approach for analysing oral health outcomes, identifying university education, the importance of dental health organization recall system and close social network, as important salutogenic factors. The large number of salutogenic factors found supporting oral health among the elderly indicates the complexity of salutogenesis and the need for robust analysing tools. Combining two current health models was considered useful for exploring these covariations. These findings have implications for future investigations, identifying important research questions to be explored in qualitative analyses.

Keywords: Oral health; elderly; observational study; salutogenesis; social determinants of health.