Document Type : Original Article


1 Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Oral Public Health, Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran


The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOC
are better at dealing with stressful situations, psychological stress, and problems and are more able
to manage them, leading to better general health. The purpose of this study was to evaluate the effect
of SOC on the oral health status of people in different age groups. A systematic search up to May
2019 was carried out in PubMed,Scopus, Psycho info, and Persian sources. Studies were included
if they evaluated the relationship between SOC and oral health behaviors (OHBs) or oral health
status including dental caries. The Newcastle‑Ottawa checklist was used to appraise the selected
articles and meta‑analysis of included studies were performed using Comprehensive Meta‑Analysis
software. Value of P < 0.05 was considered to be statistically significant. Odds ratio (OR) was used
to measure effect size with 95% confidence interval (CI). The random‑effects model was chosen
in the presence of heterogenicity. I2 index and Q index were used to measure the heterogeneity
present between the studies. Fifteen articles received the minimum score of criticism. In general,
SOC could significantly affect the oral health and OHBs of adults independently of the underlying
factors. There was a significant relationship between SOC and tooth decay in adolescents, but this
association was poor after adjusting for the underlying factors. In children, only one article revealed
an association with OHBs. Meta‑analysis revealed that SOC was significantly associated with the
caries rate (OR = 0.78, CI 95% = 0.9–0.67, P = 0.001) and tooth brushing frequency (OR = 1.22,
CI 95% = 1.1–1.31 and P < 0.001). Sense of coherence appears to be one of the effective factors
in predicting oral health behaviors and ultimately oral health, especially in adults. The number of
articles available for children and adolescents was not sufficient in this regard.


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