Association between sense of coherence and oral clinical conditions in adults and the elderly: systematic review and meta-analysis

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  • Bárbara M. da Cunha
  • Letícia M. Wambier
  • Saulo V. da Rosa
  • Carlos R. Botelho-Filho
  • Juliana S. Rocha
  • Mario V. Vettore
  • Marilisa C. L. Gabardo


Objective: This study systematically reviews the evidence on the relationship between sense of coherence (SOC) and oral clinical conditions in adults and elderly people. Methods: PubMed, Scopus, Web of Science, Latin American and Caribbean Literature in Health
Sciences - Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Brazilian Dentistry Bibliography - Bibliografia
Brasileira de Odontologia (BBO), Cochrane Library and grey literature were searched. Observational studies involving adults and elderly
people that evaluated SOC with a valid instrument and investigated oral clinical measurements as outcomes were included. Two review
authors independently assessed the studies for inclusion and extracted data. The quality of studies was assessed using the Downs and Black
checklist. Meta-analysis used the random-effect inverse-variance method to obtain pooled odds ratios (OR) and 95% Confidence Intervals
(CI) for each oral clinical condition. Results: From a total of 872 identified studies, ten observational cross-sectional and one longitudinal
study were included. Nine studies were judged of medium or high risk of bias. Meta-analyses showed that adults and elderly people with
higher SOC were less likely to present dental caries (OR 0.84; 95%CI = 0.73-0.96), periodontal disease (OR 0.58; 95%CI = 0.30-0.85),
gingivitis (OR 0.54; 95%CI = 0.18-0.90) or dental biofilm (OR 0.65; 95%CI = 0.43-0.86). Conclusions: Current evidence suggests that
better SOC is positively related to better oral clinical status in adults and elderly people. Longitudinal and intervention studies are needed
to confirm these findings.
Keywords: Adults, Oral Health, Systematic Review, Sense of Coherence

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