Oral health-related salutogenic factors : reviewing factors promoting oral health in older people and exploring dental professionals' perspective

Sammanfattning: The overarching aims of this thesis were to study oral health-related salutogenic factors among older people and explore dental professionals’ perceptions of their role in the practice of oral health promotion.Study I was an integrative review describing salutogenic factors reportedly associated with oral health and oral health-related quality of life in older people. A framework for identifying salutogenic factors, combining two theories of health, was developed. 58 papers were included in the review and 77 salutogenic factors were identified. However, there is a lack of studies with specific reference to salutogenic factors among older people.Study II was a cross-sectional study based on data for patients 60 years or older derived from a previous population-based epidemiological study. Several significant associations between outcome variables and salutogenic factors were identified. Of those, 13 previously unreported salutogenic factors could be added to the framework developed in Study I.Studies III and IV were qualitative interview studies using in-depth interviewsfor data collection and qualitative content analysis methodology for data analysis.Study III focused on exploring salutogenic factors related to oral health in twelve orally healthy patients 75 years or older. The findings highlighted the importance of patients’ internal resources, dental professionals, family, and society in supporting and reinforcing lifelong oral health.Study IV focused on exploring dental professionals’ perceptions of their role in the practice of oral health promotion and included eleven dentists and dental hygienists. The participants perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decision-making process and educational activities, as well as practicing and evaluating skills development.In conclusion, there is a need for consistency in definition of outcomes measures and hypothesis-driven research within salutogenic research in oral health field. The large number of salutogenic factors found supporting oral health among older people indicates the complexity of salutogenesis and the need for robust analyzing tools. Combining two theories of health was useful for exploring salutogenic factors related to oral health and for providing a plain overview of areas lacking knowledge, which in turn can facilitate the generation of hypotheses and therefore relevant salutogenic research.This combination could contribute to a more balanced image of factors influencing oral health, including dental professionals’ roles, and help identify critical next steps in determining priorities and allocating resources promoting good oral health in individuals and populations. Moreover, oral health-related salutogenic factors identified in the qualitative studies; i.e., categories, merit further exploration in quantitative research.