Oral health literacy among migrant mothers in Sweden. A qualitative study.

OBJECTIVE: This interview study explored the oral health literacy of migrant mothers in Sweden, with special reference to where and why they access information about oral health and how they determine the credibility of such information. MATERIAL AND METHOD: In-depth interviews were conducted with seven migrant mothers of children up to 10 years old. The mothers had entered Sweden from 2015 onwards and had been resettled in Kalmar County, Sweden. Their native language was Somalian, Dari or Arabic. The interview questions concerned the participants' experiences of seeking oral health information, as well as oral health in general and dental health services. The interviews were analysed by qualitative content analysis. FINDINGS: The main findings indicate that migrant mothers used information sourcing as a pathway to solve oral health literacy tasks. Three main categories were identified, each with subcategories, describing the migrant mothers' experiences of accessing and evaluating oral health information: 'accessible source of information', 'needs-related purpose of seeking information' and 'trustworthiness assessment'. The migrant mothers reported that in case of a dental emergency or general queries, they sought oral health information from professionals and social sources. Moreover, they perceived oral health information to be most reliable when it was provided by dental professionals, was a recurring theme, or constituted majority opinion. CONCLUSION: To improve oral health literacy in migrant mothers of young children, it is important not only to provide consistent and recurrent oral health information through accessible information channels, but also to adapt dental care to be more culturally appropriate.

Dental professionals' perception of their role in the practice of oral health promotion: a qualitative interview study.

OBJECTIVE: To explore dental professionals' perceptions of their role in the practice of oral health promotion. MATERIAL AND METHOD: In-depth interviews were conducted with three dentists, one specialist dentist and seven dental hygienists. All were employed in the public dental service in Kalmar County, Sweden and had at least 2 years' work experience. The interview questions addressed the experience and views of dental professionals with reference to their role in the practice of health promotion. The interview data were subjected to qualitative content analysis. RESULTS: Analysis revealed two themes which capture the essence of the dental professionals' perception of their role in the practice of oral health promotion. One theme, having person-focused approach, comprised four categories: 'considering the patient's life situation', 'establishing a trusting relationship with patients', 'strengthening patients' commitment to oral health' and 'health education'. The other theme, perceiving social responsibility for oral health, comprised three categories: 'dissemination of oral health knowledge', 'interprofessional collaboration' and 'equality in oral health care'. CONCLUSION: Dental professionals 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 practising and evaluating skills development. Although the dental professionals perceived that they undertook health promotion activities, they did not clearly distinguish between oral health promotion and disease prevention. There was intra- and inter-professional agreement among the dentists and dental hygienists with respect to expected outcomes for health promotion activities.

Exploring salutogenic factors supporting oral health in the elderly.

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.

Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study.

OBJECTIVE: This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness. MATERIAL AND METHOD: Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework. RESULTS: Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness. CONCLUSION: This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.

Salutogenic factors for oral health among older people: an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde.

OBJECTIVE: The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde. MATERIAL AND METHODS: This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated. RESULTS: The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m2' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors. CONCLUSIONS: The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.