Complex interrelations between self-reported oral health attitudes and behaviors, the oral health status, and oral health-related quality of life
Received 12 December 2017
Accepted for publication 13 February 2018
Published 12 April 2018 Volume 2018:12 Pages 539—549
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Alexandra Lucia Vigu,1 Dorin Stanciu,2 Lucia Maria Lotrean,3 Radu Septimiu Campian4
1Department of Dental Materials and Ergonomics, “Iuliu Haţieganu” University of Medicine and Pharmacy, 2Department of Psychology and Pedagogy, Technical University of Cluj-Napoca, 3Department of Community Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 4Department of Oral Rehabilitation, Health and Management, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Purpose: The purpose of this study was to develop and test a moderated mediation model that was able to describe the relationships between oral health-related attitudes and behaviors, oral health status (OHS), and oral health-related quality of life. The hypothesized relations corresponded to research questions such as “is a person’s oral health predicted by the actions that person takes in order to prevent oral health conditions?” and “do individuals with better oral health also have higher levels of oral health-related quality of life?”.
Materials and methods: A cross-sectional correlational study with selected predictor variables was conducted in Cluj-Napoca, Romania, among 191 participants, enrolled in the fourth and sixth years of study at the Dentistry School of the Medicine and Pharmacology, University of Cluj-Napoca. Participants completed the Hiroshima University Dental Behavior Inventory (HUDBI) questionnaire targeting specific behavior and attitude with respect to their dental self-care, Oral Health Impact Profile (OHIP) short questionnaire for measuring oral health-related quality of life, and the current OHS was assessed objectively using Decayed, Missing, Filled Teeth/Surfaces (DMFT) index. Statistical analyses were done using structural equation modeling software.
Results: Our research showed relevant associations between HUDBI, DMFT, and OHIP. The relationship between HUDBI and OHIP was mediated by DMFT. Furthermore, HUDBI worked as a moderator between DMFT and OHIP. Thus, our study revealed a case for moderated mediation, which is usually ignored in similar research.
Conclusion: The “straightforward” causality between oral health-related behavior and the actual OHS must be considered with caution, as well as their impact on the oral health-related quality of life. Further research is needed to investigate the interaction between variables, the strength of the interrelations and the magnitude of their interactions, and the confidence that can be placed in these measurements, with respect to the general population and/or those lacking domain-specific education.
Keywords: moderated mediation, oral health, HUDBI, oral health-related quality of life, DMFT
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