Background: The present study was conducted to prospectively assess the association between health-related\nquality of life (HRQoL) and the development of dental caries in adults in northern Sweden. The SF-36 questionnaire\nwas used to estimate HRQoL.\nMethods: Adults who had (i) participated in a population-based health screening in northern Sweden between\n2003 and 2009 and had completed the SF-36 questionnaire, and (ii) received a dental check-up within 1 year\n(n = 15,615) were included in the study. Of these, 9,838 had a second caries examination 2ââ?¬â??7 years after the baseline\nrecording. Information regarding SF-36, lifestyle factors and medical conditions was retrieved by questionnaires, and\nanthropometric status and blood lipid levels were measured. The association between dental caries (outcome) and\nSF-36 scores (exposure) with the inclusion of potential confounders was analysed by linear and logistic regression.\nResults: Caries increment increased significantly with decreasing scores for both physical and mental dimensions of\nSF-36 in women, but no association was seen in men. However, lifelong caries experience (DMFS) increased linearly with\ndecreasing physical HRQoL in both men and women; this was also observed for the single dimension of mental HRQoL.\nThe crude odds ratio for being in the highest caries quintile compared to the lowest when having the poorest physical\nHRQoL compared with the best physical HRQoL was 1.88 (95 % CI: 1.54ââ?¬â??2.3). Several factors were identified as potential\nconfounders in the associations between DMFS and SF-36 scores, including education level, smoking, age, medications,\nhigher levels of total cholesterol, triglycerides, systolic blood pressure, body mass index and sugar intake. Except for\neducation level and smoking, the effect sizes for the association between gradually decreasing SF-36 scores and\nincreasing caries were generally moderate.\nConclusions: Increased development of caries was associated with low physical HRQoL and some aspects of mental\nHRQoL. The mechanisms underlying these associations, which are likely confounded by both biological and lifestyle\nfactors, remain to be elucidated. The study implies that, when possible, subjects with poor HRQoL would benefit from\ncaries prevention measures meeting the underlying situation.
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