Interventions to improve adolescents’ sense of coherence and social support on quality of life and gingivitis: a cluster-randomised clinical trial

PURPOSE: to evaluate two interventions to improve sense of coherence (SOC) and social support on oral health-related quality of life (ORHQoL), health-related quality of life (HRQoL), dental biofilm and bleeding on probing (BOP) among adolescents. METHODS: A cluster-randomised school-based clinical trial was conducted with 254 adolescents aged 15-16 years from four secondary schools in Brazil. The SOC intervention group (SOC-G) included seven 60-minute sessions aimed at developing and empowering positive attitudes, personal skills and coping strategies. The SOC plus social support intervention group (SOC/SS-G) comprised face-to-face and online meetings between participants and high school students to enhance social support, along with the SOC intervention. RESULTS: Mixed-effects models revealed significant effects of SOC-G and SOC/SS-G on SOC, social support, self-esteem, dental biofilm, BOP, OHRQoL and HRQoL at three-month follow-up. Structural equation modelling showed direct effects of interventions on dental biofilm and HRQoL. Interventions indirectly predicted ORHQoL via SOC change. Social support change mediated the effect of the interventions on BOP. CONCLUSION: The present findings suggest that interventions aiming to enhance SOC and social support can positively impact quality of life and periodontal clinical outcomes among adolescents. BRAZILIAN REGISTER OF CLINICAL TRIALS (REBEC): Identifier: RBR-3rxj6y6.