Oral health, psychosocial aspects, and subjective happiness among Brazilian Army recruits: a pathway analysis

This study investigated socioeconomic, psychosocial, behavioral, and clinical factors directly and indirectly associated with subjective happiness among recruits from southern Brazil. This cross-sectional study included a sample of recruits performing mandatory military service at two military bases in southern Brazil. Questionnaires were administered to collect socioeconomic data (mother's education, family income, and participant education level), behavioral habits (toothbrushing frequency and flossing), and psychosocial variables, such as sense of coherence (SoC-13 scale), oral health-related quality of life (OHRQoL), assessed using the Oral Health Impact Profile (OHIP-14), and degree of happiness (Subjective Happiness Scale). A clinical dental examination was performed by a single trained and calibrated examiner to determine the gingival bleeding index and dental caries experience (DMFT, number of decayed, missing due to caries, or filled permanent teeth). Pathway analysis was conducted to test the direct and indirect paths linking socioeconomic, psychosocial, behavioral, and clinical factors to happiness (Stata software). Results are presented as beta coefficients (β) and p values. A total of 499 recruits aged 18-19 years were evaluated. High levels of SoC were directly associated with greater happiness (β = 0.49, p < 0.001), whereas higher OHIP-14 scores, indicating poorer OHRQoL, were directly associated with lower happiness (β = -0.09, p < 0.05). Untreated dental caries was indirectly associated with lower happiness (β = -0.03, p < 0.05) via OHRQoL. No significant paths were observed from socioeconomic or behavioral variables to happiness. In conclusion, psychosocial and clinical factors were associated with happiness levels among Brazilian Army recruits.