Digital connection: effect of online social capital and associated factors on adolescents’ oral health-related quality of life

Social capital plays a key role in health outcomes, including oral health-related quality of life (OHRQoL). With increased digital interactions, online social capital has emerged as a potential determinant of adolescent well-being. This study aimed to explore the relationship between online social capital, associated factors, and OHRQoL among adolescents. This cross-sectional study was nested within a cohort study initiated in 2010 with a representative sample of preschool children from Santa Maria, Brazil. Individuals were re-evaluated from 2022 to 2023 (n = 406), when they were between 14 and 18 years of age. OHRQoL was assessed using the Child Perception Questionnaire (CPQ 11-14). Online social capital was measured using two proxy indicators (frequency of social media use and perceived online trust) based on prior literature. Offline social capital and demographic, socioeconomic, psychosocial, and clinical variables were considered confounders. Poisson regression was used to assess associations. Results are reported as rate ratios (RR) and 95% confidence intervals (95% CI). Most adolescents (95.3%) used social media daily, and 62.9% reported having trusted online contacts. Adolescents with low online social trust had CPQ11-14 scores 8% higher (RR = 1.08; 95%CI: 1.01-1.15), indicating poorer OHRQoL. Low offline social capital was also associated with poorer OHRQoL, whereas moderate and high sense of coherence (SOC) were associated with lower impacts on OHRQoL. Social media usage frequency showed no significant association with OHRQoL. Our findings suggest that online social trust, offline social capital, and SOC are positively associated with adolescents' OHRQoL.