title: Oral disease and psychosocial risk determinants in relation to self-assessments of general health in persons with chronic whiplash-related disorders.
abstract: The aim of this study was to analyse how self-assessed general health was related to oral health among persons afflicted with whiplash-associated disorders (WAD), controlling for relevant background factors, confounders and other risk factors. Questionnaires included the SF-36 Health Survey, self-assessed oral health and relevant risk factors, in total 49 questions. Multivariable regression modelling was performed. Members of a nationwide Swedish association enlisting persons who have problems concerning a whiplash injury (n = 1,928) were included. A total of 979 persons participated in the study, a response rate of 50.8%. A multivariable regression model is presented, with general health as the dependent variable, and the independent variables inserted en-bloc. The model was highly significant with an explained variance of 28%. Among background factors, only older age appeared as significantly and strongly related to poorer general health. The strongest explanatory contributions came from the health related variables. Oral disease and extra-oral body pain were both strongly related to poorer general health, most obviously for the oral disease variable. Oral disease was significantly and to a clinically relevant degree associated with self-assessed general health. Several other psychosocial indicators of stress were also significantly related to the general health. These findings are consistent with the stress-behaviour-immune model for development of disease.
authors.affiliation: Department of Oral Public Health, Centre for Oral Health Sciences, Malm University, Sweden. bjorn.axtelius@od.mah.se
authors.forename: Björn L
authors.initials: BL
authors.lastname: Axtelius
authors.forename: Björn R
authors.initials: BR
authors.lastname: Söderfeldt
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010510:Periodontal Diseases / Q000209:etiology; D012044:Regression Analysis; D012307:Risk Factors; D012649:Self Concept; D012647:Self-Assessment; D012931:Social Environment; D013312:Stress, Physiological / Q000150:complications; D014076:Tooth Diseases / Q000209:etiology; D014911:Whiplash Injuries / Q000150:complications* / Q000503:physiopathology