title: Predictors of oral health-related quality of life in Iranian adolescents: A prospective study.
abstract: OBJECTIVE
  In the present study, we evaluated the direct and mediating (indirect) effects of clinical oral conditions, dental anxiety, sense of coherence (SOC), and socioeconomic variables on oral health-related quality of life (OHRQoL) and general health-related quality of life (GHRQoL) in Iranian adolescents.
  
  
  METHODS
  A longitudinal design was used with a sample of 1052 (694 males, mean age=15.05 years) schoolchildren from Qazvin, Iran. Each participant completed a background information sheet and the following scales at baseline: Modified Dental Anxiety Scale, SOC, PedsQL 4.0 Generic Core Scale, and PedsQL Oral Health Scale. The PedsQL 4.0 Generic Core and Oral Health scales were recompleted at the 18-mo follow up.
  
  
  RESULTS
  Father's education, monthly family income, dental anxiety, Community Periodontal Index (CPI), decayed, missing, and filled teeth (DMFT), and SOC significantly and directly predicted OHRQoL at 18 mo. Father's education had indirect effects on OHRQoL through CPI and DMFT, family income had indirect effects through DMFT, and dental anxiety had indirect effects through CPI. OHRQoL at 18 mo (β=0.499) and SOC (β=0.084) had significant and direct and mediating effects through OHRQoL on GHRQoL, while father's education, monthly family income, dental anxiety, CPI, and DMFT only showed mediating effects.
  
  
  CONCLUSIONS
  Clinical oral indicators had direct effects on OHRQoL, but mediated the effects of dental anxiety and socioeconomic status on both OHRQoL and GHRQoL.
authors.affiliation: Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.|Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.|Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Amir H
authors.identifier: http://orcid.org/0000-0002-8798-5345
authors.initials: AH
authors.lastname: Pakpour
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
authors.forename: Chung-Ying
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Griffith Health Institute, School of Dentistry and Oral Health, Gold Coast, QLD, Australia.
authors.forename: Santhosh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
authors.affiliation: Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Jansson
mesh_terms: D000293:Adolescent; D016854:Dental Anxiety / Q000453:epidemiology / Q000523:psychology*; D003729:Dental Care / Q000523:psychology; D003731:Dental Caries / Q000453:epidemiology / Q000523:psychology; D003945:Diagnosis, Oral; D005260:Female; D006801:Humans; D007182:Income; D007492:Iran; D008137:Longitudinal Studies; D008297:Male; D009909:Oral Health / Q000706:statistics & numerical data; D010512:Periodontal Index; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D060685:Sense of Coherence / Q000502:physiology*; D012923:Social Class; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000523:psychology
keywords: adolescent; longitudinal study; oral health; oral health-related quality of life; structural equation modeling