Sense of coherence and utilisation of dental services among children and adolescents: A systematic review and meta-analysis

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Abstract
This systematic review and meta-analysis aimed to synthesise the evidence on the association between sense of coherence (SOC) and the utilisation of dental services among children and adolescents. Children and adolescents aged 0–18 years and/or their parents were included. The outcome was utilisation of dental services (regular attendance and preventive-oriented use), in relation to individual or parental SOC (assessed using the SOC-13 instrument). This systematic review (PROSPERO No CRD42024626799) was conducted in accordance with the PRISMA guidelines. A comprehensive search of electronic databases (PubMed, Web of Science, EMBASE, LILACS, Scopus, and APA PsycINFO), and grey literature was conducted on January 14, 2025, and updated on September 30, 2025. No language restrictions were applied. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Meta-analyses using random-effects were performed. Eleven studies (one cohort study and ten cross-sectional studies) were included. Of these, 10 were eligible for meta-analysis. The pooled results showed a significant association between higher parents’ SOC and more regular use and preventive-oriented utilisation of dental services among children and adolescents. No statistically significant association was observed between adolescents’ SOC and dental service utilisation. Considerable heterogeneity was identified across studies. In conclusion, higher parental SOC was associated with more regular dental attendance and preventive dental care patterns during childhood and adolescence. These results underscore the relevance of psychosocial determinants within the family context and support public health strategies that incorporate family-centred and salutogenic approaches to promote preventive oral health behaviours.

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