Religiosity, spirituality, social support, health behaviour and dental caries among 35- to 44-year-old jerusalem adults: A proposed conceptual model

The aim of this study was to assess the relationship between religiosity and dental caries, and whether oral health-related behaviours, spirituality and social support are included in the potential pathways which explain the association between religiosity and dental caries. The present cross-sectional study employed a stratified sample, according to religiosity level (33.1% secular, 33.1% religious and 33.9% orthodox), of 254 Jewish adults in Jerusalem. The objective was to examine the pathway between religiosity, spirituality and social support and its effect on oral health outcomes by DMFT, controlling for socio-economic position and health behaviour determinants. Religiosity was determined and validated by self-definition. Social support was assessed by the Multidimensional Scale of Perceived Social Support. Spirituality was estimated by the Hebrew version of the SpREUK Questionnaire for Religiosity, Spirituality and Health. The mean caries experience (DMFT) was 10.75. Secular people revealed significantly higher DMFT than their religious and orthodox counterparts (78.0 vs. 43.9 and 39.3%, respectively, p < 0.01). A conceptual logistic regression model revealed a possible pathway, wherein a higher level of religiosity was distally associated with superior dental health outcomes, mediated by high spirituality, strong social support and positive oral health behaviours. The present study identified a strong statistical association between caries experience and religiosity. The direction of the association suggested that being religious had a protective effect on caries experience. Our conceptual hierarchical approach suggests a pathway to explain the association between the level of religiosity and dental caries experience. In this study this association was mediated by extrinsic (i.e. social support) and intrinsic (i.e. spirituality) pathways.