Associations of Attitudes and Practice Toward Oral Health, Socioeconomic Status, Self-Rated Oral Health, Subjective Oral Symptoms, and Oral Health-Related Quality of Life Among Residents in Eastern China: A Structural Equation Modeling Approach

Background and Purpose: The purpose of this study was to investigate the relationships among attitudes and practice about oral health, socioeconomic status, subjective oral symptoms, self-rated oral health, and oral health-related quality of life (OHRQoL) in a group of people from eastern China. Methods: Between January 2021 to February 2022, 2502 (87.4%) of the 2863 participants completed an online questionnaire. OHRQoL, Socio-demographics characteristics, attitudes and practice toward oral health, self-rated oral health and subjective oral symptoms were all covered by the questionnaires. Based on the hypothetical model, structural equation modeling with the bootstrap method was used to examine the interactions and the strength of the correlations between the measured variables. Results: The final model demonstrated acceptable data fit. Socioeconomic status (& beta; = -0.051), attitudes (& beta; = -0.100) and practice (& beta; = -0.127) toward oral health, self-rated oral health (& beta; = -0.493) and subjective oral symptoms (& beta; = 0.294) were all significantly correlated with OHRQoL. Socioeconomic status was directly linked to attitudes (& beta; = 0.046) and practice (& beta; =0.070) about oral health, and attitudes play the role of intermediary between practice and socioeconomic status (& beta; = 0.018). OHRQoL was indirectly linked with attitudes mediated by practice (& beta; = -0.092), practice mediated by subjective oral symptoms (& beta; = -0.107), subjective oral symptoms mediated by self-rated oral health (& beta; = 0.031). OHRQoL was correlated with income, educational level, and socioeconomic status. Self-rated oral health was related to educational level and socioeconomic status. Conclusion: In a sample of eastern China residents, OHRQoL was influenced by socioeconomic status, attitudes and practice toward oral health, subjective oral symptoms, and self-rated oral health.