Remaining caries-free – a personal concern: an interview study to capture the impact of salutogenic influencing factors in caries-free middle-aged adults

Caries is considered the most prevalent disease worldwide. The prevailing paradigm in caries research and care has historically focused on the identification and management of high-risk patients and the disease itself. In recent years, the salutogenic perspective has received increased attention. This perspective has the potential to offer novel insights into the mechanisms by which the disease may be treated. This study aimed to capture experiences related to the impact and use of salutogenic factors influencing the maintenance of a caries-free status among adult individuals. To ensure credibility and data quality, caries-free participants were strategically recruited through purposive sampling via an aggregated database of dental records. The study sample included 15 adult individuals (> 40 years), eight males and seven females from diverse socioeconomic backgrounds. Data were collected through semi-structured in-depth interviews. The interviews were audio-recorded and transcribed verbatim, after which they were analyzed using the qualitative content analysis method, with an inductive approach. The overarching theme identified ‘Remaining caries-free – a personal concern’, reflects the participants’ proactive engagement in their own oral health, and included a consequentialist mindset. Six key themes emerged: ‘External impact’, ‘Assisted encouragement’, ‘Acquired knowledge’, ‘Protective characteristics’, ‘Positive habits’, and ‘Personal commitment’. These influencing themes emerged from three more descriptive subthemes each, which formed the basis and provided deeper insight into the theme’s more broader contents. The results underscore the importance of a supportive social environment in fostering oral health-promoting habits, highlighting the importance of receiving support and guidance from family, friends, and society during childhood and adolescence. Furthermore, the results indicate that a meticulous personality and a well-informed approach to health may be crucial factors for maintaining a caries-free status in adulthood. A deeper understanding of the salutogenic influences that contribute to long-term caries-free status, including both the formation and maintenance of good habits from childhood to adulthood, could guide individual empowerment of self-efficacy and enhance the effectiveness of prevention strategies in dental care. This underscores the need for further exploration in this area from a lifeworld perspective where care should be person-centered also for those free of caries.