Quality of Life Research

, Volume 28, Issue 12, pp 3213–3224 | Cite as

Structural equation modeling to detect predictors of oral health-related quality of life among Japanese university students: a prospective cohort study

  • Hikari Saho
  • Daisuke EkuniEmail author
  • Kota Kataoka
  • Ayano Taniguchi-Tabata
  • Naoki Toyama
  • Yoshio Sugiura
  • Md Monirul Islam
  • Yoshiaki Iwasaki
  • Manabu Morita



This prospective cohort study of Japanese university students aimed to identify factors that might affect oral health-related quality of life (OHRQoL) and longitudinal relationships over a period of 3 years.


Students (n = 487) provided complete data before entering and 3 years later (before university graduation) participated in the present study. Decayed, missing, and filled teeth (DMFT) scores, community periodontal index, ratios (%) of teeth with bleeding on probing, and malocclusion were determined during oral examinations. The questionnaire addressed age, sex, self-rated oral health, oral health behavior, subjective oral symptoms, and OHRQoL determined using the oral health impact profile (OHIP)-14. Associations were analyzed using structural equation modeling (SEM).


The OHRQoL significantly worsened according to OHIP-14 total score (p = 0.001). The final model in the symptoms of SEM analysis showed that OHRQoL at follow-up positively correlated with OHRQoL at baseline. Self-rated oral health was directly associated with the OHRQoL at baseline (p < 0.05).


This study determined that OHRQoL at baseline was a direct predictor, and that self-rated oral health were indirect predictors of OHRQoL at follow-up among Japanese university students.


Oral health-related quality of life The oral health impact profile-14 Cohort study Self-rated oral health Structural equation modeling 



The authors are grateful to Dr. Chiaki Inabu (Junpukai Daiku Dental Clinic, Okayama, Japan) for data entry, and to Dr. Tetsuji Azuma (Department of Community Oral Health, Asahi University School of Dentistry, Mizuho, Japan), Dr. Mayu Yamane-Takeuchi, and Dr. Shinsuke Mizutani (Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University; OBT Research Center, Faculty of Dental Science, Kyushu University, Japan) for data collection.


This study was self-supported.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committees at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and at Okayama University Hospital, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Departments of Preventive DentistryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  2. 2.Departments of Preventive DentistryOkayama University HospitalOkayamaJapan
  3. 3.Health Service CenterOkayama UniversityOkayamaJapan

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