The purpose of the study was to assess the sense of coherence and its relationship with oral health and other study variables among adult patients at university dental hospital. This cross-sectional study included adult patients visiting the Dental Hospital of the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam. Sense of coherence was determined by Antonovsky's Sense of Coherence scale (SOC-13), which consists of 13 items on a 7-point Likert. DMFT index, plaque index, gingival index, and simplified oral hygiene index were used to evaluate the oral health of study participants. Bivariate and multivariable analyses were performed, and 0.05 level of significance was used in the study. The study included the data of 558 participants with a mean age of 32.19±10.11 years. The mean score of SOC was 52.77±13.11, which was significantly higher in high-income participants (P <0.001), participants without a medical condition (P=0.021), non-smokers (P <0.001), and those who visited the dentist in less than one year (P=0.028). Bivariate analysis showed statistically significant negative correlations between SOC and DMFT index (P=0.002), SOC and plaque index (P <0.001), SOC and gingival index (P=0.002), and SOC and simplified oral hygiene index (P=0.001). Multivariable analysis also showed that SOC was significantly correlated with DMFT index (P=0.001), plaque index (P <0.001), gingival index (P <0.001), and oral hygiene index (P=0.004) after controlling for age, gender, education, and monthly income. This study found that high-income and healthy participants, non-smokers, and those who visited the dental office during the last one year demonstrated significantly higher SOC. In addition, there was a statistically significant correlation between SOC and oral health. These study findings highlight the importance of raising awareness about SOC to improve oral health outcomes in adult patients.