Accounts of bullying on Twitter in relation to dentofacial features and orthodontic treatment

Fixed orthodontic appliances and adolescents' peer relations in school : A social network analysis using cross-sectional survey data

PURPOSE

Studies from the 1970s and 1980s, but also recent investigations on social media suggest that wearing a fixed orthodontic appliance can be a cause of bullying and social exclusion. With the greater uptake of orthodontic treatment in recent decades, it can be assumed that fixed braces are increasingly perceived as normal or even socially desirable. This study investigated how wearing visible fixed braces affects adolescents' social position in their peer networks using cross-sectional survey data.

METHODS

A total of 3002 students in the seventh grade (ages 12/13) at 39 secondary schools were asked about their social relationships in school. These directed network data were used to compare different indegrees (friendship, popularity and victimisation) of students with and without fixed braces. Statistical analyses were performed using ordinary least squares multiple regression models with school cohort fixed effects.

RESULTS

In all, 19% of the surveyed students indicated that they wear visible fixed braces. Girls with fixed braces were slightly more likely to be nominated for friendship and popularity and slightly less likely to be nominated for victimisation than girls without fixed braces (p < 0.05). These associations also remained stable when controlling for socioeconomic differences. Among boys, all observed associations were statistically insignificant.

CONCLUSION

We found no evidence that wearing fixed braces in adolescence is socially sanctioned by peers. Rather, female students with fixed braces even tend to hold a slightly more favourable position in their peer networks than girls without braces do. These analyses exemplify how network-analytic approaches can be successfully applied in interdisciplinary research at the intersection of sociology, epidemiology and medicine.

Pathways between verbal bullying and oral conditions among school children

PURPOSE

To investigate the direct and indirect pathways between verbal bullying and adverse oral conditions among school-aged children.

METHODS

A cross-sectional survey was conducted with 8- to 10-year-old children, enrolled in public schools in Southern Brazil. Verbal bullying was collected by self-reports. Independent variables included sociodemographic characteristics (sex, age, household income, and caregivers' educational level) and oral conditions (anterior open bite, anterior teeth crowding, upper anterior diastema, large overjet, untreated dental caries, and PUFA index). The pathways between verbal bullying and the independent variables were analysed through structural equation modelling.

RESULTS

1369 children were included. The prevalence of verbal bullying was 26.2% (95% confidence interval [CI] 23.9-28.6%). Verbal bullying was directly influenced by large overjet (standard coefficient [SC] 0.13, P < 0.01), untreated dental caries (SC 0.63, P = 0.01) and PUFA index (SC 0.75, P = 0.02). Sex (SC - 0.005, P = .04) and age (SC - 0.006, P < 0.01) indirectly influenced verbal bullying via untreated dental caries.

CONCLUSIONS

Verbal bullying was directly influenced by large overjet, untreated dental caries and PUFA index. Sex and age indirectly impacted verbal bullying through untreated dental caries.

Association between Dentofacial Features and Bullying from Childhood to Adulthood: A Systematic Review

Bullying occurs when an individual is repeatedly victimised by negative actions performed by peers. As oral features, like malocclusion and dental structural defects, can promote psychological distress, which is also found in those who are bullied, we aimed to study the association between orofacial conditions and bullying. A systematic review (PROSPERO CRD42022331693), including articles dealing with bullying and dentofacial traits, was performed following the PRISMA chart. The iterative search of eligible publications was carried out on 27 March 2023 on four databases (PubMed, PubPsych, Web of Science and Cochrane Reviews) and in the grey literature. Among the 25 articles included, 4 referred to qualitative studies, which analysed 632 interviews with children, 8 interviews with parents, 292 letters, and 321 Twitter posts. The other 21 were cross-sectional studies, which included 10,026 patients from 7 to 61 years old. Two of the qualitative studies and seven of the cross-sectional studies rated a low risk of bias, according to Joanna Briggs Institute's Critical Appraisal Tools. The majority of studies (88%) reported a relationship between malocclusion or structural defects and exposure to bullying among young adolescents. Structural dental abnormalities and severe malocclusion should be managed, among others, for psychological questions because they crystallise the loss of self-confidence and increase the risk of bullying.

Orthodontics in an online community: A computational analysis of r/Braces subreddit

BACKROUND

This study aimed to analyze the semantic network and content analyses of the posts published in a subreddit related to orthodontic treatment on Reddit (Advance Publications, Inc., San Francisco, California).

METHODS

The eight threads in the r/Braces subreddit were divided into two categories: 1) "treatment process" (Braces are off!!!, Braces progress, Before and after!, and Day 1!) and 2) "question/problem" (Question, Discussion!, Need advice! and Rant!). For both categories, a semantic network analysis was performed using the Leximancer software (Leximancer Pty Ltd., Brisbane, Australia). In addition, the quality of the posts published in the "question" thread and the usefulness of the replies provided to these questions (useful, misleading, or neutral) were analyzed.

RESULTS

Seven themes (braces, teeth, months, day, worth, started, and result) that mostly emphasized orthodontic treatment and treatment duration were elicited from the "treatment process" category, and seven themes (teeth, orthodontist, braces, week, bands, brush, and extractions) that mostly emphasized orthodontic treatment, orthodontists, and time were elicited from the "question/problem" category. It was also revealed that users voted on the posts related to the "treatment process" category and moved the posts to the list of top posts on the platform. In the "question" thread, 47.79% of the posts asked for advice and 21.11% of them were related to failures. In addition, 69% of the replies were categorized as "useful."

CONCLUSIONS

Reddit is a successful data mining platform, and the users provide highly useful replies to the questions posted on Reddit regarding orthodontic treatment.

Analysis of Smile Aesthetic Changes With Fixed Orthodontic Treatment

INTRODUCTION

 The mouth and teeth are vital in facial aesthetics and the face as a whole is the most critical individual component determining one's physical look. As dentists, we need to be aware that this might significantly alter the care given to a patient since the patient's and the dentist's ideas of beauty may be quite different. This study sought to ascertain how the general public, general dental specialists, and orthodontics all rated the attractiveness of patients who had received orthodontic treatment using a visual scale, as well as how the facial reference could be used to gauge the improvement in smiles.

METHODOLOGY

 The attractiveness of 80 continuously treated patients was assessed by comparing their pre- and post-treatment posed grin images. The attractiveness of participants' smiles was evaluated using the Visual Simple Scale, which measures affect, and the Graph of Facial Stylish Reference, which measures objectively. "Making a Jazzy Face Chart" - The analysts were able to fairly evaluate changes in elements such as the symmetry of the smile twist, the position of the gingival peak of the front teeth relative to each other, the height of the incisal edges of the front teeth, the width of the connector band of the front six teeth, and the general tip of the front teeth by referring to photographs taken during treatment. We put the Visual Basic Scale to the test by having five male orthodontists, five male general dental specialists, and five male laypeople rate how much of an improvement they noticed between the before and after photos of a patient's smile.

RESULTS

 According to the findings of the first section of the research, orthodontic treatment generally leads to an increase in all indicators. Some instances, however, demonstrated worsening in characteristics such as grin arc consonance, gingival zenith location relative to each other, and incisal edge height. The second half of this research revealed that the opinions of orthodontic specialists, general dentists, and the general public varied with regard to the beauty of a smile.

CONCLUSION

 Based on this research, we can say the following: Orthodontic treatment led to improvements in many of the variables that contribute to smile attractiveness, factors include the interproximal width of contact area, the height of the incisal margins of the front teeth, and the location of the gingival zenith in relation to one another, to name a few. The results of this research support the idea that the aesthetics of the smile should be assessed at the last stages of orthodontic treatment when fine adjustments are being made.

The paediatric dentistry-restorative dentistry interface

This paper examines the various contemporary clinical interfaces between paediatric dentistry and restorative dentistry for patients with both acquired and congenital abnormalities presenting to primary and secondary care. Dental trauma of the child or adolescent has long-standing implications on future oral health due to conditions such as ankylosis, pulp necrosis, coronal tissue loss or tooth loss, all of which provide significant challenges into adulthood. Similarly, congenital conditions, such as hypodontia and structural deficiencies or malformations, such as amelogenesis and dentinogenesis imperfecta, result in the need for collaborative, multi-speciality decision-making from a young age, creating a pathway for longitudinal multi-disciplinary team treatment planning.

Comparative evaluation of facial attractiveness by laypersons in terms of facial proportions and equate it's deviation from divine proportions - A photographic study

Introduction

The human face is a unique structure and says a lot about an individual even more than what the body indicates about the overall attractiveness. Facial attractiveness is an important key to social interactions and individual behavior. The human body is made in such a way that it follows a specific mathematical proportion called the Golden Proportion. In order for any two parts to be aesthetically proportionate, the ratio between them should be 1.618. Studies have shown that aesthetically pleasing profiles have facial proportions and ratios that closely resemble the golden proportions.

Aim

To evaluate the perception of esthetic facial photographs by laypersons and compare these with the accepted norms of divine proportions to find for any deviations from those norms.

Methodology

Forty subjects having normal soft tissue profile angle, as evaluated using Burstone's method, were selected to be photographed for the study. All the photographs were taken using DSLR Camera and under a standard photographic setup. All the photographs were edited and compiled into a PowerPoint presentation. The edited photographs on the PowerPoint presentation were displayed to 302 evaluators. These evaluators were asked to score each photograph according to a visual analogue scale with markings from 0 to 10 (with 0 being least attractive and 10 being most attractive) according to their attractiveness. All the scored photos were then grouped into three categories viz. Very attractive, Average attractive and Least attractive. Three horizontal proportions and three vertical proportions were assessed digitally in all the photographs and any deviations from the golden proportion were assessed.

Results

It was found that none of the three groups followed golden proportions accurately. However the Very Attractive group showed closest resemblance to the golden proportion as compared to the other two groups. Amongst all the horizontal and vertical proportions in the Very Attractive group, Interchelion to Interalar proportion (Ch:Ln) was the one that showed maximum deviation from the divine proportion (mean value 1.38 ± 0.15). Rest of the other horizontal and vertical proportions in the Very Attractive group were close enough to the divine proportion. However the difference between the proportions amongst the three groups was not statistically significant. Comparison between the three groups showed that Very Attractive faces showed the least deviations from the golden proportions whereas least attractive faces showed most deviations from the golden proportions.

Conclusion

The findings of this study state that the perception of aesthetically pleasing faces by laypersons do not accurately follow golden proportion but are close enough to it. The faces not showing golden proportions are perceived as less attractive.

Exploring Public Perceptions of Dental Care Affordability in the United States: A Mixed Method Analysis via Twitter

BACKGROUND

Dental care expenses are reported to present higher financial barriers than any other type of health care service in the United States. Social media platforms such as Twitter have become a source of public health communication and surveillance. Previous studies have demonstrated the usefulness of Twitter in exploring public opinion on aspects of dental care. To date, no studies have leveraged Twitter to examine public sentiments regarding dental care affordability in the U.S.

OBJECTIVE

The aim of this study was to understand public perceptions of dental care affordability in the U.S. on the social media site, Twitter.

METHODS

Tweets posted between September 1, 2017 and September 30, 2021 were collected using the Snscrape application. Query terms were selected a priori to represent dentistry and financial aspects associated with dental treatment. Data were analyzed qualitatively using both deductive and inductive approaches. Ten percent of all included tweets were coded to identify prominent themes and subthemes. The entire sample of included tweets were then independently coded into the thematic categories. Quantitative data analyses included: geographic distribution of tweets by state; volume analysis of tweets over time; distribution of tweets by content theme.

RESULTS

A final sample of 5,314 tweets were included in the study. Thematic analysis identified the following prominent themes: 1) general sentiments (1614 tweets, 30.4%); 2) delaying or forgoing dental care (1190 tweets, 22.4%); 3) payment strategies (1019 tweets, 19.2%); 4) insurance (767 tweets, 14.4%); and 5) policy statements (724 tweets, 13.6%). Geographic distributions of tweets established California, Texas, Florida, New York as the states with the most tweets. A word cloud revealed that "insurance", "need", and "work" were the most frequently used words. Qualitative analysis revealed barriers faced by individuals to accessing dental care, strategies taken to cope with dental pain, and public perceptions on aspects of dental care policy. The volume and thematic trends of tweets corresponded to relevant societal events: The Coronavirus disease 2019 (COVID-19) pandemic and debates on healthcare policy resulting from the election of President Joseph R. Biden.

CONCLUSIONS

Findings illustrate the real-time sentiment of social media users toward the cost of dental treatment and suggest shortcomings in funding that may be representative of greater systemic failures in the provision of dental care. Thus, this study provides insights for policy makers and dental professionals who strive to increase access to dental care.

Looking good but tweeting bad? The social perception of orthodontic-related posts on Twitter and Instagram

BACKGROUND

Social media plays a major role in the daily life of adolescents and has become highly interesting for healthcare research as well. The aim of this study was to explore the social perception of orthodontic-related posts on Twitter and Instagram by young adults.

METHODS

401 orthodontic-related posts were collected during a 30-day period and categorized with regard to specific characteristics - their content and the social networking site (SNS) being used as well as the presence or absence of a selfie. In order to investigate the social perception of these posts, 42 young adults rated the emotional states of the SNS users using the Self-Assessment Manikin (SAM)-Tool. A total of 4211 poster-rater observations pertaining to the three SAMs dimensions pleasure, arousal and dominance were analyzed by using linear and multinomial logistic regression analyses.

RESULTS

The investigated characteristics of the collected posts had significant effects on the perceived emotional state of the SNS users. Besides significant SNS-associated differences, there were also effects that were independent of the SNS being used: Receiving orthodontic appliances was more often associated with rather negative emotions (p < 0.001), while users who posted about the removal of such braces were more often perceived as joyful (p < 0.001). Interestingly, users whose posts contained selfies with visible braces were perceived as significantly more positive and stronger in comparison to users who did not post a picture of themselves (p < 0.05).

CONCLUSION

This research gives insights into the social perception of orthodontic-related posts on SNS. While users' emotional states were perceived highly differential on both SNS, orthodontic-related content also revealed significant effects on social perception. Because selfies with visible braces were associated with positive feelings by young adults, a modern and SNS-related way of coping with a temporary supposed impairment like fixed orthodontic appliances might have been revealed through this research.

Validation of the Psychosocial Impact of Dental Aesthetics Questionnaire in the Australian population

INTRODUCTION

The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception need for orthodontic treatment. The study aimed to determine the psychometric validity and reliability of PIDAQ in Australian adults.

METHODS

Data were collected from the National Dental Telephone Interview Survey in 2013. The PIDAQ was used, comprising 4 conceptual domains: self-confidence, social impact, psychological impact, and esthetic concern. Psychometric sensitivity was estimated for each item. Confirmatory factor analysis was performed to determine factorial validity in which the ratio of chi-square by degrees of freedom, comparative fit, and root mean square error of approximation were used as indexes of the goodness of fit. Convergent validity was estimated from the average variance extracted and composite reliability, whereas internal consistency was estimated by Cronbach standardized alpha.

RESULTS

The dataset comprised 2936 Australian adults aged ≥18 years and separated randomly into 2 subdata sets. The kurtosis and skewness values indicate an approximation to a normal distribution for each item, with acceptable thresholds for the goodness of fit and convergent validity (average variance extracted ≥0.50 and composite reliability ≥0.70), and discriminant validity was also demonstrated. Internal consistency was adequate in the 4 conceptual domains for PIDAQ for both subdata sets, with Cronbach standardized alpha being ≥0.70.

CONCLUSIONS

The psychometric sensitivity, validity, and reliability of the PIDAQ instrument in a sample of the Australian adult population were found to be adequate. Both subdata sets drawn from the sample demonstrated acceptable goodness of fit and internal consistency.

Bullying in individuals with cleft lip and palate: A Twitter analysis

OBJECTIVES

This study aimed to evaluate bullying in individuals with cleft lip and/or palate (CLP) using Twitter analysis.

MATERIALS AND METHODS

By using Twitter's advanced search feature, the four selected keywords; "bully", "bullying", "bullied" and "teased" were searched along with the terms "cleft lip and palate", "cleft lip" and "cleft palate", respectively. A total of 1010 tweets meeting the criteria were selected. The data were evaluated qualitatively using thematic analysis and the determination of the themes were based on this analysis.

RESULTS

Most of the tweets were posted by a layperson (80.8%), while most of the tweets were categorised in the theme "criticism of bullying" (36%). The tweets were distributed according to their uploader status as irrelevant individuals (60.6%), CLP subjects (26.9%), family of CLP subjects' (12.5%). Of the 1010 tweets evaluated, 707 were identified as negative, while 90 were identified as neutral and 213 were identified as positive. No significant differences were detected in retweet and like numbers between negative, neutral and positive comments (P > .05).

CONCLUSIONS

Twitter is an important platform, in which the bullying victims with CLP and their families feel free to share their personal experiences of being bullied and how they feel about it, while the others are standing against bullying and promoting social support for these individuals.

A qualitative twitter analysis of the patient experience with invisible orthodontics; lingual braces versus invisalign

Objectives:

The aim of this qualitative study was to examine orthodontic patients’ thoughts and experiences about the invisible orthodontic treatment options – lingual braces and Invisalign – through the analysis of Twitter posts’ content.

Materials and Methods:

A software program was written for the data collection. The program consecutively collected the tweets posted over an 8-month period from Twitter’s publicly accessible database. Tweets that were written in the English language and contained any of the four keywords “Invisalign,” “lingualorthodontics,” “lingualbraces,” and “invisiblebraces” were collected. The tweets that included irrelevant or incoherent posts, professional advertisements, unclear/not applicable content, and reposts were excluded from the study. Two authors, with different experiences, independently read, and analyzed the tweets. Each applicable tweet was classified into one of the three categories: Positive, negative, and neutral for two study groups (Invisalign and lingual braces). Pearson Chi-square test was used to analyze the negative and positive tweet rates of the groups.

Results:

1176 of 2407 tweets were selected as applicable and analyzed by the authors. There was a statistically significant very good agreement between the two observers (Kappa = 0.933, P < 0.001). The negative comment rate (39%) and neutral comment rate (31.1%) in the lingual group were statistically higher than the Invisalign group (27.2% and 21.7%, respectively; P < 0.001). The positive comment rate in the Invisalign group was significantly higher (51.1%) compared to the lingual group (29.9%, P < 0.001).

Conclusion:

Orthodontic patients use social media to share their experiences and feelings about their treatment process. The applicable Tweet number and the positive Tweet rate in the Invisalign group were higher than the lingual braces group.

What are dental professionals posting on Facebook? A cross-sectional content analysis

OBJECTIVE

To profile the posts on open orthodontic Facebook groups and identify which communication strategies and media modalities generate the most engagement from users.

DESIGN

A cross-sectional content analysis.

SETTING

Facebook Internet-based search.

METHODS

Post data were collected over a one-month period from the 10 largest public orthodontic Facebook groups. Evaluation of group characteristics included membership levels, number of administrators, time each group had been in existence and growth rate of each group. The number of posts, the numbers and types of engagement (likes, emojis, comments, shares) and engagement rate were calculated. The communication strategies (e.g. case presentation, course promotion, etc.) and media modalities (e.g. plain text, photograph, etc.) were recorded.

RESULTS

The study identified 190,268 Facebook members from the 10 largest orthodontic Facebook groups (median 17,811; interquartile range [IQR] 11,977). The median time the groups had existed was six years (median 2175 days; IQR 2311 days) and the median number of new group members in the past month was 1257 (IQR 2773). The median number of new group members in the past month was 1257 (IQR 2773). There were 227 postings during the study period with 2546 engagements. The overall median number of engagements was 196 (IQR 445) and the engagement rate of posts was 1.3% overall. Posts relating to course promotion (n = 63, 28%) followed by product promotion (n = 42, 19%) were the most common. Case presentation style posts accounted for 15% (n = 35). The level of engagement was greater for posts that had a clinical component compared to posts that did not (P < 0.001). For media modality, posts that included a photograph had greater engagement (P < 0.001).

CONCLUSION

There are frequent posts on course and product promotion in orthodontic Facebook groups; however, these are associated with low levels of engagement. Posts that are clinically orientated and include photographs have higher levels of engagement.

Effect of Class II functional treatment on facial attractiveness, as perceived by professionals and laypeople

The literature offers different perspectives for and against two-phase treatment of skeletal Class II malocclusion. Facial attractiveness is an important aspect to take into account, given that children with skeletal Class II are often bullied by their peers and have low self-esteem and a lower social perception. The aim of the present study was to evaluate the aesthetic perception of facial profiles by a large number of observers, before and after treatment with a functional appliance, compared to untreated controls. The pre- and post-treatment cephalograms of 20 Class II subjects treated with Sander’s bite-jumping appliance and 20 untreated historical controls were collected and transformed into black and white silhouettes depicting only the lower third of the face. An online questionnaire comprising the silhouettes of the two groups, three “calibration” profiles and an “ideal” profile was submitted to dentists, orthodontists, undergraduates and laypeople, asking them to rate the profile’s attractiveness using a Visual Analogue Scale (VAS). The effect of treatment, and observers’ age, expertise and gender were analysed. The calibration images and the ideal profiles were used to evaluate the coherence of each observer’s judgement. The protocol was approved by the local Ethics Committee. Nine-hundred and ten questionnaires were collected. Treated subjects showed a larger improvement of facial attractiveness compared to controls. A significant effect of gender on the observer’s ratings was observed. Some observers showed incoherent judgement, which had a significant effect on the regression model. In conclusion, early treatment with functional appliances seems to improve patients’ facial aesthetics. This improvement is perceived equally by dental professionals and laypeople.

Modelling risk factors for high/low Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) in the Australian adults

OBJECTIVE

Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception needed for orthodontic treatment (OT). The study aimed to (1) evaluate the psychosocial impact of dental aesthetics and the potential role of OT and (2) determine associations between PIDAQ with self-rated general and oral health, oral health-related quality of life (OHRQOL), and receipt of OT among Australian adults.

METHODS

Data were obtained from the 2013 Australian National Dental Telephone Interview Survey (NDTIS). The PIDAQ was utilized as main outcome, comprising items from four conceptual domains: self-confidence, social impact, psychological impact, and aesthetic concern. Participants reported their socio-demographic, behavioural, self-rated general and oral health as well as the poor OHRQOL using the Oral Impact on Daily Performance (OIDP) instrument and OT. The mean of PIDAQ and four subscales score and their 95% confidence intervals (CI) were estimated. Generalized liner regression was used to estimate association between PIDAQ and covariates by calculating the mean ratio (MR) and their 95% CI.

RESULTS

There were 2936 Australian adults who completed the PIDAQ items. The mean PIDAQ score was 28.8 (95% CI: 28.0-29.6). Higher PIDAQ scores were identified among those who reported non-Australian birth, lower incomes, infrequent dental visits, less than 21 teeth and brushing teeth less than twice a day, fair/poor self-rated general and oral health, and poor OHRQOL. In multivariable modelling, the mean PIDAQ score was 1.91 (95% CI: 1.82-2.00) times higher among those with OIDP score >3 and 1.06 (95% CI:1.01-1.10) times higher in those who had OT, comparing with their counterparts. Also, higher PIDAQ scores were identified among females, last visiting a dentist more than 2 years ago, fair or poor self-rated oral and general health.

CONCLUSIONS

Higher PIDAQ scores that have a greater impact on OHRQOL were associated with poorer self-rated general and oral health. This may be explained by unfavourable dental attendance and oral health habits. The positive correlation with OIDP scores verifies the validity of the PIDAQ. Those who had received OT had lower PIDAQ and OIDP scores.

A cross-sectional evaluation of the impact of Class II Division 1 malocclusion in treated and untreated adolescents on oral health-related quality of life

INTRODUCTION

The relationship between malocclusion, orthodontic treatment, and oral health-related quality of life (OHRQOL) is complicated, with some traits, such as increased overjet, having a potentially greater adverse effect on an adolescent's OHRQOL. The aim of this study was to evaluate the impact of malocclusion and orthodontic treatment on OHRQOL in adolescents presenting with Class II Division 1 malocclusion and explore the relationship between OHRQOL using a condition-specific and generic instrument and occlusal outcome.

METHODS

Two groups of adolescents were recruited from a United Kingdom university hospital: a pretreatment group of adolescents with Class II Division 1 malocclusion and a treated (posttreatment) group whose Class II Division 1 malocclusion had been corrected. Self-reported OHRQOL was assessed using the malocclusion impact questionnaire (MIQ) and the short form of Child Oral Health Impact Profile questionnaires. Occlusion severity and outcome were assessed using Peer Assessment Rating scores.

RESULTS

A total of 241 participants (106 male; 135 female) were recruited. MIQ scores differed significantly between the pretreatment and posttreatment groups, with scores being 11.35 times lower posttreatment than pretreatment, after adjusting for age and sex (95% confidence interval, -17.28 to -5.42; P <0.001). Females had higher total MIQ scores by 2.6 (95% confidence interval, 0.38 to 4.82), which was statistically significant (P = 0.022). There was a moderate correlation between MIQ and Peer Assessment Rating scores, but this relationship strengthened when omitting the global MIQ questions (Spearman's correlation coefficient, 0.59).

CONCLUSIONS

Increased overjet was associated with impaired OHRQOL using a condition-specific measure. A deeper understanding of associations between malocclusion, orthodontic treatment, and OHRQOL would benefit from longitudinal evaluation.

The Impact of the COVID-19 Epidemic on Orthodontic Patients in China: An Analysis of Posts on Weibo

Background: During the COVID-19 pandemic, many dental care services including orthodontic practice were suspended. Orthodontic patients turned to social media platforms to communicate, share experiences, and look for solutions. Our study aimed to investigate the attitudes and perspectives of orthodontic patients during the COVID-19 epidemic in China by analyzing orthodontics-related posts on Sina Weibo (a Chinese counterpart of Twitter). Materials and Methods: Potentially eligible posts on Sina Weibo platform were collected between December 30, 2019, and April 18, 2020. Posts related to both orthodontics and COVID-19 were included and then coded and classified into specific appliances and themes. Geographic and temporal distributions of the included posts were analyzed. In addition, time-lagged cross correlation was performed to explore the association between the number of daily posts and daily new COVID-19 cases/deaths in China. Chi-square tests were employed to compare the differences between fixed appliances and aligners in problems/difficulties and feelings during the epidemic. Results: Of the 28,911 posts identified, 4,484 were included in the analysis. The most frequently mentioned themes were appointments (n = 2,621, 58.5%), negative feelings (n = 2,189, 48.8%), and problems/difficulties (n = 1,155, 25.8%). A majority of posts were tweeted in regions with high levels of economic development and population density in eastern China and from February to March. The number of daily posts had a significantly positive correlation with daily new COVID-19 cases/deaths in China (P < 0.05). Compared with clear aligners, patients with fixed appliances reported more problems/difficulties (P < 0.001) and negative feelings (P < 0.001), but fewer positive feelings (P < 0.001). Conclusions: The analysis of Weibo posts provided a timely understanding of the impact of COVID-19 on orthodontic patients. Delayed appointments were their greatest concern, and negative feelings and untreated orthodontic problems increased during the suspension of dental care services. However, patients with clear aligners reported fewer negative feelings and problems than those with fixed appliances. The findings highlighted the need to consider both treatment- and psychology-related issues of orthodontic patients and how to handle them appropriately during the epidemic.

Parental Reported Bullying among Saudi Schoolchildren: Its Forms, Effect on Academic Abilities, and Associated Sociodemographic, Physical, and Dentofacial Features

Aim

To determine the prevalence of bullying, its forms, and its effect on academic abilities and school attendance, as well as associated sociodemographic, physical, and dentofacial features among Saudi schoolchildren.

Methods

This cross-sectional study recruited a sample of 1131 parents of schoolchildren 8-18 years old and requested them to complete internationally accepted questionnaires for their children. Chi-squared test and logistic regression analysis were used to analyze the data (p < 0.05).

Results

A majority (89.2%) of schoolchildren were bully victims. Physical bullying (48.9%) was the most common form of bullying. The youngest schoolchildren (8-11 years) and those who disliked school classes or neither liked nor hated them, as well as those who were truant from school, were more likely to be victims. In addition, those who had worse grades because of bullying and those who were very often bullied because of good grades or because they showed an interest in school were more likely to be victims. With regard to targeted physical features, teeth were the number one target, followed by the shape of the lips and strength, while tooth shape and color were the most common dentofacial targets, followed by anterior open bite and protruded anterior teeth. Boys and the youngest schoolchildren were more often subjected to bullying because of these features (p < 0.05).

Conclusions

The prevalence of bullying, mainly in a physical form, was high among Saudi schoolchildren, with a negative influence on students' academic abilities. Problems related to teeth, in particular, which can be treated, were targets, mainly for boys and the youngest schoolchildren. More studies are required in Saudi Arabia to explore the issue further among schoolchildren themselves.

Oral disorders associated with the experience of verbal bullying among Brazilian school-aged children: A case-control study

BACKGROUND

Dental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children.

METHODS

The study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χ² test and bivariate and multivariate conditional logistic regression analyses were used for statistical analysis.

RESULTS

A total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB.

CONCLUSION

Children aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions.

PRACTICAL IMPLICATIONS

Once oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.

Using big data to promote precision oral health in the context of a learning healthcare system

There has been a call for evidence-based oral healthcare guidelines, to improve precision dentistry and oral healthcare delivery. The main challenges to this goal are the current lack of up-to-date evidence, the limited integrative analytical data sets, and the slow translations to routine care delivery. Overcoming these issues requires knowledge discovery pipelines based on big data and health analytics, intelligent integrative informatics approaches, and learning health systems. This article examines how this can be accomplished by utilizing big data. These data can be gathered from four major streams: patients, clinical data, biological data, and normative data sets. All these must then be uniformly combined for analysis and modelling and the meaningful findings can be implemented clinically. By executing data capture cycles and integrating the subsequent findings, practitioners are able to improve public oral health and care delivery.

Impact of functional orthodontic treatment on facial attractiveness of children with Class II division 1 malocclusion

Background/objectives

Whether orthodontic treatment with functional appliances improves facial aesthetics is still under debate. This study aimed to determine whether functional orthodontic treatment improves the facial attractiveness of patients with Class II division 1 malocclusion.

Materials/method

Extraoral lateral photographs of 20 children with Class I (CLI, 11.7 ± 0.8 years), and before (T1) and after treatment (T2) photographs of patients with Class II division 1 (CLII T1 and CLII T2; mean age ± SD = 11.1 ± 0.6 years) treated with functional appliances, were transformed into black silhouettes. Three panels of examiners including 30 orthodontists (39.0 ± 10.1 years), 30 dentists (40.0 ± 9.7) and 30 laypersons (39.0 ± 9.2) evaluated the attractiveness of patients’ silhouettes using a 100-mm visual analogue scale, and the sagittal position of patients’ upper lip, lower lip, and chin using a 3-point Likert scale. Two-way ANOVA and a chi-square test were used to test differences among groups. Statistically significance was set as P  &lt;  0.05.

Results

The silhouettes of CLII T2 individuals were more attractive than those of the other groups (all Ps &lt; 0.001). The upper lip, lower lip, and the chin of these individuals were judged to be normally positioned in 69.5 per cent, 74.9 per cent, and 72.3 per cent of the assessments, respectively (all Ps &lt; 0.05).

Limitations

This study did not account for the psychological profile of the examiners, which may have affected the ratings.

Conclusions/implications

Orthodontic treatment with functional appliances is associated with a superior facial profile attractiveness. Functional treatment should be considered as a treatment option to improve the facial appearance of children with Class II division 1 malocclusion.

The Psychological Impact of Dental Aesthetics in Patients with Juvenile Idiopathic Arthritis Compared with Healthy Peers: A Cross-Sectional Study

This study aimed to assess whether dental aesthetics had a different impact on the psychosocial domains of adolescents with juvenile idiopathic arthritis (JIA) as compared with healthy peers. Fifty JIA patients and eighty controls aged between 13 and 17 years were enrolled. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered along with tools for the self-assessment of malocclusion and self-esteem. An objective evaluation of malocclusion severity was performed through a clinical evaluation with the Dental Aesthetic Index (DAI). The sample was divided according to the DAI stages of malocclusion severity; a two-way analysis of variance (ANOVA) was performed to assess whether there was a difference in the studied variables according to the malocclusion and the presence of JIA. The results showed no interaction between the malocclusion severity and the presence of JIA in all analyzed variables (all p > 0.05). According to the DAI stages, the Dental Self-Confidence domain of the PIDAQ and the Perception of Occlusion Scale showed statistically significant differences only within the controls (p = 0.027 and p = 0.014, respectively). Therefore, JIA adolescents seem to be less concerned about their dental aesthetics compared with healthy peers, and clinicians should take particular care when proposing orthodontic treatments aiming only to improve dental aesthetics.

Social media and orthodontic treatment from the patient’s perspective: a systematic review

Background

Social media are one of the most common and easily accessible ways of gaining information about orthodontic treatment.

Objective

The main objective of this study was to systematically search the literature and determine the various aspects of the interrelationship between social media and orthodontics from the patient’s perspective.

Search methods

Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were hand-searched for additional studies.

Selection criteria

Randomized clinical trials (RCTs), prospective, retrospective, and cross-sectional studies were included.

Data collection and analysis

Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate by the first two authors.

Results

One RCT, three retrospective, and four cross-sectional studies were deemed as eligible for inclusion in this review. The studies included patient’s statements in social media or results from questionnaires given to patients. The social media reported were with order of frequency: Twitter, YouTube, Facebook, Google+, Pinterest, and Instagram. The feelings the patients expressed seemed to be more positive than negative: enthusiasm, self-esteem and pleasure, excitement about the aesthetic result, excitement after braces removal but also antipathy, annoyances, reduced self-esteem, and impatience for removing mechanisms. In addition, one study referred to bullying through Twitter.

Limitations

The high amount of heterogeneity precluded a valid interpretation of the results through pooled estimates.

Conclusions and implications

This systematic review demonstrated that information about orthodontics, how the patient feels, and other psychosocial facets are spread through social media. It is intuitive that research relating to the effects and impact of orthodontic interventions should account not only for the physical impacts of treatment but also to encompass patient-centered outcomes.

Registration

The protocol of this study was not registered in publicly assessable database.

Conflicts of interest

None to declare.

Is social media the way to empower patients to share their experiences of dental care?

BACKGROUND

Social media present opportunities to understand patient experience and information needs. In this study, the authors use hypodontia as an example to explore social media use by dental patients and how this provides for understanding patient experience.

METHODS

The cross-sectional survey design involved systematic search of 6 social media online environments with hypodontia-related terms. The authors categorized records by using a coding system for user, type and theme of post, and target audience. The authors used a thematic framework approach to analyze qualitatively the word content of posts from people affected by hypodontia (nondentists).

RESULTS

The authors searched and identified 571 records and included 467 of them in their study. The authors analyzed the content of records from people affected by hypodontia (n = 176). Themes emerged about the experience of untreated hypodontia, treatment experience and outcomes, and decision making. Content analysis provided evidence about peer-to-peer communication, areas of information need, and desire for peer support.

CONCLUSIONS

Social media communities have responded to the need for information exchange and peer support by the public. Analysis of communications helped identify a need for dissemination of understandable information to patients and improved dentist awareness of patient needs.

PRACTICAL IMPLICATIONS

Clinicians should reassess understanding and information needs actively throughout treatment and identify support needs. Clinicians should refer patients to quality information sources and peer support groups.