Impact of Malocclusion on Oral Health-Related Quality of Life of 8-12 Years Old Schoolchildren in Southern Brazil

Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort

OBJECTIVE

To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors.

METHODS

Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables 'previous history of dental pain', 'self-rated oral health', clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI).

RESULTS

At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14-1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15-1.39), the presence of dental caries (PR 1.27; 95% CI 1.20-1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05-1.25).

CONCLUSIONS

The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.

Impact of parental attributes on the oral health-related quality of life of Brazilian preschool children

PURPOSE

Considering the importance of parental attitudes and their influence on children's oral health, it is important to know which characteristics may impact it. The aim of this population study was to evaluate the impact of the parental sociodemographic characteristics on the oral health-related quality of life (OHRQoL) of preschool children from southeastern Brazil.

METHODS

A population-based study was conducted with a sample of 321 children aged 2 to 5 years old who underwent a calibrated clinical oral examination to assess oral health status and their parents were asked to answer the two following questionnaires: (1) sociodemographic conditions and (2) Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Descriptive analysis, Mann-Whitney and Kruskal-Wallis tests and adjusted Poisson regression models were used.

RESULTS

Younger mothers (RP: 1.47; 95% CI: 1.11-1.95), lower household income (RP: 1.47; 95% CI: 1.11-1.96) and the presence of dental caries (RP: 2.28; 95% CI: 1.74-3.0) were more likely to have a negative impact on the OHRQoL B-ECOHIS total scores (P < 0.01).

CONCLUSION

The characteristics of mothers, such as age, schooling and salary, influenced the mean B-ECOHIS total score; however, paternal attributes were not associated with a negative impact on the children's quality of life. Also, dental caries and household income influenced the children's oral health-related quality of life.

Agreement between schoolchildren and their parents on rating the child's oral health-related quality of life

The perceptions of parents/caregivers regarding their children's oral health can influence the standard of care and decision-making regarding oral health. The children's perspective on their own oral health-related quality of life (OHRQoL) may differ from the parents/caregivers' views. This cross-sectional study aimed to analyze the agreement between the perceptions of parents/caregivers and schoolchildren regarding OHRQoL. It was conducted with a sample of children between 8 and 11 years old and their parents/caregivers from Pelotas. Children answered the Child Perceptions Questionnaire 8-10 (CPQ), and parents/caregivers answered the short form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Socioeconomic data were also collected. Children's dental caries, traumatic dental injuries, and malocclusions were examined. The Spearman's correlation test was performed. A total of 119 parents/caregivers-children pairs were included. There was an agreement between the total scores of parents/caregivers and children (0.2770; p = 0.003), in the oral symptoms (0.1907; p = 0.038), and functional limitations (0.2233; p=0.015) domains. The Bland-Altman graph showed an agreement between children's and parents/caregivers' OHRQoL total score, but there was an underestimation of approximately two points in the parents/caregivers' perception compared to the children's score. There was an agreement between the reports of parents/caregivers and children regarding children's OHRQoL.

Malocclusions and quality of life among adolescents: a systematic review and meta-analysis

BACKGROUND

Malocclusions in adolescents might have a negative impact on oral health-related quality of life (OHRQoL). Potential confounding variables (confounders) such as age, gender, caries, and socioeconomic status may skew the real relationship between malocclusions and OHRQoL.

OBJECTIVES

To analyse the effect of malocclusions in adolescents on OHRQoL, when controlled for potential confounders.

SEARCH METHODS

Five databases (PubMed, Cochrane Library, Cinahl, Scopus, and Web of Science) were searched up to 15 June 2022.

SELECTION CRITERIA

Studies in which OHRQoL in 10-19-year olds with and without malocclusions were compared.

DATA COLLECTION AND ANALYSIS

Screening, data extraction, and quality assessments were performed by four investigators independently. Risk of bias was assessed according to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) guidelines. To be included, studies had to control for confounders. Certainty of evidence was assessed with GRADE.

RESULTS

Thirteen cross-sectional studies with low and moderate risk of bias were included in the qualitative synthesis. Four of these were also included in the quantitative synthesis (meta-analysis). The 13 studies in the qualitative synthesis displayed a large variation among the indices used for malocclusion ratings, as well as in instruments measuring OHRQoL. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL. The four articles included in the quantitative synthesis (meta-analysis) measured malocclusions with DAI and OHRQoL with CPQ 11-14 short form. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL (RR/PR 1.15, 95% CI 1.12-1.18, 3672 participants).

CONCLUSIONS

There is moderate quality of evidence that malocclusions in adolescents have a negative impact on OHRQoL, after taking relevant confounders into consideration. Future studies should ideally use standardized measures for malocclusion ratings and OHRQoL.

REGISTRATION

PROSPERO. CRD42020186152.

Premature loss of primary molars: impact on the oral health-related quality of life of schoolchildren

PURPOSE

Evaluate the impact of the premature loss of primary molars due to caries on oral health-related quality of life (OHRQoL) in schoolchildren.

METHODS

A cross-sectional study was conducted with children eight to ten years of age at public schools in the city of Florianópolis selected through cluster sampling. The collection of the clinical data occurred in the school setting by four trained and calibrated examiners (Kappa > 0.7) DMFT/dmft index, PUFA/pufa index, accentuated overjet, and anterior open bite. Sex and age of the child and guardian's schooling (classified as ≤ 8 or > 8 years) were collected through a questionnaire answered by the guardians. OHRQoL was assessed using the Child Perceptions Questionnaire 8-10. The data were submitted to bivariate, multivariate, and hierarchical Poisson analyses.

RESULTS

A total of 1456 children participated in the study. The prevalence of premature tooth loss due to caries was 5.8% (n = 85). The prevalence of negative impact on OHRQoL was 47.4% (n = 691). Negative impact on OHRQoL was significantly associated with the premature loss of primary molars (p < 0.001) as well as the sex (girls), guardian's schooling (> 8 years) and the presence of untreated caries (p < 0.001).

CONCLUSION

The premature loss of primary molars due to caries was associated a negative impact on the OHRQoL of children eight to ten years of age. Negative impact is also associated with untreated caries, sex, and the level of schooling of guardians.

Orofacial dysfunction, nonnutritive sucking habits, and dental caries influence malocclusion in children aged 8-10 years

INTRODUCTION

Malocclusion is one of the most prevalent oral health problems and can affect self-esteem, social relations, and oral health-related quality of life. The present study aimed to evaluate associations between malocclusion and orofacial dysfunction, nonnutritive sucking habits, cavitated carious lesions, and anxiety in Brazilian children.

METHODS

An analytical cross-sectional study was conducted with a representative sample of 739 children aged 8-10 years. Parents or guardians provided sociodemographic data and information on the nonnutritive sucking habits of the children. The children answered the Revised Children's Manifest Anxiety Scale. Four trained examiners examined the children for the diagnosis of malocclusion (dental aesthetic index), dental caries (International Caries Detection and Assessment System), and orofacial dysfunction (Nordic Orofacial Test-Screening). The control variables were selected using a directed acyclic graph. Descriptive statistics were performed, followed by unadjusted and adjusted robust logistic regression analysis (P <0.05).

RESULTS

The following variables remained associated with the occurrence of malocclusion in the final model: nonnutritive sucking habits (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.25-4.08), orofacial dysfunction (OR, 1.56; 95% CI, 1.13-2.17), and cavitated carious lesion (OR, 1.39; 95% CI, 1.03-1.89).

CONCLUSIONS

Nonnutritive sucking habits, orofacial dysfunction, and cavitated carious lesions were associated with the presence of malocclusion in children aged 8-10 years.

Alterations of oral functions and dental malocclusions in adolescents: a cross-sectional population-based study

This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)'s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle's classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.

Oral health-related quality-of-life scores differ by socioeconomic status, mother's level of education, dental visits and severity of malocclusion in mixed dentition of eight-to-ten-year-old schoolchildren

Objective

To determinate the association among socioeconomic status subject’s mother’s level of educational attainment, dental visits, and malocclusion in mixed dentition with on the OHRQoL of eight-to-ten-year-old children.

Methods

A cross-sectional study conducted, in 2019, on Mexican children from households of different socioeconomic status (SES). The prevalence of malocclusion was evaluated using the Dental Aesthetic Index (DAI), while the SES of the participants’ households was evaluated using the three categories (corresponding to a high, middle, or low-income household) stipulated by the Consejo Nacional de Población (CONAPO or National Population Council). Oral Health-related Quality of Life (OHRQoL) was evaluated using the Child Perceptions Questionnaire (CPQ_8-10). Poisson regression models were performed for the analysis of the data obtained.

Results

A total of 79.4% of the subjects presented some type of malocclusion in mixed dentition, which was, by severity, as follows: definite (31.3%); severe (25.6%); and, very severe (22.5%). The Poisson regression model revealed a greater negative impact on the following four CPQ_8-10domains for children with severe/very severe malocclusion [RR]: oral symptoms [2.78]; functional limitations [2.72]; emotional well-being [2.59]; and, social well-being [3.99]. A greater impact on the four CPQ_8-10domains was found for children from a low-income household than for children from a high-income (p < 0.001) household. Furthermore, poor oral hygiene, lack of dental visits, and the mother’s level of educational attainment (<9 years) were found to have a negative impact on OHRQoL.

Conclusion

The findings of the present study demonstrated that the severity of malocclusion was associated with a greater negative impact on the OHRQoL of children, while those children who face greater health inequalities are likely to report a greater negative impact on their OHRQoL.

Impact of oral diseases on oral health-related quality of life: A systematic review of studies conducted in Latin America and the Caribbean

Background

We performed a systematic review of studies conducted in Latin America and the Caribbean (LAC) to assess the impact of oral diseases on oral health-related quality of life (OHRQoL).

Materials and methods

Searches were performed of the following PubMed, EMBASE, CINAHL, Scopus, and LILACS databases. Randomized clinical trials, quasi-experimental studies, cohort studies, case and control studies, and cross-sectional studies which included at least 100 participants evaluating the impact of oral diseases on OHRQoL were included. PROSPERO registry number: CRD42020156098.

Results

After exclusion of duplicates, 3310 articles were identified, 40 of which were included in this review. 90% of the studies were conducted in Brazil. The most commonly used OHRQoL measuring instruments were CPQ 11–14 (n = 9), ECOHIS (n-8) and B-ECOHIS (n = 8). The study designs included 32 cross-sectional, 2 cohort and 6 case and control studies. Most of the studies were conducted in children (n = 25) and adolescents (n = 9). Most studies identified an impact on OHRQoL in children, adolescents and adults with oral diseases. Moreover, greater oral disease severity had a greater impact on OHRQoL.

Conclusions

Most studies in LAC report a negative impact of diseases on OHRQoL. More longitudinal studies are required to confirm the results of these studies.

Randomized trial of a photography-aided behavioural intervention to reduce risk factors for caries and malocclusion in high-risk infants

OBJECTIVE

To assess the efficacy of a photography-aided behavioural intervention in reducing risk factors for dental caries and malocclusion in high-risk infants.

MATERIALS AND METHODS

In this randomized trial conducted in a maternity hospital, 55 mothers of recently born infants at high risk of developing oral diseases were allocated to either the intervention (n = 28) or usual care (n = 27). The intervention arm received the same usual care plus an enhanced, behaviour-oriented, photography-aided, two-stage (0 and +6 months) educational programme addressing nutritional, behavioural, lifestyle and familial factors that affect child's oral health. The primary outcome was the proportion of children classified as being at a 'low risk' of developing dental caries at the age of 12 months using a modified score based on the Caries-risk Assessment Form of the American Academy of Pediatric Dentistry. Secondary outcomes included risk factors for malocclusion, such as duration of exclusive breastfeeding, pacifier use and bottle-feeding and/or sippy cup usage.

RESULTS

At 12 months, the proportion of children considered at low risk for dental caries was significantly higher in the intervention group compared to usual care (71% vs 15%, respectively, relative risk = 4.82, 95% confidence interval = 1.89-12.3, p < 0.001). The median duration of exclusive breastfeeding in the intervention group was 1.7 times higher than in the control arm (5 months vs 3 months, p = 0.03).

CONCLUSION

Altogether, our findings provide evidence that a low-cost, two-stage preventive strategy using photographs to deliver a stronger visual impact might significantly reduce the incidence of risk factors for dental caries and malocclusion in 12-month-old children.

The relationship between malocclusion and oral health-related quality of life among adolescents: a systematic literature review and meta-analysis

BACKGROUND

Malocclusion is a deviation from an anatomical norm that occurs in various populations. Evidence shows that it has physical and psychological implications as well as an influence on the patient's oral health-related quality of life (OHRQoL). Self-perception of oral health plays an important role in the understanding of malocclusion's influence on the quality of life. Malocclusion has been reported to impair a patient's function, appearance, interpersonal relationships and psychological well-being.

OBJECTIVES

The aim of this study was to investigate whether adolescents aged between 11 and 18 years with malocclusion are at increased risk for having a high level of OHRQoL compared with those without malocclusion.

SEARCH METHODS

The Ovid Medline, Embase and Scopus databases were used to identify studies measuring the association between malocclusion and HRQoL.

SELECTION CRITERIA

Only cross-sectional studies were included, and the following inclusion criteria were used: subjects were systemically healthy; data were available for untreated malocclusion and OHRQoL; malocclusion was measured by Dental Aesthetic Index and Index of Orthodontic Treatment Needs; OHRQoL was assessed by Child Perception Questionnaire, Child Oral Health Impact Profile and Child Oral Health Impact Profile; and the paper was published in English.

DATA COLLECTION AND ANALYSIS

Data were extracted by two independent reviewers. The Appraisal tool for Cross-Sectional Studies (AXIS) was used to establish the risk of bias, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence quality assessment tool was used to assess the impact of malocclusion on adolescents across studies.

RESULTS

The initial search yielded 530 papers. Eleven cross-sectional studies were included in the meta-analyses, and all data describing the relationship between malocclusion and OHRQoL were gathered via a structured questionnaire. Our results showed that malocclusion is linked to decreased OHRQoL in children and adolescents aged between 11 and 18 years in continuously analysed studies. However, in dichotomously analysed studies, it was shown that young people without malocclusion are linked to decreased OHRQoL.

CONCLUSIONS

Adolescents with severe levels of malocclusion might have among the worst levels of OHRQoL. The effects of malocclusion on OHRQoL were influenced by the age of the adolescents as well as by their culture and environment.

REGISTRATION

PROSPERO (CRD42020178657).

Incisor Molar Hypomineralization and Quality of Life: A Population-Based Study with Brazilian Schoolchildren

Aim

To assess the impact of incisor molar hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perception of students and their parents/caregivers.

Materials and Methods

This is a cross-sectional population-based study with 463 Brazilian students aged 11-14 years. OHRQoL was measured using the Child Perceptions Questionnaire (B-CPQ_11-14ISF: 16) applied to students and the short version of the Parental-Caregiver Perceptions Questionnaire (B-P-CPQ) applied to parents/caregivers. The diagnosis of MIH followed the European Academy of Paediatric Dentistry criteria modified in 2019. Caries experience (ICDAS II), malocclusion (DAI), and socioeconomic and demographic factors were assessed as confounding factors for impact on OHRQoL. Cluster analysis was carried out to dichotomize the negative impact into greater and lesser impact. The chi-square test and Poisson regression were performed (p < 0.05) to verify associations between quality of life and MIH, adjusted for confounding variables.

Results

The prevalence of MIH was 10.8%. Multivariate regression demonstrated that caries experience was the only oral disease that impacted OHRQoL according to students' self-perception in the functional limitation domain (PR = 1.82; 95% CI = 1.20-2.77) and in the total questionnaire score (PR = 1.59; 95% CI = 1.00-2.51). However, according to the perception of parents/caregivers, in addition to caries experience, which affected OHRQoL in the oral symptoms (PR = 3.57; 95% CI = 1.71-7.414) and emotional well-being domains (PR = 1.71; 95% CI = 1.08-2.69), as well as in the total B-P-CPQ score (PR = 1.67; 95% CI = 1.01-2.76), malocclusion also affected OHRQoL in the social well-being domain (PR = 1.50; 95% CI = 1.07-2.10) and in the total questionnaire score (PR = 1.54; 95% CI = 1.11-2.15).

Conclusion

According to students and their parents/caregivers' perception, incisor molar hypomineralization did not influence OHRQoL of the studied sample.

Association between 2 indexes for evaluating malocclusion in the mixed dentition

INTRODUCTION

This study aimed to associate 2 indexes for evaluating malocclusion in the mixed dentition.

METHODS

A population-based cross-sectional study was conducted involving 743 children aged 8-10 years, divided into early and late mixed dentition. The Dental Aesthetic Index (DAI) and criteria proposed by Grabowski were used to evaluate malocclusion. Associations between the DAI (outcome variable) and the other independent variables (gender, race, and mixed dentition stage) were analyzed using logistic regression models. Simple logistic regression models were constructed, estimating the crude odds ratios with the respective 95% confidence intervals (CIs). The variables with P < 0.20 in the simple analyses were tested in multiple logistic regression models, estimating adjusted odds ratios with the respective 95% CIs.

RESULTS

We found that 84.01% (185/220) of the diagnoses were coincidental between the Grabowski Index and DAI in patients without malocclusion. In contrast, 59.80% (439/734) of the patients were diagnosed by both indexes (Grabowski and DAI) with malocclusion. Children with malocclusion, diagnosed by the Grabowski Index, were 5.85 (P = 0.0001 and 95% CI: 4.08-8.39) times more likely to show malocclusions when diagnosed by the DAI.

CONCLUSIONS

DAI and the criteria proposed by Grabowski were expressed differently in relation to malocclusion in the mixed dentition. This study suggests the importance of specific criteria for the evaluation of malocclusion at this stage of development.

Oral health and happiness in adolescents: A cohort study

OBJECTIVES

To investigate the influence of oral health conditions, socioeconomic status and dental care utilization on subjective happiness and identify the factors associated with changes in happiness among adolescents.

METHODS

Data were collected in 2012 and 2014. Oral health conditions were evaluated by performing clinical examinations; socioeconomic status and dental care utilization were assessed by using a questionnaire. The participants answered the Child Perceptions Questionnaire 11-14 for the evaluation of the impact of these variables on oral health-related quality of life (OHRQoL). Happiness was assessed using the Brazilian version of the Subjective Happiness Scale. For longitudinal data analysis, a mixed-effect model of linear regression was used to assess the factors related to happiness and multinomial logistic regression to appraise prospective changes in happiness.

RESULTS

A total of 1134 12-year-old adolescents were examined at baseline (response rate: 93%), and 770 were reevaluated after 2 years (retention rate: 68%). The adolescents who lived in households with lower equivalized income and greater overcrowding, had not visited the dentist in the later 6 months, had a higher number of cavitated carious lesions, and reported a higher impact on OHRQoL in 2012 presented lower happiness levels. Additionally, the adolescents with a higher number of decayed, missing or filled teeth and who reported a higher impact on OHRQoL were more likely to belong to the most unfavourable happiness trajectory categories.

CONCLUSIONS

The presence of dental caries, socioeconomic conditions, dental care utilization and OHRQoL influence happiness in adolescents. Having more teeth affected by dental caries and worse self-perception in early adolescence can lead to a decrease in happiness.

Impact of anterior occlusal conditions in the mixed dentition on oral health-related quality-of-life item levels

OBJECTIVES

To evaluate the impact of anterior occlusal conditions in the mixed dentition on item-level analysis of oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

A population-based cross-sectional study of 787 children aged 8 to 10 years was conducted. The Child Perceptions Questionnaire (CPQ8-10) was used to evaluate OHRQoL, and the analysis of item levels was performed on CPQ8-10 domains. Anterior occlusal characteristics were diagnosed according to the Dental Aesthetic Index criteria. Individual analyses were performed relating the outcome as independent variables. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).

RESULTS

No associations were found with regard to anterior occlusal characteristics (P < .001) after the variables of the previous determinants were adjusted for multivariate analysis. However, the following variables were significantly associated with negative impact on OHRQoL item levels: sex, in oral symptoms (OR = 1.42; CI, 1.07-1.89) and emotional well-being (OR = 1.34; CI, 1.00-1.79); race, in oral symptoms (OR = 1.48; CI, 1.10-1.98), emotional well-being (OR = 1.54; CI, 1.14-2.06), and social well-being (OR = 1.34; CI, 1.00-1.80); and family income in functional limitation (OR = 1.46; CI, 1.06-2.02), emotional well-being (OR = 1.71; CI, 1.21-2.42), and social well-being (OR = 1.59; CI, 1.14-2.21).

CONCLUSIONS

Anterior occlusal conditions did not affect the levels of OHRQoL items.

Gender-specific associations of malocclusion traits with oral health-related quality of life in a Finnish adult population

AIM

The aim of this cross-sectional study was to investigate gender-specific associations of different malocclusion traits with oral health-related quality of life (OHRQoL) among Finnish adults.

MATERIAL AND METHODS

The study material comprised 1885 subjects from the Northern Finland Birth Cohort 1966. A clinical oral examination including registration of occlusion was carried out in connection with a 46-year follow-up examination. The 14-item Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Subgroups with increased/decreased overjet, deep bite, open bite, lateral crossbite, and scissor bite were selected for further analysis. Subjects with normal occlusion were selected to form the normal occlusion group. Differences between subgroups and the normal occlusion group were evaluated for both genders separately. Education, number of teeth, caries, and orthodontic treatment history were chosen as confounding variables. Multivariate Poisson regression analyses were conducted to assess the effect of independent variables on OHRQoL.

RESULTS

After adjustments, decreased overjet, open bite, and scissor bite were associated with higher OHIP severity in women (P < 0.01). In men, deep bite was associated with higher OHIP severity (P = 0.007). Different malocclusion traits had associations with some OHIP dimension either in men or women. Orthodontic treatment history had a positive effect on OHRQoL in both genders.

CONCLUSION

The associations of malocclusion traits with OHRQoL differed between genders, with women reporting more impacts. Deviations from normal occlusion were generally found to have a negative impact on OHRQoL, but most of the adults with malocclusion seem to adapt to their condition.

Relationships of Dental Caries and Malocclusion with Oral Health-Related Quality of Life in Lithuanian Adolescents Aged 15 to 18 Years: A Cross-Sectional Study

There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged 15 to 18 years. A survey in a representative sample of adolescents included a clinical examination to assess dental health status using the DMFT (Decayed, Missing, and Filled Permanent Teeth) index, and malocclusion using the Index of Complexity, Outcome, and Need (ICON). The Child Perceptions Questionnaire (CPQ) was used to evaluate respondents’ OHRQoL. Negative binomial regression was fitted to associate the clinical variables with the CPQ scores. A total of 600 adolescents were examined. The overall mean DMFT score was 2.7. A need for orthodontic treatment was detected among 27.7% of adolescents. Subjects with caries lesions (DMFT > 3) had higher CPQ scores in the domains of functional limitations and social wellbeing (relative risks were 1.35 (95% confidence interval: 1.09–1.67) and 1.30 (1.03–1.64), respectively), while subjects with a need for orthodontic treatment (ICON > 43) had higher CPQ scores in the domains of emotional wellbeing and social wellbeing (relative risks were 1.81 (1.40–2.22), and 1.69 (1.34–2.14), respectively). It was concluded that both dental caries and malocclusion have negative relationships with OHRQoL in adolescents above 15 years, but their effects occur differently in each OHRQoL domain.

Comparison of Oral Health-Related Quality of Life in Treated and Non-Treated Orthodontic Patients

Introduction:

Malocclusion as an oral disorder can cause negative impact on individuals oral conditions, social interactions and self-esteem.

Aim:

The aim of this study was to compare oral health-related quality of life (OHQoL) of patients who had received fixed orthodontic treatment and patients who had not received fixed orthodontic treatment.

Materials and Methods:

Data were collected from 178 participants attended at professional dental office (mean age 22.71 years) in two groups (experimental and control). The experimental group comprised of 90 subjects who were in the retention phase, after their orthodontic treatment, and the control group comprised of 88 untreated subjects. Oral Health Impact Profile (OHIP-14) was used to assess the patients oral health related quality of life (OHQoL).

Results:

The control group had significantly higher OHIP-14 scores than experimental group (p < 0.001). Participants with treatment need reported a significantly greater negative impact on the overall OHRQoL score.

Conclusion:

Subjects with no history of orthodontic treatment had more negative oral health related quality (OHRQoL), than subjects who had completed orthodontic treatment. Dental malocclusion has significant negative impact on OHRQoL.

Socioeconomic inequalities in oral health-related quality of life in adolescents: a cohort study

PURPOSE

Socioeconomic inequalities are recognized as a major problem with people in low socioeconomic groups having worse subjective oral health outcomes, including oral health-related quality of life (OHRQoL). However, only a few longitudinal studies assessed the impact of contextual and individual socioeconomic determinants in adolescents' OHRQoL. We estimate the impact of socioeconomic inequalities on adolescents' OHRQoL over a 2-year period.

METHODS

This study followed up a random sample of 1134 12-year-old schoolchildren for 2 years in Brazil. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-year-old Children (CPQ11-14) at baseline and follow-up. Participants were clinically examined for dental caries, gingival bleeding, and malocclusion. The schoolchildren's parents answered a questionnaire regarding socioeconomic status, social capital, and adolescents' use of dental service. Socioeconomic contextual variables were collected from official city publications. Multilevel linear regression models fitted the associations between socioeconomic factors and overall CPQ11-14 scores over time.

RESULTS

A total of 747, 14-year-old adolescents were reassessed for OHRQoL (follow-up rate of 66%). Adolescents with lower mean income school's neighborhood (P < 0.05), household income (P < 0.05), and maternal schooling (P < 0.05) had higher overall CPQ11-14 scores. Female sex, attending a dentist by toothache, dental caries, and malocclusion were also associated with higher overall CPQ11-14 scores.

CONCLUSIONS

Adolescents from low socioeconomic background reported worse OHRQoL at 2-year follow-up compared to those from high socioeconomic background. Actions toward health inequalities need to address socioeconomic factors in adolescence.

Family Affluence Based Inequality in Oral Health-Related Quality of Life in a Population of Lithuanian Adolescents

Background: The social inequalities in oral health have had increasing attention in recent years. The present study aimed to explore the impact of family affluence on Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 years. Methods: The cross-sectional, population-based study included a representative sample of 881 adolescents aged 11–18 years (mean = 15.55; SD = 1.51) randomly selected from 20 schools in Lithuania. The schoolchildren completed questionnaires to evaluate their OHRQoL using a Lithuanian version of the Child Perceptions Questionnaire (CPQ). The adolescents’ family affluence was indirectly assessed by inquiring whether they possessed various modern life items. In dental examination, the severity of malocclusion was predetermined by the Index of Complexity, Outcome, and Need (ICON). The relationship among variables was examined employing the negative binomial regression and the path analysis. Results: The sum score of CPQ as a whole and the sum scores of all four domains were significantly associated with family affluence, indicating higher OHRQoL among adolescents from more affluent families. The severity of malocclusion had a significant association with emotional and social well-being domains of OHRQoL only. Conclusion: This study evidences the family affluence based inequality in OHRQoL among Lithuanian adolescents.

The Role of Low-Intensity Biostimulation Laser Therapy in Transforming Growth Factor β1, Bone Alkaline Phosphatase and Osteocalcin Expression during Orthodontic Tooth Movement in Cavia porcellus

Objective The aim of this study is to analyze the low-intensity laser therapy (LILT) biostimulation mechanism as adjuvant therapy within orthodontic treatment as a means of accelerating bone remodeling by transforming growth factor β1 (TGF-β1), bone alkaline phosphatase (BALP), and osteocalcin (OSC) expression.

Materials and Methods An analytical experimental method incorporating a posttest only randomized the control group design. The sample consisted of 24 3- to 4-month-old male Cavia porcellus weighing between 300 and 500 g divided into three groups (group 1: control, group 2: received orthodontic treatment, and group 3: received orthodontic treatment with irradiation LILT). LILT biostimulation at a dose of 4 joule/cm ² was performed daily for 3 min on the mesial-distal labial-palatal of the first dextra and sinistra incisor for 2 weeks. The TGF-β1, BALP, and OSC expression was subjected to immunohistochemical analysis. An analysis of variance with multiple comparison, a Tukey's honestly significant difference test, a Kruskal–Wallis test, and a Wilcoxon–Mann–Whitney test were all performed ( p < 0.05).

Results TGF-β1 expression was significantly different ( p = 0.047; p < 0.05) in the tension area, but not in the compression side ( p = 0.154; p > 0.05). BALP expression was significantly different in both the tension ( p = 0.009) and compression areas ( p = 0.005; p < 0.05). OSC expression was significantly different ( p = 0.034; p < 0.05) in the tension side, but not in the compression area ( p = 1.194; p > 0.05).

Conclusion LILT biostimulation can increase TGF-β1, BALP, and OSC expression during orthodontic tooth movement.

Modification and psychometric evaluation of the child perceptions questionnaire (CPQ11-14) in assessing oral health related quality of life among Lithuanian children

Background

Oral health related quality of life (OHRQoL) research among children and adolescents in Lithuania is just starting and no measures have been validated to date. Therefore, this study aimed to validate a Lithuanian version of the full (37 items) Child Perceptions Questionnaire (CPQ_11–14) within a random sample of children aged 11 to 14.

Methods

A cross-sectional survey among a randomly selected sample of schoolchildren (N = 307) aged 11 to14 was conducted. An anonymous questionnaire included the full CPQ_11–14 and items on global life satisfaction, oral health and oral life quality self-rating. The questionnaire was translated into Lithuanian using translation guidelines. In addition, an item on the oral pain was modified identifying the pain location. Standard tests (Cronbach’s α, construct validity and discriminant validity), supplemented with both exploratory and confirmatory factor analyses, were employed for psychometric evaluation of the instrument. The questionnaire was also tested by comparison students’ and their parents’ (N = 255) responses about oral symptoms and functional limitations.

Results

The modified Lithuanian version of CPQ_11–14 revealed good internal consistency reliability (Cronbach’s alpha for the total scale was 0.88). The measure showed significant associations with perceived oral health status and oral well-being, as well as with global life satisfaction (p < 0.01). Discriminant validity of the instrument was approved by comparison of children’s groups defined by self-reported caries experience and malocclusion. Factor analysis revealed a complex structure with two or three factors in each of four domains of the CPQ_11–14. Excellent or acceptable levels of indices of model fitting with the given data were obtained for oral symptoms, functional limitations and emotional well-being domains, but not for the social well-being domain. A significant association between child and parental responses was found (intraclass correlation coefficient was 0.56 and 0.43, correspondingly in domains of oral symptoms and functional limitations).

Conclusion

The Lithuanian version of the CPQ_11–14 (with a modified item that identifies location of oral pain) appears to be a valid instrument to be used in further studies for measuring OHRQoL among 11 to 14 year old children in Lithuania.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0701-5) contains supplementary material, which is available to authorized users.

Impact of Malocclusions on the Oral Health-Related Quality of Life of Early Adolescents in Ndola, Zambia

The study aimed to assess the prevalence of malocclusions and its impact on oral health-related quality of life (OHRQoL) among early adolescents in Ndola, Zambia. It used a random sample of 384 primary school children aged 12–14 years. The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) was used to assess OHRQoL, and the Dental Aesthetic Index (DAI) was used to examine dentofacial anomalies. The chi-square test was used to study whether there was a statistically significant association between variables and multivariate logistic regression for the influence of sociodemographic and malocclusions on OHRQoL. Statistical significance was set at p < 0.05. Participants' sociodemographics were 53.6% female, 41.7% aged 13 years, and 43.5% from grade six. The overall reported impact on OHRQoL was 11.7%, which was significant (p < 0.001) by age and sex, and higher in females than males. The overall prevalence of malocclusions was 27.9%, which was significant (p=0.005) by sex, and higher in males than females. Children with malocclusions reported significant (p < 0.001) negative oral health impact compared to the children without malocclusions. Spacing, diastema, and crowding were most prevalent malocclusions that showed clear inverse association with OHRQoL. The study findings provide indications that malocclusions are negatively associated with OHRQoL among Zambian early adolescents.

Relationship Between Orthodontic Treatment Need and Oral Health-Related Quality of Life among 11⁻18-Year-Old Adolescents in Lithuania

The aim was to examine the relationship between orthodontic treatment need and Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 across gender and age groups. A representative cross-sectional study of 911 adolescents aged 11–18 (mean (M) = 15.53; Standard Deviation (SD) = 1.52) was conducted in 26 public schools. The schoolchildren completed the Child Perceptions Questionnaire to evaluate their OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to evaluate the severity of malocclusion. The strength of association between variables was evaluated via negative binomial regression estimating the ratio of sum score means (RSSM). A worse OHRQoL score was associated with a higher grade of IOTN; however, only the Emotional and Social wellbeing domains were significantly affected by malocclusion (RSSM = 1.158; 95% Confidence Interval (CI): 1.083–1.237 and RSSM = 1.205; 95% CI: 1.114–1.304, respectively). The significant association was identified only among females (RSSM = 1.264; 95% CI: 1.176–1.359). A significant association was observed in all age groups for Emotional and Social well-being domains but only in the oldest age group for Oral Symptoms and Functional Limitations domains. Conclusions: Malocclusion has a negative impact on the OHRQoL of young people with emotional and social aspects being the most affected. Girls and older adolescents suffered from malocclusion more than boys and their younger counterparts.

The impact of crown fracture in the permanent dentition on children's quality of life

BACKGROUND/AIM

Among the diseases related to oral health, traumatic dental injuries (TDI) can lead to pain, loss of function and aesthetic problems, with physical, emotional and social consequences for children and their families. The aim of this study was to investigate the relationship between enamel fracture and enamel-dentin fracture with oral health-related quality of life (OHRQoL).

MATERIAL AND METHODS

This cross-sectional study had a representative sample of 1589 children between 8-10 years of age from public schools. The OHRQoL was obtained through the Child Perceptions Questionnaire (CPQ_8-10 ), which is a questionnaire validated for Brazilian children. Clinical data were collected by 4 calibrated examiners (Kappa > 0.7) using the Decay, Missing, Filled Teeth (DMFT) Index, Dental Aesthetic Index (DAI) and TDI. A socio-economic questionnaire was sent to the caregivers to be answered at home. Descriptive statistics and Poisson regression with prevalence ratio (PR) and 95% confidence interval (CI) were used for statistical analysis.

RESULTS

The prevalence of TDI was 10.6%, and among these 10.3% who had an impact on the OHRQoL, it was due to enamel-dentin fracture. Children with enamel-dentin fracture had (PR 1.35; 95% CI 1.07-1.70) higher prevalence of impact on the OHRQoL. Children with enamel fracture had no impact on the OHRQoL (P = .254).

CONCLUSION

Enamel fracture had no significant impact on children's quality of life, while enamel-dentin fracture did have an impact on quality of life.

Assessing Quality of Life using the Oral Health Impact Profile (OHIP-14) in Subjects with and without Orthodontic Treatment need in Chennai, Tamil Nadu, India

INTRODUCTION

Dental ailments like malocclusion affect not only the functional ability and aesthetic appearance of the person but also the psychological aspect of the individual.

AIM

The aim of the present study was to the find relationship between quality of life and dental malocclusion among school going adolescents in Tamil Nadu, India.

MATERIALS AND METHODS

A cross-sectional study was conducted among 342 subjects of age range 14-19 years. Oral health status was assessed using WHO basic oral health survey (2013), orthodontic treatment needs according to Index of Orthodontic Treatment Needs (IOTN) and oral health quality of life using Oral Health Impact Profile-14 (OHIP-14).

RESULTS

A total of 342 subjects were interviewed and examined. The mean DMFT score was 1.86±2.77. A 203 (59.4%) did not require any orthodontic treatment while 139 (40.6%) had orthodontic treatment need ranging from mild to very severe. It was seen that malocclusion affected some aspects of OHIP-14 significantly namely functional limitation, psychological discomfort and psychological disability. The comparison of OHIP-14 scores between treatment needed and treatment not needed was highly significant (p<0.001).

CONCLUSION

Hence, it is stated that there is an urgent need to educate the school children and in turn their parents regarding the malocclusion for its treatment to prevent any effect on quality of life of the young adults.