Dissatisfaction with dentofacial appearance and the normative need for orthodontic treatment: determinant factors

Patients' perceptions matter: Risk communication and psychosocial factors in orthodontics

INTRODUCTION

Effective risk communication is essential for achieving patient-centered oral health care, but the limited understanding of patients' subjective perceptions of orthodontic-related risks hinders this process. This study aimed to investigate adults' awareness, concerns, and risk-avoidance behaviors about long-term orthodontic risks, exploring their relationship with psychosocial factors.

METHODS

We included 498 adult patients (mean age, 27.3 ± 6.8 years; women, 75.5%) during their initial visits to the orthodontic department at a hospital in Chengdu, China. Participants' understanding of orthodontic risks was gauged before and after exposure to the Oral Health Education Comics (OHEC), a specifically designed digital tool. Concurrently, we used logistic regression models to investigate the associations between patients' depression, anxiety, self-esteem, perfectionism, and dentofacial esthetics with risk perceptions.

RESULTS

Approximately 79.5% of participants initially reported low awareness of orthodontic risks, with most knowledge from online sources. Notably, the percentage of participants with high awareness increased to 64.8% after OHEC. The negative facial soft-tissue change was most concerning for participants: 53.4% showed high concerns, and 28.1% showed high avoidance. Furthermore, linear regression indicated positive associations between depression (β = 0.42 [95% confidence interval {CI}, 0.07-0.77]) and anxiety (β = 0.76 [95% CI, 0.35-1.18]) with orthodontic risk concerns, whereas risk avoidance was positively associated with depression (β = 0.62 [95% CI, 0.27-0.97]), anxiety (β = 1.09 [95% CI, 0.68-1.50]), and perfectionism (β = 0.24 [95% CI, 0.02-0.46]).

CONCLUSIONS

Findings emphasize the imperative of streamlined risk communication in orthodontics. By incorporating comprehensible tools such as OHEC and integrating psychosocial evaluations, more refined patient-practitioner communication and psychosomatic-based dental care can be achieved.

Socioeconomic status in life course is associated with dental appearance dissatisfaction

The present study aimed to investigate the prevalence of dissatisfaction with dental appearance among 24-year-old Brazilian adults and the associated factors in life course. A subsample (n = 720) of the 1982 Pelotas Birth Cohort in southern Brazil was investigated at the ages of 15 and 24 years using clinical (caries and periodontal) examinations and interviews. The outcome was dissatisfaction with dental appearance at the age of 24 years. Covariate variables included socioeconomic factors, oral health, and dissatisfaction with general appearance collected during different periods of life. Poisson regression models with robust variance were applied. The prevalence of dissatisfaction with dental appearance was 43.5% (95%CI: 39.8-47.1). Individuals with downward income mobility (PR = 1.22, 95%CI: 1.07-1.79) and those always poor (PR = 1.21, 95%CI: 1.00-1.57) presented a higher prevalence of dissatisfaction with their dental appearance even after oral health variables and dissatisfaction with general appearance were controlled for. Moderate/severe malocclusion at 15 years (PR = 1.34, 95%CI: 1.13-1.59), highest experience of untreated dental caries at 24 years (PR = 1.82, 95%CI: 1.46-2.27), and dental pain experience at 24 years (PR = 1.29, 95%CI: 1.22-1.75) were associated with the outcome. Also, the prevalence of dissatisfaction with dental appearance was 20% higher (PR = 1.20, 95%CI: 1.01-1.43) among those dissatisfied with their general appearance. Our findings demonstrated a high prevalence of dissatisfaction with dental appearance among young adults. Lifetime economic disadvantage and dental problems (malocclusion at 15 years, untreated dental caries at 24 years, and dental pain at 24 years) were associated with dissatisfaction with dental appearance among young adults.

Effect of weight satisfaction on adolescent facial and dental satisfaction

PURPOSE

To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction.

METHODS

A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis.

RESULTS

A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06-1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08-1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80-0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80-0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83-0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01-1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01-1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66-0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55-0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction (p = 0.001).

CONCLUSIONS

While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

Orthognathic Surgery Trending: Retrospective Ten Years Cases Analysis in Nineveh Province, Iraq

AIMS

The study aimed at analyzing patient's case sheets in regard to the incidence of skeletal discrepancy present in cases and its relation with the demographic profile of the sample. All these are chronicled for more than 10 years periods.

METHODOLOGY

This is a retrospective study analysis of the orthognathic case sheets for more than 10 years period. The total numbers of patients are 678. Patient's case sheet was already prepared by the Multi-Disciplinary Team Orthognathic Surgery Clinic in Al-Salam Teaching Hospital, which is the only authorized committee in Nineveh Health Directorate.

RESULTS

The highest age percentage is between (18 and 27 y/76%). Angle class III cases are the uppermost cases (36%) from the total. A significant P value is clear at the level ≤0.05 and ≤0.01 between surgery type and discrepancy in anterior segmental osteotomies (upper and lower) which is performed in bi-maxillary protrusion cases and Angle class II cases (0.01**). Similarly, anterior segmental osteotomies (upper jaw only) which are indicated in both open bite and Angle Class II cases documented as a statistically significant P value (0.02*). The positive correlation is shown in all variables with the disharmony or facial discrepancies. Esthetic and beauty as causes for treatment recorded more than function in relation to time series.

CONCLUSION

This study documents that patients with skeletal class III accounted for the largest percentage (64%) in the study group. A high increase in patients number seeking treatment for their discrepancy is obvious with time from 2009 till 2022.

Assessment of Perception and Barriers toward Orthodontic Treatment Needs in the Saudi Arabian Adult Population

Patients’ decisions regarding orthodontic treatment are influenced by a variety of factors, such as their subjective opinions of how their oral cavity looks, age, gender, educational level, and income. The present study aimed to measure the orthodontic treatments needs for the Saudi Arabian population, and also to report potential barriers towards it. It is an observational study with cross sectional design. Data was collected from nationals and residents living in Saudi Arabia and who are at least 18 years old. A total of 1184 adult patients (880 females and 304 males) were included in this study. The population for the study was reached and chosen using a non-probability snowball sampling method. A validated and reliable questionnaire was distributed to the participants electronically through google form. Inferential statistics was applied using Pearson Chi Square test. p value < 0.05 was considered significant. The majority of the sample (73.2%) exhibited a favorable attitude toward orthodontic treatment. Most participants including male and female gender wanted orthodontic treatment primarily to have their protruding teeth fixed. The proportion of persons who cited chewing difficulty as the reason they needed orthodontic treatment was strongly influenced by the monthly income variable (p = 0.005). Cost and time of orthodontic therapy were the biggest obstacles to undergoing treatment, accounting for 34.5% and 19.5%, respectively. There was highly significant difference between the underlying medical conditions and the age and monthly income variables (p = 0.000). Based on the findings of the present study, it can be concluded that protruding teeth are the most important treatment needs perceived by the Saudi population, followed by spacing in between teeth, crowding of teeth, and unaesthetic smile. Cost of the orthodontic treatment was identified as the most significant barrier to the treatment needs, followed by long duration of orthodontic treatment, and pain.

Relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion

OBJECTIVE

This study aimed to evaluate the relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion.

METHODS

A cross-sectional study developed with 543 adolescents from 11 to 13 years of age and severe malocclusion was selected. Dental aesthetic index (DAI) diagnosed the malocclusion and selected the groups with greater severity (DAI 3 and 4). Aesthetic concern was assessed using the oral aesthetic subjective impact scale (OASIS) and considered an outcome variable. The global negative self-evaluation (GSE) evaluated self-esteem. The variables were analysed using Poisson multiple regression and the model adjustment determined by the Akaike information criterion (AICC). The effect of each variable on OASIS was expressed as a prevalence ratio (PR) with 95% confidence intervals. The analyses were performed using the R program with a significance level of 5%.

RESULTS

A significant association was observed between aesthetic concern scores and self-esteem (p<.05). Individuals with low self-esteem had OASIS scores 14% higher (PR: 1.14; 95% CI: 1.08-1.21). There was no significant association between OASIS and gender and age (p>.05).

CONCLUSIONS

Self-esteem modulates how the individual perceives malocclusion. Adolescents with severe and very malocclusion and low self-esteem have greater aesthetic concerns.

Meneghim M, Vedovello SAS. Correlation between malocclusion and history of bullying in vulnerable adolescents

OBJECTIVES

To assess the correlation between malocclusion and a history of bullying.

MATERIALS AND METHODS

A cross-sectional study of 494 adolescents aged 12 to 15 years was conducted. The National School Health Survey questionnaire (PeNSE 1 and 2) was used to determine history of bullying by identifying the victim and the abuser. Variables were evaluated based on the individual (age), environment (income, father's and mother's education, housing, government assistance, and parents' occupation), social and emotional well-being (CPQ11-14 domains), self-perceived need for orthodontic treatment, and clinical conditions (crowding, diastema, maxillary and mandibular overjet, and anterior open bite). Data were analyzed by Spearman correlation and by multivariate analysis, which allowed graphical representation of the eight variables studied in only two dimensions.

RESULTS

There was no correlation between bullying and variables related to the individual and the environment. Maxillary overjet and self-perception related to the need for orthodontic treatment were important to explain the data variability.

CONCLUSIONS

Malocclusion did not correlate with bullying history. However, increased maxillary overjet influences adolescent self-perception, suggesting a potential condition for bullying events.

Esthetic impact of maxillary midline diastema and mandibular crowding in children in the mixed dentition

INTRODUCTION

This study aimed to investigate the esthetic impact of mandibular crowding and maxillary midline diastema in children in the mixed dentition.

METHODS

The sample for this cross-sectional study comprised 785 children, aged 8-10 years, in the late mixed dentition. Mandibular crowding and maxillary midline diastema were evaluated clinically with the Dental Aesthetic Index. Mandibular crowding and maxillary midline diastema were evaluated to determine tooth size-arch length discrepancies. The sample was stratified as group 1, children without maxillary midline diastema or mandibular crowding (n = 177); group 2, children with maxillary midline diastema (n = 256); group 3, children with mandibular crowding (n = 208); and group 4, children with maxillary midline diastema and mandibular crowding (n = 144). The subjective esthetic impact was evaluated using the Orthodontic Aesthetic Subjective Impact Score. Descriptive and exploratory analyses of the data were performed. A generalized linear model was applied, adjusted for the possible confounding variables (age, gender, and race) with a significance level of 5% because the Orthodontic Aesthetic Subjective Impact Score did not meet the assumptions of analysis of variance.

RESULTS

Children in groups 2 and 3 showed greater esthetic concern than group 1 (P <0.05). Children in groups 2 and 3 did not show a significant difference with children in group 4 (P >0.05).

CONCLUSIONS

Children with mixed dentition with mandibular crowding or maxillary median diastema reported significantly more esthetic concern than children without these conditions.

Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial

BACKGROUND

The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine.

OBJECTIVE

To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants.

SUBJECTS AND METHODS

A total of 44 people, aged 17-49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)-a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg's Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study.

RESULTS

All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001).

LIMITATIONS

Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error.

CONCLUSIONS

The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects.

CLINICAL TRIAL REGISTRATION

This study was not registered.

PROTOCOL

The protocol was not published before trial commencement.

Esthetic impact of malocclusions in the anterior segment on children in the mixed dentition

INTRODUCTION

To assess the esthetic subjective effect of malocclusions in the anterior segment on children in the mixed dentition.

METHODS

A cross-sectional study was carried out with a population-based sample of 787 children aged 8-10 years in the late mixed dentition (n = 787). Orthodontic Aesthetic Subjective Impact Score determined the esthetic subjective effect. For assessing the malocclusions in the anterior segment (anterior crowding, anterior spacing, diastema, anterior open bite, and anterior maxillary overjet), the following Dental Aesthetic Index criteria were used. Sex, family income, and education level were used as control variables. The variables were analyzed using a simple logistic regression model, estimating crude odds ratios. The variables with P <0.20 in the simple analyses were tested in multiple regression models, estimating adjusted odds ratios with the respective 95% confidence intervals.

RESULTS

Increased overjet was 1.54 (95% CI: 1.08-2.17) times more likely to cause greater esthetic concern (P <0.05), especially in girls (P <0.05).

CONCLUSIONS

Increased overjet negatively affected children's esthetic self-perception in the mixed dentition.

How is orthodontic treatment need associated with perceived esthetic impact of malocclusion in adolescents?

INTRODUCTION

The purpose of this research was to evaluate the esthetic impact of orthodontic treatment need in adolescents.

METHODS

This cross-sectional study was performed with 1172 adolescents aged 12 (n = 638) years and 15 (n = 534) years from Salvador, Bahia, Brazil. The esthetic impact was the following outcome variables: Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale. The normative orthodontic treatment need was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and by the Dental Aesthetic Index (DAI). Logistic regression models were adjusted, estimating crude odds ratio with the respective 95% confidence intervals. The variables with P ≤0.20 in the individual analyses were tested in multiple logistic regression models, remaining the variables with P ≤0.05.

RESULTS

The results showed a statistically significant association for the esthetic impact (Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale) when assessing the normative orthodontic treatment need by the DAI (P <0.05). However, there was no significant association between subjective esthetic impact and normative needs when using the IOTN-DHC (P >0.05).

CONCLUSIONS

DAI was more associated with the adolescents' esthetic concern than IOTN-DHC and should be the Index of Orthodontic Treatment Need to be selected to complement the patient's self-perception.

Association between maloclusion and self-perception of oral aesthetics in adolescents

Aim: To evaluate the aesthetic self-perception capacity of adolescents from public schools regarding the presence of oral alterations from malocclusions. Methods: Cross-sectional and quantitative study with 374 adolescents between 16 and 18 years old, belonging to public schools in the city of Parnaíba, Piauí. The adolescents were separated by gender (male and female) and examined for malocclusions. The problem identified for each participant was recorded for later comparison of the influence of its presence with aesthetic self-perception. Then, all adolescents, including those who demonstrated normal occlusion during the clinical evaluation, answered a questionnaire containing eight questions about their perception of their own smile and its impact on their interpersonal relationships. Self-perception was also analyzed by comparing the responses of those with normal occlusion with that of malocclusion individuals. Student's t-tests were used to verify if there was a difference between the groups. Results: The most prevalent malocclusions after clinical examination were midline deviations, crowding and diastemas, and the ones that most scored in the adolescents' perception were crowding, misalignment and diastemas. Conclusion: The adolescents were able to perceive the aesthetic alterations resulting from malocclusions, being determinants of dissatisfaction when smiling. They were not ashamed to smile, did not consider that the ideal smile would improve their self-esteem and that misaligned teeth would not interfere with flirting and interpersonal relationships.

Dental Cingulum and Position of Fixed Orthodontic Appliance as Source of Morphological and Therapeutic Identifiers: An Unusual Case Report

Orthodontic records, such as photographs, radiographs, and dental casts, provide information useful for identification purposes because it may reveal important morphological, therapeutic, and pathological dental identifiers. Among these identifiers, the type and position of orthodontic appliances figure as distinctive tools for human identification. In this context, the present study aims to report an uncommon case of identification of a putrefied body, found near to a forest region in Brazil. The postmortem (PM) examination showed that the victim had part of a fixed orthodontic appliance installed in the maxillary and mandibular dental arches. To identify the body, relatives of the potential victim presented orthodontic examinations containing panoramic radiography and photographs of the orthodontic treatment. The body was identified based on the analysis of the radiographs and photographs that confirmed the presence of the orthodontic appliances observed PM. More specifically, the identification was supported by the analysis of bracket bonding position of the maxillary and mandibular incisors and the presence of distinctive morphological traits of the canines and incisors, as well dental roots observed radiographically. The present case highlights the importance of orthodontic records as a source of morphological dental identifiers for cases in which only unrestored teeth are available.

The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying, among Brazilian teenagers

INTRODUCTION

Orthodontic treatment aims at oral health and restoration of function as main objectives, however, psychological and social effects end up being the main reason for the demand for treatment.

OBJECTIVE

To determine the association between the oral health-related quality of life (OHRQoL), the need for orthodontic treatment and bullying among Brazilian teenagers.

METHODS

This was a cross-sectional epidemiological study. To assess the malocclusion, the Dental Aesthetic Index was used. And the Oral Health Impact Profile-14 was used to analyze the OHRQoL. The Kidscape questionnaire was used to investigate cases of bullying. The following variables were also included: previous orthodontic treatment and a desire to fix the teeth to improve one's appearance. Multivariate analysis was performed using logistic regression considering the poor OHRQoL as a response variable.

RESULTS

815 teenagers participated in the study. There was a statistically significant association between oral health-related quality of life and the variables: previous orthodontic treatment (p= 0.0270), desire to fix the teeth (p< 0.0001), sex (p= 0.0309), history of being a victim of bullying (p< 0.0001), frequency of bullying episodes (p= 0.0170), and consequences of bullying (p< 0.0001). The following were considered as risk factors for poor OHRQoL: lack of previous orthodontic treatment (OR = 2.191) and negative consequences of bullying (OR = 3.042).

CONCLUSION

The need for orthodontic treatment was not associated with the OHRQoL; however, bullying and previous orthodontic treatment had a statistically significant association with this variable.

Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis

AIM

To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents.

METHODS

Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I² statistic and a random effect model was employed. Summary effect measures were calculated as differences in means.

RESULTS

The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26-30 vs. 31-35.

CONCLUSIONS

Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Impact of Orthognathic Surgery on Quality of Life in Patients with Dentofacial Deformities

The aim of this investigation was to determine the impact of orthognathic surgery on quality of life in patients with dentofacial deformities at immediate presurgery and at 3-week, 3-month, and 6-month intervals following the surgery. Subjects included forty-three 18–40-year-old Iranian orthognathic patients who were referred to private offices in Isfahan. Data collection was performed using the 22-item Orthognathic Quality of Life Questionnaire (OQLQ). Participants completed the questionnaire prior to surgery and 3 weeks, 3 months, and 6 months after it. Differences and correlations were calculated by the two-tailed t-test, ANOVA with Repeated Measure test, and the Pearson correlation coefficient. The results showed significant reduction returned to baseline in OQLQ mean scores and aesthetic, awareness, and social subdomains in all 3 intervals after surgery. However oral function domain showed an increase at T₂ and then a decrease at next intervals. Maximum and minimum effect size were observed in aesthetic (ES = 0.7) and oral function (ES = 0.3) domain, respectively. Based on the finding of this study, in 6-month interval after surgery, orthognathic surgery causes significant improvements in quality of life in patients with dentofacial deformities as assessed in emotional, psychological, oral function, and social domains and maximum changes occurred in emotional domain.

Influence of sense of coherence on adolescents' self-perceived dental aesthetics; a cross-sectional study

Background

Sense of coherence (SOC) is a psychosocial factor capable of influencing perception of health, improving one’s ability to manage life. It is the central construct of salutogenesis. SOC allows for identification and mobilization of resources to effectively manage or solve problems, promoting health and quality of life. Using Wilson-Cleary’s conceptual model we hypothesized that SOC might contribute to self-perception of dental aesthetics. The aim of this study was to investigate whether SOC levels were related to self-perception of dental aesthetics against assessed normative orthodontic treatment need among adolescents.

Methods

A cross-sectional study was conducted with 615 male and female adolescents aged 12 to 15 years. Data collection comprised socio-demographic and socio-economic characteristics, SOC (SOC 13), self-perceived dental aesthetics (Oral Aesthetic Subjective Impact Scale), and assessment of orthodontic treatment need (Dental Aesthetic Index). Statistical analysis involved Pearson’s chi-square test, Kruskal-Wallis test, Mann-Whitney test and multiple linear regression. Spearman’s correlation coefficient was calculated for the determination of the strength of correlations among the numerical variables. The level of significance was set at 5% (p < 0.05).

Results

50.1% of the participants were classified as having a high SOC (≥ median). Overall, SOC was associated with self-perceived dental aesthetics (p = 0.048). In the adolescents with no orthodontic treatment need, those with a low SOC perceived their dental aesthetics more negatively than those with high levels of SOC. The multiple regression analysis demonstrated an inverse relationship between SOC and: 1) age (p = 0.007), SOC being higher in the younger age group; 2) self-perceived dental aesthetics (p = 0.001), a higher SOC being associated with those who had a positive dental self-perception.

Conclusions

SOC was associated with self-perceived dental aesthetics and adolescents with a high SOC were more likely to perceive their dental aesthetics more positively. SOC did not seem to influence self-perception of dental aesthetics in adolescents who were clinically assessed as having an orthodontic treatment need, however, in those where there was no orthodontic treatment need, a low SOC was associated with a negative self-perception of dental appearance.

Impact of Malocclusion on the Quality of Life of Brazilian Adolescents: A Population-Based Study

The objective of this study was to evaluate the impact of malocclusion on the quality of life (QOL) of adolescents in Brazil. We carried out a cross-sectional study in a sample population of 1015 schoolchildren aged 12 to 15 years from São Luís, Maranhão, Brazil. The explanatory variable was malocclusion, evaluated on the basis of the normative need or the adolescent’s self-perceived need for dental treatment. Normative need for dental treatment was determined by professional diagnosis, made on the basis of Angle’s classification, the Dental Aesthetic Index, and other morphological deviations (e.g., posterior crossbite, posterior open bite, and deep overbite). We analyzed the impact of malocclusion on the QOL using the Portuguese version of the Oral Health Impact Profile-14. Associations were estimated by using the prevalence ratio (PR) in Poisson regression analysis, with hierarchized modeling. An alpha of 5% was adopted as the criterion for statistical significance. The QOL of adolescents was impacted by malocclusion, classified by a normative need for treatment according to the Dental Aesthetic Index (PR = 1.27; 95% confidence interval [CI] = 1.03–1.56) or by the self-perceived need for treatment (PR = 2.54; 95% CI = 1.81–3.56). Certain sociodemographic variables, including the head of the family (PR = 1.52; 95% CI = 1.02–2.23), greater educational level of the head of the family (PR = 0.32; 95% CI = 0.17–0.61), and female sex (PR = 1.40; 95% CI = 1.05–1.89), had negative associations with QOL. We conclude that malocclusion has a negative impact on the QOL of adolescents, associated with socioeconomic conditions and the cosmetic effects of malocclusion.