Psychosocial impact of dental esthetics on quality of life in adolescents

Oral issues and childhood stress in eight-to-ten-year-old schoolchildren: a case-control study

OBJECTIVE

The aim of the present study was to investigate whether oral problems, harmful oral habits, and sociodemographic factors are associated with the occurrence of stress in schoolchildren.

MATERIALS AND METHODS

A case-control study nested within a cross-sectional study was conducted with a sample of 375 schoolchildren eight to ten years of age in the city of Diamantina, Brazil. The case group (with childhood stress) and control group (without childhood stress) were matched for age and sex at a 1:4 ratio (75 cases to 300 controls). Data collection involved the self-administration of a questionnaire by parents/caregivers addressing sociodemographic characteristics and the child's history of harmful oral habits. The children answered the Child Stress Scale (CSS) and underwent a clinical oral examination to determine the presence/absence of dental caries, malocclusion, and traumatic dental injuries. Data analysis involved the calculation of frequencies, the chi-square test, and conditional logistic regression (95% CI; p ≤ 0.05).

RESULTS

The final adjusted conditional logistic regression model showed that dental caries (OR = 1.78, 95% CI: 1.01 - 3.14, p = 0.044) and biting objects (OR = 1.81, 95% CI: 1.02 - 3.22, p = 0.041) remained associated with stress in the schoolchildren analysed.

CONCLUSION

The present results showed that children with dental caries and the habit of biting objects were more likely to have childhood stress.

CLINICAL RELEVANCE

The study allows paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and serves as a guide for decision-making related to oral problems in schoolchildren.

Chin reinforcement using the hyaluronic acid injectable filler VYC-20L and VYC-25L

BACKGROUND

The chin is an essential element of the facial unit and influences how people perceive facial aesthetic appeal. Hyaluronic acid (HA) gel injections are tried-and-true therapies for regenerative therapies with a record of success in efficacy and safety.

AIMS

To determine the best type of concentration of HA and way of injection for deep and superficial planes of chin.

MATERIALS AND METHODS

VYC-20L and VYC-25L (Juvederm Voluma XC® Juvéderm Volux®; Allergan plc) are 20- and 25-mg/mL HA gels with lidocaine, respectively, were injected with cannulas and needles on the bone, respectively.

RESULTS

Chin reinforced respecting the measures with good contouring. No serious complications. Patient was satisfied with results.

DISCUSSION

We advise using VYC 20L superficially above the muscle or with a cannula for injection, and we recommend using VYC 25L in the supraperiosteal plane.

An Assessment of the Subjective Psychological and Social Effects of Malocclusion-Related Dental Aesthetics and Its Influence on Body Self-Image and Oral Health-Related Quality of Life in Young Adults

INTRODUCTION

 Malocclusion has a psychological impact related to the patient's age. It also influences the quality of life. This research aims to test the null hypothesis that there is no association between the self-perceived psychosocial impacts of dental aesthetics with the severity of malocclusion, oral health-related quality of life (OHRQoL), and self-image of the body in young adults seeking orthodontic treatment.

MATERIALS AND METHODS

A convenience sample of young adults between 19 and 30 years old was selected for the study. The severity of malocclusion and orthodontic treatment needs were evaluated using the Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile-14 (OHIP-14), and Body Satisfaction Scale (BSS) were used to evaluate the self-perceived effects of malocclusion.

STATISTICAL ANALYSIS

 The Kruskal-Wallis test is used to analyze the distribution of components with different grades of DAI. Spearman's correlation test evaluated the correlation between independent variables and their domains. The study utilized stepwise multiple linear regression analysis to assess the predictive value of independent factors on the PIDAQ and its domains.

RESULTS

 A total of 181 subjects with a mean age of 24.4 ± 1.5 years, 42% males and 58% females, participated in this study. There was a significant correlation (p < 0.05) between all variables (OHIP-14, DAI, and BSS) and PIDAQ. There were significant correlations between the independent variables and the total score of PIDAQ (R2 = 0.16), psychological impact (R2 = 0.09), and social impact (R2 = 0.18), as well as dental self-confidence (R2 = 0.21) and aesthetic concern (R2 = 0.16).

CONCLUSION

In young adults, the self-perceived impact of dental aesthetics is moderated by the severity of malocclusion, oral health-related quality of life, and body satisfaction. The null hypothesis is rejected.

Electromyographic Assessment of Muscle Activity in Children Undergoing Orthodontic Treatment-A Systematic Review

Background: Surface electromyography (sEMG) can provide an objective and quantitative image of the functional state of neuromuscular balance in the stomatognathic system. The objective of this systematic review is to examine current scientific evidence regarding the effects of orthodontic treatment on muscle electromyographic (EMG) activity in children. Methods: The search strategy included the PubMed, PubMed Central, Web of Science, Scopus, and Embase databases. The inclusion criteria were studies assessing EMG muscle activity in children undergoing orthodontic treatment compared with untreated children. The Cochrane risk-of-bias tool (RoB2) and the Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the studies. The quality of evidence assessment was performed using GRADE analysis. The PRISMA diagram visually represented the search strategy, as well as screening and inclusion process. Results: The search strategy identified 540 potential articles. Fourteen papers met the inclusion criteria. Six studies were judged at a low risk of bias. The certainty of evidence was rated as moderate to low, according to the GRADE criteria. Studies showed alterations in EMG muscle activity in children undergoing orthodontic treatment. Conclusions: Orthodontic treatment appears to affect muscle activity in children undergoing orthodontic treatment. However, the quality of evidence is low and, therefore, it is not possible to definitively state this effect. Further long-term studies are needed to confirm the findings of this review. Study protocol number in PROSPERO database: CRD42023491005.

Socio-economic and gender dynamics influence on the parental decision-making process for children's orthodontic care - A study in Madinah, Saudi Arabia

OBJECTIVES

To investigate the socio-economic and personal factors that impact parental decisions regarding orthodontic treatment for their children in Madinah, Saudi Arabia.

MATERIALS AND METHODS

A digital self-administered questionnaire was employed to collect data from 414 parents, focusing on their motivations and barriers that influence their decision-making process regarding orthodontic treatment.

RESULTS

Income level was the most significant factor in orthodontic decisions. Parents with higher incomes were twice as likely to choose orthodontic treatment for esthetic reasons compared to parents with middle incomes. The main incentive for seeking treatment was getting advice from dental professionals, with 60% of participants rating it as the most important factor. 34.5% of respondents identified cost as the main barrier, with middle-income parents being 151% more inclined to perceive it as a significant barrier compared to high-income parents. Gender dynamics revealed that mothers exhibited 48.9% greater concern regarding treatment costs compared to fathers, whereas fathers placed 2.105 times more importance on the orthodontist's reputation than mothers.

CONCLUSION

Income levels, along with other socio-economic factors and gender dynamics, have a significant influence on parental decisions regarding orthodontic care. Personalized consultations that address these variations are crucial for improving communication between patients and practitioners and increasing the accessibility of treatment.

Dental anxiety, Quality of Life and body image: gender differences in Italian and Spanish population

BACKGROUND

Dental anxiety is an excessive and irrational negative emotional state experienced by population; the dental anxiety is common throughout the lifespan and is an obstacle to improving oral health behaviors and outcomes. The aim of this study was to assess gender differences in dental anxiety and to investigate if oral health impacts patients' Quality of Life and the perception of their body image.

METHODS

The sample consisted of 366 subjects selected in Italy and Spain (January 2021-September 2021). For this study, data were gathered using Google Forms (Google LLC, Mountain View, CA, USA). Data were collected including the Dental Anxiety Scale (DAS), Oral Health Impact Profile (OHIP-14) questionnaires and Body Uneasiness Test.

RESULTS

Women showed higher scores than men for the dental anxiety. The regression analysis showed that gender, age, and Oral Health Impact are predictors of "dental anxiety." A borderline significance emerges for the independent variable body uneasiness.

CONCLUSIONS

The dental anxiety is widespread in the population, with a higher prevalence among women and increases with increasing age. It can negatively affect patients' Quality of Life, well-being, and self-esteem. These results underline the importance of addressing both individual and group strategies for preventing or treating dental anxiety.

Body Image and Psychological Impact of Dental Appearance in Adolescents with Malocclusion: A Preliminary Exploratory Study

BACKGROUND

Body image and psychosocial functioning represent central challenges during adolescence and early adulthood. Malocclusion, defined as an irregularity in the alignment of the teeth, is known to negatively influence psychological outcomes. The current study aimed to elucidate the role of malocclusion, together with age, gender, and dental class, in body image and psychological functioning.

METHODS

A total of 126 participants aged from 12 to 19 years old (mean: 15.87, SD: 2.35, female participants: 52.4%, male participants: 47.6%) were recruited. Participants were visited at the University Hospital of Messina, Italy, and completed a sociodemographic questionnaire, the Body Image Concern Inventory (I-BICI), and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ).

RESULTS

Significant correlations were found between age, dental class, the BICI, and the PIDAQ. In particular, age showed a positive and significant correlation with PIDAQ-total score. The correlations between occlusal status and the BICI variables were all significant and positive. All correlations between occlusal status and the PIDAQ variables were all significant and positive, except for dental self-confidence. The correlations between the variables of the PIDAQ and BICI instruments were all significant and positive, except for dental self-confidence, where the directions were significant and negative. Moreover, age, gender, and occlusal status predicted BICI and PIDAQ scores. Age was a positive predictor for PIDAQ self-confidence, gender for BICI and PIDAQ total scores, along with dysmorphic symptoms, social impact, psychological impact, and aesthetic concerns. Several significant gender differences were highlighted by the analyses, with higher scores in the female group on all the BICI variables, except symptom interference, and all the PIDAQ variables, except dental self-confidence.

CONCLUSIONS

Malocclusion appeared to play a central role in the psychological, representational, and psychosocial life of the participants. This research suggests that malocclusion and dental issues influence the psychological, representational, and psychosocial life of adolescents. Further research is required to examine the psychological impact of dental problems.

The Perceptions of Dental Professionals and Laypeople to Facial Aesthetics and Mal-Occlusion in Central India Population

Introduction

Dental professionals play an important role in an individual's appearance which can affect the perception of others that can vary greatly depending on their educational and socioeconomic background.

Aim and Objective

The purpose of this study was to determine an insight of recognizing ability of dental professionals and laypersons toward facial aesthetics with different types of orthodontic malocclusion.

Materials and Methods

A questionnaire-based study was conducted on 90 dental professionals and 90 laypersons. The perceptions differences between groups were assessed using visual analogue scale on 11 photographs. Kolmolgorov-Smirnov was used for normality test.

Results

The perceptions of facial aesthetics showing various malocclusions were significantly different between dental professionals and laypersons.

Conclusion

The dental professionals and layperson perceptions regarding the facial particularly in central Indian population are significantly different for most of the malocclusion types.

Psychosocial Impact of Malocclusion and Self-Perceived Orthodontic Treatment Need among Young Adult Dental Patients

OBJECTIVES

 To investigate the psychosocial impact of malocclusion and self-rated and clinician-rated orthodontic treatment need on young adult patients in the Western Province of Saudi Arabia.

MATERIALS AND METHODS

 Eighteen- to 30-year-old patients (n=355) attending a tertiary dental care facility were included. Three instruments were used for data collection: (1) Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ), (2) aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC), self-rated and clinician-rated, and (3) clinician-rated Dental Aesthetic Index (DAI). Data analysis included descriptive statistics, Kruskal-Wallis test, Mann-Whitney U-test, and multiple linear regression analysis.

RESULTS

 Females were significantly more impacted than males on all domains with the exception of the dental self-consciousness domain. For both the self-rated and clinician-rated IOTN and the DAI, it was found that the more severe the malocclusion, the higher the impact on all domains except for the dental self-confidence domain, which showed that patients with mild malocclusions were more affected than those with moderate and severe malocclusions. Significant associations were observed between independent variables (age, sex, self-rated IOTN, and DAI) and total PIDAQ score.

CONCLUSIONS

 Perceived psychosocial impact of dental aesthetics is directly related to severity of malocclusion (self-rated and clinician-rated) for all domains of the PIDAQ accept the DSC, and females showed higher psychosocial impact than males. Clinicians should consider the impact of malocclusion and certain demographic characteristics on the psychosocial well-being of an individual when determining the orthodontic treatment need.

The associations of dental aesthetics, oral health-related quality of life and satisfaction with aesthetics in an adult population

AIM

The aim of this study was to investigate the gender-specific associations between dental aesthetics, oral health-related quality of life (OHRQoL), and satisfaction with dental aesthetics in an adult population.

MATERIALS AND METHODS

The study population consisted of 1780 individuals (822 males and 958 females) from the Northern Finland Birth Cohort 1966 (NFBC1966). Dental aesthetics were evaluated from digital 3D dental models using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Layperson and orthodontist panels evaluated the dental aesthetics of a smaller sample (n = 100). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14) questionnaire. Satisfaction with dental aesthetics was asked with one separate question. Gender-specific analyses consisted of Mann-Whitney U-tests and Spearman's correlation coefficients.

RESULTS

More than half of the population had an aesthetically acceptable occlusion, and most of the individuals were satisfied with the aesthetics. The most severe aesthetic impairments were associated with the psychological dimensions of OHIP-14. There were significant but weak associations of AC and satisfaction with aesthetics, and satisfaction with aesthetics and OHRQoL. Significant gender differences were found, men having higher mean AC scores but women reporting lower OHRQoL.

CONCLUSION

At the population level, most of the individuals were satisfied with their aesthetics, despite different dental aesthetic conditions. The most severe aesthetic impairments were associated with decreased psychological well-being, women reporting more impacts compared to men.

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.

Age and Gender Are Associated with the Component of Psychosocial Impact of Dental Aesthetics Questionnaire in Young People: A Cross-Sectional Study

(1) The aim of the study was to investigate the association between age, gender, and the component of psychosocial impact of dental aesthetics (PIDAQ) in Malaysian young people. (2) Cross-sectional data on the PIDAQ (comprised of dental self-confidence, social impact, psychological impact, and aesthetic concern variables) of Malaysian youth (n = 1425) recruited through multi-stage sampling were analyzed for mediation and moderated mediation analyses using the PROCESS macro on SPSS software. (3) Participants (mean age 16.0 ± 2.8) represented 54.8% of girls and 45.2% of boys. In the mediation model, psychological impact and aesthetic concern completely mediated the effects of social impact on dental self-confidence. In the moderated mediation model, social impact directly influenced dental self-confidence amongst participants at one standard deviation below the sample mean age and among boys. However, psychological impact completely mediated the influence of social impact on dental self-confidence amongst participants at the sample mean age and at one standard deviation above the sample mean ages, and among girls. Neither age nor gender moderated the effect of aesthetic concern on dental self-confidence. (4) Age and gender moderated the influence of social impact and psychological impact on dental self-confidence.

Is self-harm among orthodontic patients related to dislike of dentofacial features and oral health-related quality of life?

OBJECTIVES

To investigate the relationship between self-reported self-harm and dislike of dentofacial features and oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

Anonymous, self-reporting questionnaires were completed by 699 school children (aged 13-14 years), representing over 1% of the age group in Amman, Jordan. Participants were invited from 23 randomly selected schools in 10 educational directorates. OHRQoL was assessed using the Child Perception Questionnaire (CPQ 11-14). Self-harm was assessed using a constructed self-reporting questionnaire. The relationship between OHRQoL and self-harm was assessed and significant findings were identified at probability of α = 0.05.

RESULTS

Over one-quarter of schoolchildren (26.9%, n = 88) admitted self-harming behavior. Self-harm was reported to be due to dislike of dentofacial appearance among 12.9% of participants (n = 90). Higher CPQ 11-14 total scores and individual dimension scores were associated with the presence of self-harm (P < .001). High self-harm incidence was reported among participants who had dentofacial features that affected appearance (P < .001). Among subjects admitting self-harm, the frequency of self-harming behavior ranged from once to over 10 times per year.

CONCLUSIONS

Significant relationships were found between self-harm and dislike of dentofacial features and OHRQoL.

The impact of malocclusion on the oral health related quality of life of 11-14-year-old children

Background

The relationship between malocclusion and the oral health related quality of life (OHRQoL) of children needs to be explored further as existing literature presents conflicting evidence. This study aims to determine the association between malocclusion and OHRQoL of 11–14-year-old children.

Methods

This cross-sectional study was conducted among 250 caregiver/child dyads seeking orthodontic consultation at a tertiary care hospital. The OHRQoL was assessed using child perception questionnaire for 11–14-year-old children (CPQ_11–14) and the severity of malocclusion was assessed using the Dental Aesthetic Index (DAI). CPQ_11–14 scores ranged from 0 to 64, with lower scores representing better quality of life. Analysis of variance (ANOVA) was used to assess differences between domain and total CPQ_11–14 scores.

Results

The mean CPQ_11–14 score was 19.89 ± 9.8. Mean scores for the oral symptoms, functional limitations, emotional well-being, and social well-being domains were 5.26 ± 3.22, 3.67 ± 3.58, 3.98 ± 3.89 and 2.08 ± 2.98, respectively. Normal or slight malocclusion was seen in 37.6%, definite malocclusion was seen in 22.4%, severe malocclusion in 15.2% and handicapping malocclusion in 24.8% of the subjects. In comparisons by pairs, it was found that children with handicapping malocclusion had significantly (p < 0.05) higher scores for the social well-being domain as compared with children having normal/minor malocclusion, indicating a poorer quality of life.

Conclusion

Handicapping malocclusion had a significant negative impact on the social well-being domain of OHRQoL among 11–14-year-old children in this population.

Effect of malocclusion on jaw motor function and chewing in children: a systematic review

Objective

To investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children.

Materials and methods

Systematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively.

Results

The searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function.

Conclusions

Based on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general.

Clinical relevance

Comprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-04356-y.

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain)

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010.

Psychological and Social Effects of Oral Health and Dental Aesthetic in Adolescence and Early Adulthood: An Observational Study

Background: Is well known that oral health and dental aesthetic have significant effects on the sociality of human beings. The aim of the present study was to assess some aspects of oral health with possible repercussions in adolescent and youth, with particular reference to gender differences. Methods: A total of 190 subjects with female prevalence (F = 62.6%, M = 37%) and ages between 14 and 29 years old (Mean = 23.8; SD = 3.27) participated. Evaluation was carried using standardized instruments to assess quality of oral life (PIDAQ), negative impact of oral conditions (OHIP-14), and self-esteem (Rosenberg Self Esteem Scale). Correlational and difference analyses and linear regressions were performed. Results: Significant gender differences were found in terms of gender, in reference to variables such as self-confidence and convictions. Positive correlations emerged between psychological impact and social impact, aesthetic concern and social impact, convictions and self-confidence, oral health with psycho-social impact, and aesthetic concern, self-esteem with oral health. Inverse correlations emerged between psycho-social impact and self-confidence, aesthetic concern and self-confidence, oral health, and self-confidence. Multivariate linear regression indicated relations between age and psychological impact, sex and self-confidence, crooked teeth and conviction. Conclusions: The impact of oral health on the psychological well-being of young people is relevant. These factors, if considered within clinical practice, can improve the quality of life of the subject.

Alagille syndrome: Oral manifestations-A case report

The Alagille syndrome (AGLS) is a rare condition, with few studies reported in the literature, especially in the field of dentistry. It consists of a disease involving many systemic problems and specific facial features. The liver and heart are the most intensely affected organs, and depending on the severity, it may be necessary to perform transplants. It is an autosomal dominant disease with a variable expressivity, and its prevalence is 1/100,000 live births. Dental findings are conflicting. Some authors claim that dental anomalies occur only in deciduous dentitions; however, there is evidence that permanent teeth can also be affected, as will be described in this paper, through a case report of a patient diagnosed with AGLS, who sought out the Dentistry service at Pontifical Catholic University of Minas Gerais, complaining of a strong stain in her teeth, severe dental crowding, and a facial appearance of prognathism.

Factors affecting dental self-confidence and satisfaction with dental appearance among adolescents in Saudi Arabia: a cross sectional study

Background

Dental appearance affects facial beauty, social interaction and psychological well-being particularly among adolescents. The aim of the current study was to determine factors affecting adolescent dental self-confidence and satisfaction with dental appearance in Saudi Arabia.

Methods

A cross-sectional study was conducted in the Eastern Province of Saudi Arabia among 3500 students attending intermediate and high schools. Data was collected from 2637 students using the translated Arabic version of the psychosocial impact of dental esthetics questionnaire (PIDAQ) in addition to questions about smile esthetics satisfaction and demographic variables including; gender, age, school grade, and parental level of education. Statistical analysis was performed by using logistic regression to assess the effect of demographical variables on PIDAQ and its domains at 5% significance level.

Results

About 80% of the participants were satisfied or somewhat satisfied with their smiles. Tooth alignment and tooth color were the most cited reasons for adolescents’ dissatisfaction about their smile, 34% and 33% respectively. Females and participants’ fathers’ university education figured in a statistically significant way regarding higher PIDAQ and aesthetic concerns. Females were 70%, and those with fathers’ university education were 22% more likely to have a negative psychological impact. Females expressed aesthetic concerns nearly two times more than males. Participants whose fathers possessed university education had an aesthetic concern 1.25 times more compared to those whose fathers had no school or limited school education. Females and those with mothers who had university education were less likely to have positive dental self-confidence.

Conclusions

Most adolescents exhibited satisfaction with their own smiles. Smile dissatisfaction in the remaining participants was related to teeth alignment, color and shape. Females were more concerned with dental esthetics and smile satisfaction than males. Females and participants whose fathers had a university education exhibited higher psychosocial impact than males and those with or without school education. However, males showed greater self-confidence in their dental aesthetics.

Oral Health Impact Profile in Orthodontic Patients with Ectopic Canine: A Prospective Clinical Intervention of Four Treatment Modalities

This study evaluated the oral health-related quality of life (OHRQoL) in Saudi subjects with ectopic canine, severe crowding, and class I normal occlusion. Moreover, we assessed the differences among orthodontic treatment modalities (OTM) in the ectopic canine group. Study design: Retrospective and prospective evaluation. A total of 96 subjects were assessed for OHRQoL using the Oral Health Impact Profile, English version (OHIP-16). Initial comparison of the baseline data of ectopic canine subjects was made with severe crowding (>8 mm) and class I normal occlusion with the matched number and age of the subjects in later groups. Moreover, a comparison of OHIP-16 scores among four OTM in the ectopic canine group, baseline, 1 day, and 28 days after treatment were performed. OHIP-16 scores of ectopic canine, severe crowding, and class I normal occlusion group were 33.06, 33.09, and 26.43, respectively. Subjects with ectopic canine and severe crowding reported a significantly greater negative impact in terms of embarrassment, avoiding smiling, and lack of self-confidence. OHRQoL had no significant changes among the four OTM groups (p > 0.05). Untreated malocclusion had a significant negative impact on OHRQoL. The negative impact was seen in several domains 1 day after treatment, and gradual improvement was noted 28 days after treatment.

Self-Perception of Dental Esthetics among Dental Students at King Saud University and Their Desired Treatment

Objective

Dental esthetic procedures are popular worldwide, and dentists are responsible for recommending several treatment options to their patients. To do this competently, dentists must have an educated opinion of their features. Therefore, we aimed to evaluate the self-perception of dental esthetics among male and female dental students and assess its effect on their desired treatment. Methodology. We conducted a questionnaire-based cross-sectional study involving 450 male and female dental students from five academic years with different grade point averages (GPAs) and monthly household incomes. The questionnaire comprised four sections. The subjects selected their teeth-color preferences using a commercial shade guide. The outcomes were presented using descriptive statistics and were compared with Pearson's chi-square test. The level of statistical significance was set at a p-value of 0.05.

Results

Female students (52%) showed a significantly higher preference for changing their tooth color (shade B1 was desired most often), whereas male students reported a higher need for orthodontic treatment and ceramic veneers (p < 0.0001 and p=0.002). Fifth-year students were more satisfied with their teeth color as compared with 1st-year students (p=0.047). High-GPA students showed significantly lower confidence regarding their smiles (p=0.030). A high percentage of students (39.1%) with household incomes of less than 10,000 SR preferred tooth-colored restorations.

Conclusion

We concluded that the majority of dental students were confident about their smiles. Senior students were more satisfied with their teeth color, while younger students desired whiter teeth. Bleaching and orthodontics were the most desired treatment options.

Impacts of Self Perceived Malocclusion on the Oral Health Related Quality of Life of Young Adults

Self-awareness of poorly arranged teeth can influence the quality of life. This study aimed to report the impacts of self-perceived malocclusion in young adults and the association between demographic characteristics and oral health related quality of life (OHRQoL). In this cross-sectional study, six-hundred-forty-three subjects from Selangor, Malaysia selected using a multistage sampling technique answered the Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and self-rated their dental appearance using the Aesthetic Component of the Index of Orthodontic Treatment Need. Data were analyzed using multifactorial ANOVA to identify the association between demographic characteristics and total PIDA score. Five-hundred-twenty-four subjects (81.5%) completed the questionnaires. Overall, 87.8% had impacts on their OHRQoL. Psychological impact was the most impacted domain (75.8%), followed by dental self-confidence (59.4%), social impact (48.9%) and aesthetic concern (22.1%). 16.8% reported significant impacts on all domains. Their mean PIDA score was 36.3 (SD 17.1). Prevalence, extent and severity of impacts were higher amongst those with self-perceived malocclusion. Gender, ethnicity, and self-perceived malocclusion status were associated with PIDA score (p < 0.05). Sub-urban and rural females had significantly higher PIDA scores than sub-urban and rural males. In conclusion, majority of Malaysian young adults especially those with self-perceived malocclusion were impacted by their dental aesthetics.

Perception of Altered Smile Esthetics by Orthodontists, Dentists, and Laypeople in Riyadh, Saudi Arabia

Background

Mini-esthetics is an important concept in orthodontics concerned with relatedness of dentition to the face.

Purpose

We compared the perception of altered smile esthetics between orthodontists, dentists, and laypeople in Riyadh, Saudi Arabia.

Patients and Methods

A total of 216 participants (orthodontists, dentists, and laypeople) were conveniently surveyed. An image representing the ideal smile was altered in terms of buccal corridor, gingival display, and midline diastema. Using Likert scale, participants were asked to rate the attractiveness of the altered images.

Results

The three surveyed groups preferred wide rather than narrow buccal corridors. Also, as the amount of gingival display and midline diastema increased, the smile was rated less attractive. Age of participants was significantly associated with more precise recognition of gingival display and midline diastema, P<0.05 and P<0.001, respectively.

Conclusion

The concept of an ideal smile holds true across the heterogenous groups we studied despite gender and professional background.

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics

Objectives

The study explored whether television commercials change the perception of one's own dentofacial attractiveness and to identify if it is influenced by personality traits.

Materials and methods

The sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, intellect, self-esteem and perfectionism) were assessed.

Results

In their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR²=0.076; p=0.005; total model R²=0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect.

Conclusion

Psychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe malocclusion and higher cognitive abilities.

Perception of Smile Aesthetics of Patients with Anterior Malocclusions and Lips Influence: A Comparison of Dental Professionals’, Dental Students,’ and Laypersons’ Opinions

Objectives. The aim of the study was to evaluate the perception of smile aesthetics in patients with varying degrees of anterior crowding and spacing among dental specialists, dentists, dental students, and laypersons and to assess the effect of the lips position. Materials and Methods. Clinical photos of cases of anterior crowding (mild, moderate, and severe) and spacing (mild, moderate, and severe) with and without the associated lips were used. The images were evaluated by 250 persons including dental specialists, dentists, dental students, and laypersons using the rating scale method, (extremely unaesthetic to extremely aesthetic, 1 to 5, respectively). Nonparametric tests were used to analyse the data on SPSS version 24. Results. According to the 250 responses, the aesthetic perception of all severities of anterior crowding and mild and moderate spacing was found to be more aesthetic when displayed with the lips ( $p<0.05$ ). Additionally, the higher the level of dental education, the lower the aesthetic perception with and without the lips ( $p<0.05$ ). Conclusions. The lips play a significant role in improving the aesthetics of crowded anterior teeth and spaced anterior teeth. Dental educational level influences the aesthetic perception of anterior crowding and spacing. This may have an impact on treatment planning and need for orthodontic intervention.

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.

What is the best soft-tissue reference plane to quantify lip change in bimaxillary protrusion cases? A retrospective cohort study

Objectives:

The objective of the study was to evaluate the validity of five soft-tissue profile planes to actual horizontal lower lip changes following treatment of severe bimaxillary protrusion patients with vertical maxillary excess using extra-alveolar miniscrews. The null hypothesis was no differences in the incremental changes of horizontal lower lip changes from pre-treatment to post-treatment of the five methods compared to actual changes.

Materials and Methods:

Seventy adults were treated orthodontically with extractions for bimaxillary protrusion and “gummy” smile using extra-alveolar miniscrews. Lower lip horizontal position was assessed with pre- and post-treatment lateral cephalograms and five commonly used soft-tissue reference lines were used to measure horizontal lower lip treatment change.

Results:

Compared to actual therapeutic lower lip horizontal retraction (4.38 mm), soft-tissue references Ricketts’ E-line (3.89 mm) and Steiner’s S-line (3.88 mm) demonstrated no statistical difference (P > 0.05) from actual change. The five profile plane measures showed moderately high to high intercorrelations among themselves, but none of them were related to the actual amount of anteroposterior lip change that occurred. None of the five soft-tissue measurements showed a statistically significant difference (P > 0.05) between subgroups with least and greatest lower lip retraction.

Conclusion:

Under conditions of maximum lower lip retraction, Rickett’s E-line and Steiner’s S-line were fair measures of horizontal lower lip change. Although actual lower lip change and soft-tissue reference plane changes were correlated poorly, intercorrelations among the five soft-tissue references planes were moderately high. None of the five soft-tissue measurements was able to discriminate (P > 0.05) between treatments with least and greatest lower lip retraction. It may be concluded that Rickett’s E-line and Steiner’s S-line soft-tissue profile references are valid when there is considerable therapeutic retraction (4+ mm) of the lower lip.

Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis

INTRODUCTION

Currently, there is limited evidence on the effects of malocclusion on oral health and whether the correction of malocclusion results in an improvement in oral health. In this review, we examined the evidence from randomized controlled trials and prospective cohort studies to provide information on any association between malocclusion and oral health and the effects of orthodontic treatment.

METHODS

We conducted this review in 2 parts: (1) we looked at the impact of malocclusion on oral health, and (2) we reviewed the evidence on the effect of orthodontic treatment on oral health. We searched for randomized controlled trials and prospective cohort studies. The searches were completed for articles published between January 1, 1990 and October 8, 2018 and covered Medline via Ovid, Embase, and the Cochrane Database of Systematic Reviews. References of included articles and previous systematic reviews were hand-searched. No language restrictions were applied. Two members of the study team assessed the quality of the studies using the Appraisal Tool for Cross-Sectional Studies to appraise the quality of studies in part 1. The assessment was performed at the study level. Two authors assessed each study independently, with a third author consulted when a disagreement occurred. For studies in part 2, we used the Newcastle-Ottawa scale to assess the risk of bias. When studies were included in a Cochrane review, we incorporated the risk of bias assessment. We developed data extraction forms for each area of oral health under investigation (trauma, quality of life, caries, and periodontal disease). Each author piloted the form, and we held discussions to inform any necessary refinements. We extracted data from studies into 2 × 2 tables, which provided a binary analysis of malocclusion vs the outcome of interest. If these data were not available from the published paper, then studies were not included in the meta-analysis. The authors were contacted when possible to request data in this format.

RESULTS

For part 1 of the study, we identified 87 studies. The overall quality was low. We could not include any of the data into an analysis because of a large variation in the nature of the studies, data collected, and outcome measures that were selected. For part 2 of the study, we found 7 studies; however, there were similar deficiencies in the data as in part 1, and thus, we could not reach any strong conclusions.

CONCLUSIONS

Overall, there is an absence of published evidence regarding the effects of malocclusion on oral health and the impact of orthodontic treatment on oral health.

Four-dimensional oral health-related quality of life impact in children: A systematic review

Oral health‐related quality of life (OHRQoL) is an important dental patient‐reported outcome which is commonly based on 4 dimensions, namely Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact. The Oral Health Impact Profile (OHIP) is the most used OHRQoL instrument designed for adults; nevertheless, it is used off‐label for children as well. Our aim was to describe the OHRQoL impact on children measured by OHIP and map the information to the 4‐dimensions framework of OHRQoL. A systematic literature review following the PRISMA statement was conducted to include studies assessing OHRQoL of children ≤ 18 years using OHIP. The OHIP seven‐domain information was converted to the OHRQoL 4‐dimension scores accompanied by their means and 95% confidence interval. Risk of bias was assessed using a six‐item modified version of quality assessment tool for prevalence studies. We identified 647 articles, after abstracts screening, 111 articles were reviewed in full text. Twelve articles were included, and their information was mapped to the 4‐dimensional OHRQoL. Most included studies had low risk of bias. OHRQoL highest impact was observed for Oral Function, Orofacial Pain, and Orofacial Appearance for children with: Decayed‐Missing‐Filled‐Surface (DMFS) of ≥10, anterior tooth extraction without replacement and untreated fractured anterior teeth, respectively. Across all oral health conditions, Psychosocial Impact was less affected than the other three dimensions. OHIP has been applied to a considerable number of children and adolescents within the literature. One instrument and a standardised set of 4‐OHRQoL dimensions across the entire lifespan seem to be a promising measurement approach in dental and oral medicine.

Factors related to the psychological impact of malocclusion in adolescents

To study the association between orthodontic treatment need and the psychosocial impact of dental aesthetics in a sample of adolescents, as well as other associated factors. A transversal study was conducted on 1,158 adolescents (12–16 years old) examined at the schools selected for the 2018 epidemiological study on oral health in the Comunidad Valenciana (Spain). The need for orthodontic treatment was determined by DAI and IOTN. The psychosocial impact was established by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Other variables considered were sex, social class, DMFT index and Body-Mass Index, and having previously worn or presently wearing an orthodontic device. A lineal regression statistical technique was applied to study the significant associations with the scoring obtained in PIDAQ. The PIDAQ scores revealed a significant and positive lineal relationship with regard to need for orthodontic treatment: DAI (ẞ = 0.20) and IOTN-DHC (ẞ = 4.87), in women (ẞ = 2.66) and a negative one for having previously worn an orthodontic device (ẞ = − 5.74). The rest of the variables had no statistical significance (p > 0.05). The psychosocial impact of dental aesthetics in adolescents is associated with the presence of malocclusion and the female sex, while the condition of having previously worn an orthodontic device reduces the psychosocial impact.

Awareness of Parents About the Emergency Management of Avulsed Tooth in Eastern Province and Riyadh

Objective

To assess the level of parents knowledge about the emergency management of tooth avulsion in Eastern Province and Riyadh.

Methods

A cross-sectional study was carried out by means of a questionnaire-based internet survey in which 1201 parents from Eastern Province and Riyadh participated. The questionnaire contained 10 closed-ended questions and was used to assess the knowledge of parents about the emergency management of avulsed teeth in Eastern Province and Riyadh. Chi-square test was used for data analysis.

Results

In response to closed-ended questions, the statistically significant result was obtained for the history of child dental trauma in which 35% (P=0.04) of parents reported history of dental trauma in their children. These parents were belong to Eastern province (51%) and Riyadh (49%). Furthermore, only 31.3% of the parents were aware of possible storage media for transportation of avulsed tooth while 68.7% (49.5% in Eastern Province and 50.5% in Riyadh) were unaware (P=0.02) of it.

Conclusion

That the majority of the parents were unaware of emergency management for tooth avulsion in two densely populated regions of Saudi Arabia. Education of parents should be initiated at a national level.

Dentofacial mini- and microesthetics as perceived by dental students: A cross-sectional multi-site study

Background

How dental education influences students’ dental and dentofacial esthetic perception has been studied for some time, given the importance of esthetics in dentistry. However, no study before has studied this question in a large sample of students from all grades of dental school. This study sought to fill that gap. The aim was to assess if students’ dentofacial esthetic autoperception and heteroperception are associated with their actual stage of studies (grade) and if autoperception has any effect on heteroperception.

Methods

Between October 2018 and August 2019, a questionnaire was distributed to 919 dental students of all 5 grades of dental school at all four dental schools in Hungary. The questionnaire consisted of the following parts (see also the supplementary material): 1. Demographic data (3 items), Self-Esthetics I (11 multiple- choice items regarding the respondents’ perception of their own dentofacial esthetics), Self-Esthetics II (6 Likert-type items regarding the respondents’ perception of their own dentofacial esthetics), and Image rating (10 items, 5 images each, of which the respondents have to choose the one they find the most attractive). Both the self-esthetics and the photo rating items were aimed at the assessment of mini- and microesthetic features.

Results

The response rate was 93.7% (861 students). The self-perception of the respondents was highly favorable, regardless of grade or gender. Grade and heteroperception were significantly associated regarding maxillary midline shift (p < 0.01) and the relative visibility of the arches behind the lips (p < 0.01). Detailed analysis showed a characteristic pattern of preference changes across grades for both esthetic aspects. The third year of studies appeared to be a dividing line in both cases, after which a real preference order was established. Association between autoperception and heteroperception could not be verified for statistical reasons.

Conclusion

Our findings corroborate the results of most previous studies regarding the effect of dental education on the dentofacial esthetic perception of students. We have shown that the effect can be demonstrated on the grade level, which we attribute to the specific curricular contents. We found no gender effect, which, in the light of the literature, suggests that the gender effect in dentofacial esthetic perception is highly culture dependent. The results allow no conclusion regarding the relation between autoperception and heteroperception.

The effect of enamel fractures on oral health-related quality of life in adolescents

BACKGROUND/AIM

Enamel fractures are the most common type of traumatic dental injury (TDI) in children and adolescents. Recognizing the impact of these fractures on oral health-related quality of life (OHRQoL) could contribute to the establishment of treatment protocols. The aim of this study was to assess and quantify the impact of enamel fractures on overall OHRQoL and domain scores in adolescents.

MATERIALS AND METHODS

A cross-sectional study was conducted with 775 adolescents aged 11 to 14 years in the city of Santo Ângelo in southern Brazil. Sociodemographic variables were collected from parents/caregivers using a structured questionnaire. The adolescents answered the Child Perceptions Questionnaire (CPQ_11-14 ). Physical examinations were performed by an examiner who had undergone training and calibration exercises for the investigation of TDI (Andreasen criteria), dental caries (WHO criteria), and malocclusion (Dental Aesthetic Index). Data analysis involved Poisson regression with robust variance.

RESULTS

The prevalence of TDI was 11.9% and enamel fractures accounted for 79.3% of all injuries. In the multivariate analysis, adolescents with enamel fractures had 29% higher CPQ_11-14 scores (worse OHRQoL) than those without TDI, even after adjustment for sociodemographic and clinical variables (mean ratio = 1.29; 95% CI: 1.09-1.53; P = .003). Enamel fractures exerted a negative impact on the functional limitation, emotional well-being, and social well-being domains.

CONCLUSIONS

Enamel fractures exert a negative impact on the OHRQoL of adolescents, suggesting that subjective measures should be incorporated in the evaluation of patients with this traumatic injury.

An overview of radiological manifestations of acquired dental developmental disturbances in paediatric head and neck cancer survivors

OBJECTIVES

In paediatric cancer survivors treated with chemotherapy and radiotherapy therapy, late effects on dental development are quite common. Oral radiologists are not familiar with the radiographic images of these specific dental consequences of chemotherapy and radiotherapy. With the goal of educating colleagues, to raise awareness of the needs of survivors, and to identify directions for future research, we present dental radiographs of survivors treated for head and neck rhabdomyosarcoma with chemotherapy and radiotherapy. Also, based on the survivors reviewed, a radiographic inventory of commonly found late dental developmental effects seen in conjunction with treatment is presented.

METHODS

Panoramic radiographic findings of five illustrative cases are presented, from a group of 42 survivors of head and neck rhabdomyosarcoma treated at the Academic Medical Center Amsterdam, The Netherlands over the past 25 years.

RESULTS

Five cases showing dental developmental disorders are presented. These cases show an association of the location of the radiation field and the developmental stage of the teeth with the severity of the effect on dental development. We also report an inventory of severe and moderate effects of chemotherapy and radiotherapy on the development of molars and anterior teeth.

CONCLUSIONS

This paper presents five cases and a radiographic inventory to illustrate disturbances of dental development associated with chemotherapy and radiotherapy in children. Medical and dental professionals involved in the treatment of cancer survivors are relatively unaware of the dental consequences of radiation therapy and the age dependency of specific regional effects. These effects can be severe, with great impact on quality of life. Further research in this area could help improve planning of radiation therapy for children, potentially preventing or limiting dental or maxillofacial sequelae.

Association between Maternal Smoking during Pregnancy and Missing Teeth in Adolescents

Tooth agenesis and disturbance of tooth eruption is the most prevalent oral defect, and is possibly caused by the interaction of genetic and environmental factors. We hypothesized that prenatal factors may affect tooth development. The objective of this study was to examine whether smoking during pregnancy was associated with missing teeth in the offspring during adolescence. The study population comprised pregnant women and their children registered (N = 1052) at Koshu city, Japan. When the expectant mothers visited the city office for pregnancy registration, a survey was conducted to ascertain their lifestyle habits. Data on missing teeth in the children were obtained from the compulsory dental health checkup during junior high school years. Multivariate logistic regression models were fitted to assess the association between missing teeth and lifestyle habits. A total of 772 children were studied. The prevalence of missing teeth in these children was 4.9%. Children whose mothers smoked six cigarettes or more per day were 4.59 (95% CI: 1.07-19.67) times more likely to present with missing teeth than those children whose mothers did not smoke, after adjustment for possible confounders. Our findings indicate that smoking during pregnancy can be a risk factor for missing teeth in the offspring.

Effect of Esthetic Defects in Anterior Teeth on the Emotional and Social Well-being of Children: A Survey

Objectives

This study aimed to determine whether imperfections in the anterior dentition affect the emotional and/or social well being of school going children in Amritsar district of Punjab, India.

Methods

A total of 2582 children between the ages 10 and 15 years of both genders were examined. Of these, 528 children with esthetic imperfections were asked a series of questions to assess their emotional and social disposition, with respect to children with no esthetic defects.

Results

Females were more shy if they did not have a perfect anterior dentition (p = 0.000). Low socioeconomic status corresponded with gender (females) in determining emotional insecurity. Malocclusion was the most common cause of aesthetic defects (291/528 children), followed by causes such as, hypoplasisa/hypocalcification, stains, peg shaped, microdontia, congenitally missing (46.4%), trauma (30.5%) and caries (1.2%). Irrespective of cause of defect, 53.8% of children were emotionally affected, in that, were fearful of being teased by other children (77.1%).

How to cite this article

Gupta T, Sadana G, et al. Effect of Esthetic Defects in Anterior Teeth on the Emotional and Social Well-being of Children: A Survey. Int J Clin Pediatr Dent 2019;12(3):229-232.

Malocclusion-Related Quality of Life Questionnaire (MRQoLQ): Development and validation of a new psychometric tool for older adolescents with malocclusion

OBJECTIVE

To develop and validate a new psychometric tool for assessing malocclusion-related quality of life among older Indian adolescents.

METHODS

Item generation involved analysis of existing validated tools, followed by development of new items using various qualitative steps. A draft item pool of 41 questions was initially generated and subjected to item reduction through sequential steps involving two clinical studies to ensure reliability and validity. 431 subjects aged between 15 to 18 years took part in the validation study. Principal component analysis with varimax rotation was performed to get a psychometric tool with good factorial structure and maximum variance.

RESULTS

Rotated component matrix resulted in a 20 item psychometric tool containing 4 domains with a total variance of 61.57%. Inter item, item total correlation and Cronbach α (α = 0.88) ensured good reliability. A positive correlation of the scale with global question ensured convergent validity. Independent t test showed statistically significant difference (p< 0.05) between mean score of IOTN-DHC and DAI with MRQoLQ, ensuring good construct validity.

CONCLUSIONS

The newly developed psychometric tool is named as Malocclusion-Related Quality of Life Questionnaire (MRQoLQ) having 20 questions, including 2 socioeconomic items. The scale showed good reliability and initial validity, hence can be used among older adolescents with malocclusion to assess their malocclusion-related quality of life.

Effects of Rapid Maxillary Expansion and Facemask Therapy on the Soft Tissue Profiles of Class III Patients at Different Growth Stages

Objectives The aim of this study was to evaluate the effects of rapid maxillary expansion (RME) and facemask therapy on the soft tissue profiles of class III patients at different growth stages.

Materials and Methods Forty-five subjects (23 females and 22 males) were divided into prepubertal, pubertal, and postpubertal groups. Bonded type RME appliances and Petit-type facemasks were fitted to each patient, and intraoral elastics were applied from the hooks of the RME appliance to the facemask.

Statistical Analysis All measurements were statistically analyzed with SPSS version 18.0 (SPSS Inc., Chicago, IL, United States) for Windows. Repeated-measures of ANOVA and posthoc Tukey tests were used to compare the groups.

Results The soft tissue nasion, pronasale, subnasale, soft tissue A point, and labrale superior landmarks were all displaced forward and downward, and the most dramatic changes were recorded in the pubertal group. The labrale inferior, soft tissue B point, soft tissue pogonion, and soft tissue menton landmarks moved backward and downward in all groups, and the greatest displacements were observed in the pubertal group.

Conclusions The soft tissue profiles improved significantly and became more convex in all treatment groups. Although, the most favorable facial changes were observed in the pubertal growth stage, the treatments applied in the postpubertal stage also elicited significant changes and should thus be considered viable treatment options.

Psychosocial dental impact in adult orthodontic patients: what about health competence?

Background

Several studies have assessed the psychological benefits of orthodontic treatment; however, the impact of competence on psychological benefits remains unknown.

Aims: To analyze the change of the perception of psychosocial dental impact in a sample of adults undergoing orthodontic treatment (mild/moderate dental malocclusions) and to assess the possible moderating effect of health competence level.

Methods

A longitudinal prospective design was used. Three time points were included: baseline (T0), 6 months after starting orthodontic treatment (T1) and once treatment had finished (T2). The pretreatment sample consisted of 78 patients recruited from the Rey Juan Carlos University Dental Clinic, all of whom had moderate malocclusions and were going to undergo orthodontic treatment for approximately 18 months with fixed metal multibrackets. All participants were instructed to complete the Spanish version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC) on the three points of the research. Statistical analysis involved the General Linear Model (GLM) repeated-measures ANOVA to test if the outcome measures of psychosocial dental impact significantly changed over time during orthodontic treatment (baseline, at 6-month evaluation and posttreatment). To assess the effect of the previous health competence levels (high/low) in the change from baseline to the 6-month assessment, for each PIDAQ dimension, a 2*2 (time*group) repeated measures ANOVA was performed.

Results

A significant increase was observed in dental self-confidence values (T0-T1 and T0-T2). Similar results were observed for the psychological impact variables and for the IOTN-AC scores, which showed significant decreases between T0 and T1 and between T0 and T2. Finally, significantly decreases were observed between T0 and T2 in aesthetic concern. Interaction effects were found regarding the health competence variable from T0-T1 for the psychological impact, social impact and aesthetic concern and the IOTN-AC index, with significant development results regarding the high competence group.

Conclusions

The first 6 months of orthodontic treatment seemed to be key to the development of psychosocial dental impact perception, during which the role of health competence was of great importance to developing a positive change. It is necessary to follow a biopsychosocial approach towards orthodontic treatment.

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.

Aesthetic perceptions and psychosocial impact of malocclusion: comparison between cleft and non-cleft patients and their parents

Objective

To evaluate the influence of dentofacial attractiveness using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ), Satisfaction with Life Scale (SWLS) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) in patients with cleft lip/palate (CLP), and non-cleft orthodontic patients (Non-CLP) and their parents.

Materials and methods

Eighty patients (aged 11-19 years) comprising 40 CLP and 40 non-CLP were administered the PIDAQ and SWLS questionnaires to be rated individually by the patients, along with IOTN-AC rated by the patients and their parents, respectively. The subjects were also sub-divided according to their age, i.e. pre-adolescent and adolescent.

Results

The PIDAQ subpart scores for aesthetic concern differed between the two groups, with a significantly (P < 0.02) lower scoring for the CLP group. The adolescent CLP group scored more negatively than the pre-adolescent group in the dental self-confidence and social impact sub-parts of PIDAQ. No significant differences were observed for satisfaction with life. The parents' IOTN-AC score for both groups was significant (P < 0.05) greater than the patient's score, especially for adolescent subjects.

Limitations

Non-condition specific questionnaires with restrictive sampling sizing and non-inclusion of parameters like stress coping mechanism etc.

Conclusion

The parents rated the malocclusion of their child more critically than the child itself. A majority of the CLP group had a problem in identifying themselves using the IOTN-AC as no photo existed depicting a Class III or edge-to-edge malocclusion. Attitudes, especially perceptions of the aesthetics of front teeth, are crucial factors influencing patient's psychological self-concept, social confidence, and treatment need in CLP patients and non-CLP patients, having more relevance as the patient matures towards adolescence and adulthood.

Negative effect of malocclusion on the emotional and social well-being of Brazilian adolescents: a population-based study

Background/objectives

The aesthetic impact of malocclusion can have negative repercussions on quality of life, social interaction, interpersonal relationships, and psychological well-being. The aim of this study was to evaluate the impact of malocclusion on the quality of life of Brazilian adolescents.

Methods

A representative cross-sectional study of 1612 adolescents from Belo Horizonte, Minas Gerais was conducted. The adolescents responded to the Brazilian version of the Child Perception Questionnaire (CPQ11-14-ISF:16) to assess the impact of the condition on quality of life. Cases of malocclusion were diagnosed using the Dental Aesthetic Index while clinical examination was performed by three calibrated examiners. Data regarding traumatic dental injuries, dental caries, gender, type of school, age and social vulnerability was collected. Data analysis was performed using bivariate and multivariate Poisson regression with robust variance (P < 0.05).

Results

The prevalence of malocclusion was 31.3%. The presence of definite malocclusion (PR = 1.28; CI = 1.13-1.45), severe malocclusion (PR = 1.24; CI = 1.04-1.47) and handicapping malocclusion (PR = 1.55; CI = 1.31-1.84) was associated with a greater negative impact on Emotional Well-Being. The presence of definite malocclusion (PR = 1.18; CI = 1.02-1.36), severe malocclusion (PR = 1.46; CI = 1.21-1.76) and handicapping malocclusion (PR = 1.61; CI = 1.35-1.94) was also associated with a greater negative impact on Social Well-Being.

Conclusions

Adolescents with handicapping malocclusion, where the need for treatment was mandatory, suffered from a greater negative impact on quality of life, with emotional and social aspects most affected.

Psycho-social impact of orthodontic treatment in Romanian teenagers and young adults

Background and aims

This survey evaluated the psycho-social impact of oral health on the quality of life in Romanian teenage and young adult orthodontic patients.

Methods

Of the 300 standard questionnaires distributed in four dental offices, 125 questionnaires were returned. Each questionnaire contained 110 items, focusing on aspects like patients’ satisfaction, self-confidence, school/work performances and aesthetic concern, in relation to oral health. The patients were 16–25 years of age and all were undergoing or had undergone orthodontic treatment in the previous two years. Data analysis was performed using the Statistical Package for the Social Science software (SPSS), version 19.0.

Results

57.90% of the orthodontic patients participating in this study were happy about their dental status, 56.52% declared themselves not shy because of their oral health issues, 52.33% considered themselves as attractive to other people, and 57.29% replied (awarding a score between 8 and 10) that they were confident when smiling. Regarding self-confidence and school/work performances, 58% of the participants declared they avoided speaking in public because of the aspect of their teeth and 47.42% considered that their school/work performances during the fix appliance therapy stayed the same as before appliance. Nevertheless, the self-perceived facial aspect improved during orthodontic treatment (64.74% of replies had scores between 8 and 10 during the treatment versus 24.67% before the treatment). Several correlations were found between aspects such as psycho-social and functional variables, physical self-evaluation, and oral health issues.

Conclusion

Patients’ satisfaction was improved during and after appliance therapy, for more than half of the participants. Self-confidence was low in relation to school/work performances; almost half of the patients reported stagnation in their school/work performances during the fix appliance therapy. However, more than 64% of the patients participating in this study were quite satisfied about their facial aspect during and after the orthodontic treatment. Thus, the common concerns of the patients anxious about their aspect during appliance therapy are not supported by the findings of this study.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly

OBJECTIVE

To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry.

MATERIALS AND METHODS

A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed.

RESULTS

The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment.

CONCLUSIONS

A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended.