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

Quality of life among adults with less severe malocclusions seeking orthodontic treatment

OBJECTIVE

Severe malocclusions affect Oral Health Related Quality of Life (OHRQoL), but the effects of less severe malocclusions are underexplored. This study investigates OHRQoL and psychological well-being in adults with less severe malocclusion, but high subjective need of orthodontic treatment.

MATERIAL AND METHODS

This cross-sectional study included 130 study participants aged 18-75 years, with less severe malocclusion. Two groups were assessed: 65 with high subjective orthodontic treatment need and 65 in a control group. Patients with malocclusions graded with Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) index 1, 2, or 3 were included. Three questionnaires were used: Oral Health Impact Profile (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and a general appearance perception survey.

RESULTS

The high subjective need group showed significantly higher OHIP-14 scores, reflecting poorer OHRQoL, compared to the control group. When age was considered, only the orofacial appearance subscale remained significant. No clinical signs of depression or anxiety were found among participants. However, a subset in the high subjective need group spent over an hour daily on their oral appearance.

CONCLUSIONS

Adults seeking orthodontic treatment despite low objective treatment need may have impacted OHRQoL and an impairment from the time spent on their oral appearance. Dentist should consider patients' subjective treatment needs and impact on daily functioning when treating patients with mild malocclusions.

Determinants of oral health-related quality of life in orthodontic aligner wearers: A cross-sectional analysis

Oral health-related quality of life (OHRQoL) is a critical measure for assessing the impact of orthodontic treatments, including aligners. This study aimed to investigate factors associated with OHRQoL among orthodontic aligner wearers. This cross-sectional study included 34 participants. OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14), and malocclusion severity was measure with the Dental Aesthetic Index (DAI). Data on sex, age, family income, and treatment duration were collected. Bivariate analyses were conducted to examine associations between independent variables and OHRQoL. Effect sizes (ES) were calculated to indicate the magnitude of associations, categorized as small, moderate, or large. Poisson regression was performed to identify factors associated with OHRQoL, reporting beta coefficients (Coef.) and standard errors (SE). Statistical significance was set at p < 0.05. The mean age of participants was 33.8 years. In the psychological discomfort subscale, males reported higher scores, with a moderate ES. Family income showed moderate-to-large ES, with individuals from families earning < 5 wages reporting higher scores. Higher DAI scores were significantly associated with poorer OHRQoL across the following subscales: functional limitation (p = 0.002), physical pain (p = 0.001), physical disability (p = 0.005), psychological disability (p = 0.003), social disability (p = 0.001), handicap (p = 0.037), and the total score (p = 0.001). Younger individuals also reported significantly higher scores on the handicap subscale (p = 0.007). Younger individuals and those with more severe malocclusion experienced poorer OHRQoL during treatment with orthodontic aligners. Sex and family income also significantly influenced OHRQoL outcomes.

THE USAGE AND REPORTING OF DENTAL PATIENT-REPORTED OUTCOMES AMONG SYSTEMATIC REVIEWS IN ORTHODONTICS: A METHODOLOGICAL STUDY

OBJECTIVE

To summarize and analyze the usage and reporting of dental patient-reported outcomes (dPROs) within systematic reviews (SRs) published in 5 leading orthodontic journals between 2015 and 2023.

METHODS

A manual search was conducted to identify intervention (therapeutic or preventive) involved SRs published in selected journals between 2015 and 2023 from the official online archives. Two authors independently and in duplicate extracted the characteristics of each included SR, recording both the usage of dPROs in the Methods sections and the reporting of dPROs in the Results sections.

RESULTS

A total of 244 SRs were found eligible and included, of which 81 (33.2%) included dPROs. Out of the 81 SRs, 19 (23.5%) described dPROs in the Methods sections, 6 (7.4%) reported dPROs exclusively in the Results sections, and 56 (69.1%) included dPROs in both sections. In the 75 SRs that stated dPROs in their Methods sections, 38 (50.7%) identified them as primary outcomes, while 37 (49.3%) considered them secondary outcomes. Among the 62 SRs that reported dPROs in the Results section, 17 (27.4%) performed quantitative synthesis, and the remaining 45 (72.6%) conducted only qualitative synthesis. A total of 26 dPROMs were identified, of which only 11 were included in meta-analyses.

CONCLUSIONS

Only about one-third of SRs published in leading orthodontic journals included dPROs. It is recommended that researchers consider the usage of dPROs and dPROMs during the design and registration stages of orthodontic SRs and ensure transparent reporting of the results, thus facilitating evidence-based practice and shared decision-making in clinical care.

Sleep disordered breathing and oral health-related quality of life in children with different skeletal malocclusions

OBJECTIVE

To evaluate the relationship among different skeletal malocclusion patterns, sleep-disordered breathing (SDB) and children's oral health-related quality of life (OHRQoL).

METHODS

Two hundred-five patients were divided into three groups, considering skeletal malocclusion. Parents completed the Pediatric Sleep Questionnaire (PSQ) on behalf of the patients, who completed the 14-question version of the Oral Health Impact Profile (OHIP-14).

RESULTS

SDB was observed in 10.7% of children. The overall prevalence of snoring, difficulty breathing during sleeping, mouth breathing, and dry mouth on awakening was 8.78%, 7.31%, 36.09%, and 37.07%, respectively. However, there was no significant difference in OHIP-14 parameters among the skeletal groups. A positive correlation was found between OHIP-14 and PSQ and was significant in Class I and III.

CONCLUSION

Although there was no significant difference, SDB risk and sleep quality were found as most to least problematic, in the following sequential order: Class II > Class III > Class I.

A Fully Integrated Orthodontic Aligner With Force Sensing Ability for Machine Learning-Assisted Diagnosis

Currently, the diagnosis of malocclusion is a highly demanding process involving complicated examinations of the dental occlusion, which increases the demand for innovative tools for occlusal data monitoring. Nevertheless, continuous wireless monitoring within the oral cavity is challenging due to limitations in sampling and device size. In this study, by embedding high-performance piezoelectric sensors into the occlusal surfaces using flexible printed circuits, a fully integrated, flexible, and self-contained transparent aligner is developed. This aligner exhibits excellent sensitivity for occlusal force detection, with a broad detection threshold and continuous pressure monitoring ability at eight distinct sites. Integrated with machine learning algorithm, this fully integrated aligner can also identify and track adverse oral habits that can cause/exacerbate malocclusion, such as lip biting, thumb sucking, and teeth grinding. This system achieved 95% accuracy in determining malocclusion types by analyzing occlusal data from over 1400 malocclusion models. This fully-integrated sensing system, with wireless monitoring and machine learning processing, marks a significant advancement in the development of intraoral wearable sensors. Moreover, it can also facilitate remote orthodontic monitoring and evaluation, offering a new avenue for effective orthodontic care.

The prevalence of malocclusion and oral health-related quality of life among 12- and 15-year-old schoolchildren in Shanghai, China: a cross-sectional study

BACKGROUND

Malocclusion is one of the three major oral diseases and may cause deterioration in oral health-related quality of life (OHRQoL). This study aims to determine the prevalence of malocclusion by gender and its impact on quality of life among 12- and 15-year-old children in Shanghai.

METHODS

This study summarizes the data obtained in the Shanghai Oral Health Epidemiological Survey conducted in 2019. Random cluster sampling was used to select students in Shanghai. A total of 1591 12-year-old children and 747 15-year-old children were included. Each student underwent an oral examination and completed a questionnaire. The Index of Complexity, Outcome and Need (ICON) was adopted to measure the objective severity of malocclusion and Child Oral Health Impact Profile (COHIP) was applied to evaluate quality of life of schoolchildren. Comparisons of COHIP scores were performed among different treatment needs and difficulties by t-test and analysis of variance (ANOVA).

RESULTS

No significant difference was found between genders except that the prevalence of deep overbite in 12-year-old boys (1.11 ± 0.95) was significantly higher than that in girls (0.93 ± 0.88) while the prevalence of crossbite among 12-year-old girls (26%) is significantly higher than boys (20%). Malocclusion in 15-year-old children was descended compared with 12-year-old. 15-year-old students demonstrates larger impact of malocclusion on oral health than 12-year-old group except self-image. Health impacts (COHIP) increase significantly as the malocclusion becomes severer except self-image in 12-year-old group.

CONCLUSIONS

In Shanghai, the severity of malocclusion in 15-year-old children was less than 12-year-old children. Malocclusion has greater influence on oral health of 15-year-old children than 12-year-old children. Severer malocclusion generally correlates with higher level of oral health impacts in schoolchildren.

Assessment of psychosocial parameters in adolescents seeking orthodontic treatment

AIM

The aim of this study was to investigate the psychosocial impact of malocclusion and the motivation for seeking orthodontic treatment among adolescents.

METHODS

A cross-sectional study included 102 adolescents (ages 11-18) whose malocclusion was rated using 3 occlusal indices: IOTN, DAI, and PAR. The participants answered three structured questionnaires selected to measure Oral Health Related Quality of Life (OHRQoL) through the short form of the Child Oral Health Impact Profile (COHIP), the patient's perceived impact related to orthodontics through the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and self-esteem through the Rosenberg Self-Esteem Scale (RSES). Independent two-tailed t-tests, one-way mixed analysis of variance (ANOVA), and Spearman's correlations were used to test various associations.

RESULTS

Patients with higher malocclusion scores displayed increased psychosocial impact with weak to moderate correlations (0.2 < r < 0.3; p < 0.05), but 98% wished their teeth looked better, and 70% were unhappy about their smile esthetics. The IOTN esthetic component AC was better associated with psychosocial implications of malocclusion (p < 0.01). Self-motivated patients (over 80%) had higher impactful psychosocial scores than patients whose parents were motivated for treatment. Sex did not influence the findings. Older adolescents and bullied individuals were more affected by the psychological burden of malocclusion.

CONCLUSION

The results indicate the prevalence of psychosocial and esthetic impacts of malocclusion over oral and functional problems. PIDAQ discriminated better than COHIP between varying degrees of dental aesthetics. The results suggest that the orthodontist should explore patients' expectations of treatment outcomes, not only the chief complaint.

Associations between oral health impacts attributed to malocclusion and normative and self-perceived orthodontic treatment need in Turkish adolescent patients

BACKGROUND

In the socio-dental approach, the integration of normative oral health-related quality of life (OHRQoL) and behavioral propensity measures should be considered when assessing treatment needs and planning oral services. Therefore, this study aimed to evaluate the relationship between oral health impacts attributed to malocclusion and normative and self-perceived orthodontic treatment needs in adolescent patients and to determine the clinical, sociodemographic, and behavioral factors affecting their OHRQoL.

METHODS

This cross-sectional study was conducted using a convenience sample size of 105 adolescent patients aged 11-14 years who were referred to the Orthodontics Clinic in the Faculty of Dentistry, Istanbul. Data were collected using clinical examinations and a self-reported questionnaire, including the condition-specific Child Oral Impact on Daily Performances (CS-COIDP) attributed to malocclusion and sociodemographic, clinical, and behavioral factors. The index of complexity, outcome, and need (ICON), gingival index, and Decayed, Missing, Filled Teeth index was used to assess oral health status. Descriptive statistics and bivariate and multivariate regression analyses were used for the data analyses.

RESULTS

A total of 70 patients (66.7%) reported at least one impact. Furthermore, 47% of the adolescents had very difficult and difficult complexity grades. The most affected performances were "emotional (52.4%) and smiling (40%)". No significant differences were found in the total CS-COIDP scores according to caries experience; however, the gingival status was associated with the total OHRQoL. Lower tooth brushing frequency, increased malocclusion complexity, and subjective treatment need were the most important predictors of worse OHRQoL, accounting for 39.3% of the variance in the scores. ( R2 = 0.422; p < 0.001) CONCLUSIONS: Oral health professionals should consider oral behaviors, malocclusion complexity, and subjective treatment need when planning orthodontic treatment plans. Integrating ICON, CS-COIDP, and behavioral assessment will help identify adolescents who should be prioritized for treatment.

Oral habits, sociopsychological orthodontic needs, and sociodemographic factors perceived by caregivers impact oral health-related quality of life in children with and without autism?

BACKGROUND

Caregivers play a crucial role in assessing the oral health-related quality of life (OHRQoL) of young individuals with autism spectrum disorder (ASD).

AIM

This study assessed the impact of sociodemographic and oral conditions on OHRQoL and family dynamics in young individuals with and without autism, as perceived by guardians.

DESIGN

This comparative cross-sectional study included young individuals aged 6 to 14 years and their guardians. Data were collected at a specialized institution and dental schools. Guardians completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS), and sociodemographic and oral habits questionnaires. The sociopsychological need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN).

RESULTS

The sample included 144 youths and caregivers. The ASD group had higher P-CPQ and FIS scores. Factors associated with poorer perceived OHRQoL included higher youth age, lower caregiver education, higher IOTN scores, teeth clenching (RR = 1.20; 95% CI: 1.01-1.41), and lip sucking. Lower parental education (RR = 1.75; 95% CI: 1.10-2.80) and higher IOTN scores from the caregiver's perspective impacted family dynamics.

CONCLUSION

Caregivers of young individuals with ASD perceived a lower OHRQoL, and families in this group were more affected by sociodemographic and oral conditions.

Oro-facial function and quality of life in children and adolescents with large horizontal maxillary overjet-A case-control study

BACKGROUND

Large horizontal maxillary overjet (overjet) is associated with reduced bite force (BF) and number of contacts, which influence the chewing effectivity (CE). Oral health, oro-facial function (OF) and malocclusion have great impact on psychological well-being and quality of life (QoL).

OBJECTIVES

The aims of the study were to examine OF, temporomandibular disorders (TMD), BF, CE, QoL and well-being in children and adolescents with large overjet.

METHODS

The study was a case-control study including healthy children with large overjet in the study group compared to a control group of healthy children with neutral occlusion, all 9-14 years old. OF was examined by use of Nordic Orofacial Test-Screening (NOT-S), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and registration of morphological and functional occlusion. QoL and well-being were examined using KIDSCREEN-10 and Strengths and Difficulties Questionnaire.

RESULTS

The study and control groups included 37 and 32 participants, respectively. Significantly increased NOT-S score (p < .001) and reduced BF (p = .011), numbers of contacts (p < .001) and CE (p = .005) were found in the study group. BF, numbers of contacts and CE were negatively associated with erupting canines and premolars. No significant difference was found in age, gender, dental eruption, TMD diagnosis or QoL between the groups. Significantly increased emotional symptoms (p = .007), hyperactivity (p = .043) and total difficulties score (p = .009) were found in the study group.

CONCLUSION

The study group showed higher NOT-S score and reduced BF, number of contacts and CE. No difference in QoL were found between the groups, although reduced well-being and increased emotional symptoms, hyperactivity and total difficulties were found in the study group.

Impact of treatment with orthodontic aligners on the oral health-related quality of life

BACKGROUND

There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people.

AIM

To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables.

METHOD

Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined.

RESULTS

Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031).

CONCLUSION

Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.

Genetic and environmental impact on mandibular growth in mono- and dizygotic twins during adolescence: A retrospective cohort study

INTRODUCTION

This study aimed to discover the genetic and environmental factors that contribute to the mandibular development of untreated monozygotic and dizygotic twins.

MATERIAL AND METHODS

The sample, taken from the Forsyth Moorrees Twin Study, included 52 untreated monozygotic twins (36 male, 16 female) and 46 untreated dizygotic twins (23 male, 23 female). At the ages of 12 and 17, lateral cephalograms were collected and traced to assess total mandibular length, mandibular ramus length, mandibular corpus length, gonial angle, SNB, and bony chin prominence. The genetic and environmental components of variation were assessed using multilevel mixed-effects structural equation modelling.

RESULTS

At 12 years of age, high additive genetic influences were observed for total mandibular length (74%), gonial angle (76%), SNB (41%), and bony chin prominence (64%), whereas strong dominant genetic components were observed for corpus length (72%), and mandibular ramus length was under unique environment influence (54%). At 17 years of age, only total mandibular length (45%), ramus length (53%), gonial angle (76%), and bony chin prominence (68%) were under strong additive genetic control, while the remainder were under strong dominant genetic control.

CONCLUSIONS

Although monozygotic and dizygotic twins share at least a portion of their DNA, additive, dominant, or environmental components were discovered during adolescence. Nonetheless, by the age of 17, the majority of the mandibular traits are under either additive or dominant genetic impact.

The association between malocclusion and health-related quality of life in adolescents: A mediation analysis

This study investigated the role of oral health-related functional limitations and social well-being, self-perceived health, psychosocial factors, and social support in mediating the impact of malocclusion on health-related quality of life (HRQoL). A school-based 6-month cohort study was conducted with 376 12-year-old deprived adolescents. Measures at baseline included malocclusion (DAI score), dental caries, sociodemographic characteristics, psychosocial traits (self-esteem, sense of coherence, oral health beliefs), and social support. The oral health-related functional limitations and symptoms (social well-being) domains of the CPQ11-14 , self-perceived health, and HRQoL (Kiddo-KINDL) were evaluated at the 6-month follow-up. Associations between observed and latent variables (social support, psychosocial factors, and HRQoL) were evaluated using structural equation modelling, according to the Wilson and Cleary theoretical model. Malocclusion was indirectly associated with worse HRQoL, mediated by functional limitations, social well-being, and self-perceived health. Better psychosocial status was directly associated with better HRQoL, and higher social support was indirectly associated with better HRQoL via psychosocial factors. Dental caries experience, female sex, and lower family income were indirectly associated with worse HRQoL. The impact of malocclusion on HRQoL was mediated by oral health-related functional limitations, social well-being, and self-perceived health. Sociodemographic and psychosocial factors, and social support also impacted HRQoL.

Assessment of Children and "Young" Adult Patients' Quality of Life after Prosthetic Treatment of Disorders of the Craniofacial Region-A Retrospective Study

BACKGROUND

Prosthetic rehabilitation for children and juvenile patients with congenital or acquired craniofacial disorders is the area of activity of many clinicians and is a major diagnostic and therapeutic challenge for dentists.

METHODS

Studies were carried out on a group of 30 patients (10 female and 20 male) aged 2.5 to 30 years who were treated prosthetically due to congenital and acquired craniofacial disorders. The aim of this study was to assess the quality of life using the CPQ 11-14 (Child Perception Questionnaire 11-14), OQLQ (Orthognathic Quality of Life Questionnaire), and PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire).

RESULTS

Before the prosthetic treatments, the mean values in the individual questionnaires were, respectively, CPQ 11-14-54 points; OQLQ-44.4 points; and PIDAQ-47.6 points. The following values were obtained after the treatments: CPQ 11-14-12.43 points; OQLQ-22.27 points; and PIDAQ-34.03 points. All obtained differences were statistically significant.

CONCLUSIONS

The total numerical results obtained in all questionnaires decreased, which means that prosthetic rehabilitation had a positive impact on the assessment of the quality of life based on individual categories.

An artificial neural network approach for rational decision-making in borderline orthodontic cases: A preliminary analytical observational in silico study

INTRODUCTION

Artificial intelligence (AI) technology has transformed the way healthcare functions in the present scenario. In orthodontics, expert systems and machine learning have aided clinicians in making complex, multifactorial decisions. One such scenario is an extraction decision in a borderline case.

OBJECTIVE

The present in silico study was planned with the intention of building an AI model for extraction decisions in borderline orthodontic cases.

DESIGN

An observational analytical study.

SETTING

Department of Orthodontics, Hitkarini Dental College and Hospital, Madhya Pradesh Medical University, Jabalpur, India.

METHODS

An artificial neural network (ANN) model for extraction or non-extraction decisions in borderline orthodontic cases was constructed based on a supervised learning algorithm using the Python (version 3.9) Sci-Kit Learn library and feed-forward backpropagation method. Based on 40 borderline orthodontic cases, 20 experienced clinicians were asked to recommend extraction or non-extraction treatment. The decision of the orthodontist and the diagnostic records, including the selected extraoral and intra-oral features, model analysis and cephalometric analysis parameters, constituted the training dataset of AI. The built-in model was then tested using a testing dataset of 20 borderline cases. After running the model on the testing dataset, the accuracy, F1 score, precision and recall were calculated.

RESULTS

The present AI model showed an accuracy of 97.97% for extraction and non-extraction decision-making. The receiver operating curve (ROC) and cumulative accuracy profile showed a near-perfect model with precision, recall and F1 values of 0.80, 0.84 and 0.82 for non-extraction decisions and 0.90, 0.87 and 0.88 for extraction decisions.

LIMITATION

As the present study was preliminary in nature, the dataset included was too small and population-specific.

CONCLUSION

The present AI model gave accurate results in decision-making capabilities related to extraction and non-extraction treatment modalities in borderline orthodontic cases of the present population.

[Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]

Introduction

Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems.

Objective

to evaluate the effect of MIH on oral health-related quality of life in children and adolescents.

Materials and methods

A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality.

Results

Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life.

Conclusions

The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.

Impact of malocclusions on oral health-related quality of life among adolescents

DESIGN

Systematic review and meta-analysis of randomized controlled trials, non-randomized and observational studies, and previous systematic reviews if matching PECOS strategy. The protocol of the study was registered on PROSPERO.

DATA SOURCES

An electronic search was conducted in the following five databases: The Cochrane Library, PubMed, Web of Science, Scopus, and CINAHL. The search was carried out to cover the literature up to June 15, 2022. In addition, ClinicalTrials.gov and PROSPERO were searched for detecting any relevant unpublished data and ongoing studies.

STUDY SELECTION

The review was defined in PECOS format as follows: population (P), healthy adolescents (ASA Class I or II; age 10-19); Exposure (E), malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools such as Index of Orthodontic Treatment Need, Index of Complexity, Outcome and Need, Peer Assessment Rating, Dental Aesthetic Index, or any well-described tool; comparison (C), no malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools; outcome (O), self-reported oral health-related quality of life (OHRQoL) using validated tools; study design (S), randomized clinical trials, non-randomized/observational studies (prospective and cross-sectional studies with untreated/no-malocclusion controls), and previous systematic reviews if matching PECOS strategy. Studies assessing ASA Class III or higher, craniofacial conditions, previous or ongoing orthodontic or surgical treatment, and case studies were excluded.

DATA ANALYSIS

Screening and data extraction and management, risk of bias (RoB), and quality assessments were conducted by four independent investigators. RoB was assessed based on the guidelines of the Swedish Agency for Health Technology Assessment and Assessment of Social Services.

RESULTS

A total of 13 studies (non-randomized studies of cross-sectional design) were included in the qualitative synthesis, of which, 4 studies were included in the quantitative synthesis. Meta-analysis showed that malocclusions (measured with DAI) in adolescents aged 11-14 years old have a negative impact on OHRQoL (measured with CPQ 11-14 short form) (number of studies = 4, rate ratio/prevalence ratio = 1.15, 95% confidence interval = 1.12-1.18, I2 = 0.03%, Q3 = 0.09, certainty level = moderate).

CONCLUSIONS

Moderate level of evidence suggests that malocclusions in adolescents have a negative impact on the oral health-related quality of life.

Oral-health-related quality of life in adolescents: umbrella review

BACKGROUND

To evaluate oral conditions, demographic and socioeconomic characteristics of oral health-related quality of life (OHRQoL) in adolescents.

METHODS

Umbrella review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA) checklist. The search strategy used a combination of words, applied in the electronic databases PubMed, WebScience, Embase, Lilacs, Scopus and Cochrane. Included publications until January 2022, without restrictions. Data collection took place with systematized practices and the eligibility criteria were studies focusing on OHRQoL; teenagers; adolescentes; present the term "systematic review" and/or "meta-analysis" in the title or abstract. The quality assessment followed the Assessment of Multiple Systematic Reviews (AMSTAR 2) and the adherence of the article to the PRISMA was verified.

RESULTS

Three hundred sixty-two articles were identified, and 22 were included, published between 2009 and 2022. 21 Systematic reviews focused on the English language. Most studies showed heterogeneity in the methodological structuring process: 10 articles were considered of low and 10 critically low quality. Clinical conditions associated with worsening in quality of life were dental caries, malocclusion, dental trauma, toothache, edentulism, need for orthodontic treatment, irregular brushing, and periodontal disease. Socioeconomic factors related to housing, parental education, access to health care, absence of siblings and nuclear family influence OHRQoL. Completion of orthodontic treatment, health promotion programs, dental care and safe housing all have a positive impact.

CONCLUSION

Worse oral health status, older age, female sex and worse socioeconomic status were significantly associated with worse OHRQoL.

TRIAL REGISTRATION

PROSPERO CRD4202129352.

Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study

INTRODUCTION

Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population.

MATERIALS AND METHODS

A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used.

RESULTS

The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL.

CONCLUSION

The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.

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

BACKGROUND

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

OBJECTIVES

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

SEARCH METHODS

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

SELECTION CRITERIA

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

DATA COLLECTION AND ANALYSIS

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

RESULTS

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

CONCLUSIONS

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

REGISTRATION

PROSPERO. CRD42020186152.

Spontaneous changes in mandibular incisor crowding from mixed to permanent dentition: a systematic review

INTRODUCTION

Dental crowding is the most prevalent malocclusion in the mixed and permanent detitions and can have a major impact on dentofacial esthetics. However, adjustments to the development and growth of the dentition can potentiate self-correction of dental crowding during childhood.

OBJECTIVE

To evaluate the physiological behavior of mandibular incisor crowding in the transition from mixed to permanent dentition.

METHODOLOGY

Five electronic databases (PubMed, Scopus, Web of Science, LILACS and LIVIVO) and part of the gray literature (Proquest and Google Scholar) were investigated, based on the eligibility criteria associated with the acronym PECO, until June 2022. The risk of bias was assessed using the ROBINS-E tool and the certainty of evidence, the GRADE tool.

RESULTS

Among the 2.663 studies identified, five were selected for qualitative analysis, of which one have a low risk of bias, and four, a moderate risk. A total of 243 patients were evaluated. Evidence with a high level of certainty was generated indicating a tendency for improvement in mandibular incisor crowding from mixed to permanent dentition, with mandibular incisor crowding decreasing from 0.17 to 4.62 mm on average. The mandibular incisor crowding reduction seems to be associated with the amount of initial crowding and spontaneous dental arch dimensional changes that occur in the mixed dentition and culminate in the increase in arch perimeter, leeway space, incisor protrusion and transverse growth of the maxillary and mandibular arch.

CONCLUSION

Based on moderate scientific evidence, spontaneous longitudinal changes in dental arch in the transition from the mixed to the permanent dentition demonstrate a spontaneous improvement in mandibular incisor crowding by up to 4.62 mm. These evidence provide a scientific basis for planning only longitudinal follow-up in patients with mild to borderline moderate mandibular incisor crowding in the mixed dentition avoiding overtreatment.

[Malocclusion in adolescents in the State of São Paulo: spatial and hierarchical analysis]

The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.

Significance of Non-Statistically Significant Results in the Prediction of Oral Health-Related Quality of Life in Orthodontic Patients: A Survey Using Two Linking Questionnaires

Patients with a fixed orthodontic appliance may have difficulties in maintaining good oral health-related quality of life (OHRQoL), and evaluating self-perceived OHRQoL in orthodontic patients could be challenging for their orthodontists. Therefore, this research was conducted to investigate whether orthodontic postgraduates would accurately evaluate the OHRQoL of their patients. Two self-administered questionnaires were designed for patients to rate their OHRQoL and for their orthodontic postgraduates to evaluate them on OHRQoL. All pairs of patients and their orthodontic postgraduates were requested to independently complete the questionnaires. Pearson's correlation and multiple linear regression were performed to determine the relationships of the variables and to identify significant predictors on OHRQoL, respectively. There were 132 pairs of orthodontic patients and their residents who completed the questionnaires. There were no significant correlations between OHRQoL perceived by patients and evaluated by their orthodontic postgraduates in all aspects of treatment needs and dietary difficulties (p > 0.05). In addition, the regression model demonstrated no significant predictors for the self-perceived treatment needs and dietary difficulties of orthodontic patients. There seemed to be challenges for orthodontic postgraduates to evaluate their patients' oral health-related quality of life. Therefore, the OHRQoL measures should be increasingly implemented in orthodontic education and practice in order to enhance the concept of patient-centered care.

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.

Does orthodontic treatment need have an impact on oral health-related quality of life?

OBJECTIVES

The aims of this study were to determine the frequency of oral health-related quality of life (OHRQoL) impairment in a national representative sample of 8 to 9 year olds in Germany and to evaluate the impact of orthodontic treatment need.

METHODS

Data were collected in the Sixth German Oral Health Study (Sechste Deutsche Mundgesundheitsstudie, DMS 6) and subjects were sampled using a multistage sampling technique. OHRQoL was measured with a modified version of the 5‑item Oral Health Impact Profile (OHIP-5) which was administered in a computer-assisted personal interview. Children were also examined for malocclusion and orthodontic treatment need.

RESULTS

In all, 1892 children aged 8-9 years were invited to take part. Finally, data of 705 children (48.6% female) could be included in the analysis. The OHIP‑5 mean was 1.3 (±2.0). There was no relevant influence from age and gender on the OHIP‑5 summary scores (r < 0.10), but the summary scores differed when analyzed separately regarding orthodontic treatment need or no orthodontic treatment need (1.5 ± 2.0 vs. 1.2 ± 1.9, p = 0.020). Nevertheless, the level appears to be low.

CONCLUSIONS

Malocclusions with orthodontic treatment need have an influence on OHRQoL.

Longitudinal assessment of the impact of orthodontic treatment on adolescents' quality of life: a comparison between boys and girls using a condition specific questionnaire

The aim of this study was to compare the impact of the first year of wearing of a fixed orthodontic appliance on the Oral Health-Related Quality of Life (OHRQoL) between boys and girls, by means of a condition-specific instrument. The study included 69 adolescents aged 10 to 18 years, who were undergoing orthodontic treatment with a fixed appliance. Of the 69 adolescents, 38 were girls (55.1%) and 31 were boys (44.9%). They answered the Brazilian version of the Impact of Fixed Appliance Measure (B-IFAM) questionnaire three months (T1) and one year (T2) after the fixed appliance was installed. This questionnaire contains 43 questions, distributed across nine domains. The higher the scores, the more negative the perception of the adolescent concerning the impact of the fixed appliance on his/her OHRQoL. Sociodemographic and clinical variables were also analyzed, and statistical analysis was performed. For the domains, the effect size (the magnitude of the difference between girls and boys) and the minimal clinically important difference were also calculated. The adjusted regression showed that there was a significantly greater increase in the overall B-IFAM score in girls than in boys, indicating a more negative perception of the OHRQoL over the study time [Coefficient=11.77 (3.47- 20.60), p=0.006]. From T1 to T2, there was a significantly greater increase in the scores (more negative perception of OHRQoL over time) in girls than in boys for the domains aesthetics (p=0.034) and physical impact (p=0.011). These differences were clinically significant. The effect size (the magnitude of the difference) was moderate. The impact of wearing a fixed appliance on the OHRQoL was more negative in girls than in boys during the first year of orthodontic treatment.

Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index and Oral Health Status in Spanish Adolescents

BACKGROUND

Our aim was to analyze the relationship between OHRQoL (Oral-Health-Related Quality of Life) assessed by the C-OIDP (Child-Oral Impacts on Daily Performances) indexand oral health status in 13-15 years old Spanish population.

METHODS

A cross-sectional study was designed in a random sample of 337 adolescents. The C-OIDP and an oral health perception questionnaire were applied. ICDAS II (International Caries Detection and Assessment System) classification was used for assessing caries status, CPI (Community Periodontal Index) for periodontal status and discrepancy in the three planes for occlusal evaluation. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Spearman correlation tests.

RESULTS

The prevalence of impact was 48.1%. The most frequently affected dimension was eating (21.4%). The overall mean C-OIDP index was 3.28. Higher DMFT (Decayed Missed Filled Tooth) was significantly associated with C-OIDP index (p = 0.03). Participants with CPI > 0 showed an impact index almost twice as high as those with CPI = 0 (p > 0.05). Significant association was found between quality of life and CPI for women (p < 0.01). Only the molar Angle's class was associated with the impact index (p = 0.04).

CONCLUSIONS

The OHRQoL in Spanish adolescents is good. The DMFT index had an impact on adolescents' quality of life, showing a greater impact in men than in women. Periodontal status had a greater impact in women. No association between the extent of the caries lesion and the impact index was found.

Impacts of using orthodontic appliances on the quality of life of children and adolescents: systematic review and meta-analysis

BACKGROUND

Although there are previous systematic reviews about the oral health-related quality of life (OHRQoL) impact among children and adolescents after orthodontics treatment, there is no definition for the magnitude of these impacts during the therapy.

OBJECTIVE

To systematically analyse the literature on changes in the quality of life of children and adolescents during orthodontic treatment.

LIMITATIONS

Almost all the studies included in this review are non-randomized clinical trials, which are susceptible to several biases that affect the certainty of evidence obtained, especially by confounding factors and the lack of a control group.

CONCLUSIONS AND IMPLICATIONS

Based on very low certainty of evidence, wearing appliances does not seem to have a significant negative impact during the first year of orthodontic treatment. However, the meta-analytic results suggest that functional limitations in the first 3 months of treatment can be slightly more critical for the impact on the oral health quality of life and consequent patient adherence to treatment.

FUNDING

This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil (CNPq), and Fundação de Amparo à Pesquisa do Estado de Minas Gerais - Brazil (FAPEMIG).

REGISTRATION

CRD42021234407.

Influence of probiotics on the periodontium, the oral microbiota and the immune response during orthodontic treatment in adolescent and adult patients (ProMB Trial): study protocol for a prospective, double-blind, controlled, randomized clinical trial

BACKGROUND

Orthodontic treatment with fixed appliances is often necessary to correct malocclusions in adolescence or adulthood. However, oral hygiene is complicated by appliances, and prior studies indicate that they may trigger oral inflammation and dysbiosis of the oral microbiota, especially during the first 3 months after insertion, and, thus, may present a risk for inflammatory oral diseases. In recent periodontal therapeutic studies, probiotics have been applied to improve clinical parameters and reduce local inflammation. However, limited knowledge exists concerning the effects of probiotics in orthodontics. Therefore, the aim of our study is to evaluate the impact of probiotics during orthodontic treatment.

METHODS

This study is a monocentric, randomized, double blind, controlled clinical study to investigate the effectiveness of daily adjuvant use of Limosilactobacillus reuteri (Prodentis®-lozenges, DSM 17938, ATCC PTA 5289) versus control lozenges during the first three months of orthodontic treatment with fixed appliances. Following power analysis, a total of 34 adolescent patients (age 12-17) and 34 adult patients (18 years and older) undergoing orthodontic treatment at the University Hospital Erlangen will be assigned into 2 parallel groups using a randomization plan for each age group. The primary outcome measure is the change of the gingival index after 4 weeks. Secondary outcomes include the probing pocket depth, the modified plaque index, the composition of the oral microbiota, the local cytokine expression and-only for adults-serum cytokine levels and the frequencies of cells of the innate and adaptive immune system in peripheral blood.

DISCUSSION

Preventive strategies in everyday orthodontic practice include oral hygiene instructions and regular dental cleaning. Innovative methods, like adjuvant use of oral probiotics, are missing. The aim of this study is to analyse, whether probiotics can improve clinical parameters, reduce inflammation and prevent dysbiosis of the oral microbiota during orthodontic treatment. If successful, this study will provide the basis for a new strategy of prophylaxis of oral dysbiosis-related diseases during treatment with fixed appliances.

TRIAL REGISTRATION

This trial is registered at ClinicalTrials.gov in two parts under the number NCT04598633 (Adolescents, registration date 10/22/2020), and NCT04606186 (Adults, registration date 10/28/2020).

Oral health-related quality of life determinants throughout adolescence: a cohort study in Brazil

PURPOSE

Oral health-related quality of life (OHRQoL) is a complex construct that reflects the interaction among well-being, socioeconomic, oral health status, and also contextual factors. This study aimed to verify the association between poorer socioeconomic background and oral health condition on OHRQoL throughout adolescence.

METHODS

A cohort study followed a random sample of 1134 participants aged 12 years in 2012 (T1), 770 adolescents with an average age of 14 years in 2014 (T2; retention rate, 67.9%), and 768 adolescents with an average age of 17.5 years in 2018 (T3; retention rate, 67.8%). OHRQoL was collected three times using the Brazilian short version of the Childhood Perception Questionnaire 11-14 (CPQ 11-14). At baseline, the adolescents were clinically assessed by dentists, and their demographic data, socioeconomic status, use of dental services, and toothache were evaluated. The mean income of the neighborhood was used as a proxy of contextual factors. This variable was obtained from an official municipal publication. Poisson multilevel regression analyses were performed using a hierarchical approach to assess the predictors of OHRQoL over time.

RESULTS

Adolescents living in a neighborhood with low mean income, low household income, low education levels, girls, and nonwhite individuals reported poor OHRQoL. Clinical variables such as gingival bleeding and malocclusion were also associated with higher overall scores on CPQ11-14, indicating poor OHRQoL.

CONCLUSION

Our results showed that the unfavorable contextual and individual socioeconomic environment, and oral disease negatively influenced OHRQoL during adolescence.

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.

Correlations between implant success rate and personality types in the older people: A preliminary case control study

Background/ purpose

Older patients inevitably have a higher need for implant treatment, it is unknown how mental changes or psychological aspects affect the outcome of implant treatment. This study evaluated the success rate of implants and the influence of personality traits in the older people. The goal was to provide evidence for predictable implant treatment while taking into account the unique psychological changes of elders.

Materials and methods

Participants were patients who were able to independently visit our hospital between March 2004 and May 2021. Inclusion criteria were patients aged 65 years or older at the time of implant placement with regular follow-up for at least 1 year. The implant success rate was calculated by counting peri-implantitis and implant loss as failures. Multivariate analysis was used to examine the effect of patient personality characteristics on the success rate.

Results

Fifty-six implants were included in 23 patients (12 men, 11 women), with a mean age of 68.5 years (65–76) and mean maintenance duration of 9 years and 2 months. The cumulative survival rate was 87% at the patient level (94.6% at the implant level). Statistically significant differences were found for adaptive traits (odds ratio [OR] = 0.04) and non-adaptive traits (OR = 6.38); however, no significant differences were found for the other independent variables.

Conclusion

The overall implant success rate was 69.6% at the patient level (82.1% at the implant level). The personality traits in older people had a significant effect on the implant failure rate.

Impact of Malocclusion, Tooth Loss and Oral Hygiene Habits on Quality of Life in Orthodontic Patients: A Cross-Sectional Study

We aimed to assess the impact of malocclusion on oral health-related quality of life (OHRQoL) in a sample composed of adolescents, younger adults and adults seeking orthodontic treatment. Participants were consecutively enrolled from January 2019 to March 2020. The oral health impact profile (OHIP-14) was used to measure the OHRQoL. The index of complexity, outcome and need (ICON) was used to assess malocclusion. Sociodemographic, medical, and clinical questionnaires were recorded. Statistical analyses were performed according as a function of sex and age range (15-30 or >30 years old). Linear and logistic regression models were applied to assess the association between OHIP-14 total score, malocclusion, and other relevant confounding variables. In a final sample of 93 participants (60 females and 33 males, aged 15 to 60 years), men reported significantly better OHRQoL (p = 0.005). Participants aged 30 years or older reported significantly worse OHRQoL (p = 0.042). OHIP-14 was significantly correlated with age (ρ = 0.259, p < 0.05) and the number of missing teeth (ρ = 0.369, p < 0.001). Multivariable regression showed OHIP-14 being associated with the number of missing teeth (B = 1.48, SE = 0.57, p < 0.05) and the presence of missing teeth (B = 1.38, SE = 0.65, p < 0.05). Malocclusion showed no association with OHRQoL. Age and the number of missing teeth may be key factors on self-perceived OHRQoL in adult patients seeking orthodontic treatment.