Impact of fashion braces on oral health related quality of life: a web-based cross-sectional study

Oral health-related quality of life of orthodontic clear aligner versus conventional fixed appliance during treatment: A prospective cohort study

BackgroundOrthodontic clear aligners are a technologically advanced treatment modality that improves aesthetics and comfort while impacting patients' oral health-related quality of life (OHRQoL).ObjectiveThis study assessed and compared the OHRQoL of adult orthodontic patients receiving clear aligners and fixed appliances (metal and ceramic brackets) during orthodontic treatments.MethodologyOne hundred and five orthodontic patients were recruited and classified according to the treatment received. Group 1 clear aligners, group 2- fixed appliances/metal brackets, and Group 3-fixed appliances/ceramic brackets. The patients were surveyed using an Arabic version of the Oral Health Impact Profile 14 (OHIP- 14) questionnaire before (T0), 1-week (T1), and 3-months (T2) after the start of orthodontic treatment. Data was analysed using SPSS software at a significance level set at ≤0.05.ResultsThe mean OHIP scores showed no significant difference between the 3 groups at T0 (p = 0.09) and T2 (p = 0.41) time intervals. On the contrary, the mean OHIP scores at T1 significantly differed between 3 groups (p = 0.03). The mean OHIP scores within the groups at different time intervals was significantly different. Multiple comparison within the groups showed significant reduction in the mean OHIP scores from T0 to T1 and T2 period and further from T1 to T2 period, and the mean differences were statistically significant (p < 0.001).ConclusionAdult patients treated with clear aligners had significantly higher OHRQoL than those who underwent conventional fixed bracket-based treatment after 7 days of treatment but OHRQoL was similar after three months of treatment.

To assess the knowledge, awareness, and perception of non-dentists offering orthodontic treatment among the Malaysian young adult population

BACKGROUND

The increasing number of young adults seeking cheaper and easily accessible orthodontic treatment from unlicensed practitioners in Malaysia poses significant risks to patients. Therefore, it is essential to evaluate their motivations and awareness regarding such practices. The objective of our study was to assess the knowledge, awareness, and perceptions of non-dentists offering orthodontic treatment among the Malaysian young adult population.

METHODS

This was a cross-sectional study. An online self-administered questionnaire was distributed to Malaysian citizens aged 18-37 years. The questionnaire consisted of 11 questions that investigated their awareness of non-dentists offering orthodontic treatment, the harmful effects of braces fitted by non-dentists, and potential strategies to mitigate this phenomenon.

RESULTS

The study was completed by 426 participants, predominantly Malay, with a mean age of 22.9 years. A total of 76.1% reported awareness of braces fixed by non-dentists, primarily through social media platforms such as Instagram and Facebook. Lower cost emerged as the predominant motive (83.6%) for opting for non-dentist orthodontic treatment, followed by no waiting list (48.8%). Notably, the majority of participants acknowledged the illegality (70%) and potential harm (77%) associated with non-dentists providing orthodontic treatment. Legal enforcement (53.1%) was identified as the preferred method for mitigating this practice. Occupation significantly influenced knowledge of illegal orthodontic treatment (p < 0.05), however no significant association was found for gender and level of education (p > 0.05).

CONCLUSION

The survey revealed that young adults are aware of and informed about non-dentists offering orthodontic treatment. While they identified cost as the primary reason for seeking such services, they also recognized legislation and public awareness through campaigns and social media as effective strategies to address this issue. Additionally, significant differences in legal awareness were observed among different occupational levels.

Comparison of sleep quality between clear aligner and fixed appliance orthodontic therapies

BACKGROUND

Although available evidence suggests that orthodontic appliances can impact quality of life, there is limited information on the impact of orthodontic appliances on sleep quality. This study aimed to compare sleep quality between patients undergoing orthodontic treatments using conventional fixed appliances and clear aligners.

METHODS

Adult patients attending clinics in Saudi Arabia participated in this cross-sectional study. Sleep quality was assessed using the validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical significance was determined using inferential analysis, with a P < 0.05 considered statistically significant.

RESULTS

There were 69 patients included in the study. The average age of a patient (33.12 ± 8.1) who received the clear aligner was significantly higher than those who received the fixed appliance (27.7 ± 5.9) (P < 0.05). The variation in the average score of ESS because of the education level was found to be statistically significant (P < 0.05). No significant difference was observed between the mean average ESS and PSQI global scores across the two orthodontic treatment groups. The average sleep latency scores were significantly higher in females than males when analyzing the PSQI component score across sex (P < 0.05). In education, ESS, PSQI global, habitual sleep efficiency, the use of sleep medication, and daytime dysfunction had a positive, weak, but significant correlation.

CONCLUSIONS

Overall, this study concluded that regardless of the orthodontic appliances used, there was no statistically significant difference in sleep quality during the treatment.

An assessment of the pH changes and metal ions released into artificial saliva by fake orthodontic braces

BACKGROUND

This present study assesses changes in the pH as well as the metal ions that fake braces release into artificial saliva (AS) using a pH meter and inductively coupled plasma atomic emission spectroscopy (ICP-AES), respectively.

METHODS

Three sets of fake archwires (AWs) and brackets (Bs) as well as a set of controls were immersed in AS and placed in an incubator shaker at 50 rpm and 37°C. At Days 0, 1, 7, 14, 21, and 28, the pH of the AS medium was measured and 3.0 ml of AS was collected and stored at -20°C for elemental analysis.

RESULTS

Significant changes in pH were observed on Days 0, 1, 7, 14, 21, and 28 in the AS of the AW group. However, these changes were only observed in the B group on Days 0 and 7. The fake samples released a large quantity of sodium (Na), potassium (K), and calcium (Ca) ions, at concentrations exceeding 100 mg/L, post-28 days of immersion. The control and fake braces samples released other ions; such as lithium (Li), magnesium (Mg), barium (Ba), chromium (Cr), copper (Cu), lead (Pb), and aluminium (Al); at concentrations that did not exceed 10 mg/L.

CONCLUSIONS

The pH of the AS of all the samples increased post-incubation. Only 10 ions; namely, Na, Li, K, Mg, Ca, Ba, Cr, Cu, Pb, and Al; were detected in the AS.

Associations of Attitudes and Practice Toward Oral Health, Socioeconomic Status, Self-Rated Oral Health, Subjective Oral Symptoms, and Oral Health-Related Quality of Life Among Residents in Eastern China: A Structural Equation Modeling Approach

Background and Purpose

The purpose of this study was to investigate the relationships among attitudes and practice about oral health, socioeconomic status, subjective oral symptoms, self-rated oral health, and oral health-related quality of life (OHRQoL) in a group of people from eastern China.

Methods

Between January 2021 to February 2022, 2502 (87.4%) of the 2863 participants completed an online questionnaire. OHRQoL, Socio-demographics characteristics, attitudes and practice toward oral health, self-rated oral health and subjective oral symptoms were all covered by the questionnaires. Based on the hypothetical model, structural equation modeling with the bootstrap method was used to examine the interactions and the strength of the correlations between the measured variables.

Results

The final model demonstrated acceptable data fit. Socioeconomic status (β = -0.051), attitudes (β = -0.100) and practice (β = -0.127) toward oral health, self-rated oral health (β = -0.493) and subjective oral symptoms (β = 0.294) were all significantly correlated with OHRQoL. Socioeconomic status was directly linked to attitudes (β = 0.046) and practice (β =0.070) about oral health, and attitudes play the role of intermediary between practice and socioeconomic status (β = 0.018). OHRQoL was indirectly linked with attitudes mediated by practice (β = -0.092), practice mediated by subjective oral symptoms (β = -0.107), subjective oral symptoms mediated by self-rated oral health (β = 0.031). OHRQoL was correlated with income, educational level, and socioeconomic status. Self-rated oral health was related to educational level and socioeconomic status.

Conclusion

In a sample of eastern China residents, OHRQoL was influenced by socioeconomic status, attitudes and practice toward oral health, subjective oral symptoms, and self-rated oral health.

The Attitudes of Children Undergoing Orthodontic Treatment toward Face Mask Wearing during the COVID-19 Pandemic: A Cross Sectional Study

During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children’ attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1—Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2—Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children.

Orthodontic Adolescent Patients’ Attitudes toward Protective Face Mask Wearing during the COVID-19 Pandemic

Background and Objectives: The COVID-19 pandemic led to restrictive measures, which aimed to limit the spread of the SARS-CoV-2 virus. These restrictions impacted all areas of life, including the activity of dental offices. For patients with orthodontic appliances, closing the dental offices was a major issue, as most orthodontic treatments last for more than a year and require regular checkups. The aim of this research was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic, and, especially, wearing a face mask had on a sample of Romanian teenagers undergoing fixed orthodontic treatment. Material and Methods: The study group consisted of 277 orthodontic patients, with ages between 12 and 17.9 years, from North-Western Romania. They completed a 9-item questionnaire. The control group consisted of 231 participants, with ages between 12 and 17.9 years. They completed an 8-item questionnaire. Results: Most patients from the study group were not worried that wearing a protective face mask would hide their braces (never—49.5%; rarely—26.7%), and their desire to undergo an orthodontic treatment was not affected by the compulsoriness of face mask wearing (never—51.6%; rarely—26%). In contrast to that, in the control group, more than 50% of the participants were worried to some degree that wearing a protective face mask would hide their smile (occasionally—29.9%; frequently—18.2%; very frequently—2.2%). The majority of the participants from the study group did not consider interrupting the orthodontic treatment due to the COVID-19 pandemic (62.5%), and the majority of the participants from the control group did not consider not going to the dentist due to the COVID-19 pandemic (70.6%). Most of the participants from the study group were not happy that they had to wear a face mask, which covered their orthodontic appliances, during the orthodontic treatment (68.6%). The attitude was similar to that of the participants from the control group, who were not happy that they had to wear a face mask, that covered their smile (51.1%). In the study group, most patients did not want face mask wearing to continue to be compulsory, given the fact that their orthodontic appliances were no longer visible (52%). In the control group, the attitude was similar, with 48.1% of the participants not wanting face mask compulsoriness to be maintained. Conclusions: In conclusion, although, most patients would not like to continue wearing a face mask as a mandatory regulation, they were not concerned or negatively affected by wearing a protective face mask, even though face masks hid their braces.

Exploring the Quality of Life for Saudi Patients Utilizing Dental Healthcare Services: A Systematic Review

Over three billion people globally are affected by oral diseases. The Kingdom of Saudi Arabia (KSA) has declared a new vision for 2030, which includes an aim to improve the quality of healthcare in the Kingdom while maintaining the efficacy of spending. The Oral Health Impact Profile (OHIP) is a quality of life instrument that helps evaluate health status. This study aims to evaluate equity in accessing dental services and the integration of different types of dental services in the Kingdom of Saudi Arabia. A systematic review of the MEDLINE, ClinicalTrials.gov, and EBSCOhost Research Databases was conducted on August 1, 2021. To answer the research question, the SPIDER search tool that identified the sample, the phenomenon of interest, design, evaluation, and research type prior to conducting the review was adapted. Multiple steps were followed to identify the results. The first step was scanning and selecting the related titles. The second step involved reviewing the abstracts, and the third step involved scanning the full manuscript for all criteria to determine and validate the eligibility of the articles. Twenty-two articles remained in the final stage of the study. The first study applying the OHIP instrument in the KSA was in 2010, and the latest was in 2021. In terms of cities, nine cities accounted for research within eight administrative regions. Of the 4794 patients recruited within these reviewed articles, the highest number of patients reported was 1141 for fashion braces, while the minimum number of patients was 32 for conventional complete dentures. This study shows that the Arabic OHIP tool was successfully adapted by multiple dental studies in the KSA with various dental services and results were reported. The reviewed studies suggest that equity and integration of dental health services are well established in Saudi Arabia. Moreover, the major role of dental academic researchers has been identified.

Assessment of Oral Health-Related Quality of Life and Its Associated Factors among the Young Adults of Saudi Arabia: A Multicenter Study

Oral health-related quality of life (OHRQoL) is an essential indicator of people's overall health and health-related quality of life. Poor oral health and OHRQoL among young adults lead to numerous negative consequences and an increased burden on the healthcare system. The present study is aimed at assessing the OHRQoL among the young adults of Saudi Arabia, identifying self-rated oral health, and determining the relationship between sociodemographic and lifestyle factors with the OHRQoL. The present analytical cross-sectional survey was conducted among 1152 health and non-health-related college university students from three randomly selected universities. The OHRQoL was evaluated using the validated Arabic version of the oral health impact profile-14 questionnaire (OHIP-14). Of the population studied, one-fourth of the participants (24.9%) reported poor or fair oral health, and the highest OHIP-14 score was found in the domains of physical pain (4.14), followed by psychological discomfort (4.07). Logistic regression analysis revealed that the poor oral health category was significantly associated with male gender (ref: female: adjusted OR (AOR) = 1.89, 95%CI = 1.23–2.94, p = 0.004), daily smokers (ref: nonsmokers: AOR = 3.47, 95%CI = 1.97–4.82, p < 0.001), chocolate and candies intake more than once a day (ref: never; AOR = 1.54, 95%CI = 1.10–2.19, p = 0.034), and did not seek periodical dental care (ref: periodic dental care received: AOR = 2.23, 95%CI = 1.53‐2.86, p = 0.002). The present study revealed the factors associated with poor OHRQoL. The concerned authorities should consider the implementation of periodic dental checkups for university students, especially for the high-risk group. Furthermore, it is recommended to have regular health education programs that will help to change the student's lifestyle and poor oral health behaviors.

Factors associated with the use of fashion braces of the Saudi Arabian Youth: application of the Health Belief Model

BACKGROUND

In spite of the fact that fashion braces (FBs) have been in the spotlight in recent years among both orthodontists and the general public in several countries, there is still limited evidence regarding FBs. The aim was to identify health-related behaviors in using FBs by considering the Health Belief Model (HBM).

METHODS

A cross-sectional study with a random sampling technique was conducted in Jazan, Saudi Arabia. The data was obtained from different middle and high schools students, and first-year students at Jazan University. The questionnaire collected data on demographic characteristics and 27 items to examine the constructs of the HBM. Chi Square test was carried out to establish the factors associated with using, the intention to use, and previous knowledge on the use of fashion braces. Logistic regression analysis was utilized to determine the factors associated with the use of fashion braces.

RESULTS

406 study participants completed the questionnaire with a response rate of 88.3%. Majority of respondents were males (52.2%) and > 19 years old (44.3%). Only 9.9% students had used the FBs. However, 25.7% of students had the intention to use them. The perceived susceptibility, perceived benefits and cues to action constructs scores were fair with the mean values of 15.38 (SD = 9.4), 28.17 (SD = 10.8) and 6.65 (SD = 2.50), respectively. However, the perceived barrier score was high with the mean values of 22.14 (SD = 7.50), and lower score of self-efficacy with mean of 8.73 (SD = 3.30). Gender, age, monthly income (family), and education level were significantly (p < 0.05) associated with the use of fashion braces among the study's participants. Based on the results of logistic regression analysis family income, perceived susceptibility, and risk severity constructs predict the use of fashion braces in the study's sample.

CONCLUSIONS

The current study suggests that the family income, perceived susceptibility, and risk severity of students significantly influence the use of fashion braces. Hence, it is recommended that researchers should investigate effective educational strategies and programs for improving young people's knowledge about fashion braces and focus more on low family income students so that their using of fashion brace will be decreased.