Mediation and moderation effect of the big five personality traits on the relationship between self-perceived malocclusion and psychosocial impact of dental esthetics

Acceptance of potential risks in adult orthodontic patients and the influence of personality traits

OBJECTIVES

To determine acceptance of potential risks in orthodontic treatment and whether it could be affected by personality traits of patients.

MATERIALS AND METHODS

Two hundred sixty-one adult participants consulting for orthodontic treatment were involved in this cross-sectional study. Acceptance of 18 orthodontic risks was investigated with a structured questionnaire. Personality traits of included patients were assessed with a validated Chinese version of the Big Five Inventory. Statistical analyses were performed as appropriate, and potential correlations were identified using multivariate binary logistic regression analysis.

RESULTS

Acceptability of the investigated orthodontic risks ranged from 47.1% to 87.0%, with periodontitis being the least accepted. Length of treatment (P = .015) and relapse (P = .007) were more unacceptable to older patients. Female participants showed less tolerance to periodontitis (P = .017) than male counterparts. Among the five dimensions of personality traits, conscientiousness was significantly associated with acceptance of tooth extraction and associated risks (odds ratio [OR] = 1.131, P = .002), problems eating (OR = 1.182, P < .001), problems speaking (OR = 1.111, P = .022), and appliance breakage (OR = 1.109, P = .008), while openness was a significant predictor to the acceptance of length of treatment (OR = 1.090, P = .044).

CONCLUSIONS

Among patients seeking orthodontic treatment, periodontitis was the least accepted risk. A significant association was found between the acceptance of certain orthodontic risks and personality traits, especially conscientiousness and openness.

Treatment motivation, psychosocial impact, and perfectionism in children and adult orthodontic patients: A cross-sectional study

INTRODUCTION

With a shift in orthodontics from a more traditional biomedical model toward a more biopsychosocial model, orthodontists must understand their patients' psychological condition. This study aimed to investigate treatment motivation, psychosocial impact from malocclusion, and perfectionism in children and adult orthodontic patients and to examine the relationships among these various factors.

METHODS

A total of 193 participants (114 children and 79 adults) were included. All participants completed a treatment motivation questionnaire, Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Frost Multidimensional Perfectionism Scale (FMPS), and self-perceived Aesthetic Component of the Index of Orthodontic Treatment Need. Malocclusion severity was assessed using the Dental Health Component of the Index of Orthodontic Treatment Need by 1 orthodontist.

RESULTS

Statistically significant differences were found between children and adults regarding motivation concerning function, PIDAQ total, as well as subscores except for dental self-confidence (P <0.01) and subscores of FMPS, such as concerns over mistakes and parental expectations (P <0.05). The multiple regression analysis demonstrated a direct relationship between PIDAQ and age, gender, total FMPS, self-perceived Aesthetic Component of the Index of Orthodontic Treatment Need, and motivation (P <0.01).

CONCLUSIONS

Adults anticipate greater improvement in oral function and experience greater negative psychosocial impact from malocclusion compared with children. Orthodontic patients with higher age, being female, high level of perfectionism, or negative self-perception of dental esthetics are associated with greater negative psychosocial impact from malocclusion. In addition, patients experiencing a greater negative psychosocial impact tend to have a strong motivation for orthodontic treatment.

Patients' and Parents' Concerns over Orthodontic Treatment during the COVID - 19 Pandemic

Objective

We aimed to assess the impact of the COVID-19 pandemic on the concern of adolescents in orthodontic treatment, and to determine whether personality traits and parental perception were predictors of adolescent patients' concerns.

Participants and methods

The sample consisted of 229 adolescent patients (57.2% female) and 223 parents (65.1% female). Questionnaires included items about the importance of infection control and concern about treatment duration and results. Their latent structure was determined using exploratory factor analysis. The Big Five Inventory was used for assessing personality traits. Predictors of patients' and parental orthodontic concern and awareness of the importance of infection control measures were tested by the hierarchical multiple regression analysis.

Results

Two factors were revealed for the patient questionnaire, Treatment concern (TC) and Awareness of the importance of measures (AM), and four factors for the parent questionnaire, Parents' treatment concern (PTC), Parents' awareness of the importance of measures (PAM), Parents' concern about the pandemic (PCP) and Parents' concern about their child with regards to the pandemic (PCC). Adolescents' personality traits were not predictors of either TC or AM. PTC was a predictor of TC (p<0.001), accounting for 28% of the variance. PAM and the patient's following of the news were predictors of AM (p≤0.022), accounting for 24% and 2% of the variance, respectively.

Conclusion

Parental concern and awareness of measures had an important role in attitudes of adolescent orthodontic patients during the COVID-19 pandemic, while personality traits did not. The clinician should put additional emphasis on communication with the parent.

What impact do personality traits have on self-perception of dental aesthetics?

BACKGROUND

Malocclusion has significant social, psychological and physical impacts on the quality of life. This study aimed to study psychosocial impact of dental aesthetics among students, and how it was modified by personality traits.

METHODS

Chinese version of Eysenck Personality Questionnaire Short Scale of (EPQ-RSC) and Chinese version of Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) were used to investigate 555 undergraduate students, aged 18 to 24 years. The participants and investigators self-rated their own dental aesthetics using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). The malocclusion was assessed by two independent investigators using the Dental Health Component (DHC) of IOTN.

RESULTS

No statistically significant difference was found for gender (p = 0.829) nor for majors (p = 0.598) in the psychosocial impact of dental aesthetics. Total and subscale PIDAQ scores differed significantly among the 3 IOTN grades. PIDAQ scores strongly correlated with Eysenck personality. The dimensions of extraversion and neuroticism, and dental health component grades had significant impact on participants' psychosocial well-being of dental aesthetics.

CONCLUSIONS

Neurotic people with high self-concerns perceived greater psychosocial impact. Outgoing people appear to be less affected psychosocially by dental aesthetics.

Effect of personality traits on the association between clinically assessed malocclusion and the psychosocial impact of dental aesthetics

OBJECTIVE

We aimed to assess whether personality traits affect the relationship between malocclusion and the psychosocial impact of dental aesthetics and whether they act as its mediators or moderators.

SETTINGS AND SAMPLE POPULATION

The cross-sectional study included 252 participants with permanent dentition (62% female) aged 12-39 years.

MATERIALS AND METHODS

The Big Five Inventory, the Psychosocial Impact of Dental Aesthetics Questionnaire and the Index of Complexity, Outcome and Need were used. Moderation and mediation were tested by hierarchical stepwise multiple linear regression.

RESULTS

Malocclusion was the most significant predictor of dental self-confidence (DSC), aesthetic concern (AC), social impact (SI) and psychological impact (PI), accounting for 12%-28% of respective variability (P < .05). Adult age, male sex and higher neuroticism and agreeableness were additional predictors of higher DSC (P < .05). Adolescent age was a predictor of higher AC, SI and PI, and female sex of higher AC and PI (P < .05). Mediation by personality traits was not proven, however, openness, agreeableness and neuroticism were moderators. A tendency of decrease in AC was associated with an increase in malocclusion complexity in adolescents lower in openness and decrease in SI in adolescents with lower agreeableness. There was also a tendency of higher increase of AC associated with an increase of malocclusion degree in adults higher in neuroticism.

CONCLUSION

In adolescents, openness and agreeableness moderate the relationship between malocclusion and AC and SI, respectively. Neuroticism is a moderator of the association between malocclusion and AC in adults.

Factors Influencing Appliance Wearing Time during Orthodontic Treatments: A Literature Review

This review aims to analyze the multiple factors affecting patients’ level of compliance (how much they wear removable devices/clear aligners) during orthodontic treatments and to investigate the available methods and devices to monitor the appliance wearing time and to improve it. A literature search was conducted on electronic databases (Pubmed, Scopus, and Google Scholar). The results of the present study suggest that compliance indicators may misestimate the intraoral wearing time. Compliance is affected by patient-related factors (age, personality traits, the importance of personal appearance, self-perception of malocclusion), appliance-related factors (visibility, pain/discomfort), and clinician-related factors (trust, clear and complete communication, motivation). The motivation of pre-pubertal patients is mostly external, while adolescents/young adults have intrinsic motivation for orthodontic treatment. Patients’ self-reports tend to overestimate the appliance wearing time. Even if there is a lack of evidence, teledentistry might improve patients’ awareness of being monitored, thus increasing the time for which orthodontic devices are worn. Compliance is a key factor for clear aligner treatments, but high-quality studies focusing on this aspect are missing. Further studies should focus on how to handle the lack of cooperation and how to increase compliance in order to maximize the treatment’s results.

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.

Influence of personality traits on a patient's decision to accept orthognathic surgery for correction of dentofacial deformity

OBJECTIVES

To investigate the influence of personality traits in addition to quality of life (QoL) on the decision to accept orthognathic surgery.

MATERIALS AND METHODS

A total of 108 patients (68% female) aged 14-53 years (median, 18 years; interquartile range, 17-25.75 years), with skeletal malocclusions of Index of Orthognathic Functional Treatment Need grades 3-5 (moderate to very great need for surgery) were included in this cross-sectional study. Personality traits of extraversion, neuroticism, agreeableness, openness, consciousness, perfectionism, and self-esteem and dimensions of Orthognathic Quality of Life Questionnaire were compared between patients who accepted orthodontic preparation for orthognathic surgery and those who refused (n = 55 vs 53).

RESULTS

Patients who accepted the suggested surgical procedure had higher age, perfectionism, facial esthetic (FE) concern, social aspect, and impairment of oral function (OF) as well as lower self-esteem with small to medium effect sizes (P ≤ .040; r = 0.198-0.399). Other personality traits and awareness of dentofacial deformity did not differ between the groups. In multiple logistic regression analysis, while controlling for sex, perfectionism, and self-esteem, the following predictors of acceptance of orthognathic surgery were higher: FE concern (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.3-9.1), OF (OR, 3.0; 95% CI, 1.0-8.6), and age ≥18 years (OR, 2.7; 95% CI, 1.0-7.1; P < .001).

CONCLUSIONS

Extraversion, neuroticism, agreeableness, conscientiousness, and openness do not significantly affect a patient's decision to accept orthognathic surgery. The influence of self-esteem and perfectionism is primarily on perception of alteration of QoL induced by dentofacial deformity.

Predicting denture satisfaction and quality of life in completely edentulous: A mixed-mode study

Aim:

The aim of the study was to evaluate the effect of dentist's communication skills and patient's psychological factors in predicting denture satisfaction and quality of life.

Settings and Design:

Cohort study.

Materials and Methods:

Patient-related variables were obtained using questionnaires in both pre- and post-intervention phases. In addition to this, in preintervention phase, lacunae in doctor–patient communication were obtained. Based on this, the postgraduates were trained in relevant communication skills required during complete denture treatment. In postintervention phase, the postgraduates were again followed up for continuation or decay of skills.

Statistical Analysis:

Mixed-mode approach - quantitative and qualitative analysis.

Results:

Both groups were similar in psychological parameters, personality domains, denture quality and quality of life at baseline. However, there was significant difference in denture satisfaction (P < 0.001) in both the groups. In the experimental group, denture satisfaction was more (80.4%) and quality of life had improved from baseline to 3 months (P = 0.000). Denture satisfaction was associated with self-efficacy (P = 0.002) and the communication skills of the dentist (P = 0.000). Quality of life was associated with the conscientiousness domain of personality (P = 0.049) and the communication skills of the dentist (P < 0.05).

Conclusion:

Satisfaction and quality of life with dentures were associated with self-efficacy, conscientiousness domain and the communication skills of the dentist. Denture satisfaction can be predicted by dentist communication skills. Therefore, training in communication skills for complete denture patient management and assessment of the psychological profile of the patient could contribute to the effective patient-centered practice to avoid patient dissatisfaction.

Is the adolescent's esthetic concern associated with anterior occlusal conditions or the malocclusion severity level?

OBJECTIVES

To assess the esthetic impact of anterior occlusal conditions and malocclusion severity levels.

MATERIALS AND METHODS

A population-based cross-sectional study of 700 adolescents aged 15 to 19 years was conducted. The Oral Aesthetic Subjective Impact Scale (OASIS) was used to evaluate the subjective esthetic impact of malocclusion. The Dental Aesthetic Index (DAI) criteria were used to diagnose the anterior occlusal characteristics in isolation and the severity levels of malocclusion. The variables with P < .20 in the individual analyses were tested in multiple logistic regression models, and those with P < .10 remained in the model. The adjusted odds ratio (OR) was estimated with a 95% confidence interval (CI).

RESULTS

Of the adolescents, 42% showed negative self-perception of malocclusion. In addition, 15.4% of adolescents had severe malocclusion (DAI 3) and 18.9% very severe malocclusion (DAI 4). Crowding and spacing were shown to be 2.90 (CI: 2.06-4.09) and 2.53 (CI: 1.65-3.86) times, respectively, more likely to cause a negative esthetic impact in adolescents (P < .05). In addition, adolescents with orthodontic treatment need (DAI 2, 3, and 4) were more likely to report a negative esthetic impact (P < .05).

CONCLUSIONS

Anterior crowding and spacing are the conditions that most influence the esthetic concern of adolescents. Adolescents with very severe malocclusion and higher orthodontic treatment need are more likely to report a negative esthetic impact.

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.

A biopsychosocial-cultural model for understanding oral-health-related quality of life among adolescent orthodontic patients

Background

Based on previous theoretical oral-health-related quality of life (OHRQoL) models and most recently framework, as well as sociocultural model of body image dissatisfaction, the current study aimed to investigate the effect of individual (dental aesthetics and dental appearance social comparison) and sociocultural factors (social reinforcement from parents, peers and mass media on dental aesthetics) as well as their interaction on psychosocial dimension of OHRQoL among adolescent orthodontic patients.

Methods

In this cross-sectional study comprising 427 adolescent orthodontic patients (151 boys and 276 girls) aged between 11 and 16 years old, the psychosocial dimension of OHRQoL was measured by Psychosocial Impact of Dental Aesthetics Questionnaire. Individual predictor of dental aesthetics was defined by the Aesthetic Component of the Index of Orthodontic Treatment Need, and dental appearance social comparison was assessed by four items adapted from Physical Appearance Comparison Scale. Sociocultural predictor of social reinforcement was measured by six items adapted from Perceived Sociocultural Pressure Scale. Spearman correlations, path analyses, and structural equation modeling were used to build up several predictive models.

Results

As hypothesized, two direct pathways were observed that patients’ dental aesthetics and all three sources of social reinforcement directly predicted the psychosocial dimension of OHRQoL. Meanwhile, we observed one indirect pathway, that three sources of social reinforcement predicted the psychosocial dimension of OHRQoL, in part, through dental appearance social comparison.

Conclusions

This study provides preliminary evidence indicating that dental aesthetics, social reinforcement and dental appearance comparison are reliable predictors of psychosocial dimension of OHRQoL among adolescent orthodontic patients.

Relationship between normative and self-perceived criteria for orthodontic treatment need and satisfaction with esthetics and mastication in adolescents

INTRODUCTION

Orthodontic treatments are performed to improve esthetics and masticatory functions. In general, clinical criteria are used to recommend such treatments without considering the opinion of the patient. This study aimed to evaluate the relationship between technically defined orthodontic need (normative criteria) and the need for treatment perceived by adolescent patients.

METHODS

A total of 215 students aged between 15 and 19 years were selected and asked to respond to a questionnaire concerning their perception of need for orthodontic treatment and their satisfaction with their own esthetics and mastication. One trained and calibrated examiner obtained normative data using the Dental Aesthetic Index (DAI) on the need for orthodontic treatment of these students.

RESULTS

Associations were found between the DAI score and the patient's perception of need for orthodontic treatment (P <0.001), satisfaction with esthetics (P = 0.003), and satisfaction with mastication (P = 0.047). When occlusal characteristics were analyzed separately, associations between several normative and perceived needs, as well as for satisfaction with esthetics, were found. Satisfaction with mastication analysis was only found to be associated with open bite malocclusion (P = 0.003).

CONCLUSIONS

The DAI revealed a consistent opinion in adolescents to link their perceived malocclusion-related conditions to esthetics.

Non-extraction and multiloop edgewise technique versus orthognathic surgery and fixed appliance in adult class II patients: a cephalometric comparative study

BACKGROUND

An alternative approach to surgery for treating class II adult borderline patients is the non-extraction and multiloop edgewise archwire (MEAW) technique. The aim of the present study is to compare dentoskeletal effects of the orthognathic surgery with the MEAW technique.

METHODS

Thirteen adults (ten women, three men; mean age, 27.8 years) were consecutively treated using the MEAW approach. The control group was made of 13 adults (nine women, four men; mean age, 26.2 years) treated by orthognathic surgery and the multibracket appliance before and after surgery. Lateral headfilms before and after all the treatments were traced for linear and angular measurements, and data were blindly analyzed. ANOVA was conducted to compare any difference over time between the two treatments. Differences over time for each variable, separately for surgery and MEAW, were assessed by Wilcoxon test.

RESULTS

No significant differences between the two groups were detected at baseline. Both treatments were effective in correcting dental discrepancies. A significant difference over time between the two treatments was found in several cephalometric measurements.

CONCLUSIONS

Considering the limits of the present sample the following conclusion emerged: in the MEAW group, the malocclusion correction was predominantly dentoalveolar, and a significant profile change was observed. Significant skeletal and occlusal plane changes were obtained with the orthognathic surgery approach.