Malocclusion impacts adolescents' oral health-related quality of life

Impact of molar incisor hypomineralization on oral health-related quality of life, dental fear and anxiety in Swedish children

OBJECTIVES

The aims this research were to analyze self-reported oral health-related quality of life (OHRQoL) and dental fear and anxiety (DFA) in 11-year-old patients after either restorative treatment or after extraction of first permanent molars (FPM) affected by severe molar incisor hypomineralization (MIH). The research question focused on whether these treatments lead to different outcomes of DFA and OHRQoL over time.

MATERIALS AND METHODS

GuREx-MIH, a multicenter trial, was conducted involving 83 children aged 6-9 years who were diagnosed with severe MIH in FPMs. Patients were randomly assigned to receive either restorative treatment with resin composite or extraction. Patient comfort was assessed through OHRQoL and DFA, using the Swedish version of the Child Perceptions Questionnaire (CPQ11-14) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), which were administered before treatment (T0) and at follow-up when patients were 11 years old (T1). Descriptive statistical analyses were conducted and comparisons between the restorative and extraction groups were performed using T-tests.

RESULTS

A total of 79 patients completed the study, with 43 allocated to restorative treatment and 36 to extraction. At follow-up, the mean OHRQoL score was 8.9 (standard deviation [SD] 7.3) for patients in the restorative group and 9.6 (SD 6.7) for those in the extraction group (p: 0.337, T-test). The mean DFA score was 21.5 (SD 5.5) for the restorative group and 23.1 (SD 6.8) for the extraction group (p: 0.130, T-test).

CONCLUSIONS

Restorative treatment and extraction of FPMs affected by MIH lead to similar impact on DFA and OHRQoL at 11 years of age.

Causal effect of molar incisor hypomineralisation on oral health-related quality of life of Australian children aged 7-16 years

PURPOSE

Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel characterised by demarcated opacities. Aesthetic and functional sequelae of MIH may manifest as reduced oral health related quality of life (OHRQoL). This study aims to investigate the impact of the presence and severity of MIH on children's OHRQoL.

METHODS

This cross-sectional study recruited children aged 7-16 years-of-age attending specialist paediatric dental clinics in Melbourne, Australia. Clinical examination utilised the modified European Academy of Paediatric Dentistry index to quantify the presence and severity of MIH. OHRQoL data was collected via the Child Perception Questionnaire, Parent-Caregiver Perception Questionnaire and Family Impact Statement. Causal analysis used quantile regression and included poor medical health as a confounding variable. Sensitivity analysis used the same model and different strata of MIH lesion location and severity.

RESULTS

131 participants with complete self-reported OHRQoL data were included in the causal analysis. The estimated average causal effect after adjusting for poor medical health showed the estimated difference in medians of child-reported OHRQoL was 6 (CI = 2.62, 12.25, p = 0.02) in the MIH group compared to the unaffected group. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 7 (CI = 1.87, 11.99, p = 0.01) for severe MIH group and - 1 (CI = - 5.16, 3.62, p = 0.63) for the mild group compared to those unaffected. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 5.16 (CI = - 2.42, 10.99, p = 0.15) for participants with MIH-affected incisors compared to the rest of the cohort.

CONCLUSIONS

MIH impacts children's OHRQoL as reported by self and parent/caregiver.

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.

Evaluation of Pediatric Oral Health-Related Quality of Life score in children with traumatic dental avulsion injury: A Questionnaire-Based Cross-Sectional survey

BACKGROUND/AIM

Dental avulsion injury, being one of the traumatic dental injuries, has negative impacts on children's life quality. This study aims to evaluate the Pediatric Oral Health-Related Quality of Life (POQL) scores of children with dental avulsion history from their perspective.

MATERIALS AND METHODS

The population of this cross-sectional study comprises 40 patients, aged between 8 and 14, who have a history of dental avulsion, in comparison to 40 other healthy peers. A questionnaire including general questions (such as age, gender, loss of tooth due to dental avulsion, malocclusion) and POQL instrument, with subscales including physical function, social function, emotional function, and role function, were completed by these children. Mann-Whitney U-test is used when comparing the POQL scores.

RESULTS

The social scores (median: 47, interquartile range [IQR]: 17-95) and total score percentages (median: 30, IQR: 14-40) of children with a history of avulsion were higher than those of their healthy peers (p < 0.05). The higher total POQL scores among girls (median: 37, IQR: 31-47) with a history of dental avulsion compared to boys (median: 19, IQR: 8-34) (p = .002) can be attributed to girls achieving higher scores in both social (median: 81, IQR: 39-100) and emotional (median: 35, IQR: 17-47) scores following dental avulsion (psocial = .02, pemotional = .006). Whether the avulsed tooth is replanted or not, it has not made any visible impact on the POQL scores. However, the loss of replanted teeth over time has created a borderline significant difference in emotional scores (median: 21, IQR: 11-35, p = .055).

CONCLUSION

Within the limits of our study, avulsion injuries have negative effects on children's emotional, social, and total quality of life. Even though avulsion injuries may be inevitable, to prevent these negative effects, it is vital to provide appropriate psychological support in the treatment of these children.

Association between self-reported oral habits and oral health related quality of life of adolescents in Ibadan, Nigeria

Oral habits such as nail biting, thumb/digit sucking and teeth grinding could be harmful, and may lead to teeth misalignment, anterior open bite, protruded or flared upper anterior teeth especially if they persist into adolescence. Such orofacial dysfunction may result to impairment of the Oral Health Related Quality of Life (OHRQoL) of an individual. The extent to which oral habits affect the major domains of the self-reported outcomes remains understudied especially during adolescence, a unique period of growth, where there is increased aesthetic desire, increased self-awareness, and unique social and psychological needs. The aim of this study, therefore, was to determine the prevalence of oral habits and its association with oral health related quality of life of adolescents. This cross-sectional study was conducted among 700 adolescents aged 10 to 19 years (with mean age 14.6 (±1.3) years) attending 14 secondary schools in Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed sociodemographic characteristics of the students, oral habits and OHRQoL with Oral Health Impact Profile 5 (OHIP-5). Data were analyzed with SPSS and p value was at <5%. Mann Whitney U statistics was used to test for associations between OHIP-5 scores and presence or absence of oral habits. Logistic regression was used for multivariate analysis. A total of 363 (51.9%; 95%CI = 48.1%-55.6%) bite their nails, 216 (30.9%; 95%CI = 27.5%-34.4%) breathe with their mouth, 122 (17.4%; 95%CI = 14.7%-20.4%) suck their lips, 89 (12.7%; 95%CI = 10.3%-15.4%) grind their teeth together and 32 (4.6%; 95%CI = 3.1%-6.7%) sucked their thumbs. A total of 403 (81.1%) adolescents who engaged in at least an oral habit reported an impairment of their OHRQoL. Painful aching in the mouth was the most frequently affected OHRQoL item reported by the adolescents who engaged in oral habits. Those who sucked their thumbs (OR = 2.3, 95%CI = 1.1-4.7, p = 0.028) and those who sucked their lips were more likely to have poorer OHRQoL (OR = 1.6, 95%CI = 1.1-2.5, p = 0.024). Oral habits were prevalent among the adolescents and affected their OHRQoL. Those who sucked their thumbs and lips were more likely to report poorer OHRQoL than those who did not.

Impact of orthodontic treatment on OHRQoL of adolescents: a longitudinal study

OBJECTIVE

The aim of this study was to evaluate the extent to which orthodontic treatment need is perceived by the patients and by the orthodontist, as well as the possible impacts on the OHRQoL (Oral Health-Related Quality of Life) over the course of conventional orthodontic treatment in adolescent patients.

METHODS

The sample consisted of 55 adolescents. The perception of patients and orthodontists relative to the malocclusion was evaluated by the IOTN (Index of Orthodontic Treatment Need). The OHRQoL was evaluated by the Child-OIDP (Child-Oral Impacts on Daily Performances) questionnaire before the conventional orthodontic appliance was bonded (T0); and at the following time intervals: after one week (T1), one month (T2), three months (T3), six months (T4), and after the end of orthodontic treatment (T5).

RESULTS

Adolescents who had large orthodontic treatment needs had a poor OHRQoL, according to their self-perception (p=0.003) and according to the orthodontist's perception (p<0.001), when compared with patients with small and moderate needs. There was statistically significant difference in the OHRQoL between the time intervals T0 and T1 (p=0.021), T2 and T3 (p<0.001), T3 and T4 (p=0.033), and T0 and T5 (p<0.002). At the end of treatment, all evaluated participants reported an improvement in OHRQoL.

CONCLUSIONS

It was concluded that adolescents and orthodontists agreed with regard to the perception of orthodontic treatment need. In the first week and in the first month of orthodontic treatment, there was a negative impact on the OHRQoL. After three months, an improvement of OHRQoL was detected, which has progressed over time.

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 Orthodontic Treatment Need and Oral Health-Related Quality of Life in Asthmatic Children Aged 11 to 14 Years Old: A Cross-Sectional Study

This study investigated the need for orthodontic treatment in asthmatic children aged 11 to 14 years and how the treatment affected their oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

This cross-sectional study was conducted at the dental clinic of the University of Salamanca in 2020-2022. The study selected a consecutive sample of 140 children with asthma (52.1% girls; 47.9% boys). This study used the Orthodontic Treatment Needs Index (OTN) to analyze the need for orthodontic treatment and the Children's Perception Questionnaire (CPQ11-14) to assess OHRQoL.

RESULTS

Sex and age did not significantly influence the need for orthodontic treatment, although age may be considered influential for OHRQoL concerning oral symptoms (p < 0.01), functional limitations (p < 0.05), and total score on the CPQ_11-14 questionnaire (p < 0.05): the younger the age, the greater the effect of the need for orthodontic treatment on OHRQoL. The social well-being of the patients was much more significantly impacted by the need for orthodontic treatment (15.7 ± 1.91) than by oral symptoms (7.64 ± 1.39), which were the least impacted. In all parts of the CPQ_11-14 questionnaire and in the patients' total scores, we observed significant agreement (p < 0.01) that treatment influenced OHRQoL.

CONCLUSION

An inverse relationship exists between the severity of the treatment needed and OHRQoL.

Impact of dental bullying on bruxism associated with poor sleep quality among adolescents

This study aimed to investigate the impact of school bullying and oral health-related verbal bullying on the occurrence of bruxism associated with poor sleep quality among adolescents. This cross-sectional study was nested in a cohort study performed with a sample of children from southern Brazil. Possible sleep bruxism was determined by the question: "Has anyone told you that you grind your teeth in your sleep?" Sleep quality was determined by answering the following question: "How would you classify the quality of your sleep?". The outcome was created by combining occurrence of sleep bruxism and poor sleep quality. The Sense of Coherence (SOC) was assessed using the SOC-13 scale. Bullying was investigated using the victim scale of the Olweus Bullying Questionnaire and oral health-related verbal bullying using an item from the Child Perceptions Questionnaire-11-14. Demographic, socioeconomic, psychosocial, and clinical data were also collected. Poisson regression models with robust variance were used. Results were expressed as prevalence ratio (PR) and 95% confidence intervals (95% CI). A total of 429 adolescents with a mean age of 12.6 (standard deviation 1.3) years were evaluated. The prevalence of bruxism associated with poor sleep quality was 23.7%. Victims of school bullying (PR 2.06; 95%CI: 1.01-4.22) and oral health-related verbal bullying (PR 1.87; 95%CI: 1.18-2.95) presented higher prevalence of bruxism associated with poor sleep quality. Factors such as skin color and SOC were also associated with the outcome. These findings suggest an association between episodes of bullying and bruxism related to poor sleep quality.

Benefits in Oral Health during Orthodontic Treatment of Patients Aged 17 to 21 Years

OBJECTIVES

 The aim of the present study was to evaluate the effects of orthodontic treatment on patients' oral health-related quality of life (OHRQoL) in a population aged 17 to 21 years. The influence of gender and malocclusion severity was also investigated.

MATERIALS AND METHODS

 In the present study, 108 patients were enrolled. Each patient completed a questionnaire about oral health impact profile (OHIP)-14 before treatment and after 12 months of treatment. The severity of the initial malocclusion was evaluated through the index for orthodontic treatment need (IOTN).

STATISTICAL ANALYSIS

 Statistical analysis was performed to assess the presence of difference in OHRQoL score before and after the treatment, and the influence of gender and IOTN score on the observed outcomes.

RESULTS

 We found no significant differences related to gender regarding their perception of how malocclusion affects the quality of life before orthodontic treatment. Moreover, no significant differences were found between males and females regarding their perception of how orthodontic treatment affects the quality of life 12 months after orthodontic treatment. Also, the analysis showed no statistically significant difference between males and females in the correlation IOTN-OHIP for Grades 2 and 3. A statistically significant difference between males and females was found only in Grade 4, both before (p=0.046) and after treatment (p=0.051).

CONCLUSION

 Finally, OHIP-14 can be a valuable instrument to assess the perceptions and the expectations of patients toward orthodontic treatment.

Concern of adolescents in conflict with the Law about their oral health

Objective: To assess the self-perception of adolescents in conflict with the law about their concern with oral health, in addition to tracing their relationship with other related variables. Methods: A cross-sectional study involving male institutionalized adolescents in a city in southern Brazil who underwent clinical examination and interviews to understand their concern for their oral health and the relationship between this outcome and associated factors. Concern about oral health was obtained through a validated questionnaire. Two fitted models were performed using Poisson regression (α < 0.05). One of them used the decayed, missing, and filled teeth index (DMF-D), and another considered the components of this index as exploratory variables. Results: Sixty-eight adolescents were included, and a high occurrence (75%) of concern about their oral health was observed. In the final multivariate analysis that included DMFT, this index (prevalence ratio [PR]: 1.033; 95% confidence interval [95%CI]: 1.004 – 1.063) and concern about tooth color (PR: 2.208; 95%CI: 1.028 – 4.740) were significantly associated with oral health concerns. When the various index components were included in the multivariate model, only the number of decayed teeth (PR: 1.073; 95%CI: 1.007 – 1.144) and concerns about tooth color (PR: 2.250; 95%CI: 1.057 – 4.793) were associated with the outcome. Conclusion: Institutionalized adolescents are highly concerned about their oral health, being associated with a DMF index, especially the decayed component, and a concern with the color of their teeth.

Comparing oral health-related quality of life, oral function and orofacial aesthetics among a group of adolescents with and without malocclusions

OBJECTIVE

The aim was to analyze how malocclusion relates to perception of oral health-related quality of life (OHRQOL), oral function and orofacial aesthetics among a group of adolescents in Sweden.

MATERIAL AND METHODS

Thirty patients with a need for orthodontic treatment (IOTN-DHC grade 4 and 5) and 30 patients with normal occlusion (IOTN-DHC grade 1), aged 13-17 years, were included in the study. A questionnaire containing three parts was used; The Oral Health Impact Profile (OHIP-S14), Jaw Functional Limitational scale (JFLS-20) and Orofacial Aesthetic scale (OES). Malocclusions, orthodontic treatment need and confounders, such as earlier dental treatment and temporomandibular disorders, were registered.

RESULTS

Adolescents with malocclusions were more often embarrassed by their mouth and teeth compared to controls (p < .05). Aesthetically, adolescents with malocclusions were more negatively affected by the appearance of the mouth and teeth as well as the over-all facial appearance (p < .05).

CONCLUSIONS

Malocclusions clearly affects the adolescents with need for orthodontic treatment in this study. It influences their OHRQOL in the psychosocial impact dimension. Aesthetically they perceive their oral and facial appearance as worse compared to controls. Although embarrassed and unpleased with their oral appearance they still rate themselves as having a good oral health with low jaw function limitations.

Descriptive epidemiology of dental malocclusion in Najran patients seeking orthodontic treatment

Background

Untreated malocclusion can lead to compromised aesthetic function, depression, and low self-esteem. The aim of this study was to evaluate dental malocclusion in Najran, Saudi Arabia as no data existed before.

Method

This was a retrospective study analyzing the casts of all patients in Najran, Kingdom of Saudi Arabia, seeking orthodontic management for malocclusion between 2017 and 2019.

Measurements

The consultant orthodontist is the single investigator involved in collecting the details of demographics followed by molar relationships, overjet, overbite, crowding and spacing using digital caliper on each dental cast. Data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp.

Results

A total of 326 patients sought treatment for different types of malocclusion. There were 143 males and 183 females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. The prevalence for Class I, II and III malocclusions at 95% CI was (0.76 (0.757, 0.774)), 0.251 (0.243, 0.260) and 0.529 (0.519, 0.539) respectively. Fifty-one (15.6%) patients had reversed overjet, 65 (19.9%) reduced overjet, and 86 (26.4%) increased overjet. One hundred and sixty-four (50.3%) cases of reduced overbite and 99 (30.4%) cases of deep overbite were also observed. Tooth size arch length discrepancy were noticed with crowding and spacing in 83 (26.4%) and 71 (21.8%) patients, respectively.

Conclusions

This study has shown the prevalence of Class I, Class II, and Class III malocclusion to be 72.7%, 11.6% and 15.6% respectively. Increased over jet and crowding was demonstrated in more patients, though it is not statistically significant.

Impact of malocclusion severity on the quality of life of non-white adolescents

The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.

Impact of oral diseases on oral health-related quality of life: A systematic review of studies conducted in Latin America and the Caribbean

Background

We performed a systematic review of studies conducted in Latin America and the Caribbean (LAC) to assess the impact of oral diseases on oral health-related quality of life (OHRQoL).

Materials and methods

Searches were performed of the following PubMed, EMBASE, CINAHL, Scopus, and LILACS databases. Randomized clinical trials, quasi-experimental studies, cohort studies, case and control studies, and cross-sectional studies which included at least 100 participants evaluating the impact of oral diseases on OHRQoL were included. PROSPERO registry number: CRD42020156098.

Results

After exclusion of duplicates, 3310 articles were identified, 40 of which were included in this review. 90% of the studies were conducted in Brazil. The most commonly used OHRQoL measuring instruments were CPQ 11–14 (n = 9), ECOHIS (n-8) and B-ECOHIS (n = 8). The study designs included 32 cross-sectional, 2 cohort and 6 case and control studies. Most of the studies were conducted in children (n = 25) and adolescents (n = 9). Most studies identified an impact on OHRQoL in children, adolescents and adults with oral diseases. Moreover, greater oral disease severity had a greater impact on OHRQoL.

Conclusions

Most studies in LAC report a negative impact of diseases on OHRQoL. More longitudinal studies are required to confirm the results of these studies.

Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study

Objective:

To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL).

Methods:

7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated.

Results:

A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains.

Conclusion:

Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

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

BACKGROUND

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

OBJECTIVE

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

SUBJECTS AND METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

CLINICAL TRIAL REGISTRATION

This study was not registered.

PROTOCOL

The protocol was not published before trial commencement.

Modelling risk factors for high/low Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) in the Australian adults

OBJECTIVE

Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception needed for orthodontic treatment (OT). The study aimed to (1) evaluate the psychosocial impact of dental aesthetics and the potential role of OT and (2) determine associations between PIDAQ with self-rated general and oral health, oral health-related quality of life (OHRQOL), and receipt of OT among Australian adults.

METHODS

Data were obtained from the 2013 Australian National Dental Telephone Interview Survey (NDTIS). The PIDAQ was utilized as main outcome, comprising items from four conceptual domains: self-confidence, social impact, psychological impact, and aesthetic concern. Participants reported their socio-demographic, behavioural, self-rated general and oral health as well as the poor OHRQOL using the Oral Impact on Daily Performance (OIDP) instrument and OT. The mean of PIDAQ and four subscales score and their 95% confidence intervals (CI) were estimated. Generalized liner regression was used to estimate association between PIDAQ and covariates by calculating the mean ratio (MR) and their 95% CI.

RESULTS

There were 2936 Australian adults who completed the PIDAQ items. The mean PIDAQ score was 28.8 (95% CI: 28.0-29.6). Higher PIDAQ scores were identified among those who reported non-Australian birth, lower incomes, infrequent dental visits, less than 21 teeth and brushing teeth less than twice a day, fair/poor self-rated general and oral health, and poor OHRQOL. In multivariable modelling, the mean PIDAQ score was 1.91 (95% CI: 1.82-2.00) times higher among those with OIDP score >3 and 1.06 (95% CI:1.01-1.10) times higher in those who had OT, comparing with their counterparts. Also, higher PIDAQ scores were identified among females, last visiting a dentist more than 2 years ago, fair or poor self-rated oral and general health.

CONCLUSIONS

Higher PIDAQ scores that have a greater impact on OHRQOL were associated with poorer self-rated general and oral health. This may be explained by unfavourable dental attendance and oral health habits. The positive correlation with OIDP scores verifies the validity of the PIDAQ. Those who had received OT had lower PIDAQ and OIDP scores.

Correlation between adolescent orthodontic quality of life and ABO Discrepancy Index in an orthodontic treatment-seeking population: A cross-sectional study

OBJECTIVE

To evaluate the association between adolescents' orthodontic quality of life before initiating orthodontic treatment and their objective case complexity as measured by the American Board of Orthodontics' Discrepancy Index (DI).

DESIGN AND SETTING

A single-centre, cross-sectional survey study.

METHODS

The Orthodontic Quality of Life Assessment Survey (OQoLAS) was administered to 240 adolescents (aged 11-14 years) during their record-gathering appointment. After completion of the survey, a DI score was calculated for each patient based on pretreatment measurements. Pearson correlation coefficients, r, were used to assess the association of DI scores with OQoLAS total and subdomain scores. A multiple linear regression of OQoLAS total scores adjusting for age, gender and DI scores was conducted.

RESULTS

The study did not find a strong correlation between OQoLAS and DI scores (r = 0.10; P = 0.6497). On average, the OQoLAS scores (functional, emotional and social subdomains of OQoLAS) were slightly higher among girls than among boys but there was no statistical difference for total OQoLAS score between boys and girls (42.4 vs. 45.4, P = 0.2005). However, there was a significant difference in oral health perception rating between boys and girls, with girls being more likely to rate their oral health positively (adjusted P = 0.0226). The total DI scores of boys with respect to girls were not statistically different (P = 0.4256). The components of the DI that showed highest score were for cephalometric measures, followed by overjet; and the lowest scores were for lateral open bite and buccal posterior crossbite. The measure of association analysis did not show any strong correlation between the OQoLAS (total score and subdomain scores), and DI score or any of its components.

CONCLUSION

Malocclusion severity was not found to be correlated with orthodontic quality of life in adolescents aged 11-14 years seeking orthodontic treatment.

Effect of malocclusion severity on oral health related quality of life in Malay adolescents

BACKGROUND

The present study aims to determine the impact of malocclusion on oral health related quality of life (OHRQoL) among 13-16 years old Malay school children.

METHODS

School children aged between 13 and 16 years old were randomly selected from a secondary school in Penang. Malay version of Oral Health Impact Profile-14 (OHIP-14) questionnaires were given to the subjects. This questionnaire has 14 questions with seven domains which are functional limitation, psychological discomfort, physical pain, physical disability, psychological and social disability, and handicap. Index of orthodontic treatment need dental health component was used to assess the orthodontic treatment need. Overjet (reversed overjet), open bite, overbite, cross bite, impeded eruption, crowding, defects of cleft lip and palate, Class II and Class III buccal occlusion, present of supernumerary and hypodontia were assessed.

RESULTS

255 students participated in this study. Mean score and standard deviation for OHIP-14 were 8.64 (± 7.32) for males and 11.05 (± 9.41) for females respectively. There was statistically significant difference in mean score of OHIP-14 between male and female (p = 0.023). A weak positive correlation was found between malocclusion severity and OHRQoL (r = 0.186; p < 0.01). Malocclusion had a negative impact on OHRQoL of the students in the present study. This impact was prominent in psychological discomfort and psychological disability domains of OHIP-14 (p < 0.05).

CONCLUSION

Increase in severity of malocclusion was associated with a negative impact on OHRQoL. Females exhibited more negative impact of malocclusion on their OHRQoL. Psychological domain was the most affected one.

The prevalence of malocclusion is higher in schoolchildren with signs of hyperactivity

INTRODUCTION

Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to evaluate the association between signs of attention deficit-hyperactivity disorder and malocclusion in schoolchildren.

METHODS

A cross-sectional study was conducted with a representative sample of 633 children aged 7-12 years. The children were clinically examined for malocclusion using the Dental Aesthetic Index. The predominant breathing pattern was also determined. Parents answered a questionnaire addressing socioeconomic characteristics and the presence of nonnutritive sucking habits. The Swanson, Nolan, and Pelham Scale-IV was filled out by both parents and teachers to compare behavioral patterns. The children were submitted to a neuropsychological evaluation using the Raven's Colored Progressive Matrix Test. Data analysis involved the chi-square test and Poisson regression analysis.

RESULTS

The prevalence of malocclusion was 42% higher among children with signs of hyperactivity reported by both parents and teachers (prevalence ratio [PR], 1.42; 95% confidence interval [CI], 1.11-1.81; P = 0.004). In the final Poisson regression model, the prevalence of malocclusion was lower among schoolchildren aged 11 and 12 years (PR, 0.62; 95% CI. 0.52-0.73; P <0.001) and higher among those who used a pacifier for at least 4 years (PR, 1.25; 95% CI, 1.02-1.54; P = 0.029) as well as those classified as mouth breathers (PR, 1.28; 95% CI, 1.09-1.51; P = 0.003).

CONCLUSIONS

The prevalence of malocclusion was higher among children with signs of hyperactivity independently of age, pacifier use, and mouth breathing.

Oral health-related quality of life among 12-year-olds

Aim: To assess oral health-related quality of life (OHRQoL) and associated factors among the 12-year-old population of the state of Minas Gerais, Brazil. Methods: Cross-sectional data from the SB-Minas Gerais 2012 study were used. The presence of poor OHRQoL was assessed using the Oral Impact on Daily Performance (OIDP) and its dimensions (physical, psychological and social domains). Independent variables included sociodemographic factors and variables related to the use of dental care and oral health conditions. The association between the outcomes and the independent variables were tested using logistic regression and the results reported as odds ratio with 95% confidence interval. Results: Prevalence of poor OHRQoL was 31.4%; the psychological domain was the most affected (22.6%). Pain and dissatisfaction with oral health were associated with poor OHRQoL on overall OIDP and all its domains. Non-whites had greater poor OHRQoL than whites on overall OIDP and physical domain. Conclusion: Self-perceived oral health and social inequalities were associated with poor OHRQoL.

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

BACKGROUND/AIM

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Parental influence is the most important predictor of child's orthodontic treatment demand in a preadolescent age

The aim was to explore the predictive value of objective treatment need, impaired quality of life, and parental influence on orthodontic treatment demand in preadolescents and adolescents. A secondary goal was to validate 16-item Child Perceptions Questionnaire for the 11-14 year age group (CPQ11-14): item-impact and stepwise-regression short-forms. A convenience sample of 287 participants (55% female) was used for validation. Internal consistency, test-retest reliability, and convergent validity were evaluated. Predictors of treatment demand were explored in 197 orthodontic patients: 93 preadolescents (51% females), 104 adolescents (55% females). Hierarchical linear regression and multilevel logistic regression models were used to explore the predictive power of age, gender, objective treatment need, impaired quality of life and parental influence on treatment demand. CPQ11-14 regression short-form had acceptable psychometric properties. Significant linear predictors of treatment demand were impaired emotional well-being (EW) (β = 0.335, p = 0.002), parental influence (β = 0.221, p = 0.002), and malocclusion severity (β = 0.152, p = 0.025). In logistic regression, parental influence was revealed as the most important predictor of treatment demand in preadolescents, OR = 7.7 (95% confidence interval CI 2.4-25.1; p = 0.001); objective treatment need in adolescents, OR = 4.5 (95% CI 1.5-12.9; p = 0.006). The increase of impairment in EW by one scalar point increased treatment demand by 1.4 (95% CI 1.1-1.9; p = 0.017) in preadolescents; 1.3 (95% CI 1.0-1.7; p = 0.021) in adolescents. Greater parental agreement and motivation for treatment could result in higher preadolescents' cooperation. Orthodontic treatment in adolescents might be more effective with the patient-oriented approach.

Analysis of the combined risk of oral problems in the oral health-related quality of life of Brazilian adolescents: multilevel approach

OBJECTIVES

The objective of this study was to evaluate the combined risk of oral problems in the oral health-related quality of life (OHRQoL) of adolescents aged 15 to 19 years in São Paulo state (Brazil) in the year of 2015.

MATERIALS AND METHODS

Data from the São Paulo State Oral Health Survey (SBSP-15) and the contextual characteristics of the cities of São Paulo state, evaluated in the year 2015 were accessed. Correlations were made between contextual factors (i.e., coverage of the family health team, average supervised tooth brushing, number of first dental appointments, and average income), individual sociodemographic variables (i.e., ethnicity, gender, and schooling) and dental problems (dental pain, caries, overjet, open bite, indication for endodontic and exodontic treatment, gingival bleeding, and dental trauma). These variables were correlated with the quality of life of the adolescents using the Oral Impacts on Daily Performance (OIDP) index. Multilevel Poisson regressions were performed to calculate the rate ratio (RR) with 95% confidence interval (CI).

RESULTS

According to the bivariate analysis, the presence of low (RR, 1.62; 95% CI 1.07-2.46) and very intense (RR, 2.53, 95% CI 1.92-3.34) dental pain, indication for endodontic (RR, 1.31; 95% CI 1.05-1.63) or for exodontic (RR, 1.31; 95% CI 1.06-1.63) treatment, and gingival bleeding (RR, 1.41; 95% CI 1.11-1.80) reduced the quality of life of adolescents. All domains of OIDP scores were associated between healthy and unhealthy individuals (p < 0.001) increasing mean scores with combined oral health problems. Higher impact on quality of life was associated with simultaneous presence of dental pain, gingival bleeding, and indication for exodontic treatment (RR, 6.03; 95% CI, 4.02-9.04) in the adolescents.

CONCLUSION

Individual and contextual factors and the various dental problems are independently associated with the quality of life of Brazilian adolescents aged 15 to 19 years, especially when they are associated with the perception of intense dental pain, gingival bleeding, and indication for exodontic treatment, with up to six times greater impact on OIDP.

CLINICAL RELEVANCE

The study highlighted the importance for an integral treatment in adolescents, considering that the associated risk of several dental diseases can progressively affect the quality of life of this population.

Socioeconomic inequalities in oral health-related quality of life in adolescents: a cohort study

PURPOSE

Socioeconomic inequalities are recognized as a major problem with people in low socioeconomic groups having worse subjective oral health outcomes, including oral health-related quality of life (OHRQoL). However, only a few longitudinal studies assessed the impact of contextual and individual socioeconomic determinants in adolescents' OHRQoL. We estimate the impact of socioeconomic inequalities on adolescents' OHRQoL over a 2-year period.

METHODS

This study followed up a random sample of 1134 12-year-old schoolchildren for 2 years in Brazil. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-year-old Children (CPQ11-14) at baseline and follow-up. Participants were clinically examined for dental caries, gingival bleeding, and malocclusion. The schoolchildren's parents answered a questionnaire regarding socioeconomic status, social capital, and adolescents' use of dental service. Socioeconomic contextual variables were collected from official city publications. Multilevel linear regression models fitted the associations between socioeconomic factors and overall CPQ11-14 scores over time.

RESULTS

A total of 747, 14-year-old adolescents were reassessed for OHRQoL (follow-up rate of 66%). Adolescents with lower mean income school's neighborhood (P < 0.05), household income (P < 0.05), and maternal schooling (P < 0.05) had higher overall CPQ11-14 scores. Female sex, attending a dentist by toothache, dental caries, and malocclusion were also associated with higher overall CPQ11-14 scores.

CONCLUSIONS

Adolescents from low socioeconomic background reported worse OHRQoL at 2-year follow-up compared to those from high socioeconomic background. Actions toward health inequalities need to address socioeconomic factors in adolescence.

The Role of Low-Intensity Biostimulation Laser Therapy in Transforming Growth Factor β1, Bone Alkaline Phosphatase and Osteocalcin Expression during Orthodontic Tooth Movement in Cavia porcellus

Objective The aim of this study is to analyze the low-intensity laser therapy (LILT) biostimulation mechanism as adjuvant therapy within orthodontic treatment as a means of accelerating bone remodeling by transforming growth factor β1 (TGF-β1), bone alkaline phosphatase (BALP), and osteocalcin (OSC) expression.

Materials and Methods An analytical experimental method incorporating a posttest only randomized the control group design. The sample consisted of 24 3- to 4-month-old male Cavia porcellus weighing between 300 and 500 g divided into three groups (group 1: control, group 2: received orthodontic treatment, and group 3: received orthodontic treatment with irradiation LILT). LILT biostimulation at a dose of 4 joule/cm ² was performed daily for 3 min on the mesial-distal labial-palatal of the first dextra and sinistra incisor for 2 weeks. The TGF-β1, BALP, and OSC expression was subjected to immunohistochemical analysis. An analysis of variance with multiple comparison, a Tukey's honestly significant difference test, a Kruskal–Wallis test, and a Wilcoxon–Mann–Whitney test were all performed ( p < 0.05).

Results TGF-β1 expression was significantly different ( p = 0.047; p < 0.05) in the tension area, but not in the compression side ( p = 0.154; p > 0.05). BALP expression was significantly different in both the tension ( p = 0.009) and compression areas ( p = 0.005; p < 0.05). OSC expression was significantly different ( p = 0.034; p < 0.05) in the tension side, but not in the compression area ( p = 1.194; p > 0.05).

Conclusion LILT biostimulation can increase TGF-β1, BALP, and OSC expression during orthodontic tooth movement.

Orthodontic treatment need, self-esteem, and oral health-related quality of life among 12-yr-old schoolchildren

The aim of this study was to investigate the association between orthodontic treatment need and oral health-related quality of life (OHRQoL) among 12-yr-old children. The study also assessed whether self-esteem modifies and/or moderates this relationship. Cross-sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio-economic and demographic characteristics, dental pain, self-esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self-esteem with OHRQoL. A modifying effect of self-esteem on the relationship between DAI and OHRQoL was observed. Self-esteem did not mediate the abovementioned relationship. Children with lower scores of self-esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self-esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self-esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self-esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.

Item-level analysis of the relationship between orthodontic treatment need and oral health-related quality of life in Korean schoolchildren

INTRODUCTION

This study aimed to evaluate the associations between normative orthodontic treatment need and oral health-related quality of life (OHRQoL) at an item level as well as subscale and total score levels among schoolchildren.

METHODS

A cross-sectional study was conducted on 2,010 randomly selected children aged approximately 8, 10, 12, and 15 years residing in the Gyeonggi province, Korea. Children were clinically examined with the Index of Orthodontic Treatment Need (IOTN). To measure OHRQoL, the Child Oral Health Impact Profile (COHIP) was used.

RESULTS

In the physical health domain of COHIP, crooked teeth, discoloration, "food sticking," and "difficulty keeping teeth clean" were significantly associated with IOTN levels (P < 0.05), whereas pain, sensitivity and bleeding, bad breath, mouth breathing, and dry mouth were not. In addition, present and future dental health were significantly associated with IOTN levels, although self-confidence, attractiveness, and future health were not. As expected, the 5 subscale scores and total score of COHIP were significantly associated with IOTN levels after adjustment for gender, age, socioeconomic level, and caries state.

CONCLUSIONS

This study suggests the importance of in-depth investigation at the item level of OHRQoL assessment scales to better evaluate the impact of malocclusion that might be alleviated by orthodontic treatment.

Oral health-related quality of life in children using the child perception questionnaire CPQ11-14: a review

OBJECTIVES

The Child Perceptions Questionnaire 11-14 (CPQ11-14) is the most common and effective indicator of paediatric oral health-related quality of life. The aim of this review was to verify if CPQ11-14 can be considered a valid instrument for assessing the impact of oral health on the quality of life of adolescents for the paediatric population aged between 11 and 14 years old and which dental conditions mainly affect it.

STUDY DESIGN

A literature research from Pubmed Medline database was adopted to identify the eligible studies among the published articles related to CPQ 11-14 using keyword search strategy. From 170 initial articles, a total of 128 articles were included for the full text reading.

RESULTS

Conditions that mainly interest the oral health-related quality of life are untreated dental caries, dental trauma, increased dental protrusion, wearing orthodontic appliances, and severe periodontal disease.

CONCLUSION

CPQ 11-14 seems to be a solid and valid indicator to measure oral health-related quality of life, because it has been widely tested and validated in several states including developed, developing and underdeveloped countries.

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

Background/objectives

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

Methods

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

Results

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

Conclusions

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

Impact of Malocclusions on the Oral Health-Related Quality of Life of Early Adolescents in Ndola, Zambia

The study aimed to assess the prevalence of malocclusions and its impact on oral health-related quality of life (OHRQoL) among early adolescents in Ndola, Zambia. It used a random sample of 384 primary school children aged 12–14 years. The Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) was used to assess OHRQoL, and the Dental Aesthetic Index (DAI) was used to examine dentofacial anomalies. The chi-square test was used to study whether there was a statistically significant association between variables and multivariate logistic regression for the influence of sociodemographic and malocclusions on OHRQoL. Statistical significance was set at p < 0.05. Participants' sociodemographics were 53.6% female, 41.7% aged 13 years, and 43.5% from grade six. The overall reported impact on OHRQoL was 11.7%, which was significant (p < 0.001) by age and sex, and higher in females than males. The overall prevalence of malocclusions was 27.9%, which was significant (p=0.005) by sex, and higher in males than females. Children with malocclusions reported significant (p < 0.001) negative oral health impact compared to the children without malocclusions. Spacing, diastema, and crowding were most prevalent malocclusions that showed clear inverse association with OHRQoL. The study findings provide indications that malocclusions are negatively associated with OHRQoL among Zambian early adolescents.

Association between Global Life Satisfaction and Self-Rated Oral Health Conditions among Adolescents in Lithuania

Background: This study aims to explore the extent to which the perceived oral conditions predict adolescent global life satisfaction (GLS); Methods: The sample in a cross-sectional survey consisted of 1510 Lithuanian adolescents (41.7% boys) aged 11-18. The survey was conducted by means of self-report questionnaires that were administrated in school classrooms ensuring confidentiality and anonymity of the participants. The schoolchildren rated their GLS and answered the questions about perceptions of their oral health. The relationship between GLS and oral health variables was estimated using unadjusted and adjusted binary logistic regression and nonparametric correlation analyses; Results: The research showed that the majority of adolescents rated their GLS highly; however, girls, older adolescents and adolescents from less affluent families were less likely to report high scores. GLS was significantly associated with subjective overall oral health assessment. The odds of reporting low GLS were 50% higher for adolescents with good oral health (OR = 1.51; p < 0.001; 95% CI = 1.18-1.93), and two and half time as higher for adolescents with perceived fair/poor oral health (OR = 2.78; p < 0.001; 95% CI = 1.72-4.50) compared to adolescents with subjectively excellent/very good oral health. Nonparametric correlations indicated lower GLS to be significantly associated with higher scores of Child Perceptions Questionnaire (.

Bruxism and quality of life in schoolchildren aged 11 to 14

The purpose of this study is to assess quality of life in relation to oral health in schoolchildren with sleep bruxism. It is a transversal observational study of 594 schoolchildren (aged 11-14) of the municipality of Teresina, in the Brazilian State of Piauí. Quality of life was assessed through the Brazilian version of the CPQ11-14 questionnaire, in the short form (ISF:16).The presence of sleep bruxism was assessed from reports by the people legally responsible for the children. The results were analyzed by: calculation of an Odds Ratio (OR) estimate of chances; descriptive analysis; a Pearson Chi-squared test; a Likelihood Ratio test; and multiple logistic regression. A statistically significant association was found between sleep bruxism and the total score on the CPQ11-14 (p < 0.001), and with the scores in two domains: functional limitation (p = 0.033);and social wellbeing (p= 0.020).No association was found between quality of life and the variables gender or age. The final regression model showed that the presence of sleep bruxism increases the chance of having a greater effect on quality of life (ORadj=1.82 (1.54 - 2.10), IC = 95%).It is concluded that sleep bruxism had a negative impact on the quality of life of the schoolchildren, principally in the two domains functional limitations and changes in social wellbeing.

Exploring the impact of malocclusion and dentofacial anomalies on the occurrence of traumatic dental injuries in adolescents

OBJECTIVE

To investigate the association between malocclusion/dentofacial anomalies and traumatic dental injuries (TDI) in adolescents.

MATERIALS AND METHODS

The sample of this cross-sectional study comprised 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório, southern Brazil. Parents answered a structured questionnaire addressing demographic and socioeconomic characteristics. An examiner who had undergone a training and calibration exercise recorded malocclusion/dentofacial anomalies (Dental Aesthetic Index, DAI), TDI (Andreasen), and dental caries (World Health Organisation). Statistical analyses (SPSS software) involved Poisson regression with robust variance.

RESULTS

The prevalence of TDI was 11.6%, and the prevalence of defined, severe, and handicapping malocclusion was 24.0%, 21.6%, and 22.0%, respectively. The multivariate analysis demonstrated that the probability of TDI was approximately twofold higher among adolescents with severe malocclusion (prevalence ratio [PR] 2.22; 95% confidence interval [CI] 1.14-4.31) and handicapping malocclusion (PR 1.95; 95% CI 1.01-3.85) in comparison to those with normal occlusion or minor malocclusion. Defined malocclusion was not significantly associated with the outcome. Among the dentofacial anomalies evaluated, the probability of TDI was nearly twofold higher among adolescents with overjet greater than 3 mm (PR 1.96; 95% CI 1.14-3.37) and 2.2-fold higher among those with an abnormal molar relationship (PR 2.24; 95% CI 1.17-4.32), after controlling for confounding variables.

CONCLUSIONS

Severe and handicapping malocclusion, accentuated overjet, and abnormal molar relationship were strongly associated with the occurrence of TDI. Future studies should investigate whether the treatment of these conditions can help reduce the occurrence of TDI in adolescents.

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

Background

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

Methods

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

Results

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

Conclusions

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

Perception of parents and caregivers regarding the impact of malocclusion on adolescents' quality of life: a cross-sectional study

Objective:

The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL).

Methods:

This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance.

Results:

Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables.

Conclusions:

Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

Impact of Dental Trauma on Quality of Life Among 11-14 Years Schoolchildren

Background

Traumatic injuries are common dental problems in pediatric dentistry that may influence the children's quality of life.

Aim

the aim of this study is to assess the impact of traumatic dental injuries (TDI) and oral health-related quality of life (OHRQoL) among Egyptian schoolchildren aged 11-14 years.

Materials and Methods

A cross-sectional study was carried out involving a sample of 11700 schoolchildren from public and private schools of Mansoura city, Egypt. OHRQoL was assessed using Child Perceptions Questionnaire. Clinical examination included the presence and type of TDI, malocclusion status, and dental caries in anterior teeth (decayed, missing, and filled teeth).

Results

The prevalence of TDI was 13.6%. Untreated TDI was more likely to have a negative impact on the children's daily living regarding pain, functional, emotional, and social aspect than treated injuries and control children. Pearson's correlation test indicated significant association between trauma and malocclusion and dental caries.

Conclusion

Untreated dental injury has a negative impact on quality of life regarding social, functional, and emotional aspects. However, treated injured teeth appear to improve social and emotional aspects of the OHRQoL of school children, whereas functional limitations may continue because of the pulpal and periodontal effects of the injury.

Effect of malocclusion on the self-esteem of adolescents

INTRODUCTION:

Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment.

OBJECTIVES:

This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships.

MATERIALS AND METHODS:

Adolescent students aged 12–19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN.

RESULTS:

The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference (P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem (P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem.

CONCLUSIONS:

The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects.

Oral Health Related Quality of Life among Tamil Speaking Adults Attending a Dental Institution in Chennai, Southern India

INTRODUCTION

Oral Health-Related Quality of Life (OHRQoL) indicates an individual's perception of how their well-being and quality of life is influenced by oral health. It facilitates treatment planning, assessing patient centred treatment outcomes and satisfaction.

AIM

The study aimed to identify the factors influencing OHRQoL among Tamil speaking South Indian adult population.

MATERIALS AND METHODS

Non-probability sampling was done and 199 subjects aged 20-70 years were recruited for this observational study. The subjects were requested to fill a survey form along with the validated Tamil General Oral Health Assessment Index (GOHAI-Tml) questionnaire in the waiting area following which clinical examination was done by a single experienced Periodontist.

RESULTS

The mean score with standard deviation for physical dimension was 4.34±0.96, psychological dimension was 4.03±1.13 and pain was 4.05±1.09 on GOHAI. Greater impacts were seen for psychosocial dimensions like pleased with the appearance of teeth/denture Q7 (3.7±1.2), worried about the problems with teeth/denture Q9 (3.7±1) and pain or discomfort in teeth Q12 (3.8±1). Functions like swallowing Q3 (4.5±0.8) and speaking Q4 (4.6±0.7) were minimally affected. As age increased subjects perceived more negative impacts as indicated by lower ADD-GOHAI and higher SC-GOHAI scores (p<0.01). Subjects complaining of bad breath, bleeding gums and Temporomandibular Joint (TMJ) problems, reported poor OHRQoL (p<0.05). It was observed that as self-perceived oral and general health status deteriorated, OHRQoL also worsened (p<0.01). Subjects with missing teeth, cervical abrasion, restorations, gingival recession and mobility had more impacts on OHRQoL (p<0.05). Subjects diagnosed with periodontitis had lower OHRQoL as reported on the scale than gingivitis subjects (p<0.01).

CONCLUSION

In this study minimal impact was seen in all the three dimensions assessed with GOHAI. Factors like age, education, employment status, income, self-reported oral health, self-perceived general health, satisfaction with oral health, perceived need for treatment and denture wearing status influenced perceived OHRQoL. Bad breath, bleeding gums, TMJ problems, more number of missing teeth, decayed teeth, cervical abrasion, gingival recession and mobility were associated with poor OHRQoL.

The impact of malocclusions on oral health-related quality of life in children-a systematic review and meta-analysis

INTRODUCTION

A limited amount of systematic literature reviews on the association between malocclusions and oral health-related quality of life (OHRQOL) summarize inconclusive results. Therefore, we conduct a systematic review and meta-analysis on the association of malocclusions with OHRQOL in children.

METHODS

Relevant studies were identified in Pubmed, Embase, Cochrane, Google Scholar and other databases. All studies with data on malocclusions or orthodontic treatment need and OHRQOL in children were included. Methodological quality of the studies was assessed with the Newcastle-Ottawa Scale (NOS). Random effects models were used to estimate summary effect measures for the association between malocclusion and OHRQOL in a continuous and a categorical data analysis. Tests for heterogeneity, publication bias and sensitivity of results were performed.

RESULTS

In total, 40 cross-sectional studies were included in the meta-analyses. Summary measures of the continuous data show that OHRQOL was significantly lowered in children with malocclusions (standardized mean difference (95 % CI] = 0.29 (0.19-0.38)). The summary odds ratio for having an impact on OHRQOL was 1.74 times higher in children with malocclusion than in children without malocclusions. Heterogeneity among studies was partly explained by malocclusion assessment, age of the children and country of study conduction.

CONCLUSION

Our results provide evidence for a clear inverse association of malocclusion with OHRQOL. We also showed that the strength of the association differed depending on the age of the children and their cultural environment.

CLINICAL RELEVANCE

Dentists benefit from understanding the patient differences regarding the impact of malocclusions.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

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

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

Racial Differences in Oral Health-Related Quality of Life: A Multilevel Analysis in Brazilian Children

This cross-sectional study aimed to assess the influence of race/ethnicity on Brazilian children' oral health-related quality of life (OHRQoL). A multistage random sampling selected a representative sample of 1,134 twelve-years-old children from public schools of Santa Maria, a city in Southern Brazil. Participants were examined by 4 calibrated clinicians (minimum Kappa-value for inter-examiner agreement of 0.8) and the Brazilian short version of the Child Perceptions Questionnaire (CPQ11-14) was administered. The children's parents or guardians answered questions regarding their demographics and socioeconomic status. Associations were analyzed using multilevel Poisson regression models. Children from racial/ethnic minority groups had poorer OHRQoL. The mean CPQ11-14 score was 1.08 times higher for non-white children than their white counterparts' score. "Social" and "Emotional well-being" were the most affected domains for non-white children, with significantly higher mean scores as compared to white children (RR 1.19, 95% CI, 1.07-1.33; and RR 1.14; 95% CI 1.04-1.24). This association remained significant even after adjusting for individual and contextual covariates. OHRQoL disparities are prevalent among children from racial/ethnic minority groups. Non-white children have lower OHRQoL compared to white children.