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.     

Oral health-related quality-of-life among children in Swedish dental care: The impact from malocclusions or orthodontic treatment need

Objectives. To describe oral health-related quality-of-life (OHRQoL) and the impact of malocclusions or orthodontic treatment need in a cohort of children in Swedish dental care, using the Swedish version of the Child Perceptions Questionnaire–Impact Short Form (CPQ_11–14–ISF:16). Subjects and methods. Two hundred and fifty-seven children (mean age = 11.5 years, SD = 0.8, range = 9.8–13.5 years) completed the CPQ_11–14–ISF:16 in conjunction with a clinical examination. In addition to malocclusions and orthodontic treatment need (based on the Index of Orthodontic Treatment Need–Dental Health Component), possible confounders (caries, enamel defects, dental trauma, headache and socio-economic markers) were recorded. Children also rated their own dental fear on the Children’s Fear Survey Schedule–Dental Sub-scale (CFSS-DS). Results. The mean total CPQ_11–14–ISF:16 score was 9.31. The logistic regression analyses revealed an impact of orthodontic treatment need on OHRQoL (CPQ), but no clear association between higher severity and higher impact on OHRQoL was seen. Dental fear and headache appeared to discriminate for poorer OHRQoL. No impact from caries, enamel defects, dental trauma, or socio-economic markers was revealed. Conclusions. This cohort of children reported good self-perceived OHRQoL. Effects on OHRQoL from malocclusions or orthodontic treatment need were limited and inconsistent. Dental fear and headache were found to be more distinct impact factors on OHRQoL than were malocclusions or orthodontic treatment need.     

Correlation between oral health-related quality of life and orthodontic treatment need in children and adolescents—a prospective interdisciplinary multicentre cohort study

Purpose

Oral health-related quality of life (OHRQoL) is a construct for assessing the self-perceived oral health of patients. The aim of this study was to investigate the correlation between OHRQoL and orthodontic treatment need in consideration of demographic and psychological factors.

Patients and methods

This multicentre study included 250 patients with an indication for orthodontic diagnostics. In cooperation with the Institute of Clinical Psychology at the University of Würzburg, validated and internationally acknowledged questionnaires were selected to assess OHRQoL (COHIP-G19) and health-related quality of life (HRQOL). Self-esteem and behavioural problems were taken into consideration as possible psychological factors. Orthodontic treatment need was assessed using the Index of Orthodontic Treatment Need—Dental Health Component (IOTN-DHC), the Index of Orthodontic Treatment Need—Aesthetic Component (IOTN-AC) and the Dental Aesthetic Index (DAI). Possible significant correlations between the collected parameters and OHRQoL were evaluated by means of linear regression analysis.

Results

Objective orthodontic treatment need (IOTN-DHC and DAI) was significantly correlated with OHRQoL. Further factors significantly influencing OHRQoL in children and adolescents were age, HRQOL, self-esteem and behavioural problems.

Conclusions

Objective orthodontic treatment need significantly influences OHRQoL in children and adolescents. Further studies are required to investigate if OHRQoL may be improved by correcting misaligned teeth and jaws.

     

Impact of malocclusion on oral health–related quality of life in young adults

Objective:To assess oral health–related quality of life (OHRQoL) in young adult patients with malocclusion and to measure the association between orthodontic treatment need and OHRQoL.Materials and Methods:The study sample comprised 190 young adults aged 18 to 25 years who were attending orthodontic clinics at the Faculty of Dentistry. The Index of Orthodontic Treatment Need-Dental Health Component was used to measure orthodontic treatment need. Each participant was assessed for OHRQoL before and after treatment by using the Oral Health Impact Profile, Chinese version (OHIP-14).Results:Patients who had little or no, borderline, and actual need for orthodontic treatment represented 21.6%, 50.5%, and 27.9% of the total sample, respectively. OHRQoL (total OHIP-14 score and score for each domain) improved after treatment (P < .05). Significant differences in summary OHIP-14 scores were apparent with respect to orthodontic treatment need. Participants with high treatment need reported a significantly greater negative impact on the overall OHRQoL score. The greatest impact was seen in the psychological discomfort domain and the psychological disability domain.Conclusion:Malocclusion has a significant negative impact on OHRQoL. This is greatest for the psychological discomfort and psychological disability domains. The orthodontic treatment of malocclusion improves OHRQoL of patients.     

Bullying in orthodontic patients and its relationship to malocclusion,self-esteem and oral health-related quality of life

Objectives: To measure the self-reported frequency and severity of bullying amongst patients referred for orthodontic treatment and to investigate whether there is a relationship between levels of self-reported bullying, malocclusion and need for orthodontic treatment and an individual's self-esteem and oral health-related quality of life (OHRQoL). Design and setting: Cross-sectional study of an adolescent group referred for orthodontic assessment at three UK hospitals. Subjects and methods: Three hundred and thirty-six participants aged between 10 and 14 years were recruited. Validated questionnaires were used to measure the self-reported frequency and severity of bullying, self-esteem and OHRQoL. Orthodontic treatment need was assessed using IOTN. Results: The prevalence of bullying was 12·8%. Being bullied was significantly associated with Class II Division 1 incisor relationship (P?=?0·041),increased overbite (P?=?0·023),increased overjet (P?=?0·001)and a high need for orthodontic treatment assessed using AC IOTN (P?=?0·014).Bullied participants also reported lower levels of social competence (P<0·001),athletic competence (P<0·001), physical appearance related self-esteem (P<0·001)and general self-esteem (P<0·001). Higher levels of oral symptoms (P?=?0·032),functional limitations (P<0·001), emotional (P<0·001)and social impact (P<0·001) from their oral condition, resulting in a negative impact on overall OHRQoL (P<0·001),were also reported. Conclusions: Significant relationships exist between bullying and certain occlusal traits, self-esteem and OHRQoL.     

Can Oral Health‐Related Quality of Life Measures Substitute for Normative Needs Assessments in 11 to 12‐year‐old Children?

OBJECTIVES: 1) assess the relationship between a measure of condition-specific oral health-related quality of life (OHRQoL) and the related normative need for dental treatments, and 2) test the diagnostic validity of the condition-specific OHRQoL measure for specific dental conditions in a group of primary school children. METHODS: A cross-sectional study of all 11 to 12 year-olds carried out in a municipal area of Suphanburi province, Thailand. 1034 children (91.8%) were dentally examined to assess their normative needs for 6 types of treatment (dental caries, traumatic dental injuries, enamel defects, periodontal, orthodontic and prosthodontic treatment). OHRQoL was assessed using the Child-OIDP index and its Condition-Specific impacts measure for the 6 treatment types. RESULTS: The prevalence of specific types of normative needs ranged from 3.2% (prosthodontic) to 97.0% (periodontal) and for Condition-Specific oral impacts from 0.7% (prosthodontic) to 50.6% (dental caries). Despite their statistically significant relationship for every treatment type except for periodontal treatment when need was indicated by a CPI score of 1, there were large differences between measures of normative need and oral impacts. High proportions of children had normative need without impacts and vice versa. The biggest differences were for appearance-related conditions (e.g. enamel defects and orthodontic treatment). For every type of treatment, oral impacts poorly predicted the normative needs of individuals. CONCLUSIONS: Although normative needs and OHRQoL are associated, when assessed appropriately, there was considerable discrepancy between them. OHRQoL measures cannot replace normative needs. Instead, both should be used in combination in order to cover different dimensions of oral health.     

Evaluation of a quality of life measure for children with malocclusion

OBJECTIVE: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion. DESIGN: A cross-sectional study comparing two groups of individuals. SETTING: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield. SUBJECTS AND METHODS: The malocclusion group consisted of 116 patients aged 11-14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11-14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT 相似文献   

The German version of the child perceptions questionnaire on oral health-related quality of life (CPQ-G11�C14)

Objective

The aim of this study was to determine the frequency of oral health-related quality of life (OHRQoL) impairment and to establish norm values for the German version of the Child Perceptions Questionnaire (CPQ-G11?C14, 35?questions) in the general population aged 11 to 14?years.

Subjects and methods

Data were collected in a national survey (n=1,597, mean age: 12.5?±?1.2?years, 49.3% female) and subjects sampled using a multistage technique. OHRQoL was measured with the CPQ-G11?C14, which was presented in a personal interview. Norm values were computed for the CPQ-G11?C14 summary score (simple sum of all item responses). The CPQ-G11?C14 summary score distribution was described by empirical cumulative distribution functions. Because orthodontic treatment was closely associated with CPQ-G11?C14 summary scores, percentile-based norms were stratified by this variable.

Results

The CPQ-G11?C14 mean was 12.6?±?15.9?units. There was no influence of age (p>0.05) or gender (p>0.05) on the CPQ-G summary scores, but the summary scores varied according to orthodontic treatment status (p<0.001). Among the general population sample, CPQ-G11?C14 scores of the 50% less-impaired subjects were ??7. The same percentage of subjects undergoing orthodontic treatment had scores of ??13 and those without orthodontic treatment had scores of ??5. We observed scores of ??32?points in 90% of the population. That figure was ??50?points for subjects undergoing orthodontic treatment and ??21?points for those without orthodontic treatment. The most frequent problems the children and adolescents reported (CPQ-G answers ??often?? and ??very often??) were ??breathing through the mouth?? (13.0%), ??mouth sores?? (4.4%) and ??bad breath?? (4.3%).

Conclusion

The norm values we present provide a frame of reference for future cross-sectional studies in the general population and in patient populations with specific oral conditions when measuring OHRQoL by CPQ-G11?C14 in children and adolescents aged 11 to 14?years old.     

错(牙合)畸形对儿童口腔健康相关生活质量影响的研究

目的:调查错(牙合)畸形对儿童生活质量的影响.方法:选择门诊就诊儿童118名,采用IOTN-DHC指数评价错(牙合)畸形严重程度,采用儿童和家长版Michigan-OHRQoL量表测定对生活质量的影响.结果:错(牙合)畸形在咀嚼等客观方面对家长和儿童影响较一致,家长对儿童牙齿的主观评价较儿童自身评价高;收入较高与教育程度高的家长评价错(牙合)畸形对患儿的生活质量影响较大.结论:错(牙合)畸形对儿童的口腔健康相关生活质量有影响,影响程度与家长收入及教育程度有关.     

A socio-dental approach to assessing children's orthodontic needs

Traditional methods of assessing orthodontic treatment need using mainly clinical measures are inadequate and would be improved by integrating normative, oral health-related quality of life (OHRQoL), and behavioural propensity measures. This study aimed to develop and test a socio-dental system of orthodontic needs assessment, and to compare normative and socio-dental estimates of orthodontic need. The socio-dental system integrates three types of need: normative need (NN), impact-related need (IRN) and propensity-related need (PRN). A cross-sectional survey of all 1,126 children aged 11-12 years in Suphanburi, Thailand, was carried out to test the new system. The dental health component of the Index of Orthodontic Treatment Need was used to assess NN, and the simplified oral hygiene index for oral hygiene status. Oral impacts were assessed using the child-Oral Impacts on Daily Performances (child-OIDP) index. A self-administered questionnaire recorded information on demographic and oral health-related behaviour. Treatment needs were assessed according to the developed socio-dental system. The socio-dental approach to assess orthodontic needs was easy to use and readily accepted by the children. The estimates of orthodontic need assessed normatively and socio-dentally differed markedly. The prevalence of NN and IRN was 35.0 and 10.5 percent, respectively, thus representing a reduction of approximately 70 percent in the volume of treatment need according to the new method. Children with IRN had different levels of propensity for orthodontic treatment, and therefore required appropriate treatment plans according to their PRN. Of the 10.5 percent with IRN, 6.9 percent had high or medium-high PRN, while 3.6 percent were at medium-low and low levels of propensity.     

The provision and outcome of orthodontic services in a Norwegian community: a longitudinal cohort study

In a systematic child dental care system, professionals, consumers, and purchasers have a common interest in ensuring that provision and outcome of orthodontic care fulfill the goals of the service and the public's expectations. The purpose of this prospective study was to examine whether treatment was in fact provided to children with a normative treatment need, and also to assess the outcome of treatment. The baseline data were established for a sample of 83 11-year-olds before decisions about orthodontic treatment had been made, by recording the individuals' orthodontic concern as reported in questionnaires and their occlusal condition according to an index of orthodontic treatment need (NOTI). At re-examination at the age of 16 years, it was also recorded whether the individual had received orthodontic treatment. Most individuals (83%) with a normative need had been treated as well as some individuals without need but who had expressed orthodontic concern. Treatment had resulted in occlusal improvement ('health gain') in most patients, and generally this improvement paralleled a decrease in concern. The goals of the orthodontic service seem to have been fulfilled to the extent that residual treatment need was infrequent. The high treatment rate (63%) and standard may explain why all individuals, both treated and untreated, expressed satisfaction with their dental appearance at 16 years of age.     

Changes in psychological health,subjective food intake ability and oral health‐related quality of life during orthodontic treatment

Assessing changes in patient's psychological health and oral health‐related quality of life (OHRQoL) over time during orthodontic treatment may help clinicians to treat patients more carefully. To evaluate changes in mental health, self‐reported masticatory ability and OHRQoL during orthodontic treatment in adults, this prospective study included 66 adults (30 men, 36 women; mean age, 24·2 ± 5·2 years). Each patient completed the Korean versions of the State–Trait Anxiety Inventory, Zung Self‐Rating Depression Scale, Rosenberg self‐esteem scale, key subjective food intake ability (KFIA) test for five key foods and Oral Health Impact Profile‐14 (OHIP‐14K) at baseline (T0), 12 months after treatment initiation (T1) and debonding (T2). All variables changed with time. Self‐esteem and the total OHIP‐14K score significantly decreased and increased, respectively, at T1, with a particular increase in the psychological and social disabilities scores. There were no significant differences in any questionnaire scores before and after treatment. The total OHIP‐14K score was positively correlated with trait anxiety and depression, and negatively correlated with self‐esteem and KFIA at T0, regardless of the treatment duration. Older patients showed a significant increase in the total OHIP‐14K score at T1 and T2. OHRQoL worsened with an increase in the treatment duration. Our results suggest that OHRQoL temporarily deteriorates, with the development of psychological and social disabilities, during orthodontic treatment. This is related to the baseline age, psychological health and self‐reported masticatory function. However, patients recover once the treatment is complete.     

Bullying in orthodontic patients and its relationship to malocclusion,self-esteem and oral health-related quality of life

Abstract

Objectives: To measure the self-reported frequency and severity of bullying amongst patients referred for orthodontic treatment and to investigate whether there is a relationship between levels of self-reported bullying, malocclusion and need for orthodontic treatment and an individual’s self-esteem and oral health-related quality of life (OHRQoL).

Design and setting: Cross-sectional study of an adolescent group referred for orthodontic assessment at three UK hospitals.

Subjects and methods: Three hundred and thirty-six participants aged between 10 and 14 years were recruited. Validated questionnaires were used to measure the self-reported frequency and severity of bullying, self-esteem and OHRQoL. Orthodontic treatment need was assessed using IOTN.

Results: The prevalence of bullying was 12·8%. Being bullied was significantly associated with Class II Division 1 incisor relationship (P?=?0·041), increased overbite (P?=?0·023), increased overjet (P?=?0·001) and a high need for orthodontic treatment assessed using AC IOTN (P?=?0·014). Bullied participants also reported lower levels of social competence (P<0·001), athletic competence (P<0·001), physical appearance related self-esteem (P<0·001) and general self-esteem (P<0·001). Higher levels of oral symptoms (P?=?0·032), functional limitations (P<0·001), emotional (P<0·001) and social impact (P<0·001) from their oral condition, resulting in a negative impact on overall OHRQoL (P<0·001), were also reported.

Conclusions: Significant relationships exist between bullying and certain occlusal traits, self-esteem and OHRQoL.     

Relationship of the Dental Aesthetic Index to the oral health-related quality of life

Objective:To assess the impact of malocclusion on the quality of life.Materials and Methods:This cross-sectional study involved 150 subjects attending the Primary Care Unit with no history of orthodontic treatment. The Dental Aesthetic Index (DAI) with 10 occlusal characteristics were measured on study models. Oral health-related quality of life (OHRQoL) was assessed with the Malaysian version of the Oral Health Impact Profile questionnaire (OHIP-14). The Spearman rank-order correlation coefficient was used to evaluate the relationship between the malocclusion and quality of life.Results:Significantly weak correlations (r = .176) were found between the DAI and the OHRQoL. Females and the younger age group (12–19 years) tended to score higher on the OHIP-14 than their counterparts. For males, domain 3 (psychological discomfort; r = .462), domain 4 (physical disability; r = .312), domain 7 (handicap; r = .309), and overall score (r = .289) were weak correlates but significant to the DAI compared with females. The older age group showed a significant weak correlation in domain 3 (psychological discomfort; r = .268) and domain 7 (handicap; r = .238), whereas the younger age group showed no correlation with any domain.Conclusions:The DAI score does not predict the effect of malocclusion on the OHRQoL.     

Craniomandibular disorders with special reference to orthodontic treatment: an evaluation from childhood to adulthood.

The purpose of the present study was to reexamine a group of children and adolescents with respect to signs and symptoms of craniomandibular disorders (CMD) and to evaluate whether any differences could be found between persons who had received orthodontic treatment earlier and those who had not. A total of 402 children in three age groups (7, 11, and 15 years) had participated in a cross-sectional study on the relationship between malocclusion and signs and symptoms of CMD. Ten years later they were asked to answer a questionnaire. In the youngest age groups (now 17 and 21 years old) 190 (76%) subjects answered the questionnaire. In the oldest age group (now 25 years old) completed questionnaires were received from 103 (84%) subjects, and 83 (62%) of those subjects appeared for a clinical examination. Subjects with a history of orthodontic treatment had a lower prevalence of subjective symptoms of CMD (TMJ sounds included) than those without any experience of orthodontics. Although the differences were small, it was more evident for the oldest age group. The clinical examination has shown that persons who had undergone orthodontic treatment had a significantly lower clinical dysfunction index than those who had not.     

Objective,Subjective, and Self‐Assessment of Preadolescent Orthodontic Treatment Need – A Function of Age,Gender, and Ethnic/Racial Background?

Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES.     

Malocclusion traits and oral health–related quality of life in children with osteogenesis imperfecta: A cross-sectional study

BackgroundThe incidence of malocclusion is higher among people with osteogenesis imperfecta (OI) than the general population, and treatment options are limited due to the weak structure of bones and teeth. Focusing on those malocclusion traits that might have a high impact on a patient’s oral health–related quality of life (OHRQoL) is warranted.MethodsA total of 138 children and adolescents with OI were examined for malocclusion traits. OHRQoL was measured using age-specific versions (8 through 10 years and 11 through 14 years) of the Child Perceptions Questionnaire (CPQ), considering the following domains: oral symptoms, functional limitation, emotional well-being, and social well-being. Higher scores implied worse OHRQoL. Multivariable ordinal logistic regression was used to estimate the association between malocclusion traits and OHRQoL.ResultsAmong children aged 8 through 10 years (n = 56), the CPQ and its constituent domain scores were relatively similar between those with malocclusion (higher scores) and those without. In the adolescent (n = 82) group aged 11 through 14 years; however, those with posterior crossbite (odds ratio, 5.01; 95% confidence interval, 1.40 to 12.41) or open bite (odds ratio, 3.21; 95% confidence interval, 1.21 to 10.23) experienced statistically significantly higher degrees of functional limitations (a higher functional limitation score) than those without.ConclusionsAdolescents with OI and posterior open bites or crossbites have substantial self-reported functional limitations and worse oral symptoms, which warrants additional investigation and therapeutic trials in an attempt to improve the malocclusion. In addition, the authors found that the CPQ can be a useful tool in a clinical trial of orthodontic interventions in OI.     

Back Matter

Abstract

Objective: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion.

Design: A cross-sectional study comparing two groups of individuals.

Setting: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield.

Subjects and methods: The malocclusion group consisted of 116 patients aged 11–14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11–14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT ≤2, with no history of orthodontic treatment. The children completed the child perception questionnaire (CPQ), including global ratings of oral health and satisfaction. Each child rated their own IOTN aesthetic component (AC) score.

Outcome measures: Total CPQ scores and responses in the four domains. Self-perceived AC scores and responses to global rating of oral health, life overall and satisfaction rating were recorded.

Results: There was a statistically significant difference between the malocclusion and non-malocclusion total CPQ scores (P = 0.012). These differences were significant for the emotional (P = 0.006) and social well-being (P = 0.001) health domains, and not significant for the oral symptoms and functional limitations health domains. There were significant correlations between the total CPQ score and overall well-being (R _s = 0.397) and patient satisfaction (R _s = 0.362).

Conclusions: Malocclusion has a negative impact on the OHRQoL of an adolescent. A shortened version of this form, specifically for prospective orthodontic patients, may be beneficial as an additional measure to assess need for treatment especially as some of the questions in the oral symptoms and functional limitations subscales of the current questionnaire are not relevant to orthodontic patients.