Correlation between general quality of life and oral health related quality in the mixed dentition.

The aim of this study was to evaluate the convergence between the domains of the Autoquestionnaire Qualité de Vie Enfant image (AUQUEI) and the Child Perceptions Questionnaire (CPQ8-10) in the mixed dentition. A sample of 676 children aged 8 to 10 years responded to the health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) questionnaires using the AUQUEI and the CPQ8-10, respectively. Clinical (dental caries and malocclusion) and socioeconomic variables were assessed. The validity of convergence between scores (total and per domain) of the two instruments was assessed by Spearman correlation analysis, considering that non-zero coefficient values represented a correlation between scores. The median was calculated to compare the scores of each questionnaire relative to the variables, and the nonparametric Mann-Whitney test was applied to determine statistically significant differences between the categories. A weak significant correlation (between 0.30 and 0.50) was observed between the domains and the total scores of instruments (p < 0.05), except for the leisure domain (p > 0.05). Participants with a lower family income had worse HRQoL (p < 0.05), and those with caries and malocclusion experience had worse OHRQoL (p < 0.05). In conclusion, the AUQUEI and CPQ8-10 instruments showed a weak correlation. Income and clinical variables had a negative impact on the AUQUEI and CPQ8-10, respectively.

Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic treatment versus Invisalign: a randomised clinical trial.

BACKGROUND: We evaluated anxiety, pain, and oral-health-related quality of life in individuals treated with conventional fixed appliances (Group A) and clear aligners (Group B) for moderate malocclusion during the initial phase of orthodontic treatment. METHODS: Sixty individuals, separated into Group A (n = 30) and Group B (n = 30), were included in the study. They completed the Anxiety Levels, Oral Health Impact Profile-14, and Oral Health Related Quality of Life - United Kingdom/Surveys after the application of attachments on days 0 (T1), 10 (T10), and 20 (T20). Their pain levels were evaluated with the Visual Analogue Scale on days 0, 2, and 6 in the 2nd and 6th hours and on the 1st, 3rd, 7th, 14th, and 21st days. RESULTS: Per the VAS questionnaire, pain levels in the 2nd hour, 6th hour, 1st day, and 3rd day were significantly lower in Group B than in Group A. In the OHIP-14 survey results, the comparison between Group A and Group B showed a significant difference only on the 1st day. The STAI and OHRQoL-UK survey results did not differ significantly between the groups. CONCLUSIONS: We found no significant difference between the two groups in terms of anxiety levels, and pain among individuals in Group A was higher than in Group B only at the beginning of the treatment. No significant differences were observed in terms of individuals' quality of life. TRIAL REGISTRATION: NCT06133296 (retrospectively registered)- Registration Date:15/11/2023.

Aesthetic perception of patient in developmental age in interceptive orthodontic treatment.

AIM: Patients at development age show considerable attention to the shape of the face from both an aesthetic and relational point of view, to arouse interest from researchers. There are few studies related to profile analysis in patients of developmental age. Therefore, the objective of the present study was to analyse the importance of the aesthetic perception of the patient in development age in relation to the profile, before and after interceptive orthodontic treatment. MATERIALS: A sample of 25 patients who came to our observation for dentoskeletal malocclusions was considered. A questionnaire was proposed to each patient, before and after the interceptive orthodontic treatment (T0 and T1), to evaluate the aesthetic perception before and after the orthodontic treatment and its psychosocial impact. Profile analysis was performed using photographic documentation (at T0 and T1). The variables considered were the Ricketts line, the facial convexity angle, the nasolabial angle, and the labiomental angle. CONCLUSION: Interceptive orthodontic treatment has proven to be of valid clinical and psychological help. This result is confirmed by the complete aesthetic satisfaction of the patient in the frontal and latero-lateral planes.

Evaluating the influence of dental aesthetics on psychosocial well-being and self-esteem among students of the University of Novi Sad, Serbia: a cross-sectional study.

BACKGROUND: A person's smile has been identified as one of the first observed facial characteristics. Even minor deviations from societal beauty standards, especially among younger individuals, can have a negative effect on their self-esteem. The aim of this research is to evaluate the self-perceived psychosocial impact of dental aesthetics and self-esteem among respondents and their association, as well as to determine the main factors contributing to dissatisfaction with dental appearance. METHODS: This research was conducted as a cross-sectional study that surveyed students of the University of Novi Sad. Other Universities and private faculties were excluded from participation. Data collection used standardized questionnaires measuring the Psychosocial Impact of Dental Aesthetics (PIDAQ) and the Rosenberg Self-Esteem Scale (RSES). Questionnaire (an online GoogleForms) was sent to the students via official Facebook groups of the faculties, student's e-mails and Instagram profiles. Data analysis included descriptive statistics, Students T-test, ANOVA, multiple linear regression analysis and Spearman coefficient. To test internal consistency, Cronbach's alpha(α) was calculated for the questionnaire as a whole (0,761) and each used questionnaire (PIDAQ - 0.766; RSES - 0.765). Cronbach's alpha(α) was also calculated for each domain from PIDAQ (DSC-0.946; SI-0.882; PI-0.953; AC-0.916). RESULTS: The study involved 410 participants, predominantly female (80%), aged between 21 and 23 (45.4%), primarily in ther first academic year (21.5%), and with a grade point average between 8.01 and 9.00 (42.4%). Data analysis has shown a statistically significant difference in the total PIDAQ score and SI subdomain in relation to the academic year (total PIDAQ p = 0.025; SI p = 0.000). In terms of self-esteem, results of multiple linear regression analysis showed that the academic year (95%CI: 0.410-1.837; p = 0.002) and the average point grade (95%CI: -0.025-1.600; p = 0.047) were significant predictors of greater self-esteem. The Spearman coefficient value (r=-0.316, p < 0.001) confirmed a statistically significant negative correlation between PIDAQ and self-esteem. Only 34% of respondents expressed satisfaction with their teeth. Dissatisfaction about the smile was primarily attributed to the arrangement and positioning of their teeth (32.2%). Financial constraints were identified as the main barrier for seeking interventions to improve smile satisfaction (39.5%). CONCLUSION: Students experiencing a greater psychosocial impact of dental aesthetics tended to exhibit lower self-esteem.

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

BACKGROUND: Large horizontal maxillary overjet (overjet) is associated with reduced bite force (BF) and number of contacts, which influence the chewing effectivity (CE). Oral health, oro-facial function (OF) and malocclusion have great impact on psychological well-being and quality of life (QoL). OBJECTIVES: The aims of the study were to examine OF, temporomandibular disorders (TMD), BF, CE, QoL and well-being in children and adolescents with large overjet. METHODS: The study was a case-control study including healthy children with large overjet in the study group compared to a control group of healthy children with neutral occlusion, all 9-14 years old. OF was examined by use of Nordic Orofacial Test-Screening (NOT-S), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and registration of morphological and functional occlusion. QoL and well-being were examined using KIDSCREEN-10 and Strengths and Difficulties Questionnaire. RESULTS: The study and control groups included 37 and 32 participants, respectively. Significantly increased NOT-S score (p < .001) and reduced BF (p = .011), numbers of contacts (p < .001) and CE (p = .005) were found in the study group. BF, numbers of contacts and CE were negatively associated with erupting canines and premolars. No significant difference was found in age, gender, dental eruption, TMD diagnosis or QoL between the groups. Significantly increased emotional symptoms (p = .007), hyperactivity (p = .043) and total difficulties score (p = .009) were found in the study group. CONCLUSION: The study group showed higher NOT-S score and reduced BF, number of contacts and CE. No difference in QoL were found between the groups, although reduced well-being and increased emotional symptoms, hyperactivity and total difficulties were found in the study group.

Impact of COVID-19 on the self-esteem, psychological and dental esthetics of dental students.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has badly affected the mental health, quality of life, and self-esteem of students worldwide. OBJECTIVE: The current study aimed to evaluate the psychological impact and self-esteem of dental students using Rosenberg self-esteem scale and PIDAQ during the COVID-19 pandemic. METHOD: This cross-sectional research was conducted amongst the dental students studying at various dental colleges in Karachi, Pakistan from January to May 2022. Evaluation of psychological aspect and self-esteem of students was carried out using "Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ)", and "Rosenberg self-esteem scale" as perceived by students during the pandemic. For data analysis SPSS v24 was used. Data analysis comprised of descriptive analysis, Spearman correlation, One-way Anova and Linear regression. The level of significance of p value was less than 0.05. RESULTS: Overall 332 students participated, among which there were 181 females (54.5%), 151 males (45.5%). Dental self-confidence showed a negative relationship with social influence, psychological effect, and aesthetic concern, while it was positively linked with self-esteem during the pandemic. Social impact demonstrated association with psychological impact, aesthetic concern, and self-esteem, while it was negatively correlated with dental confidence. Rosenberg score showed positive correlation with all the variables. Statistically significant association was identified for variables when compared with gender. Regression analysis indicated association of age with dental confidence and RSS, while gender with social influence. CONCLUSION: The pandemic, aside from affecting the health of individuals worldwide, also badly affected the well-being, mental health, and self-esteem of the dental students. Dental aesthetics plays a crucial role in the mental wellbeing and self-esteem of the students.

Improvement on oral health related quality of life after orthosurgical treatment: a mixed methods study.

The aim of this study was to understand the influence of orthosurgical treatment on oral health-related quality of life (OHRQoL) in patients with Class II and III skeletal malocclusion by conducting a mixed method case series study. Nineteen patients submitted to orthosurgical treatment in a private practice in Brazil were included in the sample. Data were collected retrospectively and interviews were held from March 2020 to July 2021. Patients answered to the Oral Health Impact Profile (OHIP-14) in the first part of the interview and subsequently answered the qualitative questions. The overall mean of OHIP-14 after treatment was 4.21 (SD 4.68). The qualitative data were analyzed according to thematic analysis and four themes emerged from the interviews: a) concept of quality of life, b) pre-treatment life, c) post-treatment life, and d) positive and negative aspects of treatment. Quality of Life was reported by the patients as the absence of feeling pain, having emotional and physical health, having a satisfactory esthetic appearance and self-esteem. Before treatment, most Class II patients used to complain about breathing and sleeping problems, while Class III patients complained more intensely about esthetics. Pain was a common problem reported by both Class II and Class III patients. In general, improvement was perceived in self-esteem, esthetics, function and pain. Complaints about negative aspects of the treatment were restricted to the postoperative period. The orthosurgical treatment was important for improving the OHRQoL of patients in terms of esthetic, functional and psychosocial aspects.

Psychological impact and perceptions of orthodontic treatment of adult patients with different motivations.

INTRODUCTION: Motivations, perceptions, and psychosocial states of adult patients with orthodontic disorders in China have not been widely studied. The study assessed the psychosocial states and perceptions of adult patients undergoing orthodontic treatments with different motivations. METHODS: Two hundred forty-three adult patients (mean age, 30.2 ± 7.4 years; women, 79.0%) undergoing orthodontic treatment were recruited from a tertiary stomatology hospital. The patients answered a patient-centered questionnaire regarding motivations and perceptions of orthodontic treatment and the Psychosocial Impact of Dental Aesthetics Questionnaire. Data were analyzed using the chi-square test on the basis of multiple responses. Multiple linear regression analyses were performed to determine the association between motivation factors and the Psychosocial Impact of Dental Aesthetics Questionnaire subscale scores (P <0.05). RESULTS: Patients with various motivations were as follows: occlusal function reason (70.4%), dental esthetic reason (54.7%), facial esthetic reason (24.3%), and following others' suggestions (18.5%). Patients with esthetic or occlusal motivations exhibited significantly greater need and interest for orthodontic treatment (P <0.001). Multiple linear regression analyses revealed that the scores of social impact, psychological impact, and esthetic concern subscales were significantly associated with both dental and facial esthetic motivations (P <0.001). CONCLUSIONS: The primary motivations of Chinese patients were observed to be improved esthetics and occlusal function. Patients with esthetic or occlusal motivations exhibited significantly greater need and interest in treatment. Patients with facial or dental esthetic motivations experienced greater impacts of psychosocial states. Therefore, the patient motivations and impacts of esthetic-related psychosocial states on them should be considered during treatment.

Orthodontic retreatment need and related self-perceived factors among contemporary college freshmen in China.

Given that an increasing number of patients who received orthodontic treatment during their childhood or adolescence are seeking retreatment in contemporary China, it is of great necessity to comprehensively understand their motivations. A valid and reliable self-designed questionnaire, based on the Index of complexity, outcome and need (ICON), was distributed online to college freshmen who received orthodontic treatment during their childhood or adolescence. After collecting their basic information and orthodontic retreatment needs data from the survey, the participants' general self-perception of front facial appearance, lateral facial appearance and tooth alignment, as well as their self-perceived dental alignment, occlusal status, oral function and psychological status, were assessed. Correlation analysis, Chi-square test, Kruskal-Wallis test and logistic regression were performed. Reliability was evaluated for 20 paired questionnaires, and all questions were found to be reliable (intraclass correlation coefficient, >0.70). Among the 1609 participants with a history of orthodontic treatment, 45.56% were males and 54.44% were females. Their mean age was 18.48 ± 0.91 years. Our results showed that self-perceived front facial appearance, lateral facial profile, tooth alignment, occlusal status, oral function and psychological status were significantly correlated with orthodontic retreatment needs. Both appearance and psychological status affected their self-perceived dental alignment and occlusal status. In conclusion, patients who received orthodontic treatment during their childhood or adolescence in contemporary China seek orthodontic retreatment because they desire better aesthetics of their front facial appearance and tooth alignment, especially the anterior region of the tooth, the lower part of the face and a decent pronunciation. Additionally, psychological concerns should be viewed as an urge, while intraoral factors should be viewed as the foundation during future clinical practice regarding orthodontic retreatment in this age group.

Do the oral health-related quality of life and the magnitude of its association with malocclusion differ by developmental stages of schoolchildren?

INTRODUCTION: As schoolchildren go through multiple developmental periods, their oral health-related quality of life (OHRQOL) level may change over time. It is important to understand the association between malocclusion and OHRQOL in treatment planning for schoolchildren. This study aimed to examine OHRQOL and its association with malocclusion among schoolchildren at different developmental stages. METHODS: Data from a representative sample of 2010 Korean schoolchildren aged 7-17 years were analyzed. The participants completed a self-administered questionnaire, and their orthodontic treatment needs were assessed by a dentist. OHRQOL was measured using the Child Oral Health Impact Profile (COHIP). Higher COHIP scores indicate better OHRQOL. RESULTS: The mean age of the sample was 11.9 ± 2.5 years, and slightly more boys (53.0%) were in the sample. The total COHIP score (P <0.001) and 4 subscale scores (P <0.01) were lower in older age groups. Compared with those who needed orthodontic treatment, children with no and borderline orthodontic treatment needs were 1.9 times (odds ratio [OR], 1.9; 95% confidence interval, 1.5-2.4) and 1.5 times (OR, 1.5; 95% confidence interval, 1.1-2.1) more likely to have a higher COHIP score, respectively. The degree of association varied across age groups: a larger effect was found in the oldest group (aged 15 years) (OR, 4.1) than in younger groups (ORs, 1.5-2.2). CONCLUSIONS: OHRQOL and the magnitude of its association with malocclusion varied by age among schoolchildren, particularly in functional and social-emotional well-being. Given the variation, schoolchildren's developmental stages should be considered in treatment planning.

Psychosocial impact of malocclusion in the school performance. A Hierarchical Analysis.

OBJECTIVE: To identify any association between the psychosocial impact of malocclusion and academic performance in adolescents. METHODS: Cross-sectional study in a sample of 297 adolescents aged 10 to 14 years old enrolled in public schools. A self-complete questionnaire enquiring about socioeconomic, demographic, and psychological characteristics and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered in classrooms. The school provided documents related to School Performance (average grade in the Portuguese subject and absences). A conceptual structure was built, and independent variables were inserted hierarchically into logistic models for school performance (outcome). Independent variables were: Gender, age, caries status (DMFT), orthodontic treatment need (IOTN-DHC), psychological impact (PIDAQ) and school commitment (class absences and missed classes). RESULTS: Boys (OR = 3.56; 95% CI: 1.54-8.21) with caries experience (OR = 2.77; 95% CI: 1.23-6.23), need for orthodontic treatment (OR = 0.40; 95% CI; 0.18-0.91) and adolescents who reported a psychological impact (OR = 2.70; 95% CI: 1.16-6.30) had worse school performance. CONCLUSION: Boys with caries and malocclusion experience who reported the psychological impact of the need for orthodontic treatment are more likely to have worse school performance.

Cross-Cultural Adaptation and Validation of the Portuguese Version of the Psychosocial Impact of Dental Aesthetics Questionnaire.

The aim of this study was to cross-culturally adapt and validate the psychosocial impact of dental esthetics questionnaire (PIDAQ) to the Portuguese language. The PIDAQ was culturally translated and adapted according to international guidelines. In this cross-sectional study, we enrolled 501 subjects in a population-based epidemiological survey conducted at the Egas Moniz Dental Clinic (Almada, Portugal) in June 2022. The participants answered the Portuguese version of the PIDAQ (PIDAQ-PT), which was a 23-item scale with four conceptual domains (self-confidence, social impact, psychological impact and esthetic concern factor). Psychometric properties were estimated using content validity, construct validity, internal consistency and test−retest reliability. The PIDAQ-PT presented an intraclass correlation coefficient (ICC) of 0.84, and a 95% confidence interval (0.73−0.90, p < 0.001), with values for the Cronbach's alpha coefficient of the subconstructs ranging from 0.93 to 0.98. In the confirmatory factor analysis (CFA), the final models presented a good fit, with the comparative fit indices (CFIs) ranging from 0.905 to 0.921 and the root mean squared error of approximation (RMSEA) ranging between 0.088 and 0.090. The PIDAQ-PT was shown to be a valid and reliable tool to assess oral health values in a Portuguese population. Further studies should evaluate the psychometric properties of the oral personal representation on dental specialties and its impact on dental appointments and procedures.

Validation of the Simplified Malaysian Psychosocial Impact of Dental Aesthetics Questionnaire for the Sociodental Approach to Estimate the Orthodontic Treatment Need.

(1) This study aimed to generate a simplified form of the Malaysian psychosocial impact of dental aesthetics questionnaire (PIDAQ[M]) and validate its use in the sociodental approach for estimating orthodontic treatment need. (2) Two eight-item forms were derived: an impact simplified PIDAQ[M] (ISP8), comprising the most impactful items as rated by 35 participants, and a regression simplified PIDAQ[M] (RSP8), derived from regression analysis of 590 participants' data from the PIDAQ[M] validation study. Their psychometric performances were assessed for internal consistency, validity (criterion and construct), reproducibility (reliability and agreement), and responsiveness to change. The sociodental estimates were based on 204 orthodontic patients' data who were assessed for normative need, impact-related need, and propensity-related need. McNemar analysis compared the sociodental estimates when both simplified PIDAQ[M] forms and the original PIDAQ[M] were used to measure impact-related need. (3) Both simplified PIDAQ[M] forms were valid, reproducible, and responsive. The sociodental estimates when using the ISP8 (38.2%) were similar to when the PIDAQ[M] (35.8%) was used (p > 0.05) but overestimated by 3.4% (p < 0.05) when the RSP8 (39.2%) was used as the assessment tool. (4) The simplified PIDAQ[M] can replace the original PIDAQ[M] in the sociodental approach to estimate the orthodontic treatment needs of the Malaysian population.

Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders.

OBJECTIVE: To evaluate the prevalence and severity of malocclusion and its impact on oral health-related quality of life (OHRQoL) and self-reported satisfaction of patients with anorexia and bulimia nervosa. METHODS: The sample consisted of sixty women who attended a specialized mental health clinic of a Brazilian medical school. Participants were distributed into two groups: patients with anorexia and bulimia nervosa (ABN; n=30) and control patients without eating disorders (CN; n=30). The dental occlusion was evaluated by the Dental Aesthetic Index; the OHRQoL was assessed using the OHIP-14 questionnaire; and the self-reported satisfaction with the appearance of teeth, speech ability and chewing was obtained by interviews. RESULTS: Severe and very severe malocclusion were observed in 26.67% and 46.67% of patients in the ABN group, respectively, while the CN group showed 80.00% of patients without abnormality/mild malocclusion. ABN group showed a higher proportion of patients (p < 0.05) with tooth loss, spacing in the region of incisors, maxillary misalignment, and mandibular misalignment in relation to CN group. ABN group presented lower (p< 0.05) OHRQoL and self-reported satisfaction with the appearance of teeth, speech ability and chewing, compared to the CN group. There was a significant positive correlation (p< 0.05) between the Dental Aesthetic Index and OHIP-14 scores in the ABN group. CONCLUSIONS: The prevalence of severe malocclusion in ABN group was high, with a negative impact on OHRQoL and self-reported satisfaction with the chewing ability, speech ability and appearance of teeth.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents.

BACKGROUND: The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. METHODS: This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem. RESULTS: A significant correlation was found between self-esteem and self-perceived smile (r = 0.294; P < 0.001) and dental aesthetics (r = 0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem. CONCLUSIONS: The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

The Psychosocial Impact of Dental Esthetics in Undergraduates with Borderline Malocclusion.

Background: The study investigates the existing correlation between self-perceived malocclusion, the psychosocial impact of dental esthetics, and whether this link involves personality traits. Methods: The 179 questionnaires from 615 undergraduates in Wenzhou were used for analysis after applying the exclusion criteria. The Psychosocial Impact of the Dental Aesthetics Questionnaire (PIDAQ) was administered to evaluate participants' perceptions of the psychosocial impacts of malocclusion. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). The Chinese version of the Eysenck Personality Questionnaire-Short Scale (EPQ-RSC) evaluated participants' personality characteristics. The Kruskal-Wallis test was used to assess differences between the IOTN-Dental Health Component (DHC) and expectations of orthodontic treatment. Linear regression was applied with PADAQ and its subscale scores against possible variables. Results: The total and subscale PIDAQ scores were positively correlated with neuroticism. Total PIDAQ scores, the DHC, and the Aesthetic Component (AC) were significantly positively correlated with the subjective AC. The DHC was significantly negatively correlated with extroversion. Conclusions: We confirmed a modest link between the need for orthodontic treatment and the psychosocial impact of dental esthetics.

The impact of orthognathic surgery on quality of life in individuals with oral clefts.

BACKGROUND/OBJECTIVES: To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. MATERIALS AND METHODS: A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. RESULTS: OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (ß = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (ß = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (ß = 0.02). LIMITATIONS: The short follow-up period of 6 months after orthognathic surgery. CONCLUSIONS/IMPLICATIONS: This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.

Orthodontic treatment demand in young adolescents - Are parents familiar with their children's desires and reasons?

AIM: To assess the levels of agreement between parents and adolescents about young adolescents' orthodontic treatment demand and to what extent is treatment demand conditioned by family and psychosocial impacts and oral function. DESIGN: This cross-sectional study included 221 adolescents (11-14 years, 54% female) and their parents. A 5-point scale was used to assess orthodontic treatment demand. Adolescents self-administered the Child Perceptions Questionnaire, and parents self-administered the Parental-Caregivers Perceptions Questionnaire and Family Impact Scale. The Index of Orthodontic Treatment Need Dental Health Component (IOTN DHC) was used for determining malocclusion severity. Intraclass correlation coefficient and Cohen's kappa coefficient were used for the assessment of agreement between two informants. RESULTS: The parent-child agreement on children's orthodontic treatment demand was weak, concording in 67.4% of cases. The most common reasons for seeking orthodontic treatment derive from the emotional (EW) and social well-being domains for both informants. In linear regression, the adolescent's reporting of impaired EW and IOTN DHC was the only significant linear predictor of orthodontic treatment demand. CONCLUSION: Parents cannot correctly assess the orthodontic treatment demand of their children. Impaired EW is the most significant self-reported determinant of adolescents' demand for orthodontic treatment. Family relationships and parental perspective have a low influence.

The consequences of living with a severe malocclusion: A review of the literature.

AIM: To facilitate the orthognathic shared decision-making process by identifying and applying existing research evidence to establish the potential consequences of living with a severe malocclusion. METHODS: A comprehensive narrative literature review was conducted to explore the potential complications of severe malocclusion. A systematic electronic literature search of four databases combined with supplementary hand searching identified 1024 articles of interest. A total of 799 articles were included in the narrative literature review, which was divided into 10 themes: Oral Health Related Quality Of Life; Temporomandibular Joint Dysfunction; Masticatory Limitation; Sleep Apnoea; Traumatic Dental Injury; Tooth Surface Loss; Change Over Time; Periodontal Injury; Restorative Difficulty; and Functional Shift and Dual Bite. A deductive approach was used to draw conclusions from the evidence available within each theme. RESULTS: The narrative literature review established 27 conclusions, indicating that those living with a severe malocclusion may be predisposed to a range of potential consequences. With the exception of Oral Health Related Quality Of Life, which is poorer in adults with severe malocclusion than those with normal occlusions, and the risk of Traumatic Dental Injury, which increases when the overjet is >5 mm in the permanent and 3 mm in the primary dentition, the evidence supporting the remaining conclusions was found to be of low to moderate quality and at high risk of bias. CONCLUSION: This article summarises the findings of a comprehensive narrative literature review in which all of the relevant research evidence within a substantive investigative area is established and evaluated. Notwithstanding limitations regarding the quality of the available evidence; when combined with clinical expertise and an awareness of individual patient preferences, the conclusions presented may facilitate the orthognathic shared decision-making process and furthermore, may guide the development of the high-quality longitudinal research required to validate them.

The value of adult orthodontics: Do the public's willingness-to-pay values reflect the profession's?

OBJECTIVE: To explore how the public and dental professionals would value an orthodontic service for adults by eliciting their willingness-to-pay (WTP), a standardised health economics technique which quantifies 'strength of preference' in monetary terms. Despite increasing demand, adults in the UK are only eligible for NHS orthodontic treatment if there is severe dental health or complex multidisciplinary need. Orthodontic services are provided to children aged under 18 years who are eligible by their Index of Orthodontic Treatment Need (IOTN) score. Consequently, many adults who may have a need for treatment as determined by IOTN are unable to access this service. DESIGN: Cross-sectional survey. SETTING: General dental practices in North East England and national specialists approached through the British Orthodontic Society (BOS). PARTICIPANTS: Public participants were recruited from general dental practices. Dentists were recruited from local dental lists and members of the BOS. METHODS: Participants were asked if they would be willing to pay to see an orthodontic service extended to all adults in England with a qualifying IOTN. Clinical photographs of three malocclusions were presented and maximum WTP in additional tax per household per year was elicited using shuffled payment cards. RESULTS: A total of 205 dentists and 206 public participants were recruited. Pairwise tests showed a statistically significant difference in WTP between the public and professionals for all malocclusions, with the public giving higher valuations. In both groups, the Class III scenario elicited a higher WTP than the class I or II malocclusion. However, when all other factors were controlled for using a regression analysis, the group (public or profession) and the other variables did not significantly influence WTP. CONCLUSION: The public and professionals were willing to pay for an adult orthodontic service. Due to this variability and unpredictability the allocation of healthcare resources will remain contentious.