Malocclusion and Scoliosis: Is There a Correlation?

Scoliosis is a complex three-dimensional malformation of the spine. Although its etiology is still being investigated, it is clear that a number of factors can influence this syndrome. The spinal deformity of idiopathic scoliosis can be viewed from an etiopathogenetic perspective as a symptom of a complicated condition with a multifactorial etiology. Numerous studies have established its relationship with malocclusion, but it is still unclear how these factors interact. Malocclusion is a change in the physiological alignment of the upper and lower teeth that can be either dental or skeletal in origin. This study's objective is to assess the relationship between scoliosis and malocclusion.

A total of 646 patients were enrolled (554 females and 92 males), 447 with scoliosis and 199 without, from private dental and orthopedic practices, to answer an anonymous questionnaire. They were selected in private dental and orthopedic practices where they had dental and orthopedic examinations. Twenty-two patients were excluded because of a lack of answers. Participants were given a bilingual survey, in English and Italian, composed of 13 questions formulated specifically for this study, using Google Forms (Google LLC, Mountain View, CA, USA).

Univariate analysis of the question "Do you have scoliosis?" shows a significant correlation with the following questions: "Was scoliosis a family issue?" (p < 0.05 OR 7.30 IC: 3.05-17.46) "Do you have malocclusion?" (p < 0.05, OR: 1.19 IC:1.0-1.34) and "Was mal-occlusion a family issue?" (p < 0.01, OR: 1.39 IC 1.10-1.77). Performing a multivariate analysis for the same variables, the best predictors of scoliosis were "Was scoliosis a family issue?" (p < 0.001) and "Was malocclusion a family issue?" (p < 0.05), while the question "Do you have malocclusion" lost significance.

This study adds further confirmation that there might be an important connection between malocclusion and scoliosis; it suggests that dentists and orthopedists have to check, as early as possible, for the probable presence of both pathologies to avoid a severe progression which, in most cases, may require significant therapy and even surgery.