Association between malocclusion severity and adolescents' psychosocial status

The impact of dentoskeletal malocclusion on the psychosocial status and oral health-related quality of life (OHRQoL), especially in adolescents, has been a subject of considerable debate in the literature.

The aim of the study was to explore the relationship between the severity of dental and skeletal malocclusions and adolescents' self-esteem, their perception of dentofacial aesthetics, and the psychosocial impact of dental aesthetics.

Adolescent patients (aged 10-18 years) seeking orthodontic treatment in a hospital clinic were recruited for the study. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), the Orofacial Esthetic Scale (OES), the Rosenberg Self-Esteem Scale (RSES), and the Aesthetic Component of the index of orthodontic treatment need (IOTN-AC) were administered during the first consultation. Overbite (OVB), overjet (OVJ) and the Dental Health Component of the IOTN (IOTN-DHC) were measured by a trained operator on digital models. Lateral cephalometric radiographs were used to evaluate skeletal malocclusions in the sagittal and vertical planes. Comparisons between the groups were performed using analysis of variance (ANOVA), the Kruskal-Wallis test or the χ2 test. Correlations between variables were assessed using Pearson's or Spearman's correlation tests.

The majority of adolescents classified according to the IOTN-DSC as having a definite need for orthodontic treatment by clinicians perceived their own need for treatment as low or non-existent. No statistically significant differences were found in the PIDAQ, OES and RSES scores among different IOTN-DHC subgroups. Overjet was associated with self-esteem, while OVB was correlated with dental self-confidence and overall assessment of orofacial aesthetics. Skeletal variables were not associated with the studied domains. The PIDAQ was significantly positively correlated with the IOTN-AC and negatively correlated with the RSES.

The perception of malocclusion severity differs between patients and clinicians, highlighting the need to consider patients' values when defining orthodontic goals. Overjet and OVB are clinical variables that can influence the psychosocial domain in adolescents.