Changes in oral health-related quality of life and self-esteem after fixed orthodontic treatment

To examine the associations of fixed orthodontic treatment with oral health-related quality of life (OHRQoL) and self-esteem (SE) in relation to sex and premolar extraction status.

Adult patients undergoing fixed orthodontic treatment at a private orthodontic practice from 2010 to 2021 were included. Pre- and posttreatment OHRQoL and SE were evaluated using the Orthognathic Quality of Life Questionnaire (OQLQ) and Rosenberg Self-Esteem Scale (RSE), respectively. Outcomes were compared by sex and premolar extraction status.

A total of 358 patients (mean age: 26.98 years), including 250 female patients (69.8%) and 206 patients (57.5%) who underwent premolar extraction, were evaluated in this study. Before treatment, male patients had higher OHRQoL and SE than female patients (OQLQ score: 20.25 vs. 25.77, P < 0.001; RSE score: 31.99 vs. 30.06, P < 0.001). After treatment, OHRQoL improved in both sexes (P < 0.001) and SE improved in female patients (P < 0.001), although the between-sex difference was not significant. Male patients maintained higher OHRQoL and SE than female patients posttreatment (OQLQ score: 12.56 vs. 16.79, P < 0.001; RSE score: 32.44 vs. 30.94, P = 0.001). Pretreatment OHRQoL and SE in the extraction group were lower than those in the non-extraction group (OQLQ score: 25.82 vs. 21.78, P = 0.005; RSE score: 30.21 vs. 31.23, P = 0.018), but these differences became non-significant posttreatment (P > 0.05).

After orthodontic treatment, OHRQoL improved in both sexes and SE improved in female patients, although the clinical significance of these changes was uncertain. In the extraction group, OHRQoL and SE were initially lower than those in the non-extraction group but showed no significant intergroup differences after treatment.