Clinical Psychological Correlates of Malocclusion: Body Image Concerns and Oral Health-Related Quality of Life

Background: Malocclusion is a highly prevalent condition, affecting approximately 56% of the global population. Beyond its functional and physical characteristics, malocclusion has been associated with psychosocial outcomes, particularly body image concerns and perceived quality of life. The present study aimed to investigate the associations among Angle class, body image concerns, and oral health-related quality of life. Methods: A total of 136 adolescents aged 10 to 19 years (M = 15.49; SD = 2.64; 47.8% males and 52.2% females) were recruited from the "Gaetano Martino" University Hospital of the University of Messina. Following the clinical diagnosis and classification of malocclusion according to Angle's classification (Class I, Class II, and Class III), participants underwent a psychodiagnostic assessment comprising a sociodemographic questionnaire, the Italian version of the Body Image Concern Inventory (I-BICI), and the Oral Health Impact Profile (OHIP-14). Results: Greater body image concerns were significantly associated with poorer oral health-related quality of life. Female participants reported significantly higher levels of body image concerns than males, whereas no significant sex differences emerged in OHIP-14 scores. Generalized linear models further showed that Angle class was significantly associated with body image concerns and oral health-related quality of life after controlling for age and sex. Conclusions: The findings indicate that Angle class is associated with body image concerns and oral health-related quality of life in adolescents with malocclusion. These results highlight the relevance of considering body image concerns and patient-reported oral health-related quality of life alongside conventional orthodontic assessment, supporting a more comprehensive, patient-centered approach to orthodontic care.