BackgroundThis paper describes the cross-cultural adaptation of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) into Malay version (Malay PIDAQ), an oral health-related quality of life (OHRQoL) instrument specific for orthodontics for Malaysian adolescents between 12 and 17 years old.MethodsThe PIDAQ was cross-culturally adapted into Malay version by forward- and backward-translation processes, followed by psychometric validations. After initial investigation of the conceptual suitability of the measure for the Malaysian population, the PIDAQ was translated into Malay, pilot tested and back translated into English. Psychometric properties were examined across two age groups (319 subjects aged 12–14 and 217 subjects aged 15–17 years old) for factor structure, internal consistency, reproducibility, discriminant and construct validity, criterion validity, and assessment of floor and ceiling effects.ResultsFit indices by confirmatory factor analysis showed good fit statistics (comparative fit index = 0.936, root-mean-square error of approximation = 0.064) and invariance across age groups. Internal consistency and reproducibility tests were satisfactory (Cronbach’s α = 0.71-0.91; intra-class correlations = 0.72-0.89). Significant differences in Malay PIDAQ mean scores were observed between subjects with severe malocclusion and those with slight malocclusion based on a self-rated and an investigator-rated malocclusion index, for all subscales and all age groups (p < 0.05). Construct validity of the Malay PIDAQ subscales with those who rated themselves with excellent to poor dental appearance and those who felt they needed or did not need braces, showed significant associations for all age groups (p < 0.05). Criterion validity also showed significant association between the Malay PIDAQ scores with those with and without impact on daily activities attributed to malocclusion. There were no ceiling effects detected but floor effects were detected for the Aesthetic Concern subscale.ConclusionThe study has provided initial evidence for the validity and reliability of the Malay PIDAQ to assess the impact of malocclusion on the OHRQoL of 12–17 year old Malaysian adolescents.

BackgroundThe Malay version of the Psychosocial Impact of Dental Aesthetics Questionnaire has been validated for use by Malaysian adolescents. Although Malay is their national language, English is widely used as the lingua franca among Malaysians of different ethnicities. This study aimed to validate an English version of the PIDAQ adapted for use by Malaysian adolescents to optimize data capture from adolescents who prefer English as the medium for communication.MethodsThe published English version of PIDAQ was pilot tested on 12- to 17-year-old adolescents, resulting in a few modifications to suit the Malaysian variety of English. Psychometric properties were tested on 393 adolescents who attended orthodontic practices and selected schools. Malocclusion was assessed using the Malocclusion Index, an aggregation of Perception of Occlusion Scale and the Aesthetic Component of the Index of Orthodontic Treatment Need, by the subjects (MI-S) and investigators (MI-D). Data were analysed for internal consistency and age-associated invariance, discriminant, construct and criterion validities, reproducibility and floor and ceiling effects using AMOS v.20 and SPSS v.20.ResultsThe item Don’t like own teeth on video of the Aesthetic Concern (AC) subscale was not relevant to a large proportion of participants (11.7%). Therefore, it was removed and the Malaysian English PIDAQ was analysed based on 22 items instead of 23 items. Confirmatory factor analysis showed good fit statistics (comparative fit index: 0.902, root-mean-square error of approximation: 0.066). Internal consistency was good for the Dental Self-Confidence, Social Impact and Psychological Impact subscales (Cronbach’s alpha: 0.70-0.95) but lower (0.52–0.62) though acceptable for the AC subscale as it consisted of only 2 items. The reproducibility test was acceptable (intra-class correlations: 0.53–0.78). For all PIDAQ subscales, the MI-S and MI-D scores of those with severe malocclusion differed significantly from those with no or slight malocclusion. There were significant associations between the PIDAQ subscales with ranking of perceived dental appearance, need for braces and impact of malocclusion on daily activities. There were no floor or ceiling effects.ConclusionThe adapted Malaysian English PIDAQ demonstrated adequate psychometric properties that are valid and reliable for assessment of psychological impacts of dental aesthetics among Malaysian adolescents.

Dental quackery has been a problem for decades and is becoming a major concern in many countries, including Malaysia. Recent development of a new service offered by quacks in Malaysia is “fake braces”, which alarmed dental professionals. The fake braces appear similar to the professionally fitted orthodontic appliances comprising of archwires that are secured on brackets by coloured ligatures except they are fitted by unqualified individuals who have no formal clinical training. In addition, the orthodontic materials and dental equipment used for this illegal service were substandard and unregulated. Therefore, such fitted appliances are harmful to the teeth and oral health. Efforts to record the extent of fake braces practice and its oral health consequences have been challenging as they are marketed through the social media, and the victims were either reluctant to come forward or did not know the appropriate channel to file a complaint to the health authority. This paper aims to highlight typical presentation of fake braces, modus operandi of fake braces providers, the harmful effects of fake braces on the patient’s oral health, the role of social media advertising in promoting fake braces, and the impacts to the illegal providers.

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This study aimed to assess the prevalence, extent and severity of the psychosocial impact of dental aesthetics (PIDA) among Malaysian adolescents especially those with self-perceived malocclusion, and to determine if age and gender affected their PIDA. A cross-sectional study using a self-administered questionnaire was conducted on 12-17 year old schoolchildren from schools across Malaysia selected via a multi-stage sampling method. The questionnaire included the Malaysian Psychosocial Impact of Dental Aesthetics (Malaysian PIDA) questionnaire and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC). The Malaysian PIDA measured four domains: (Dental Self Confidence, 6 items; Social Impact, 8 items; Psychological Impact, 6 items; and Aesthetic Concern, 2 items) to assess impacts on the oral health-related quality of life specific to malocclusion. While the IOTN-AC comprised a 10-point photographic scale to assess self-perceived malocclusion. Data analysis using SPSS version 20 was involved using complete data on 901 participants. The prevalence of PIDA was 90.0% while prevalence associated with self-perceived malocclusion was 96.0%. Impact of dental aesthetics was highest on the psychological wellbeing of the adolescents, followed by their self-confidence. In terms of the extent of impact, 14.0% reported significant impact on all four domains and 19.2% were associated with self-perceived malocclusion. The prevalence of impacts was higher in younger adolescents and females. In terms of the extent and severity of impacts, younger adolescents reported higher impacts but with small effect sizes, while differences between boys and girls were not significant.