Severe malocclusion negatively impacts adolescents' quality of life

Abstract

Palavras-chaves: Má Oclusão. Adolescente. Qualidade de Vida. Epidemiologia. Saúde Pública. RESUMOObjetivo: Avaliar o impacto da má oclusão severa na qualidade de vida relacionada à saúde bucal de adolescentes (OHRQoL). Métodos: Este estudo consistiu em uma amostra de 117 adolescentes entre 11 e 12 anos, que responderam à versão brasileira da forma abreviada do Child Perception Questionnaire (CPQ11-14). Este questionário tem 16 itens distribuídos igualmente em quatro domínios: sintomas bucais (SO), limitações funcionais (LF), bem-estar emocional (BE) e bemestar social (BS). Escores mais altos indicam um impacto negativo maior na OHRQoL. A má oclusão foi avaliada por meio do Índice Estético Dental. Os adolescentes foram alocados nas seguintes categorias: sem má oclusão/má oclusão leve, má oclusão definitiva e má oclusão severa. Análise descritiva, teste de Kruskal Wallis, teste de Dunn, regressão logística univariada e multivariada foram conduzidas. Resultados: Indivíduos com má oclusão severa apresentaram escores significativamente mais elevados do que aqueles sem má oclusão/má oclusão leve para o BE (p=0,001), BS (p=0,027) e para o escore total do CPQ11-14 (p=0,015). Adolescentes com má oclusão severa apresentaram 2,63 vezes mais chance de apresentar um impacto negativo alto na OHRQoL do que aqueles sem má oclusão/má oclusão leve, independentemente das variáveis de confusão (IC=1,07-6,45, p=0,035). Conclusão: A má oclusão severa afeta negativamente a OHRQoL dos adolescentes. ABSTRACT Aim:To assess the impact of severe malocclusion on adolescents' oral healthrelated quality of life (OHRQoL). Methods: This study consisted of a sample of 117 adolescents between 11 and 12 years, who answered the Brazilian version of the short form of the Child Perception Questionnaire ). This questionnaire has 16 items distributed equally across four domains: oral symptoms (OS), functional limitations (FL), emotional well-being (EW) and social well-being (SW). Higher scores indicate a greater negative impact on OHRQoL. Malocclusion was evaluated using the Dental Aesthetic Index. Adolescents were assigned to the following categories: no or slight malocclusion, defined malocclusion and severe malocclusion. Descriptive analysis, the Kruskal Wallis test, post hoc test, univariate and multivariate logistic regression were conducted. Results: Individuals with severe malocclusion presented significantly higher scores than those with no or slight malocclusion for the EW (p=0.001), SW (p=0.027) and for the overall CPQ 11-14 score (p=0.015). Adolescents with severe malocclusion showed a 2.63 greater chance of presenting a high negative impact on OHRQoL than those with no or slight malocclusion regardless of the confounding variables (CI=1.07-6.45, p=0.035). Conclusion: Severe malocclusion negatively impacts adolescents' OHRQoL.

Impact of oral diseases on oral health-related quality of life: A systematic review of studies conducted in Latin America and the Caribbean

“…In relation to the study design, 32 were cross-sectional studies, 2 were cohort studies and there were 6 case and control studies. With regard to the classification of studies included according to age group, 24 studies were performed in children [ 16 – 19 , 25 , 27 , 29 – 37 , 39 , 40 , 43 , 45 , 47 , 51 , 52 , 54 , 55 ], 10 were in adolescents [ 20 , 22 – 24 , 26 , 28 , 44 , 46 , 48 , 50 ], 4 were adult studies [ 21 , 38 , 42 , 53 ] and 2 study included more than one age group [ 41 , 49 ]. They all also evaluated the impact of oral disease over OHRQoL, classified according to exposure to one or more oral diseases, tooth decay, malocclusion, TDI, periodontal diseases, temporomandibular dysfunction, salivary gland pathologies, cleft lip and palate, and edentulism and found studies related to dental caries (n = 7) [ 20 , 25 , 32 , 36 , 37 , 43 , 54 ], malocclusion (n = 2) [ 24 , 26 ], TDI (n = 3) [ 29 , 39 , 44 ], periodontal disease (n = 1) [ 38 ], cleft lip and palate (n = 1) [ 40 ], temporomandibular dysfunction (n = 1) [ 41 ], edentulism (n = 1) […”

“…The quality of life measurement instruments used in the different studies were as follows; CPQ8-10 [ 27 , 31 , 35 , 36 , 40 , 47 , 49 ], CPQ11-14 [ 20 , 22 – 24 , 26 , 28 , 48 – 50 ], ECOHIS [ 16 , 29 , 33 , 37 , 45 , 52 , 54 ], B-ECOHIS [ 18 , 19 , 25 , 30 , 32 , 39 , 43 , 51 ],OHIP-14 [ 21 , 42 , 46 , 53 ],OHIP [ 38 , 41 ],C-ECOHIS [ 55 ], SOHO-5 [ 17 ], B-SOHO-5 [ 34 ] and Child-OIDP [ 44 ], the most frequent being CPQ11-14(n-9), B-ECOHIS(n-8). The association between quality of life and oral diseases was expressed using RR, OR and PR and mean difference hypothesis tests and beta coefficients.…”

“…Twenty studies investigating the association between malocclusion and OHRQoL were identified ( Table 1 ), 18 in Brazil, one in Peru and one in Colombia. Of these, 12 studies included children between 2 and 10 years old [ 16 , 18 , 19 , 27 , 31 , 33 , 35 , 45 , 47 , 51 , 52 , 55 ], 7 included the pre-adolescent population between 11 and 14 years old [ 22 – 24 , 26 , 28 , 48 , 50 ], and one was in children between 8 and 12 years old [ 49 ]. Of the total studies, 12 assessed malocclusions according to the criteria of the dental aesthetic index (DAI) while 9 evaluated the absence or presence of the disease.…”

“…One of the studies [ 23 ] found no significant association between severe malocclusion and OHRQoL, except in cases of definite and handicapping malocclusion. In addition, two studies reported that the most severe states of malocclusion were associated with worse OHRQoL, even though the less severe states of the condition were not associated [ 24 , 49 ].…”

“…With regard to the evaluation of the quality of the studies, eight were of good quality [ 20 , 21 , 26 , 31 – 33 , 49 , 53 ], 22 were of intermediate quality [ 16 – 19 , 22 , 23 , 25 , 27 – 29 , 34 , 35 , 37 , 42 , 43 , 45 , 47 , 48 , 50 , 51 , 54 , 55 ] and ten were of poor quality [ 24 , 30 , 34 , 36 , 38 , 39 , 41 , 44 , 46 , 52 ] ( Table 3 ).…”