Oral health-related quality of life and orthodontic treatment seeking

Introduction: The aim of this study was to assess oral health-related quality of life (OHQOL) in adolescents who sought orthodontic treatment. A comparison between these adolescents and their age-matched peers who were not seeking orthodontic treatment provided an assessment of the role of OHQOL in treatment seeking. Methods: The sample consisted of 225 subjects, 12 to 15 years of age; 101 had sought orthodontic treatment at a university clinic (orthodontic group), and 124, from a nearby public school, had never undergone or sought orthodontic treatment (comparison group). OHQOL was assessed with the Brazilian version of the short form of the oral health impact profile, and malocclusion severity was assessed with the index of orthodontic treatment need. Results: Simple and multiple logistic regression analysis showed that those who sought orthodontic treatment reported worse OHQOL than did the subjects in the comparison group (P<0.001). They also had more severe malocclusions as shown by the index of orthodontic treatment need (P=0.003) and greater esthetic impairment, both when analyzed professionally (P=0.008) and by self-perception (P<0.0001). No sex differences were observed in quality of life impacts (P=0.22). However, when the orthodontic group was separately evaluated, the girls reported significantly worse impacts (P=0.05). After controlling for confounding (dental caries status, esthetic impairment, and malocclusion severity), those who sought orthodontic treatment were 3.1 times more likely to have worse OHQOL than those in the comparison group. Conclusions: Adolescents who sought orthodontic treatment had more severe malocclusions and esthetic impairments, and had worse OHQOL than those who did not seek orthodontic treatment, even though severely compromised esthetics was a better predictor of worse OHQOL than seeking orthodontic treatment. (Am J Orthod Dentofacial Orthop 2010; 138: 152-9)