Oral Health Quality of Life Outcomes of Children Following Orthodontics

Objectives: Despite the widespread belief that orthodontics improves psychological well-being and self-esteem, there is little objective evidence to support this. The objective of this study was to use a three-year prospective longitudinal cohort design study to evaluate oral health-related quality of life (OHRQoL) outcomes in children with malocclusion following orthodontic treatment.

Methods: sixty four children were assessed before after receiving orthodontic treatment. Age-specific, multidimensional and self-reporting child perception questionnaires were used (COHRQoLQ). Overall, subscale, and individual scores were compared. Two sub-scales of the Child Health Questionnaire (CHQ-CF87) were administered concurrently: Self Esteem (SE) and Mental Health (MH). The normative need was assessed using the Dental Aesthetic Index (DAI). Children's rating of own dental aesthetics was recorded using the Aesthetic Component of The Index of Orthodontic Treatment Need (IOTN.AC).

Results: Children reported significant increases of the social (p<0.05) and emotional well-being domain scores (p<0.001) of the COHRQoLQ following orthodontic treatment. No significant changes were noted in terms of oral symptoms or functional limitations domains. In global ratings, they rated their oral health, dental aesthetics and function to be markedly better than before treatment (p<0.001). Although there was no difference over time in their ratings of self esteem, the mental health domain changed considerably after treatment (p<0.001). Furthermore, analysis of the responses to individual questions explained the modest reduction in the overall COHRQoLQ score.

Conclusions: This study was able to demonstrate significant improvement in the social and emotional well-being of children receiving orthodontic treatment as measured by both the OHRQoLQ and the generic MH scale of the CHQ-CF87. Unlike previous studies of this nature, an item based analysis of OHRQoL data was employed because of the multi-dimensional nature of COHRQoL measures. The lack of changes in self esteem following orthodontic treatment may reflect its mediating role as a personal resource. Age related changes in these psychosocial constructs will be further explained upon completion of the study.