Malocclusion and its Treatment Effects on Adolescents' Quality of Life

Introduction: The relationship between malocclusion and quality of life (QoL) is complex and not well understood. The objective of this study was to determine whether malocclusion and its treatment influence an adolescent's general and oral health-related QoL. Methods: We used an observational, cross-sectional design with a longitudinal component. Clinical and self-report data were collected on 293 participants age 11-14. They were recruited from orthodontic and pediatric dental clinics at the University of Washington and a community clinic. Participants were classified into pre-comprehensive orthodontic (n=93), post-interceptive orthodontic (n=44), and non-orthodontic comparison (n=156) groups. Dental esthetics and occlusion were evaluated with the Index of Complexity, Outcome, and Need (ICON). Three QoL questionnaires were completed: Youth Quality of Life (YQoL) to assess general QoL, Children's Oral Health-Related Quality of Life (COHQoL) to assess oral health QoL, and Treatment Expectations and Experiences, to evaluate expectations for change in specific aspects of their lives. Results: In general, overall and oral health QoL were high in this population. The instruments were correlated such that children with higher OHQoL also reported higher general QoL. No differences emerged on these measures between the two clinic populations. Nor were there differences between the three study groups on general and oral health QoL. There was little effect of malocclusion complexity on any QoL measure. Both pre- and post-orthodontic participants expected improvements in their health, oral function, appearance and social well-being following orthodontic treatment. The post-interceptive group's post-treatment experiences were consistent with their pre-treatment expectations in all domains. Conclusions: Malocclusion and its treatment do not appear to affect general or oral health QoL to a measurable degree, despite subjective and objective evidence for improved appearance, oral function, health and social well-being. Funding: This research was supported by NIDCR Grant U54DE14254 and the University of Washington, Department of Orthodontics Alumni Fund.