EFFECTS OF MALOCCLUSION ON ORAL HEALTH RELATED QUALITY OF LIFE (OHRQoL): A CRITICAL REVIEW

European Scientific Journal July 2015 edition vol.11, No.21 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 EFFECTS OF MALOCCLUSION ON ORAL HEALTH RELATED QUALITY OF LIFE (OHRQoL): A CRITICAL REVIEW Ziad Salim Abdul Majid BDS, DipImpDent Faculty of Dentistry, Beirut Arab University, Lebanon Faculty of Dentistry, Libyan International Medical University, Libya Randa F. Abidia BDS, DDPH RCS, MSc, PhD (UK) Professor, Department of Preventive Dental Sciences, Faculty of Dentistry, Princess Nora Bint Abdul Rahman University, Saudi Arabia Abstract Objectives: The purpose of this paper is to provide a useful critical review relating to the effects of malocclusion on the physical, social, and psychological aspects of the Quality of Life (QoL) of patients. Methods: The information presented in previous articles was reviewed. They include reviews, meta-analyses, cross-sectional studies, retrospective and prospective longitudinal studies, and randomized controlled trials. These full-text English-language papers were studied to determine the effects of malocclusion on QoL. Results: Recent studies have found that malocclusion is associated with higher levels of dissatisfaction with appearance, and have the potential to negatively impact Oral Health Related Quality of Life (OHRQoL). However, due to the differences in study designs, population demographics studied, and methods of assessment of physical, social, and psychological health, the evidence needs more analysis. Conclusion: In recent years, attention to patient-centered assessment has greatly increased. The orthodontist’s point of view has expanded from dentofacial esthetics to the patient’s overall OHRQoL. This leads to increase in dental practitioners comprehensively and rigorously, thus assessing the effects of malocclusion on QoL. The demand on standardized, valid, and reliable data collection instruments will increase as practices treats malocclusion issues to elevate patient’s overall OHRQoL. Keywords: Malocclusion, Psychology, Orthodontic treatment, OHRQoL 386 European Scientific Journal July 2015 edition vol.11, No.21 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 Introduction Oral Health-related Quality of Life and Malocclusion The concept of Oral health-related quality of life (OHRQoL) has multiple qualities and can be defined as “the absence of negative impacts of oral conditions on social life and positive sense of dentofacial selfconfidence” (Inglehart et al., 2002). Thus, the difficulty arises in the subjective evaluation of the patient’s perceived physical, psychological, and social aspects of oral health. It is difficult to utilize any one standard evaluation tool to determine how the patient feels about themselves (Locker and Allen, 2007; Silvola et al., 2011). However, this concept of a patient’s view of OHRQoL means that the idea of a “good oral health” should include the patient’s self-esteem, psychological, and social well-being, as well as the absence of hard and soft tissue oral diseases (Ingelhart et al., 2002). Malocclusion is a widespread oral condition that occurs worldwide. It differs from the majority of medical and dental conditions in that it is ‘a set of dental deviations’ rather than a disease. Therefore, its treatment is different from other conditions. Often, the “cure” for malocclusion involves an orthodontic procedure, designed to return occlusion to what is considered as an idealized state. If the occlusion is considered to be functional and esthetic, then the malocclusion is considered to be resolved (Masood et al., 2013). The etiology of malocclusion includes many causes from genetic, traumatic, and environmental factors. However, there are many chemical and teratogenic factors that can result in cleft lip/palate or other cranio-facial defects in utero (Proffit, WR., 2013). Literature has described a relatively high incidence of heritability of craniofacial dimensions and low incidence of the heritability of dental arch variations (Proffit, WR., 2013; Johannsdottir et al., 2005). Research is ongoing to determine with clarity, the relationships between the heritability and the development of malocclusions that include both skeletal and dental components (Proffit, WR., 2013; Mossey et al.,1999). Obviously, malocclusions may have a negative influence on the physical, psychological, and social development of young people. However, this is beyond the typically discussed problems of growth and occlusal development in malocclusive condition. Typically, the problems of malocclusions in relationship with tooth injuries or functional problems have been discussed (Järvinen, S. et al., 1979; Forsberg et al., 1993). However, these malocclusions have a long-lasting impact on an individual’s selfesteem, self-confidence, and social interactions. Hence, this is regarded as the concept of OHRQoL (de Oliveira and Sheiham, 2003). At first, the research appears inconclusive. Many psychological tests and long-term follow-ups do not reveal a significant correlation between malocclusion and the symptoms of psychological distress (Taghavi Bayat et 387 European Scientific Journal July 2015 edition vol.11, No.21 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 al., 2013). Subsequently, more focused research metrics that are designed to directly investigate the physical, social, and psychological impact of malocclusion on OHRQoL have been developed. Therefore, these can better assess the effects of malocclusion on people’s lives. A better understanding of the need for orthodontic treatment beyond the measurement of clinical parameters can be attained. Social and psychological effects are often the key motives for a patient to seek orthodontic treatment. Furthermore, patients are notorious for their ability to live with functional, rather than cosmetic issue. This reflects the importance of OHRQoL as the measurement for orthodontic treatment need, as well as patient’s satisfaction of the outcome (Masood et al., 2012). Psychological, Social, and Physical Impacts in Relation to Malocclusion It is now established that malocclusion and dento-facial deformities are prevalent enough to provide a large enough sample group to be studied. Also characterized in literature is the influence of malocclusion on the physical, social, and psychological “functioning” of the patient (Lee et al., 2007; Rusanen et al., 2010). Thus, it is important to understand the biopsychosocial aspects of the malocclusion and its repercussion on the general QoL. This can be addressed especially in adolescent patients because this developmental period is a specific phase of the human development that is characterized by anatomical, physiological, psychological, and social transformations. Consequently, information about how malocclusion affects these patients may offer an evaluation of patient perceived need and priority for the treatment of those individuals that are acutely aware of deviations from norm. This should, in theory, enable better (...truncated)