Impact of malocclusion on the quality of life of children aged 8 to 10 years

The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil.

Methods:

The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study.

Results:

Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ_8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038).

Conclusions:

Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.

Keywords:
Mixed dentition; Malocclusion; Quality of life.

Authorship

Sônia Rodrigues Dutra

Private practice (Belo Horizonte/MG, Brazil).Private practice (Belo Horizonte/MG, Brazil).BrazilBelo Horizonte, MG, BrazilPrivate practice (Belo Horizonte/MG, Brazil).

Henrique Pretti

Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia (Belo Horizonte/MG, Brazil).Universidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilUniversidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia (Belo Horizonte/MG, Brazil).

Milene Torres Martins

Universidade Estadual de Montes Claros, Curso de Odontologia (Montes Claros/MG, Brazil).Universidade Estadual de Montes ClarosBrazilMontes Claros, MG, BrazilUniversidade Estadual de Montes Claros, Curso de Odontologia (Montes Claros/MG, Brazil).

Cristiane Baccin Bendo

Miriam Pimenta Vale

Contact address: Sônia Rodrigues Dutra Av. Antônio Carlos, 6627 - Belo Horizonte/MG - CEP: 31.270-901, Brasil E-mail: soniardutra@yahoo.com.br

Authors contribution

Conception or design of the study: SRD, HP, MTM, MPV. Data acquisition, analysis or interpretation: SRD, MTM, CBB. Writing the article: SRD, CBB. Critical revision of the article: SRD, MTM, CBB, MPV. Final approval of the article: SRD, MTM, CBB, MPV.

SCIMAGO INSTITUTIONS RANKINGS

Private practice (Belo Horizonte/MG, Brazil).Private practice (Belo Horizonte/MG, Brazil).BrazilBelo Horizonte, MG, BrazilPrivate practice (Belo Horizonte/MG, Brazil).

Tables

Tables (5)

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Table 1
Sample frequency (n = 270) according to the variables; Belo Horizonte, Brazil, 2015.

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Table 2
Frequency of the types of malocclusion; Belo Horizonte; Brazil, 2015.

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Table 3
Bivariate Poisson regression showing the influence of DAI categories, dental caries and social vulnerability on quality of life; Belo Horizonte; Brazil, 2015.

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Table 4
Mean and standard deviation of CPQ_8-10 according to independent variables; Belo Horizonte; Brazil, 2015.

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Table 5
Multivariate Poisson regression showing the influence of types of malocclusion and dental caries on quality of life; Belo Horizonte; Brazil, 2015.

Table 1 Sample frequency (n = 270) according to the variables; Belo Horizonte, Brazil, 2015.

Variables	Frequency n (%)
Sex
Male	135 (50%)
Female	135 (50%)
Age (years)
8	114 (42.2%)
9	109 (40.4%)
10	47 (17.4%)
Social vulnerability
Low vulnerability	188 (69.6%)
High vulnerability	82 (30.4%)
Presence of untreated decayed teeth
No	183 (67.8%)
Yes	87 (32.2%)
DMFT (mean and SD)	0.91 (1.49)
DAI
≤ 25	157 (58.1%)
26-30	75 (27.8%)
31- 35	31 (11.5%)
≥ 36	07 (2.6%)

Note: SD = standard deviation; DMFT was used as a quantitative variable.

Table 2 Frequency of the types of malocclusion; Belo Horizonte; Brazil, 2015.

Malocclusion	Frequency n (%)
Anterior crowding
No crowding	96 (35.6%)
One crowded segment	107 (39.6%)
Two crowded segments	67 (24.8%)
Anterior spacing
No spacing	51 (18.9%)
One segment with spacing	119 (44.1%)
Two segments with spacing	100 (37.0%)
Incisal diastema (mm)
<2	227 (84.1%)
≥2	43 (15.9%)
Larger anterosuperior irregularity (mm)
<2	212 (78.5%)
≥2	58 (21.5%)
Larger anteroinferior irregularity (mm)
<2	213 (78.9%)
≥2	57 (21.1%)
Maxillary anterior overjet (mm)¹
<3	198 (73.3%)
≥3	65 (24.0%)
Mandibular anterior overjet (mm)
Absent	247 (91.5%)
Present	23 (8.5%)
Anterior open bite (mm)
Absent	250 (92.5%)
Present	20 (7.5%)
Anteroposterior molar relationship
Normal	205 (75.9%)
One-half cusp	65 (24.1%)

Note: ¹ Maxillary anterior overjet does not amount to 100% due to seven cases of anterior crossbite.

Table 3 Bivariate Poisson regression showing the influence of DAI categories, dental caries and social vulnerability on quality of life; Belo Horizonte; Brazil, 2015.

CPQ_8-10
	Mean (SD)	PR (95%CI)	p value
DAI (Malocclusion)
DAI≤ 25 (Normal occlusion or mild malocclusion)	13.5 (11.7)	0.442 (0.258-0.758)	0.003
DAI= 26-30 (Definite malocclusion)	18.1 (15.6)	0.591 (0.339-1.031)	0.064
DAI= 31 - 35 (Severe malocclusion)	12.5 (10.5)	0.407 (0.224-0.740)	0.003
DAI≥36 (Extremely severe malocclusion)	30.6 (23.2)	1
Presence of untreated decayed teeth
No	13.7 (12.9)	0.758 (0.613-0.937)	0.01
Yes	18.1 (14.1)	1	0.01
DMFT	_______	1.11 (1.06-1.63)	<0.001
Social vulnerability
Low vulnerability	14.6 (13.0)	0.892 (0.710-1.121)	0.327
High vulnerability	16.3 (14.4)	1	0.327

Note: CI = confidence interval; DAI = Dental Aesthetic Index; PR = prevalence ratio; SD = standard deviation; DMFT was used as a quantitative variable.

Table 4 Mean and standard deviation of CPQ_8-10 according to independent variables; Belo Horizonte; Brazil, 2015.

Variables	CPQ_8-10	p value
	Mean (SD)
Anterior crowding²
No crowding	14.2 (12.6)	0.813
One crowded segment	15.0 (12.6)
Two crowded segments	16.5 (15.8)
Anterior spacing²
No spacing	16.6 (15.8)	0.627
One segment with spacing	14.5 (13.2)
Two segments with spacing	15.0 (12.5)
Incisal diastema¹
<2	14.6 (13.5)	0.056
≥2	17.9 (13.1)
Anterosuperior irregularity¹
<2	15.2 (13.8)	0.82
≥2	14.9 (12.2)
Anteroinferior irregularity¹
<2	14.5 (13.4)	0.084
≥2	17.3 (13.5)
Maxillary anterior overjet¹
<3mm	13.6 (11.7)	0.038
≥3mm	19.4 (17.1)
Mandibular anterior overjet¹
Absent	15.2 (13.7)	0.866
Present	14.3 (10.6)
Anterior open bite¹
Absent	14.7 (13.0)	0.27
Present	19.5 (18.3)
Anteroposterior molar relationship¹
Normal	14.2 (12.4)	0.229
One-half cusp	18.0 (16.0)

Note: ¹ Mann-Whitney test; ² Kruskal-Wallis test; SD = standard deviation.

Table 5 Multivariate Poisson regression showing the influence of types of malocclusion and dental caries on quality of life; Belo Horizonte; Brazil, 2015.

Malocclusion	PR	95% CI	p value
Incisal diastema (in mm)
<2	1	0.88-1.48	0.313
≥2	1.14
Larger anteroinferior irregularity (in mm)
<2	1	0.93-1.49	0.176
≥2	1.18
Maxillary anterior overjet (in mm)
<3mm	1	1.03-1.70	0.028
≥3mm	1.32
Social vulnerability
Low vulnerability	1	0.90-1.42	0.296
High vulnerability	1.13
DMFT	1.09	1.05-1.15	<0.001

Note: PR = prevalence ratio; CI = confidence interval; DMFT was used as a quantitative variable.
Presence of untreated decayed teeth variable was not inserted in the multivariate model due to its high correlation with DMFT.

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Impact of malocclusion on the quality of life of children aged 8 to 10 years

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[1] Contact address: Sônia Rodrigues Dutra Av. Antônio Carlos, 6627 - Belo Horizonte/MG - CEP: 31.270-901, Brasil E-mail: soniardutra@yahoo.com.br