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Perception of parents and caregivers regarding the impact of malocclusion on adolescents’ quality of life: a cross-sectional study



The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL).


This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance.


Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables.


Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

Parents; Caregivers; Malocclusion; Adolescent; Quality of life

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