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Correlation between oral health-related quality of life and orthodontic treatment need in children and adolescents—a prospective interdisciplinary multicentre cohort study

Zusammenhang zwischen mundgesundheitsbezogener Lebensqualität und kieferorthopädischem Behandlungsbedarf bei Kindern und Jugendlichen – Eine prospektive, interdisziplinäre und multizentrische Kohortenstudie

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

Oral health-related quality of life (OHRQoL) is a construct for assessing the self-perceived oral health of patients. The aim of this study was to investigate the correlation between OHRQoL and orthodontic treatment need in consideration of demographic and psychological factors.

Patients and methods

This multicentre study included 250 patients with an indication for orthodontic diagnostics. In cooperation with the Institute of Clinical Psychology at the University of Würzburg, validated and internationally acknowledged questionnaires were selected to assess OHRQoL (COHIP-G19) and health-related quality of life (HRQOL). Self-esteem and behavioural problems were taken into consideration as possible psychological factors. Orthodontic treatment need was assessed using the Index of Orthodontic Treatment Need—Dental Health Component (IOTN-DHC), the Index of Orthodontic Treatment Need—Aesthetic Component (IOTN-AC) and the Dental Aesthetic Index (DAI). Possible significant correlations between the collected parameters and OHRQoL were evaluated by means of linear regression analysis.

Results

Objective orthodontic treatment need (IOTN-DHC and DAI) was significantly correlated with OHRQoL. Further factors significantly influencing OHRQoL in children and adolescents were age, HRQOL, self-esteem and behavioural problems.

Conclusions

Objective orthodontic treatment need significantly influences OHRQoL in children and adolescents. Further studies are required to investigate if OHRQoL may be improved by correcting misaligned teeth and jaws.

Zusammenfassung

Ziel

Das Konstrukt mundgesundheitsbezogene Lebensqualität (MLQ) erfasst die subjektiv wahrgenommene Mundgesundheit des Patienten. Ziel der vorliegenden Untersuchung war es, den Zusammenhang zwischen MLQ und kieferorthopädischem Behandlungsbedarf unter Berücksichtigung demographischer und psychologischer Einflussfaktoren zu untersuchen.

Patienten und Methodik

Mittels multizentrischer Patientenakquise wurden 250 Patienten mit Indikation für eine kieferorthopädische Befundung in die Studie eingeschlossen. In Zusammenarbeit mit dem Institut für Klinische Psychologie der Universität Würzburg wurden valide, international anerkannte Fragebogeninstrumente für die Erfassung der MLQ (Child Oral Health Impact Profile, deutsche Fassung, COHIP-G19) und der gesundheitsbezogenen Lebensqualität (GLQ) ausgewählt. Als mögliche psychologische Einflussfaktoren wurden des Weiteren das Selbstwertgefühl und Verhaltensauffälligkeiten berücksichtigt. Der kieferorthopädische Behandlungsbedarf wurde mithilfe des IOTN-DHC (Index of Orthodontic Treatment Need – Dental Health Component), IOTN-AC (Index of Orthodontic Treatment Need – Aesthetic Component) und DAI (Dental Aesthetic Index) quantifiziert. Die erhobenen Parameter wurden mittels linearer Regressionsanalysen auf signifikante Zusammenhänge mit der MLQ untersucht.

Ergebnisse

Für den objektiven kieferorthopädischen Behandlungsbedarf (IOTN-DHC, DAI) konnte ein signifikanter Zusammenhang mit der MLQ nachgewiesen werden. Des Weiteren beeinflussten das Alter, die GLQ, das Selbstwertgefühl sowie Verhaltensauffälligkeiten von Kindern und Jugendlichen die MLQ signifikant.

Schlussfolgerungen

Der objektive kieferorthopädische Behandlungsbedarf zeigt einen signifikanten Einfluss auf die MLQ von Kindern und Jugendlichen. Mittels weiterer Studien bleibt zu klären, ob durch die Korrektur von Zahn- und Kieferfehlstellungen die MLQ der Patienten verbessert werden kann.

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References

  1. Agou S, Locker D, Streiner DL, Tompson B (2008) Impact of self-esteem on the oral-health-related quality of life of children with malocclusion. Am J Orthod Dentofacial Orthop 134:484–489

    Article  PubMed  Google Scholar 

  2. Angermeyer MC, Kilian R, Matschinger H (2000) WHOQOL-100, WHOQOL-BREF (WHO-QOL): Handbuch für die deutschsprachigen Version der WHO Instrumente zur Erfassung von Lebensqualität. Hogrefe, Göttingen

    Google Scholar 

  3. Ashari A, Mohamed AM (2015) Relationship of the dental aesthetic index to the oral health-related quality of life. Angle Orthod 86:337–342

    Article  PubMed  Google Scholar 

  4. Barbosa TS, Gaviao MB (2008) Oral health-related quality of life in children: part I. How well do children know themselves? A systematic review. Int J Dent Hyg 6:93–99

    Article  PubMed  Google Scholar 

  5. Barbosa TS, Gaviao MB (2008) Oral health-related quality of life in children: part II. Effects of clinical oral health status. A systematic review. Int J Dent Hyg 6:100–107

    Article  PubMed  Google Scholar 

  6. Bekes K, John MT, Schaller HG, Hirsch C (2011) The German version of the child perceptions questionnaire on oral health-related quality of life (CPQ-G11-14): population-based norm values. J Orofac Orthop 72:223–233

    Article  PubMed  Google Scholar 

  7. Bekes K, John MT, Zyriax R, Schaller HG, Hirsch C (2012) The German version of the Child Perceptions Questionnaire (CPQ-G11-14): translation process, reliability, and validity in the general population. Clin Oral Investig 16:165–171

    Article  PubMed  Google Scholar 

  8. Blanz B, Remschmidt H, Schmidt M, Warnke A (2006) Psychische Störungen im Kindes- und Jugendalter: ein entwicklungspsychopathologisches Lehrbuch. Schattauer, Stuttgart

    Google Scholar 

  9. Bonomi AE, Patrick DL, Bushnell DM, Martin M (2000) Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. J Clin Epidemiol 53:1–12

    Article  PubMed  Google Scholar 

  10. Broder HL (2007) Children’s oral health-related quality of life. Community Dent Oral Epidemiol 35(Suppl 1):5–7

    Article  PubMed  Google Scholar 

  11. Broder HL, Wilson-Genderson M, Sischo L (2012) Reliability and validity testing for the Child Oral Health Impact Profile-Reduced (COHIP-SF 19). J Public Health Dent 72:302–312

    Article  PubMed  PubMed Central  Google Scholar 

  12. Choi SH, Kim BI, Cha JY, Hwang CJ (2015) Impact of malocclusion and common oral diseases on oral health-related quality of life in young adults. Am J Orthod Dentofacial Orthop 147:587–595

    Article  PubMed  Google Scholar 

  13. Clijmans M, Lemiere J, Fieuws S, Willems G (2015) Impact of self-esteem and personality traits on the association between orthodontic treatment need and oral health-related quality of life in adults seeking orthodontic treatment. Eur J Orthod 37:643–650

    Article  PubMed  Google Scholar 

  14. Collani G von, Herzberg PY (2003) Eine revidierte Fassung der deutschsprachigen Skala zum Selbstwertgefühl von Rosenberg. Z Different Diagnost Psychol 24(1):3–7

    Article  Google Scholar 

  15. Constitution of the World Health Organization (1946) Public Health Rep 61:1268–1279

    Google Scholar 

  16. De Baets E, Lambrechts H, Lemiere J, Diya L, Willems G (2012) Impact of self-esteem on the relationship between orthodontic treatment need and oral health-related quality of life in 11- to 16-year-old children. Eur J Orthod 34:731–737

    Article  PubMed  Google Scholar 

  17. Dimberg L, Lennartsson B, Bondemark L, Arnrup K (2015) Oral health-related quality-of-life among children in Swedish dental care: the impact from malocclusions or orthodontic treatment need. Acta Odontol Scand 74(2):127–133

    PubMed  Google Scholar 

  18. Ferring D, Filipp S‑H (1996) Messung des Selbstwertgefühls: Befunde zu Reliabilität, Validität und Stabilität der Rosenberg-Skala (Measurement of self-esteem: Findings regarding reliability, validity, and stability of the Rosenberg Scale). Diagnostica 42:284–292

    Google Scholar 

  19. Frank W, Pfaller K, Konta B (2008) Mundgesundheit nach kieferorthopädischer Behandlung mit festsitzenden Apparaten. Health Technology Assessment (HTA), vol 66

    Google Scholar 

  20. Genderson MW, Sischo L, Markowitz K, Fine D, Broder HL (2013) An overview of children’s oral health-related quality of life assessment: from scale development to measuring outcomes. Caries Res 47(Suppl 1):13–21

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gift HC, Atchison KA (1995) Oral health, health, and health-related quality of life. Med Care 33:57–77

    Article  Google Scholar 

  22. Gilchrist F, Rodd H, Deery C, Marshman Z (2014) Assessment of the quality of measures of child oral health-related quality of life. BMC Oral Health 14:40

    Article  PubMed  PubMed Central  Google Scholar 

  23. Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586

    Article  PubMed  Google Scholar 

  24. Hassan AH, Hel AS (2010) Association of orthodontic treatment needs and oral health-related quality of life in young adults. Am J Orthod Dentofacial Orthop 137:42–47

    Article  PubMed  Google Scholar 

  25. Jenny J, Cons NC (1996) Comparing and contrasting two orthodontic indices, the index of orthodontic treatment need and the dental aesthetic index. Am J Orthod Dentofacial Orthop 110:410–416

    Article  PubMed  Google Scholar 

  26. Johal A, Cheung MY, Marcene W (2007) The impact of two different malocclusion traits on quality of life. Br Dent J 202:E2

    Article  PubMed  Google Scholar 

  27. John MT, Hujoel P, Miglioretti DL, LeResche L, Koepsell TD, Micheelis W (2004) Dimensions of oral-health-related quality of life. J Dent Res 83:956–960

    Article  PubMed  Google Scholar 

  28. Kang JM, Kang KH (2014) Effect of malocclusion or orthodontic treatment on oral health-related quality of life in adults. Korean J Orthod 44:304–311

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kragt L, Dhamo B, Wolvius EB, Ongkosuwito EM (2016) The impact of malocclusions on oral health-related quality of life in children—a systematic review and meta-analysis. Clin Oral Investig 20:1881–1894

    Article  PubMed  Google Scholar 

  30. Lampert T, Kroll L, Müters S, Stolzenberg H (2013) Messung des sozioökonomischen Status in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56:631–636

    Article  PubMed  Google Scholar 

  31. Liu Z, McGrath C, Hagg U (2009) The impact of malocclusion/orthodontic treatment need on the quality of life. A systematic review. Angle Orthod 79:585–591

    PubMed  Google Scholar 

  32. Liu Z, McGrath C, Hagg U (2011) Associations between orthodontic treatment need and oral health-related quality of life among young adults: does it depend on how you assess them? Community Dent Oral Epidemiol 39:137–144

    Article  PubMed  Google Scholar 

  33. Lohbeck A, Schultheiß J, Petermann F, Petermann U (2015) Die deutsche Selbstbeurteilungsversion des Strengths and Difficulties Questionnaire (SDQ-Deu-S). Diagnostica

  34. McGrath C, Broder H, Wilson-Genderson M (2004) Assessing the impact of oral health on the life quality of children: implications for research and practice. Community Dent Oral Epidemiol 32:81–85

    Article  PubMed  Google Scholar 

  35. O’Brien K, Kay L, Fox D, Mandall N (1998) Assessing oral health outcomes for orthodontics—measuring health status and quality of life. Community Dent Health 15:22–26

    PubMed  Google Scholar 

  36. O’Brien K, Wright JL, Conboy F, Macfarlane T, Mandall N (2006) The child perception questionnaire is valid for malocclusions in the United Kingdom. Am J Orthod Dentofacial Orthop 129:536–540

    Article  PubMed  Google Scholar 

  37. Patrick DL, Erickson P (1993) Health status and health policy: quality of life in health care evaluation and resource allocation. Oxford University Press, New York

    Google Scholar 

  38. Ravens-Sieberer U, Erhart M, Rajmil L, Herdman M, Auquier P, Bruil J, Power M, Duer W, Abel T, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J, European KG (2010) Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Qual Life Res 19:1487–1500

    Article  PubMed  PubMed Central  Google Scholar 

  39. Siegler R, Eisenberg N, DeLoache J, Saffran J (2016) Entwicklungspsychologie im Kindes- und Jugendalter. Springer, Berlin Heidelberg

    Book  Google Scholar 

  40. Sierwald I, John MT, Sagheri D, Neuschulz J, Schuler E, Splieth C, Jost-Brinkmann PG, Reissmann DR (2015) The German 19-item version of the Child Oral Health Impact Profile: translation and psychometric properties. Clin Oral Investig 20:301–313

    Article  PubMed  Google Scholar 

  41. Slade GD (1997) Measuring oral health and quality of life. Background and Rationale for the Conference.

    Google Scholar 

  42. Zhang M, McGrath C, Hagg U (2006) The impact of malocclusion and its treatment on quality of life: a literature review. Int J Paediatr Dent 16:381–387

    Article  PubMed  Google Scholar 

  43. Zhou Y, Wang Y, Wang X, Voliere G, Hu R (2014) The impact of orthodontic treatment on the quality of life a systematic review. BMC Oral Health 14:66

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This study was funded by the German Orthodontic Society (Wissenschaftsfonds der Deutschen Gesellschaft für Kieferorthopädie—129/2017).

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Authors and Affiliations

  1. Department of Orthodontics, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany

    Felix Kunz, Stefan Keß, Laura Geim & Angelika Stellzig-Eisenhauer

  2. Institute of Clinical Psychology, University of Würzburg, Würzburg, Germany

    Petra Platte

  3. Centre for Clinical Studies, University Hospital of Regensburg, Regensburg, Germany

    Florian Zeman

  4. Department of Orthodontics, University Hospital of Regensburg, Regensburg, Germany

    Peter Proff

  5. Department of Orthodontics, University Hospital of Erlangen, Erlangen, Germany

    Ursula Hirschfelder

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  1. Felix Kunz
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Correspondence to Felix Kunz.

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Conflict of interest

F. Kunz, P. Platte, S. Keß, L. Geim, F. Zeman, P. Proff, U. Hirschfelder and A. Stellzig-Eisenhauer declare that they have no competing interests.

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Kunz, F., Platte, P., Keß, S. et al. Correlation between oral health-related quality of life and orthodontic treatment need in children and adolescents—a prospective interdisciplinary multicentre cohort study. J Orofac Orthop 79, 297–308 (2018). https://doi.org/10.1007/s00056-018-0142-4

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