Psychosocial impact of dental aesthetics, orthodontic treatment needs, and self-esteem in amazonian adolescents

Arnoldo Brasil Muniz Junior; Caroline Nogueira de Moraes; Stéfany de Lima Gomes; Carmem do Nascimento Bastos; Heloisa Cristina Valdrighi; Mario Vedovello Filho; Silvia Amélia Scudeler Vedovello; Diego Patrik Alves Carneiro

doi:10.14393/BJ-v41n0a2025-76534

Authors

Arnoldo Brasil Muniz Junior Centro Universitário da Fundação Hermínio Ometto
Caroline Nogueira de Moraes Universidade de Campinas https://orcid.org/0000-0001-8385-0841
Stéfany de Lima Gomes Universidade de Campinas https://orcid.org/0000-0002-7383-2815
Carmem do Nascimento Bastos Universidade de Campinas https://orcid.org/0000-0002-0067-3614
Heloisa Cristina Valdrighi Centro Universitário da Fundação Hermínio Ometto https://orcid.org/0000-0001-7567-1990
Mario Vedovello Filho Centro Universitário da Fundação Hermínio Ometto
Silvia Amélia Scudeler Vedovello Universidade de Campinas https://orcid.org/0000-0002-7203-2867
Diego Patrik Alves Carneiro Centro Universitário da Fundação Hermínio Ometto https://orcid.org/0000-0001-7864-3055

DOI:

https://doi.org/10.14393/BJ-v41n0a2025-76534

Keywords:

Adolescent, Malocclusion, Psychosocial impact, Self-esteem.

Abstract

This study aimed to evaluate the psychosocial impact of dental aesthetics on the quality of life associated with normative and subjective orthodontic treatment needs and the self-esteem of adolescents living in the Brazilian Amazon region. It is a cross-sectional observational study conducted with 212 adolescents of both sexes enrolled in public schools in Boca do Acre (Amazonas, Brazil). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) assessed the psychosocial impact of malocclusion, and the Global Negative Self-Evaluation (GSE) scale evaluated the adolescents' self-esteem. The assessment of normative and subjective orthodontic treatment needs used the Index of Orthodontic Treatment Need (IOTN), including its dental health (DHC) and aesthetic (AC) components. Initial descriptive analyses of the data used absolute and relative frequencies, medians, and interquartile ranges. Poisson regression models with robust variance estimators appraised the prevalence ratios - with respective confidence intervals (95% CI) - of the associations with the PIDAQ. The prevalence of adolescents needing normative orthodontic treatment (IOTN-DHC) was 76.4%, and the subjective orthodontic treatment need prevalence (IOTN-AC) was 9.0%. Adolescents with low self-esteem reported a more significant impact on dental aesthetics (PR = 1.25; 95% CI: 1.14-1.36; p < 0.05). The study concluded that self-esteem and the psychosocial impact of dental aesthetics on the quality of life of Amazonian adolescents are significantly associated.

References

ABDULLAH, MS, and ROCK, WP. Assessment of orthodontic treatment need in 5,112 Malaysian children using the IOTN and DAI indices. Community Dental Health. 2001, 18(4):242-8.

ALSAGOB, E.I. et al. Impact of Self-Perceived Dental Esthetic on Psycho-Social Well-Being and Dental Self Confidence: A Cross-Sectional Study Among Female Students in Riyadh City. Patient Prefer Adherence. 2021, 15:919-926. https://doi.org/10.2147/PPA.S308141

ALSAKER, F.D., and OLWEUS, D. Assessment of global negative self-evaluations and perceived stability of self in Norwegian pre-adolescents and adolescents. Journal of Early Adolescence. 1986, 6(3):269-78. https://doi.org/10.1177/0272431686063005

Altas do Desenvolvimento Humano no Brasil. http://www.atlasbrasil.org.br/2013/ranking (accessed Feb 01, 2020).

Boca do Acre, Estado do Amazonas [Internet]. Senado Federal. [cited 2024 Jul 4]. Available from: https://www12.senado.leg.br/noticias/materias/2011/05/27/boca-do-acre-estado-do-amazonas

BROOK, P.H., and SHAW, W.C. The development of an index of orthodontic treatment priority. European Journal of Orthodontics. 1989, 11(3):309-20. https://doi.org/10.1093/oxfordjournals.ejo.a035999

DALLÉ, H., et al. Malocclusion, facial and psychological predictors of quality of life in adolescents. Community Dental Health. 2019, 36(4):298-302. https://doi.org/10.1922/CDH_4633Dalle05

DE SOUZA, B.S., et al. Occlusal and facial features in Amazon indigenous: An insight into the role of genetics and environment in the etiology dental malocclusion. Archives of Oral Biology. 2015,60(9):1177-86.

https://doi.org/10.1016/j.archoralbio.2015.04.007

DOS SANTOS, P.R., et al. Influence of quality of life, self-perception, and self-esteem on orthodontic treatment need. American Journal of Orthodontics and Dentofacial Orthopedics. 2017; 151(1):143-147. https://doi.org/10.1016/j.ajodo.2016.06.028

EL MOURAD, A.M., et al. Self-Perception of Dental Esthetics among Dental Students at King Saud University and Their Desired Treatment. International Journal of Dentistry. 2021, 2021:6671112. https://doi.org/10.1155/2021/6671112

GODINHO, J., et al. Contribution of facial components to the attractiveness of the smiling face in male and female patients: A cross-sectional correlation study. American Journal of Orthodontics and Dentofacial Orthopedics. 2020;157(1):98-104. https://doi.org/10.1016/j.ajodo.2019.01.022

KAUR, P., et al. Impact of Dental Disorders and its Influence on Self Esteem Levels among Adolescents. Journal of Clinical and Diagnostic Research: JCDR. 2017, 11(4):ZC05-ZC08. https://doi.org/10.7860/JCDR/2017/23362.9515

KLAGES, U., et al. Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. European Journal of Orthodontics. 2006, 28(2):103-11. https://doi.org/10.1093/ejo/cji083

KRAGT, L., et al. Influence of self-esteem on perceived orthodontic treatment need and oral health-related quality of life in children: the Generation R Study. European Journal of Orthodontics. 2018, 40(3):254-261. https://doi.org/10.1093/ejo/cjx054

LINCOLN, T.M., et al. Is fear of others linked to an uncertain sense of self? The relevance of self-worth, interpersonal self-concepts, and dysfunctional beliefs to paranoia. Behavior Therapy. 2010, 41(2):187-97. https://doi.org/10.1016/j.beth.2009.02.004

MANDALL, N.A., et al. Perceived aesthetic impact of malocclusion and oral self-perceptions in 14-15-year-old Asian and Caucasian children in greater Manchester. European Journal of Orthodontics. 2000, 22(2):175-83. https://doi.org/10.1093/ejo/22.2.175

MILITI, A., et al. Psychological and Social Effects of Oral Health and Dental Aesthetic in Adolescence and Early Adulthood: An Observational Study. International Journal of Environmental Research and Public Health. 2021, 18(17):9022. https://doi.org/10.3390/ijerph18179022

MUNIZ-JUNIOR, A.B., et al. A Multivariate Analysis of the Psychosocial Impact of Malocclusion and Self-Esteem in Adolescents. Pesquisa Brasileira de Odontopediatria e Clínica Integrada. 2022, 22:e200178. https://doi.org/10.1590/pboci.2022.081

NABARRETTE, M., et al. Esthetic impact of malocclusions in the anterior segment on children in the mixed dentition. American Journal of Orthodontics and Dentofacial Orthopedics. 2021, 159(1):53-58. https://doi.org/10.1016/j.ajodo.2019.11.019

NORMANDO, D., et al. Dental crowding: the role of genetics and tooth wear. The Angle Orthodontist. 2013, 83(1):10-5. https://doi.org/10.2319/020112-91.1

PATUSCO, V., et al. Smile prevails over other facial components of male facial esthetics. Journal of the American Dental Association. 2018, 149(8):680-687. https://doi.org/10.1016/j.adaj.2018.03.019

POLCE LYNCH, M., et al. Adolescent self-esteem and gender: Exploring relations to sexual harassment, body image, media influence, and emotional expression. Journal of Youth and Adolescence. 2001, 30:225–44. https://doi.org/10.1023/A:1010397809136

PRADO, R.F., et al. Prospective evaluation of the psychosocial impact of the first 6 months of orthodontic treatment with fixed appliance among young adults. The Angle Orthodontist. 2016, 86(4):644-8. https://doi.org/10.2319/063015-434.1

RAGHAVAN, S., et al. Aesthetic perceptions and psychosocial impact of malocclusion: comparison between cleft and non-cleft patients and their parents. European Journal of Orthodontics. 2019, 41(1):38-45. https://doi.org/10.1093/ejo/cjy022

RECABARREN, N.A.G., et al. Relationship between aesthetic concern and self-esteem in adolescents with severe malocclusion. Acta odontologica Scandinavica. 2023, 81(4):255-258. https://doi.org/10.1080/00016357.2022.2125437

RICHARDS, M.R., et al. Contribution of malocclusion and female facial attractiveness to smile esthetics evaluated by eye tracking. American Journal of Orthodontics and Dentofacial Orthopedics. 2015, 147(4):472-82. https://doi.org/10.1016/j.ajodo.2014.12.016

SANTOS, P.M., et al. Validity of the Psychosocial Impact of Dental Aesthetics Questionnaire for use on Brazilian adolescents. Dental Press Journal of Orthodontics. 2016, 21(3):67–72. https://doi.org/10.1590/2177-6709.21.3.067-072.oar

SARDENBERG, F., et al. Malocclusion and oral health-related quality of life in Brazilian schoolchildren. The Angle Orthodontist. 2013, 83(1):83-9. https://doi.org/10.2319/010912-20.1

SHARMA, A., et al. Objective and subjective evaluation of adolescent's orthodontic treatment needs and their impact on self-esteem. Revista Paulista de Pediatria. 2017, 35(1):86-91. https://doi.org/10.1590/1984-0462/;2017;35;1;00003

STOJILKOVIĆ, M., et al. Evaluating the influence of dental aesthetics on psychosocial well-being and self-esteem among students of the University of Novi Sad, Serbia: a cross-sectional study. BMC Oral Health. 2024, 24(1):277. https://doi.org/10.1186/s12903-024-04002-5

TWIGGE, E., et al. The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients. European Journal of Orthodontics. 2016, 38(6):593-601. https://doi.org/10.1093/ejo/cjv093

VEDOVELLO, S.A.S., et al. Exploring the perception of orthodontic treatment need using the Dental Aesthetic Index and Index of Orthodontic Treatment Need. American Journal of Orthodontics and Dentofacial Orthopedics. 2019, 156(6):818-822. https://doi.org/10.1016/j.ajodo.2019.01.020

YANG, C.C., et al. Social Media and Psychological Well-Being Among Youth: The Multidimensional Model of Social Media Use. Clinical Child and Family Psychology Review. 2021, 24(3):631-650. https://doi.org/10.1007/s10567-021-00359-z

ZAIDI, A.B., et al. Effects of dental aesthetics on psycho-social wellbeing among students of health sciences. The Journal of the Pakistan Medical Association. 2020, 70(6):1002-1005.