The aim of this study was to determine the occurrence of oral health impacts among patients with severe malocclusions and dentofacial deformities before treatment. A further aim was to evaluate the effect of gender or the type of malocclusion on the oral impacts. The study comprised 151 adult patients who were referred for orthodontic or surgical-orthodontic treatment to the Oral and Maxillofacial Department, Oulu University Hospital, Finland during the years 2001-2004. The study group consisted of 92 females and 59 males with a mean age of 35.5 years [standard deviation (SD) 11.5 years, range 16-64 years]. A self-completed Oral Health Impact Profile (OHIP)-14 questionnaire was used to measure oral impacts during a 1 month reference period. The prevalence, extent, and severity scores were calculated from the OHIP-14. Malocclusions were registered at clinical examination. The prevalence and mean extent and severity scores were compared among malocclusion groups and between genders. Statistical significance was evaluated with Mann-Whitney, Kruskall-Wallis, Chi-squared, and Fisher's exact tests. The prevalence of oral impacts perceived fairly or very often was 70.2 per cent. The mean severity and extent scores were 17.2 (SD 10.5, range 0-45) and 2.5 (SD 2.6, range 0-10), respectively. Physical pain as well as psychological discomfort and disability were the most commonly perceived oral impacts. Being self-conscious, feeling tense, having difficulties in relaxing, and being somewhat irritable with other people were more common in females than in males. No differences were observed in oral impacts among the malocclusion groups. Compared with a 'normal' population, patients with severe malocclusions report high levels of oral impacts. Females reported oral impacts more often than males.
Improvement in esthetic satisfaction due to the treatment of severe malocclusion improves oral health-related quality of life, particularly by decreasing psychological discomfort and psychological disability.
The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.
The aim of this study was to evaluate the relationship between occlusal characteristics and oral health-related quality of life in adults who underwent orthodontic or orthodontic-surgical treatment. The study group consisted of 51 adult patients (35 women, 16 men) with severe malocclusion and considerable functional disorders. Thirty-six of the patients underwent combined orthodontic-surgical treatment, while 15 underwent orthodontic treatment. Data were collected before and after treatment. Mean follow-up period was 5.0 years (range 2.2-6.7 years). Occlusal characteristics were measured from dental casts by using Peer Assessment Rating (PAR) index. A self-completed Oral Health Impact Profile (OHIP-14) was used to measure oral impacts. The changes in PAR and OHIP-14 were measured, and correlation between PAR and OHIP tested before and after treatment and in the changes during the follow-up. Statistical significance was evaluated with the paired samples t-test and Mann-Whitney U-test, and the correlation between PAR and OHIP scores assessed using Pearson's and Spearman's correlation coefficient. The occlusion was significantly improved in all subjects, mean PAR reduction being 78.1 per cent. The prevalences of oral impacts at threshold `fairly often' or `very often' before and after treatment were 70.6 per cent and 9.8 per cent, respectively (P < 0.001). The PAR and OHIP scores correlated after treatment but not before treatment or in the changes. The treatment of severe malocclusion reduced the reported oral impacts to the level of general population and significantly improved oral health-related quality of life.
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