The impact of malocclusions on oral health-related quality of life in children—a systematic review and meta-analysis

Abstract

IntroductionA limited amount of systematic literature reviews on the association between malocclusions and oral health-related quality of life (OHRQOL) summarize inconclusive results. Therefore, we conduct a systematic review and meta-analysis on the association of malocclusions with OHRQOL in children.MethodsRelevant studies were identified in Pubmed, Embase, Cochrane, Google Scholar and other databases. All studies with data on malocclusions or orthodontic treatment need and OHRQOL in children were included. Methodological quality of the studies was assessed with the Newcastle-Ottawa Scale (NOS). Random effects models were used to estimate summary effect measures for the association between malocclusion and OHRQOL in a continuous and a categorical data analysis. Tests for heterogeneity, publication bias and sensitivity of results were performed.ResultsIn total, 40 cross-sectional studies were included in the meta-analyses. Summary measures of the continuous data show that OHRQOL was significantly lowered in children with malocclusions (standardized mean difference (95 % CI] = 0.29 (0.19–0.38)). The summary odds ratio for having an impact on OHRQOL was 1.74 times higher in children with malocclusion than in children without malocclusions. Heterogeneity among studies was partly explained by malocclusion assessment, age of the children and country of study conduction.ConclusionOur results provide evidence for a clear inverse association of malocclusion with OHRQOL. We also showed that the strength of the association differed depending on the age of the children and their cultural environment.Clinical relevanceDentists benefit from understanding the patient differences regarding the impact of malocclusions.Electronic supplementary materialThe online version of this article (doi:10.1007/s00784-015-1681-3) contains supplementary material, which is available to authorized users.

Impact of demographic and clinical variables on the oral health‐related quality of life among five‐year‐old children: a population‐based study using self‐reports

“…Regarding the occlusal traits, we observed that the increased overjet had a negative impact on the quality of life of 5‐year‐old children independent of the presence of remaining clinical and demographic variables. A recent systematic review concluded that, in overall, children with malocclusions showed a negative impact on their OHRQoL. The association combined different age groups (from 1‐ to 5‐year‐old group to 11‐ to 17‐year‐old group of participants) and the use of different OHRQoL instruments, however.…”

“…Scarce evidence is available from self-reports of five-year-old children, however 8 . On the other hand, a recent systematic review did not associate malocclusions and the OHRQoL of preschool children measured by proxy reports 14 .…”

“…Scarce evidence is available from self‐reports of five‐year‐old children, however. On the other hand, a recent systematic review did not associate malocclusions and the OHRQoL of preschool children measured by proxy reports. As far as we know, there are no articles evaluating the impact of malocclusions on young children's OHRQoL using self‐reports instruments such as the SOHO‐5.…”

Impact of malocclusion on oral health-related quality of life in 10–14-year-old children of Mumbai, India

“…observed that the children between the age of 11 and 14 years were more likely to show impact of malocclusion on OHRQOL as compared to younger age group. [5]…”

The association of subjective orthodontic treatment need with oral health‐related quality of life

“…In line with this, a recent meta-analysis showed that the association between objective orthodontic treatment need assessed with the DAI and OHRQoL is highly heterogeneous, whereas this association assessed with the IOTN is not. 28 Finally, like in every observational study, our study findings might be affected by residual confounding, although we were able to minimize confounding of the study findings by constructing fully adjusted models including indicators for socioeconomic status and objective orthodontic treatment need.…”