Childhood intelligence and early tooth wear patterns.

OBJECTIVE: The aim of this study is to explore the relationships between early dental wear patterns and preschool IQ (Intelligence Quotient, by Stanford-Binet) of the child to illuminate the historic relationship of mental queries and bruxism. METHODS: The dental study participants were 864 Euro-American preschool and school children whose IQs were tested for school maturity purposes at the age of 4 years, followed by dental data in a cross-sectional manner at the mean age of 7.8 years. Worn dentitions were classified as "symmetric" or "right-" and "left-sided," based on the faceting of the teeth. RESULTS: In general, the relationships of tooth wear and intelligence were scarce, reflecting social background factors. Statistically significant results between asymmetric wear and gender groups suggest that direction of jaw function has a role in the regulation of processes responsible for individual mental performance in childhood. DISCUSSION: Increased left-side tooth wear and early advantage in the intelligence test in girls is intriguing due to the fact that they reach maturity earlier than boys in verbal articulation, controlled in most cases by the limited area on the left side of the brain.

Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion?

INTRODUCTION: The aim was to evaluate the relationships of changes in facial pain, temporomandibular disorders (TMDs) and oral health-related quality-of-life (OHRQoL) in adults who underwent orthodontic or orthodontic/surgical treatment. METHODS: Sixty-four patients (46 women, 18 men, range 18-64 years) with severe malocclusion and functional problems were treated in Oulu University Hospital. Of these, 44 underwent orthodontic-surgical and 20 orthodontic treatment. Data were collected with questionnaires and clinical stomatognathic examinations before and on average 3 years after treatment. The OHRQoL was measured with OHIP-14 (The Oral Health Impact Profile), the intensity of facial pain with the Visual Analogue Scale (VAS) and the severity of TMD with the Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indices. RESULTS: A significant improvement was found in facial pain, signs and symptoms of TMD and OHRQoL after the treatment (p < 0.05). The decrease in VAS was associated with improvement in OHIP-14 severity (r = 0.296, p = 0.019). The correlations between changes in OHIP-14 severity and Ai and Di were not statistically significant. CONCLUSION: Treatment of severe malocclusion seemed to improve OHRQoL via decreased facial pain. Decreased facial pain was associated especially with improved OHRQoL dimensions of physical pain, physical disability and social disability.

Dental esthetics and quality of life in adults with severe malocclusion before and after treatment.

OBJECTIVE: To investigate the association between satisfaction with dental esthetics and quality of life, and esthetics satisfaction in relation to esthetic evaluations of three panel groups. MATERIALS AND METHODS: Fifty-two patients (36 women, 16 men; age 18-61 years) with severe malocclusion were treated in Oulu University Hospital. Of these, 38 and 14 patients underwent orthodontic/surgical treatment and orthodontic treatment, respectively. A questionnaire and dental photographs were collected before and after treatment. The 14-item Oral Health Impact Profile (OHIP-14) was used to measure oral health-related quality of life. Satisfaction with dental esthetics was evaluated using the Visual Analogue Scale. Dental photographs were presented to three panel groups: 30 laypersons, 30 dental students, and 10 orthodontists, who rated the photographs using the Aesthetic Component of the Index of Orthodontic Treatment Need. RESULTS: Oral health-related quality of life (OHIP-14 severity score) and esthetic satisfaction (according to the Visual Analogue Scale) improved after the treatment (P < .001). The most unsatisfied patients reported oral effects more often both before and after treatment. Changes in oral health-related quality of life components of severity, psychological discomfort, and psychological disability correlated positively with the changes in esthetic satisfaction. Orthodontists graded the situation before treatment as worse and the outcome as better than the laypersons; the level of grading by dental students fell between these two groups. CONCLUSION: 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.

Occlusal characteristics and quality of life before and after treatment of severe malocclusion.

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.

Pathways between temporomandibular disorders, occlusal characteristics, facial pain, and oral health-related quality of life among patients with severe malocclusion.

The aim of this study was to examine the pathways between temporomandibular disorders (TMDs), occlusal characteristics, facial pain, and oral health-related quality of life in patients with severe malocclusion. The study comprised 94 (34 men and 60 women, mean age 38 years) adult patients who were referred for orthodontic or surgical-orthodontic treatment. All the patients had severe malocclusion. Oral health-related quality of life was measured with the Oral Health Impact Profile-14 scale (OHIP-14), the intensity of facial pain using a Visual Analogue Scale (VAS), TMD with Helkimo's clinical dysfunction index (Di), and occlusal characteristics with the Peer Assessment Rating (PAR). A hypothetical model of the interrelationships between these factors was constructed based on the conceptual model of biological, behavioural, and psychosocial consequences of oral diseases. The associations were studied with path analysis. Women reported poorer oral health-related quality of life, higher pain levels, and had more severe TMD than men, but the gender difference was statistically significant only in pain and TMD. In contrast to the hypothetical model, among women the occlusal characteristics were not directly associated with oral health-related quality of life or facial pain. Among men, the occlusal characteristics were directly associated with oral health-related quality of life. In conclusion, patients with severe malocclusion who also have TMD and facial pain more often have impaired oral health-related quality of life. The associations of the occlusal characteristics with oral health-related quality of life differ between genders. Therefore, these associations should be studied separately among genders.

Quality of life in patients with severe malocclusion before treatment.

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.

Primary tooth wear in functional lateralities.

PURPOSE: The purpose of this study was to explore the sidedness of primary tooth horizontal wear facets between the left and right sides of the dentition among 2 types of functionally lateralized (hand, foot, eye) children--those who were true right-sided (TRS), and partially or totally nonright-sided (NRS) at 4 years of age. METHODS: Study subjects were 855 children with signs of wear in deciduous teeth on the dental casts (N=1,720) of the GOS (Genetic Odontometric Study of the Collaborative Perinatal) project, carried out in the 1960s in the United States by the National Institute of Neurological Disorders and Stroke (NINDS) in a cross-sectional manner at a mean age of 8(1/2) years (40% Caucasian and 60% African-American children). The statistical method used was chi-square analysis. RESULTS: Tooth wear was identified from dental casts in approximately 50% of cases. Wear was symmetric (equal on the right and left) in 49% of these dentitions, while asymmetric wear was found in 50%. Left-sided extra wear was slightly more common (26%) than right-sided extra wear (24%), but gender and race differences appeared. Statistically significant unilateral wear was found among TRS Caucasian boys on the dentition's right side. In NRS Caucasian boys, however, the left-sided extra wear was more common than for the right-sided extra wear (P=.04). In Caucasian girls, the same relationship appeared, but the difference was not significant (P=.11). In African American TRS children, the left-sided extra wear was more common, and symmetric proportion was increased in boys. The differences between laterality and gender groups, however, were not statistically significant. CONCLUSIONS: Sidedness in the form and function of a primary dental apparatus has variation among gender and race groups that is involved with the determination of general structural and functional lateralities. Early asymmetric oral functioning (unilateral bolus placement, sucking, chewing, bruxism, etc) should be considered in registration of the various phases of occlusal development, also having craniofacial aspects due to asymmetric growth promoting function.

MRI of TMJ in patients with severe skeletal malocclusion following surgical/orthodontic treatment.

The aim of this study was to evaluate temporomandibular joints (TMJ) by magnetic resonance imaging (MRI) in patients who had undergone surgical/orthodontic or orthodontic treatment in a three-year follow-up study. Subjects consisted of 20 patients (40 TMJ), 16 females and four males (mean age 33.7 years, range 19-53 years), with severe temporomandibular disorders (TMD) referred to the Oral and Maxillofacial Department at Oulu University Hospital due to skeletal jaw discrepancy. All patients underwent extensive surgical/orthodontic or orthodontic treatment between 1996 and 2003. Clinical stomatognathic examination and MRI examinations were performed before the surgical/orthodontic or orthodontic treatment and one year after the completion of the treatment. The average treatment time was 23 months (range 12-34 months). MRI revealed a marked decrease, especially in the number of TMJ with joint effusion after the treatment. There were only a few changes in the number of diagnosed disk dislocations before and after the treatment. In five joints with anterior disk dislocation with reduction (r-ADD), a change to anterior disk dislocation without reduction (nr-ADD) was found. In 25 of the 40 condyles, the condylar configuration was normal on MRI before the treatment and in 19 condyles one year after the treatment. TMD signs and symptoms according to the Helkimo dysfunction index showed a statistically significant decrease after the treatment.