Association of malocclusion, happiness, and oral health-related quality of life (OHRQoL) in schoolchildren.

OBJECTIVE: The aim of this study was to assess the impact of malocclusion on children's oral health-related quality of life (COHRQoL) and self-reported happiness. METHODS: A cross-sectional study was conducted in a representative sample of 12-year-old schoolchildren from Santa Maria, South Brazil. Four calibrated examiners carried out clinical exams to evaluate malocclusion [Dental Aesthetic Index (DAI)], dental caries (DMFT), and dental trauma (O'Brien classification, used in the Children's dental health survey in the UK, 1994). Participants answered the Brazilian versions of the Child Perceptions Questionnaire (CPQ11-14 ) and the Subjective Happiness Scale (SHS). Parents completed a structured questionnaire regarding socioeconomic status. Data analysis was conducted using multilevel Poisson regression models. RESULTS: A total of 1,134 adolescents (boys: 45.8 percent; girls: 54.1 percent) were enrolled in the study. The DAI overall score ranged from 13 to 63 (mean: 25.19, standard error: 0.19); 57.6 percent of the subjects had minor or no malocclusion and 24.4 percent had definite malocclusion. Severe malocclusion and handicapping malocclusion were found in 10.4 percent and 7.4 percent of the subjects, respectively. After adjustment, the severity of malocclusion was associated with high mean values of the CPQ11-14 overall score, and the emotional well-being and social well-being domains were the most affected. Lower levels of happiness were also associated with the severity of malocclusion: those with definite malocclusion presented lower scores on the SHS scale (Rate Ratio 0.97; 95 percent CI 0.94-0.99). CONCLUSION: Malocclusion had a negative impact on COHRQoL and happiness, mainly on the emotional and social domains.

The influence of normative and subjective oral health status on schoolchildren's happiness.

BACKGROUND: Traditional methods to measure oral health based on clinical standards are limited because they do not consider psychosocial and functional aspects of oral health. It has been recommended that these measures need to be supplemented by data obtained from patients regarding their individual perceptions on oral health-related quality of life (OHRQoL). Happiness is a multidimensional construct comprising both emotional and cognitive domains, and has been defined as "the degree to which an individual judges the overall quality of his or her life as a whole favorably". It has been associated with several health outcomes, including oral health. The aim of this study was to assess the impact of oral health conditions, oral health-related quality of life (OHRQoL), and socioeconomic factors on the subjective happiness of Brazilian adolescents. METHODS: A cross-sectional study was conducted in 2012 on a representative sample of 12-year-old schoolchildren in Santa Maria-RS, Brazil. The data were collected through dental examinations and structured interviews. The participants underwent an evaluation aimed at detecting dental caries, traumatic dental injuries, malocclusion, and gingival bleeding. They also completed the Brazilian versions of the Child Perceptions Questionnaire-short form (CPQ11-14-ISF: 16) and the Subjective Happiness Scale (SHS), which was our outcome variable. Socioeconomic conditions were evaluated through a questionnaire that was completed by the participants' parents. Poisson regression analysis was used to determine the association between the explanatory variables and the outcome. Moreover, a correlation analysis was performed to determine the relationship between the SHS scores and the overall and domain scores of the CPQ11-14-ISF: 16. RESULTS: A total of 1,134 children were evaluated. Unadjusted analyses showed that happiness was associated with socioeconomic indicators, the use of dental services, clinical status, and scores on the OHRQoL measure. After adjustment, household overcrowding (RR: 0.96; 95% CI: 0.93-0.98), dental caries (RR: 0.98; 95% CI: 0.97-0.99), malocclusion (RR: 0.98; 95% CI: 0.96-0.99), and the severity associated with the CPQ11-14 (RR: 0.95; 95% CI: 0.93-0.97) still showed a significant association with lower levels of the mean SHS score. CONCLUSIONS: Happiness is influenced by oral conditions, socioeconomic status, and OHRQoL.