Dynamic changes in oral health-related quality of life and self-esteem across different stages of adolescent orthodontic treatment and the influence of psychosocial factors
10.12016/j.issn.2096-1456.202550227
- Author:
YAO Jinyu
1
;
WANG Youyang
1
;
PENG Youjian
1
Author Information
1. The Stomatology Center of Renmin Hospital, Wuhan University
- Publication Type:Journal Article
- Keywords:
orthodontic treatment;
malocclusion;
oral health-related quality of life;
self-esteem;
treatment phase differences;
dental appearance;
social stigma;
influencing factors
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2025;33(11):944-953
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the dynamic changes in oral health-related quality of life (OHRQoL) and self-esteem (SE) across different stages of adolescent orthodontic treatment and the influence of psychosocial factors, thereby providing scientific evidence for the clinical development of individualized treatment protocols that integrate both functional correction and psychological intervention.
Methods :This study was reviewed and approved by the medical ethics committee, and informed consent was obtained from patients. A cross-sectional design was employed to randomly select 355 adolescent patients with malocclusion (133 pre-treatment, 112 during treatment, and 110 post-treatment) who received care at the Department of Stomatology, Renmin Hospital of Wuhan University in April 2025. The Oral Health Impact Profile (OHIP)-14 was used to assess OHRQoL levels, the Global Self-Esteem Scale (GSE) was used to evaluate SE levels, and an additional questionnaire on dental appearance-related psychosocial aspects was administered. Kruskal-Wallis tests were used to compare differences between treatment stage groups, followed by Dunn post hoc tests. Spearman correlation analysis was employed to assess the associations between variables, including orthodontic treatment stages, OHRQoL, and SE, as well as SE and dental appearance-related psychosocial aspects.
Results :OHRQoL and its four dimensional scores showed significant differences across different stages of orthodontic treatment. Specifically, the total OHIP-14 score showed no significant difference between pre-treatment and during treatment [12.0 (7.0, 18.0) vs. 13.0 (9.0, 17.0)], but significantly decreased to 4.0 (0.8, 11.0) post-treatment (P<0.001). The total scores for physical pain and discomfort dimension and physical disability dimension demonstrated a pattern of during treatment > pre-treatment > post-treatment (P<0.05). The total scores for handicap dimension showed no significant difference between pre-treatment and during treatment, but post-treatment scores were significantly lower than both pre-treatment and during treatment levels (P < 0.001). The total scores for psychological discomfort dimension showed a significant decreasing trend across treatment stages (P<0.001). The total GSE score showed significant differences only between pre-treatment and during treatment [18.0 (12.0, 23.0) vs. 13.5 (9.3, 20.8), P=0.014], with recovery to 14.0 (12.0, 18.0) post-treatment. Different treatment stages showed a moderate negative correlation with total OHIP-14 score (r=-0.362, P<0.001) and a weak negative correlation with total GSE score (r=-0.104, P=0.049). The appearance satisfaction index showed a significant increasing trend across treatment stages (P<0.001), while being teased about teeth and hiding teeth and avoiding smiling index significantly decreased (both P<0.001). Being teased about teeth index (r=0.349, P<0.001) and hiding teeth and avoiding smiling index (r=0.412, P<0.001) were significantly correlated with total GSE score.
Conclusion:Adolescents undergoing orthodontic treatment experience a significant improvement in quality of life, with self-esteem levels notably increasing during the mid-treatment phase and a continuous reduction in negative psychosocial experiences related to dental appearance. This suggests that orthodontists should prioritize psychological support and social adaptation guidance throughout the treatment process, with consistent attention to changes in patients’ self-esteem.
- Full text:2025111016462912923青少年正畸治疗不同阶段口腔健康相关生活质量与自尊的动态变化及社会心理因素影响.pdf
