Malocclusion and peer relationships in school children aged 10-14 years in the United Kingdom: A cross-sectional study

Introduction

This was a cross-sectional observational study carried out in 16 schools in the Southeast of the United Kingdom using a convenience sample based on geographic location and agreement to participate, aiming to investigate the relationship between malocclusion and peer relationships in school children aged 10-14 years.

Methods

Peer relationships, self-esteem, and oral health–related quality of life (OHRQoL) were measured using 3 questionnaires: the Loneliness and School Dissatisfaction Questionnaire, the Rosenberg Self-Esteem Scale, and the Malocclusion Impact Questionnaire (MIQ). The esthetic impact of malocclusion and orthodontic treatment needs were assessed using the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC).

Results

Complete data were collected for 698 participants. School children with a definite need for orthodontic treatment (IOTN-AC, 8-10) reported higher levels of loneliness (P = 0.036) and lower OHRQoL (P <0.001), but there was no difference in self-esteem compared to those with IOTN-AC score 1-7. The relationship between malocclusion and loneliness was fully mediated through OHRQoL (P <0.001) and moderated by self-esteem in girls so that mediation was evident in people with low and average self-esteem but not high self-esteem. In boys, as there was no direct relationship between malocclusion and loneliness, mediation did not occur.

Conclusions

A significant relationship was found between malocclusion and peer relationships in girls, and this was moderated by self-esteem.