UCSF

Background and Objective:

Oral health related quality of life (OHRQoL) is the aspect of one’s general well being, which is directly related to the mouth. Burdens on OHRQoL may deleteriously affect one’s ability to eat, speak, and socialize without discomfort, or embarrassment. However, different aspects of oral disease weigh against it in different ways. For instance, malocclusion affects different subdomains of OHRQoL than does caries. While the association between crooked teeth and social burdens has been reported, the relationship is unclear about how specific parameters of malocclusion like overbite or openbite may individually affect OHRQoL. Our objectives are to determine, in a sample group of adolescent and young adult subjects from Mexico and Peru: 1) how OHRQoL increases or decreases in relation to overbite; 2) to examine how overbite relates with subdomains of OHRQoL; and 3) to determine how severity on the spectrum of vertical dental relationships (severe deep bite through severe open bite) may alter the relationship between the oral health related quality of life. 4) To determine if there is an association between sleep disordered breathing, speech difficulties and vertical bite status.

Materials and Methods:

This was a cross-sectional, population-based, quantitative, epidemiological study. 2,042 subjects from 5 regions in Mexico and Peru aged 11-20 had their occlusion evaluated via the ICON index. Caries experience was quantified, via visual inspection, using the Decayed, Missing and Filled Surfaces (DMFS) index. Oral health related quality of life was measured with the COHIP-19 questionnaire. Vertical bite status, caries status, and malocclusion severity were analyzed in relation to quality of life, using ANOVA with bonferroni correction’s as needed. For dmfs a kruskal-wallis and mann-whitney U tests were used. Finally, a multivariate regression analysis was utilized to account for possible confounding factors as age, sex, and dmfs. Significance set at p<0.05.

Results:

51% of the study population was categorized as needing orthodontic treatment. 50% had severe caries experience (DMFS>5). Malocclusion severity was significantly associated with a decrease in OHRQoL (p<0.001). OHRQoL was significantly associated with caries in an inverse relationship for overall COHIP and all 6 subscales (p<0.001), except UC Emotional Well-Being (p=0.49). No significant association was found between vertical bite status and OHRQoL. DMFS for severe open bite subjects was significantly higher (dmfs=10.1 for open bite greater than 4mm) versus deep over bite subjects (dmfs=4.4 for fully covered overbites).

Conclusions: In the regions studied and age group analyzed the following can be concluded.

There is no association between overall OHRQoL, the subscales, and severity of vertical bite status in our population. There is a statistically significant decrease in Oral health related quality of life versus malocclusion severity and treatment need. There is a significant decrease in Oral health related quality of life versus caries experience except as it relates to ones attractiveness and confidence (Self esteem). There is a significant relationship between severe open bites and an increased caries experience.