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      Associations between Malocclusion and Oral Health-Related Quality of Life among Mongolian Adolescents

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          Abstract

          Malocclusion may affect oral health-related quality of life (OHR-QoL), however, the previously detected associations were affected by confounding factors. We hypothesized that there is indeed an association between OHR-QoL and malocclusion and investigated in a population-based study of 420 Mongolian adolescents mean age: 12.6 (standard deviation (SD) = 1.09) years from two secondary schools, located in an urban and a suburban area. We randomly selected two classes from each school. The Index of Orthodontic Treatment Need (IOTN) was used to assess malocclusion. OHR-QoL was assessed using the Child Perceptions Questionnaire (CPQ). Multivariate analysis was used to determine whether malocclusion had an independent effect on OHR-QoL. Overall, the existence of any type of malocclusion was not significantly associated with CPQ results. However, increased overjet was significantly associated with oral symptoms (coefficient: 0.66, 95% CI: 0.14–1.19), functional limitations (coefficient: 0.62, 95% CI: 0.17–1.08), and social well-being (coefficient: 0.50, 95% CI: 0.06–0.93). Deep bite was also significantly associated with oral symptoms (coefficient: 0.54, 95% CI: 0.23–0.84) and functional limitations (coefficient: 0.45, 95% CI: 0.19–0.72). Although malocclusion per se was not significantly associated with OHR-QoL, specific types of malocclusion, i.e., increased overjet and deep bite, were associated with OHR-QoL.

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          Most cited references41

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          The development of an index of orthodontic treatment priority.

          P Brook, W Shaw (1989)
          The aim of this study was to develop a valid and reproducible index of orthodontic treatment priority. After reviewing the available literature, it was felt that this could be best achieved by using two separate components to record firstly the dental health and functional indications for treatment, and secondly the aesthetic impairment caused by the malocclusion. A modification of the index used by the Swedish Dental Health Board was used to record the need for orthodontic treatment on dental health and functional grounds. This index was modified by defining five grades, with precise dividing lines between each grade. An illustrated 10-point scale was used to assess independently the aesthetic treatment need of the patients. This scale was constructed using dental photographs of 12-year-olds collected during a large multi-disciplinary survey. Six non-dental judges rated these photographs on a visual analogue scale, and at equal intervals along the judged range, representative photographs were chosen. To test the index in use, two sample populations were defined; a group of patients referred for treatment, and a random sample of 11-12-year-old schoolchildren. Both samples were examined using the index and satisfactory levels of intra- and inter-examiner agreement were obtained.
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            Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

            Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.
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              Assessment of oral health related quality of life

              In Dentistry, as in other branches of Medicine, it has been recognised that objective measures of disease provide little insight into the impact of oral disorders on daily living and quality of life. A significant body of development work has been undertaken to provide health status measures for use as outcome measures in dentistry. In descriptive population studies, poor oral health related quality of life is associated with tooth loss. There is a less extensive literature of longitudinal clinical trials, and measurement of change and interpretation of change scores continues to pose a challenge. This paper reviews the literature regarding the development and use of these oral health related QoL measures and includes an appraisal of future research needs in this area.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                10 August 2017
                August 2017
                : 14
                : 8
                : 902
                Affiliations
                [1 ]Department of Maxillofacial Reconstruction and Function, Division of Maxillofacial/Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; miyumort@ 123456tmd.ac.jp (M.A.); y-yasuda.mort@ 123456tmd.ac.jp (Y.Y.); t-ogawa.mort@ 123456tmd.ac.jp (T.O.); tsasant@ 123456gmail.com (T.T.)
                [2 ]Department of Prosthodontics and Orthodontics, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia; ganjargal@ 123456mnums.edu.mn (G.G.); amarsaikhan@ 123456mnums.edu.mn (A.B.)
                [3 ]Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
                Author notes
                [* ]Correspondence: fujiwara.hlth@ 123456tmd.ac.jp (T.F.); k-moriyama.mort@ 123456tmd.ac.jp (K.M.); Tel.: +81-3-5803-5187 (T.F.); +81-3-5803-5533 (K.M.)
                Article
                ijerph-14-00902
                10.3390/ijerph14080902
                5580605
                28796181
                89201ad9-90ee-413a-a799-a889097d9753
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 June 2017
                : 08 August 2017
                Categories
                Article

                Public health
                child perceptions questionnaire,malocclusion,mongolia,oral health-related quality of life

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