Perception of parents and caregivers regarding the impact of malocclusion on adolescents’ quality of life: a cross-sectional study

ABSTRACT Objective: The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL). Methods: This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance. Results: Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables. Conclusions: Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

摘要
**目的**：本研究旨在评估父母及照料者对错𬌗畸形（malocclusion）对青少年口腔健康相关生活质量（Oral Health-related Quality of Life，OHRQoL）影响的认知情况。
**方法**：本项横断面研究纳入280名11~12岁青少年的父母/照料者作为研究对象，所有受试者均填写父母/照料者感知问卷（Parental-Caregiver Perceptions Questionnaire，P-CPQ）。本研究的因变量为父母评估的青少年生活质量；核心自变量为青少年错𬌗畸形情况，采用牙齿美观指数（Dental Aesthetic Index，DAI）进行诊断。依据DAI截断值，将青少年错𬌗畸形分为四个严重程度等级，并对应不同正畸治疗建议：无需/轻微矫治需求、选择性矫治、推荐优先矫治、强制矫治。本研究纳入青少年年龄、性别及家庭月收入作为混杂变量。统计学分析包含描述性统计、双变量分析及稳健方差泊松回归。
**结果**：本研究初始纳入的280名父母/照料者中，18名拒绝填写P-CPQ问卷，最终共262名受试者完成评估，有效应答率为93.5%。在校正混杂变量后，青少年错𬌗畸形的严重程度与父母/照料者感知到的口腔症状维度（p<0.05）、功能受限维度（p<0.001）、情绪健康维度（p<0.001）、社会健康维度（p<0.001）及P-CPQ总分（p<0.001）的负面影响程度显著正相关。
**结论**：父母及照料者均认为错𬌗畸形会对青少年的OHRQoL产生负面影响；错𬌗畸形的严重程度越高，对青少年OHRQoL的不良影响也越显著。