European Archives of Paediatric Dentistry

, Volume 16, Issue 4, pp 357–363 | Cite as

Effect of malocclusion among adolescents on family quality of life

  • L. G. AbreuEmail author
  • C. A. Melgaço
  • M. H. N. G. Abreu
  • E. M. B. Lages
  • S. M. Paiva
Original Scientific Article



To evaluate the effect of malocclusion among adolescents on their families’ oral health-related quality of life (OHRQoL).


A consecutive sample of 125 parents/caregivers of Brazilian adolescents was chosen. Participants were asked to answer the Brazilian version of the Family Impact Scale (FIS). The main independent variable was adolescents’ malocclusion, which was measured with the Dental Aesthetic Index. Gender, age, and family monthly income were the other independent variables. Data analysis involved descriptive statistics, Mann–Whitney test, and univariate and multiple logistic regression.


Among the 125 participants initially admitted to the present study, two were excluded so that 123 parents/caregivers participated providing a response rate of 98.4 %. The overall FIS score revealed a more frequent effect for families of adolescents who presented malocclusion (P = 0.005). Significant findings were also observed for parental emotions (P = 0.022), family conflict (P = 0.010), and financial burden (P = 0.010) subscales. When the independent variables family monthly income and malocclusion were inserted together in the regression model, families with a monthly income of <5 Brazilian minimum wages (approximately US$ 325.00 per month) were more likely to have a worse OHRQoL, and families whose adolescents presented malocclusion were 3.55 more likely to have a poorer quality of life than those families whose adolescents did not present malocclusion.


Families of adolescents with malocclusion were more likely to report a worse OHRQoL.


Family Adolescent Malocclusion Parents Caregivers Quality of life 



This study was supported by the National Council for Scientific Development (CNPq), the Coordination for the Improvement of Higher Level Education Personnel (CAPES), and the State of Minas Gerais Research Foundation (FAPEMIG), Brazil.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Abanto J, Carvalho TS, Mendes FM, et al. Impact of oral diseases and disorders on oral health-related quality of life of preschool children. Community Dent Oral Epidemiol. 2011;39:105–14.PubMedCrossRefGoogle Scholar
  2. Abanto J, Paiva SM, Raggio DP, et al. The impact of dental caries and trauma in children on family quality of life. Community Dent Oral Epidemiol. 2012;40:323–31.PubMedCrossRefGoogle Scholar
  3. Abreu LG, Melgaço CA, Abreu MH, Lages EM, Paiva SM. Impact of the first eight months of orthodontic treatment with a fixed appliance on the families of adolescent patients. Angle Orthod. 2014;84:1074–8.PubMedCrossRefGoogle Scholar
  4. Allen PF. Assessment of oral health related quality of life. Health Qual Life Outcomes. 2003;1:40.PubMedCentralPubMedCrossRefGoogle Scholar
  5. Amin MS, Harrison RL, Weinstein P. A qualitative look at parents’ experience of their child’s dental general anaesthesia. Int J Paediatr Dent. 2006;16:309–19.PubMedGoogle Scholar
  6. Antunes LS, Maués CP, Nadaes MR, et al. The impact of nonsyndromic oral clefts on family quality of life. Spec Care Dent. 2014;34:138–43.CrossRefGoogle Scholar
  7. Barbosa T de S, Gavião MB. Evaluation of the Family Impact Scale for use in Brazil. J Appl Oral Sci. 2009;17:397–403.PubMedCentralGoogle Scholar
  8. Bendo CB, Paiva SM, Abreu MH, Figueiredo LD, Vale MP. Impact of traumatic dental injuries among adolescents on family’s quality of life: a population-based study. Int J Paediatr Dent. 2014;24:387–96.PubMedCrossRefGoogle Scholar
  9. Brignardello-Petersen R, Carrasco-Labra A, Shan P, Azazpazhooh A. A practitioner’s guide to developing critical appraisal skills: what is the difference between clinical and statistical significance? J Am Dent Assoc. 2013;144:780–6.PubMedCrossRefGoogle Scholar
  10. Cunningham SJ, Hunt NP. Quality of life and its importance in orthodontics. J Orthod. 2001;28:152–8.PubMedCrossRefGoogle Scholar
  11. Dawoodbhoy I, Delgado-Ângulo EK, Bernabé E. Impact of malocclusion on the quality of life of Saudi children. Angle Orthod. 2013;83:1043–8.PubMedCrossRefGoogle Scholar
  12. Goursand D, Paiva SM, Zarzar PM, Pordeus IA, Allison PJ. Family Impact Scale (FIS): psychometric properties of the Brazilian Portuguese language version. Eur J Paediatr Dent. 2009;10:141–6.PubMedCrossRefGoogle Scholar
  13. Grimes DA, Schulz KF. Descriptive studies: what they can and cannot do. Lancet. 2002;359:145–9.PubMedCrossRefGoogle Scholar
  14. Jenny J, Cons NC. Establishing malocclusion severity levels on the Dental Aesthetic Index (DAI) scale. Aust Dent J. 1996;41:43–6.PubMedCrossRefGoogle Scholar
  15. Kirkwood BR, Stern J. Essential of medical statistics. 2nd ed. London: Blackwell; 2003.Google Scholar
  16. Kramer FJ, Gruber R, Fialka F, Sinikovic B, Schliephake H. Quality of life and family functioning in children with nonsyndromic orofacial clefts at preschool ages. J Craniofac Surg. 2008;19:580–7.PubMedCrossRefGoogle Scholar
  17. Levin KA. Study design III: cross-sectional studies. Evid Based Dent. 2006;7:24–5.PubMedCrossRefGoogle Scholar
  18. Locker D. Applications of self-reported assessments of oral health outcomes. J Dent Educ. 1996;60:494–500.PubMedGoogle Scholar
  19. Locker D, Jokovic A, Stephens M, et al. Family impact of child oral and oro-facial conditions. Community Dent Oral Epidemiol. 2002;30:438–48.PubMedCrossRefGoogle Scholar
  20. Malden PE, Thomson WM, Jokovic A, Locker D. Changes in parent-assessed oral health-related quality of life among young children following dental treatment under general anaesthetic. Community Dent Oral Epidemiol. 2008;36:108–17.PubMedCrossRefGoogle Scholar
  21. Marques LS, Ramos-Jorge ML, Paiva SM, Pordeus IA. Malocclusion: esthetic impact and quality of life among Brazilian school children. Am J Orthod Dentofac Orthop. 2006;129:424–7.CrossRefGoogle Scholar
  22. Marques LS, Filogônio CA, Filogônio CB, et al. Aesthetic impact of malocclusion in the daily living of Brazilian adolescents. J Orthod. 2009;36:152–9.PubMedCrossRefGoogle Scholar
  23. Martins-Júnior PA, Marques LS, Ramos-Jorge ML. Malocclusion: social, functional and emotional influence on children. J Clin Pediatr Dent. 2012;37:103–8.PubMedCrossRefGoogle Scholar
  24. Oliveira BH, Nadanovsky P. Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol. 2005;33:307–14.PubMedCrossRefGoogle Scholar
  25. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–9.PubMedCentralPubMedGoogle Scholar
  26. Rosenbach G, Quintão C, Almeida MA. Orthodontics around the world: orthodontics in Brazil: excellence for a minoriy. J Orthod. 2000;27:99–102.PubMedCrossRefGoogle Scholar
  27. Schwappach DL. Resource allocation, social values and the QALY: a review of the debate and empirical evidence. Health Expect. 2002;5:210–22.PubMedCrossRefGoogle Scholar
  28. Sischo L, Broder HL. Oral health-related quality of life: what, why, how, and future implications. J Dent Res. 2011;90:1264–70.PubMedCentralPubMedCrossRefGoogle Scholar
  29. Strauss RP, Cassell CH. Critical issues in craniofacial care: quality of life, costs of care, and implications of prenatal diagnosis. Acad Pediatr. 2009;9:427–32.PubMedCrossRefGoogle Scholar
  30. Tak M, Nagarajappa R, Sharda AJ, et al. Prevalence of malocclusion and orthodontic treatment needs among 12–15 years old school children of Udaipur, India. Eur J Dent. 2013;7(Suppl 1):S45–53.PubMedCentralPubMedCrossRefGoogle Scholar
  31. Thomson WM, Malden PE. Assessing change in the family impact of caries in young children after treatment under general anaesthesia. Acta Odontol Scand. 2011;69:257–62.PubMedCrossRefGoogle Scholar
  32. Ukra A, Foster Page LA, Thomson WM, et al. Impact of malocclusion on quality of life among New Zealand adolescents. N Z Dent J. 2013;109:18–23.Google Scholar

Copyright information

© European Academy of Paediatric Dentistry 2015

Authors and Affiliations

  • L. G. Abreu
    • 1
    • 3
    Email author
  • C. A. Melgaço
    • 1
  • M. H. N. G. Abreu
    • 2
  • E. M. B. Lages
    • 1
  • S. M. Paiva
    • 1
  1. 1.Department of Paediatric Dentistry and Orthodontics, School of DentistryFederal University of Minas GeraisBelo HorizonteBrazil
  2. 2.Department of Community and Preventive Dentistry, School of DentistryFederal University of Minas GeraisBelo HorizonteBrazil
  3. 3.Belo HorizonteBrazil

Personalised recommendations