The Psychosocial Impacts of Developmental Enamel Defects in Children and Young People

  • Zoe MarshmanEmail author
  • Helen D. Rodd


Within pediatric healthcare, increasing importance is being placed on the patient’s own experience of illness and related treatments. Clearly there is a need for dentists to also appreciate how various oral conditions may impact on their young patients. The dental literature has a long tradition of epidemiological, clinical, and laboratory research relating to developmental defects of enamel (DDE). Psychosocial research, however, is a more recent line of enquiry, and one that is still in its infancy, particularly where children and young people are concerned. In this chapter we will consider how disturbances in enamel formation can affect the appearance and function of teeth which, in turn, can impact on an individual’s emotions and social interactions. In addition, the need for patients to undergo, sometimes complex and prolonged, courses of treatment may bring its own positive or negative effects. We will first broadly consider the various approaches that can be used to gain insight into children’s perspectives of oral conditions and dental treatment. The psychosocial impacts of DDE will then be described in terms of how they affect the individual, how dental interventions affect the individual, and, lastly, how others view young people with DDE.


Oral health-related quality of life Developmental defects of enamel Dental fluorosis Amelogenesis Imperfecta Psychosocial impacts Social judgment Appearance 


  1. 1.
    Do LG, Spencer A. Oral health-related quality of life of children by dental caries and fluorosis experience. J Public Health Dent. 2007;67(3):132–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Arrow P. Child oral health-related quality of life (COHQoL), enamel defects of the first permanent molars and caries experience among children in Western Australia. Community Dent Health. 2013;30(3):183–8.PubMedGoogle Scholar
  3. 3.
    Bendo C, Paiva S, Varni J, Vale M. Oral health-related quality of life and traumatic dental injuries in Brazilian adolescents. Community Dent Oral Epidemiol. 2014;42(3):216–23.Google Scholar
  4. 4.
    Eslami N, Majidi MR, Aliakbarian M, Hasanzadeh N. Oral health-related quality of life in children with cleft lip and palate. J Craniofac Surg. 2013;24(4):e340–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Kotecha S, Turner PJ, Dietrich T, Dhopatkar A. The impact of tooth agenesis on oral health-related quality of life in children. J Orthod. 2013;40(2):122–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Scapini A, Feldens CA, Ardenghi TM, Kramer PF. Malocclusion impacts adolescents’ oral health-related quality of life. Angle Orthod. 2013;83(3):512–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Hall M, Gibson B, James A, Rodd HD. Children’s experiences of participation in the cleft lip and palate care pathway. Int J Paediatr Dent. 2012;22(6):442–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Gilchrist F, Rodd HD, Deery C, Marshman Z. Involving children in research, audit and service evaluation. Br Dent J. 2013;214(11):577–82.PubMedCrossRefGoogle Scholar
  9. 9.
    Jokovic A, Locker D, Guyatt G. Short forms of the Child Perceptions Questionnaire for 11–14-year-old children (CPQ(11–14)): development and initial evaluation. Health Qual Life Outcomes. 2006;4:4.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Jokovic A, Locker D, Stephens M, Kenny D, Tompson B, Guyatt G. Validity and reliability of a questionnaire for measuring child oral-health-related quality of life. J Dent Res. 2002;81(7):459–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Jokovic A, Locker D, Tompson B, Guyatt G. Questionnaire for measuring oral health-related quality of life in eight- to ten-year-old children. Pediatr Dent. 2004;26(6):512–8.PubMedGoogle Scholar
  12. 12.
    Broder HL, McGrath C, Cisneros GJ. Questionnaire development: face validity and item impact testing of the child oral health impact profile. Community Dent Oral Epidemiol. 2007;35:8–19.PubMedCrossRefGoogle Scholar
  13. 13.
    Gherunpong S, Tsakos G, Sheiham A. Developing and evaluating an oral health-related quality of life index for children; the CHILD-OIDP. Community Dent Health. 2004;21(2):161–9.PubMedGoogle Scholar
  14. 14.
    Astrom AN, Mashoto K. Determinants of self-rated oral health status among school children in northern Tanzania. Int J Paediatr Dent. 2002;12(2):90–100.PubMedCrossRefGoogle Scholar
  15. 15.
    Michel-Crosato E, Biazevic MGH, Crosato E. Relationship between dental fluorosis and quality of life: a population based study. Braz Oral Res. 2005;19(2):150–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Parekh S, Almehateb M, Cunningham SJ. How do children with amelogenesis imperfecta feel about their teeth? Int J Paediatr Dent. 2014;24(5):326–35.Google Scholar
  17. 17.
    Rodd HD, Marshman Z, Porritt J, Bradbury J, Baker SR. Oral health-related quality of life of children in relation to dental appearance and educational transition. Br Dent J. 2011;211(2):E4.PubMedCrossRefGoogle Scholar
  18. 18.
    Rodd HD, Marshman Z, Porritt J, Bradbury J, Baker SR. Psychosocial predictors of children’s oral health-related quality of life during transition to secondary school. Qual Life Res. 2012;21(4):707–16.PubMedCrossRefGoogle Scholar
  19. 19.
    Coffield KD, Phillips C, Brady M, Roberts MW, Strauss RP, Wright JT. The psychosocial impact of developmental dental defects in people with hereditary amelogenesis imperfecta. J Am Dent Assoc. 2005;136(5):620–30.PubMedCrossRefGoogle Scholar
  20. 20.
    Marshman Z, Baker SR, Bradbury J, Hall MJ, Rodd HD. The psychosocial impact of oral conditions during transition to secondary education. Eur J Paediatr Dent. 2009;10(4):176–80.PubMedGoogle Scholar
  21. 21.
    Craig S. How children view other children with enamel defects. MPhil thesis. Sheffield: University of Sheffield; 2013.Google Scholar
  22. 22.
    Rodd HD, Abdul-Karim A, Yesudian G, O’Mahony J, Marshman Z. Seeking children’s perspectives in the management of visible enamel defects. Int J Paediatr Dent. 2011;21(2):89–95.PubMedCrossRefGoogle Scholar
  23. 23.
    Marshman Z, Gibson B, Robinson PG. The impact of developmental defects of enamel on young people in the UK. Community Dent Oral Epidemiol. 2009;37(1):45–57.PubMedCrossRefGoogle Scholar
  24. 24.
    Vargas-Ferreira F, Ardenghi TM. Developmental enamel defects and their impact on child oral health-related quality of life. Braz Oral Res. 2011;25(6):531–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Pope AW, Ward J. Self-perceived facial appearance and psychosocial adjustment in preadolescents with craniofacial anomalies. Cleft Palate Craniofac J. 1997;34(5):396–401.PubMedCrossRefGoogle Scholar
  26. 26.
    Lovegrove E, Rumsey N. Ignoring it doesn’t make it stop: adolescents, appearance, and bullying. Cleft Palate Craniofac J. 2005;42(1):33–44.PubMedCrossRefGoogle Scholar
  27. 27.
    Helderman WHV, Mkasabuni E. Impact of dental fluorosis on the perception of well-being in an endemic fluorosis area in Tanzania. Community Dent Oral Epidemiol. 1993;21(4):243–4.CrossRefGoogle Scholar
  28. 28.
    Chankanka O, Levy SM, Warren JJ, Chalmers JM. A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol. 2010;38(2):97–109.PubMedCrossRefGoogle Scholar
  29. 29.
    Sujak SL, Abdul Kadir R, Dom TN. Esthetic perception and psychosocial impact of developmental enamel defects among Malaysian adolescents. J Oral Sci. 2004;46(4):221–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Robinson PG, Nalweyiso N, Busingye J, Whitworth J. Subjective impacts of dental caries and fluorosis in rural Ugandan children. Community Dent Health. 2005;22(4):231–6.PubMedGoogle Scholar
  31. 31.
    Locker D. Disparities in oral health-related quality of life in a population of Canadian children. Community Dent Oral Epidemiol. 2007;35(5):348–56.PubMedCrossRefGoogle Scholar
  32. 32.
    Poulsen S, Gjorup H, Haubek D, Haukali G, Hintze H, Lovschall H, et al. Amelogenesis imperfecta – a systematic literature review of associated dental and oro-facial abnormalities and their impact on patients. Acta Odontol Scand. 2008;66(4):193–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Jalevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Paediatr Dent. 2002;12(1):24–32.PubMedGoogle Scholar
  34. 34.
    Jalevik B, Klingberg G. Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls – a longitudinal study. Int J Paediatr Dent. 2012;22(2):85–91.PubMedCrossRefGoogle Scholar
  35. 35.
    McDonald S, Arkutu N, Malik K, Gadhia K, McKaig S. Managing the paediatric patient with amelogenesis imperfecta. Br Dent J. 2012;212(9):425–8.PubMedCrossRefGoogle Scholar
  36. 36.
    Bevans KB, Riley AW, Moon J, Forrest CB. Conceptual and methodological advances in child-reported outcomes measurement. Expert Rev Pharmacoecon Outcomes Res. 2010;10(4):385–96.PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Dashash M, Yeung CA, Jamous I, Blinkhorn A. Interventions for the restorative care of amelogenesis imperfecta in children and adolescents. Cochrane Database Syst Rev. 2013;6:CD007157.PubMedGoogle Scholar
  38. 38.
    Zebrowitz L, Montepare J. Social psychological face perception: why appearance matters. Soc Pers Psychol Compass. 2008;2:1497–517.CrossRefGoogle Scholar
  39. 39.
    Dion K. Physical attractiveness and evaluation of children’s transgressions. J Pers Soc Psychol. 1972;24(2):207–13.PubMedCrossRefGoogle Scholar
  40. 40.
    Langlois JH, Kalakanis L, Rubenstein AJ, Larson A, Hallam M, Smoot M. Maxims or myths of beauty? A meta-analytic and theoretical review. Psychol Bull. 2000;126(3):390–423.PubMedCrossRefGoogle Scholar
  41. 41.
    Shaw WC. The influence of children’s dentofacial appearance on their social attractiveness as judged by peers and lay adults. Am J Orthod Dentofacial Orthop. 1981;79(4):399–415.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Academic Unit of Dental Public Health, School of Clinical DentistryUniversity of Sheffield, Claremont CrescentSheffieldUK
  2. 2.Department of Oral Health and DevelopmentSchool of Clinical Dentistry, University of Sheffield, Claremont CrescentSheffieldUK

Personalised recommendations