The psychosocial impact of developmental dental defects in people with hereditary amelogenesis imperfecta.
BACKGROUND
Amelogenesis imperfecta (AI) is a hereditary dental condition with poor esthetics and dental sensitivity that frequently requires extensive dental treatment. The authors hypothesized that AI is associated with a negative psychosocial outcome.


METHODS
Family members with and without AI completed a questionnaire including demographic and dental history questions, as well as a number of psychometric scales. The authors investigated the effects of AI status (with versus without), sex and age on each of the psychosocial outcomes using a generalized linear model.


RESULTS
Subjects with AI (n = 30) had higher levels of social avoidance and distress, as well as higher levels of dysfunction, discomfort and disability attributable to their oral condition compared with subjects without AI (n = 29). The relationship of AI status to fear of negative evaluation, mastery and self-esteem was age-dependent. Younger subjects with AI tended to have higher fear of negative evaluation scores, while older subjects without AI tended to have higher fear of negative evaluation scores. Additionally, subjects without AI showed a definite decrease in mastery and self-esteem scores with age, while subjects with AI tended to show an increase in mastery and self-esteem scores with age.


CONCLUSIONS
These results indicate that having AI has a marked impact on the psychosocial health of affected people comparable with the impact of systemic health conditions, especially at younger ages.


CONCLUSIONS
Dental coverage for AI traditionally is excluded by third-party payers as being solely for esthetic reasons. The authors' study shows that AI has marked psychosocial effects, which suggests that dental treatment could be medically necessary and has far-reaching implications for the affected person's overall health.
Coffield
Kristina D
KD
Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
Phillips
Ceib
C
Brady
Melissa
M
Roberts
Michael W
MW
Strauss
Ronald P
RP
Wright
J Timothy
JT
D000328:Adult; D000567:Amelogenesis Imperfecta / Q000523:psychology*; D000704:Analysis of Variance; D001007:Anxiety; D017742:Dental Care for Chronically Ill; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D011594:Psychometrics; D011610:Psychosocial Deprivation; D011788:Quality of Life; D012649:Self Concept; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires