title: Bullying in orthodontic patients and its relationship to malocclusion,self-esteem and oral health-related quality of life.
abstract: OBJECTIVE
  To measure the self-reported frequency and severity of bullying amongst patients referred for orthodontic treatment and to investigate whether there is a relationship between levels of self-reported bullying, malocclusion and need for orthodontic treatment and an individual's self-esteem and oral health-related quality of life (OHRQoL).
  
  
  METHODS
  Cross-sectional study of an adolescent group referred for orthodontic assessment at three UK hospitals.
  
  
  METHODS
  Three hundred and thirty-six participants aged between 10 and 14 years were recruited. Validated questionnaires were used to measure the self-reported frequency and severity of bullying, self-esteem and OHRQoL. Orthodontic treatment need was assessed using IOTN.
  
  
  RESULTS
  The prevalence of bullying was 12·8%. Being bullied was significantly associated with Class II Division 1 incisor relationship (P = 0·041),increased overbite (P = 0·023),increased overjet (P = 0·001)and a high need for orthodontic treatment assessed using AC IOTN (P = 0·014).Bullied participants also reported lower levels of social competence (P<0·001),athletic competence (P<0·001), physical appearance related self-esteem (P<0·001)and general self-esteem (P<0·001). Higher levels of oral symptoms (P = 0·032),functional limitations (P<0·001), emotional (P<0·001)and social impact (P<0·001) from their oral condition, resulting in a negative impact on overall OHRQoL (P<0·001),were also reported.
  
  
  CONCLUSIONS
  Significant relationships exist between bullying and certain occlusal traits, self-esteem and OHRQoL.
authors.affiliation: East Kent Hospitals University NHS Foundation Trust,Ethelbert Road, Canterbury, Kent CT1 3NG, UK. Jad_Seehra@hotmail.com.
authors.forename: Jadbinder
authors.initials: J
authors.lastname: Seehra
authors.forename: Padhraig S
authors.initials: PS
authors.lastname: Fleming
authors.forename: Tim
authors.initials: T
authors.lastname: Newton
authors.forename: Andrew T
authors.initials: AT
authors.lastname: DiBiase
mesh_terms: D000293:Adolescent; D058445:Bullying; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D061326:Index of Orthodontic Treatment Need; D016015:Logistic Models; D008312:Malocclusion, Angle Class II / Q000523:psychology*; D009971:Orthodontics, Corrective / Q000523:psychology*; D011788:Quality of Life; D012649:Self Concept; D057566:Self Report; D018709:Statistics, Nonparametric