title: Discomfort associated with fixed orthodontic appliances: determinant factors and influence on quality of life.
abstract: OBJECTIVE
  To investigate the determinant factors of discomfort attributed to the use of fixed orthodontic appliance and the effect on the quality of life of adolescents.
  
  
  METHODS
  Two hundred and seventy-two individuals aged between 9 and 18 years old, enrolled in public and private schools and undergoing orthodontic treatment with fixed appliance participated in this cross-sectional study. The participants were randomly selected from a sample comprising 62,496 individuals of the same age group. Data was collected by means of questionnaires and an interview. Discomfort intensity and bio-psychosocial variables were assessed using the Oral Impact on Daily Performance questionnaire. Self-esteem was determined using the Global Negative Self-Evaluation questionnaire. Statistical analysis involved the chi-square test and both simple and multiple Poisson regression analyses.
  
  
  RESULTS
  Although most individuals did not present discomfort, there was a prevalence of 15.9% of impact on individuals' daily life exclusively due to the use of fixed orthodontic appliance. Age [PR: 3.2 (95% CI: 1.2-8.5)], speech impairment [PR: 2.2 (95% CI: 1.1-4.6)], poor oral hygiene [PR: 2.4 (95% CI: 1.2-4.8)] and tooth mobility [PR: 3.9 (95% CI: 1.8-8.1)] remained independently associated with a greater prevalence of discomfort (P ≤ 0.05).
  
  
  CONCLUSIONS
  Discomfort associated with the use of fixed orthodontic appliances exerted a negative influence on the quality of life of the adolescents comprising the present study. The determinants of this association were age, poor oral hygiene, speech impairment and tooth mobility.
authors.forename: Leandro Silva
authors.initials: LS
authors.lastname: Marques
authors.forename: Saul Martins
authors.initials: SM
authors.lastname: Paiva
authors.forename: Raquel Gonçalves
authors.initials: RG
authors.lastname: Vieira-Andrade
authors.forename: Luciano José
authors.initials: LJ
authors.lastname: Pereira
authors.forename: Maria Letícia
authors.initials: ML
authors.lastname: Ramos-Jorge
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000523:psychology; D005260:Female; D005884:Gingival Hemorrhage / Q000209:etiology / Q000523:psychology; D006209:Halitosis / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D009910:Oral Hygiene; D009967:Orthodontic Appliances / Q000009:adverse effects*; D010146:Pain / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D012649:Self Concept; D013064:Speech Disorders / Q000209:etiology / Q000523:psychology; D013651:Taste Disorders / Q000209:etiology / Q000523:psychology; D014086:Tooth Mobility / Q000209:etiology / Q000523:psychology
keywords: Adolescent; Orthodontics; Quality of life