title: Relationships between dental appearance, self-esteem, socio-economic status, and oral health-related quality of life in UK schoolchildren: A 3-year cohort study.
abstract: OBJECTIVE
  To examine the relationships between dental appearance, characteristics of the individual and their environment, and oral health-related quality of life (OHQoL) in young people over time.
  
  
  METHODS
  A total of 374 young people (122 boys, 252 girls) aged 11-12 years from seven different XX schools were recruited at baseline and 258 (78 boys, 180 girls) followed-up 3 years later, aged 14-15 years (69 per cent response rate). Participants completed a measure of OHQoL (CPQ11-14 ISF-16) and self-esteem (SE, CHQ-CF87). A clinical examination was undertaken, including clinician and self-assessed normative measures of need [Index of Orthodontic Treatment Need (IOTN)] and dental caries. The Index of Multiple Deprivation was used to indicate socio-economic status (SES).
  
  
  RESULTS
  There was a general improvement between baseline and follow-up in the measures of malocclusion, as well as OHQoL. Multiple linear regression indicated that there were significant cross-sectional associations at baseline between OHQoL and SES (rho = -0.11; P = 0.006), SE (rho = -0.50; P < 0.001), and self-assessed IOTN (rho = 0.27; P < 0.001). There were significant longitudinal associations between the change in OHQoL and change in SE (rho = -0.46; P < 0.001) and change in the decayed, missing, or filled surfaces (rho = -0.24; P = 0.001). The mean improvement in the total CPQ11-14 ISF-16 score for those with a history of orthodontic treatment was 3.2 (SD = 6.9; P = 0.009) and 2.4 (SD = 8.8; P < 0.001) for those with no history of treatment. The difference was not statistically significant (P = 0.584).
  
  
  CONCLUSIONS
  OHQoL improved in young people over time, whether they gave a history of orthodontic treatment or not. Individual and environmental characteristics influence OHQoL and should be taken into account in future studies.
authors.affiliation: *Orthodontics, Academic Unit of Oral Health and Development, School of Clinical Dentistry, Sheffield, UK, p.benson@sheffield.ac.uk.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Benson
authors.affiliation: King Abdulaziz National Guard Hospital, Alhasa, Saudi Arabia.
authors.forename: Thaer
authors.initials: T
authors.lastname: Da'as
authors.affiliation: Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London.
authors.forename: Ama
authors.initials: A
authors.lastname: Johal
authors.affiliation: Tameside General Hospital, Lancashire.
authors.forename: Nicky A
authors.initials: NA
authors.lastname: Mandall
authors.affiliation: Bromley and Wimbledon, London.
authors.forename: Alison C
authors.initials: AC
authors.lastname: Williams
authors.affiliation: Psychology in Relation to Dentistry and.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Baker
authors.affiliation: Dental Public Health, Academic Unit of Dental Public Health, School of Clinical Dentistry, Sheffield, UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Marshman
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000523:psychology; D004739:England; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006801:Humans; D061326:Index of Orthodontic Treatment Need; D008137:Longitudinal Studies; D059012:Lost to Follow-Up; D008297:Male; D008310:Malocclusion / Q000523:psychology; D009909:Oral Health; D011788:Quality of Life; D012649:Self Concept; D012647:Self-Assessment; D012737:Sex Factors; D012923:Social Class; D035862:Vulnerable Populations