title: The impact of dental appearance and anxiety on self-esteem in adult orthodontic patients.
abstract: OBJECTIVE
  To analyse the relationship between different dimensions of dental appearance impact and self-esteem in adult patients undergoing orthodontic treatment, with special attention to the possible mediating role of anxiety.
  
  
  METHODS
  A quasi-experimental design was used with a matched control group (without orthodontic treatment). In each group (experimental and control), there were 85 patients.
  
  
  METHODS
  The impact of dental appearance was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). State anxiety was assessed with the State Anxiety Inventory (STAI-S) and self-esteem with Rosenberg's self-esteem scale.
  
  
  RESULTS
  In both groups (experimental and control), self-esteem correlates negatively, ranging between 0.26 and 0.43, with all dimensions of dental appearance impact (except for the positive dental self-confidence dimension, where all correlations were positive). Anxiety correlates positively, ranges between 0.35 and 0.44, with social impact, psychological impact and aesthetic concern, although it maintains no significant correlations with dental self-confidence. Nevertheless, in patients undergoing orthodontic treatment, anxiety plays a mediating role between dental impact dimensions and self-esteem, whilst for the control group anxiety only plays a mediator role between psychological impact and self-esteem.
  
  
  CONCLUSIONS
  Anxiety plays a fundamental role in the effect of perceived dental impact on self-esteem in adult patients undergoing orthodontic treatment. These results have important practical implications for the design of bio-psycho-social intervention programs that contemplate cognitive-affective variables as an essential part of orthodontic treatment in adults.
authors: Department of Orthodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors: M
authors: M
authors: Romero-Maroto
authors: Department of Orthodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors: N
authors: N
authors: Santos-Puerta
authors: Department of Orthodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors: M J
authors: MJ
authors: González Olmo
authors: Department of Psychology, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors: C
authors: C
authors: Peñacoba-Puente
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008311:Malocclusion, Angle Class I / Q000523:psychology / Q000628:therapy; D008312:Malocclusion, Angle Class II / Q000523:psychology / Q000628:therapy; D008313:Malocclusion, Angle Class III / Q000523:psychology / Q000628:therapy; D016910:Orthodontic Brackets; D009971:Orthodontics, Corrective / Q000523:psychology*; D012649:Self Concept; D055815:Young Adult
keywords: adults; anxiety; dental impact; orthodontics; self-esteem