title: Treatment-associated changes in malocclusion and oral health-related quality of life: A 4-year cohort study.
abstract: BACKGROUND
  The impact of orthodontic treatment on oral health-related quality of life (OHRQoL) in adolescents being treated in orthodontic practices has not yet been explored longitudinally. The aim of this cohort study was to describe the changes in both malocclusion and OHRQoL with orthodontic treatment.
  
  
  METHODS
  One hundred seventy-four patients (ages, 10-17 years; 64.4% girls; 81.6% European) underwent 2-arch, fixed-appliance treatment in a 4-year prospective study conducted across 19 specialist orthodontic practices throughout New Zealand. They were assessed before treatment, at debond (when 87.4% of the baseline sample were reassessed), and at a mean 21 months postdebond (when 59.4% of the baseline sample were reassessed). OHRQoL was measured using the Child Perceptions Questionnaire, and the Dental Aesthetic Index was used to measure occlusion.
  
  
  RESULTS
  Among the 104 patients who took part in all 3 assessments, little change in OHRQoL overall was seen at the end of treatment, despite considerable improvement in malocclusion (with the mean Dental Aesthetic Index score falling from 35.9 at baseline to 21.3 at debond). The mean Child Perceptions Questionnaire 11-14 was slightly greater at debond, and this was most notable in the functional limitations subscale. By the end of the study (21 months postdebond, on average), the decreases in Child Perceptions Questionnaire 11-14 scores were all substantial, especially in the emotional well-being and social well-being subscales.
  
  
  CONCLUSIONS
  Malocclusion affects orthodontic patients' OHRQoL before treatment. A temporary increase in symptomatic impacts seen by the debond stage appears to ameliorate with time, with the benefits of orthodontic treatment for OHRQoL manifesting themselves some months later.
authors.affiliation: Associate professor, Department of Orthodontics, School of Dentistry, The University of Queensland, Herston, Queensland, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Healey
authors.affiliation: Professor, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Robin D C
authors.initials: RD
authors.lastname: Gauld
authors.affiliation: Professor, Sir John Walsh Research Institute, Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand. Electronic address: murray.thomson@otago.ac.nz.
authors.forename: W Murray
authors.initials: WM
authors.lastname: Thomson
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000523:psychology / Q000628:therapy*; D009909:Oral Health; D009971:Orthodontics, Corrective / Q000379:methods / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors