title: Perception of parents and caregivers regarding the impact of malocclusion on adolescents' quality of life: a cross-sectional study.
abstract: The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents' oral health -related quality of life (OHRQoL).
  This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents' malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents' age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance.
  Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents' malocclusion was significantly associated with a higher negative impact on parents'/caregivers' perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables.
  Parents/caregivers reported a negative impact of malocclusion on adolescents' OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.
authors.affiliation: PhD student, Universidade Federal de Minas Gerais (UFMG), Department of Pediatric Dentistry and Orthodontics, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Lucas Guimarães
authors.initials: LG
authors.lastname: Abreu
authors.affiliation: Postdoctorate fellow, Universidade Federal de Minas Gerais (UFMG), Department of Pediatric Dentistry and Orthodontics, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Camilo Aquino
authors.initials: CA
authors.lastname: Melgaço
authors.affiliation: Professor, Universidade Federal de Minas Gerais (UFMG), Department of Community and Preventive Dentistry, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Mauro Henrique
authors.initials: MH
authors.lastname: Abreu
authors.affiliation: Professor, Universidade Federal de Minas Gerais (UFMG), Department of Pediatric Dentistry and Orthodontics, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Elizabeth Maria Bastos
authors.initials: EM
authors.lastname: Lages
authors.affiliation: Professor, Universidade Federal de Minas Gerais (UFMG), Department of Pediatric Dentistry and Orthodontics, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Saul Martins
authors.initials: SM
authors.lastname: Paiva
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010465:Perception; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires