Objective: To examine the relationships between the clinical and non-clinical factors of malocclusion including OHRQoL, socio-economic status and self-esteem with children using the simplified Wilson and Cleary model as an analytical framework.
Methods: This study was a cross-sectional questionnaire and clinical analytical study. One thousand and twenty five children aged 11-12 years attending schools in UK (n = 380) and Saudi Arabia (n = 645) participated in the study. All children completed the CPQ ISF-16 and the self-esteem subscale of the Child Health Questionnaire (CHQ-CF87) at school under the direction of the principal investigator. Socio-economic status was assessed using postcode in the UK and occupation of the head of the household in Saudi Arabia. After the completion of the questionnaires, participants had a clinical examination including the IOTN (ac & dhc), overjet, anterior open bite and caries experience.
Results: Oral health status of participants (IOTN and caries experience) was comparable to other studies in the UK and Saudi Arabia. The results of this study support the postulated mediator role of self-esteem and socio-economic status when evaluating OHRQoL in schoolchildren. Self-esteem was found to be the major mediator that can influence the emotional and social impacts of malocclusion on OHRQoL in schoolchildren. Furthermore, children with high socio-economic status were found to have lower impact on OHRQoL.
Conclusion: Self-esteem was found to have a significant influence on the impact of malocclusion. These findings have implications for the assessment of the need for NHS orthodontics treatment of children in the future.