Malocclusion, bullying and oral health-related quality of life: are they associated?

By Renata Colturato Joaquim Gatto, Post-Doctor, Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Odontologia de Araçatuba, Preventive and Social Dentistry Graduate Program, Araçatuba, SP, Brazil

Researches of the Graduate Program in Preventive and Social Dentistry of FOA/UNESP found that the need for orthodontic treatment had a lower impact on oral health-related quality of life (OHRQoL) than episodes of bullying among adolescents.

According to the article “The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying among Brazilian teenagers”, published in the Dental Press Journal of Orthodontics (vol. 24, no. 2), students that reported negative consequences associated with bullying were three times more likely to have poor OHRQoL. The need for orthodontic treatment was not associated with OHRQoL. However, adolescents that had already received orthodontic treatment had a protective factor against poor OHRQoL.

To reach these conclusions, the authors examined 815 students in public schools. Students responded a questionnaire with questions about bullying and a validated instrument, the Oral Health Impact Profile (OHIP-14), to assess OHRQoL. In addition to the questionnaires, the students underwent oral examinations using the Dental Aesthetic Index (DAI) to evaluate the need for orthodontic treatment, according to the recommendations of the World Health Organization. Although several studies discuss bullying, no previous investigation has examined the effect of bullying on OHRQoL of Brazilian adolescents. The examinations to determine the need for orthodontic treatment and OHRQoL were conducted in a clinical setting and evaluated adolescents that sought treatment for an either aesthetic or functional reason. Adolescence is a time of great changes (HOLMQVIST; FRISÉN, 2012; SILVA; TAQUETTE; COUTINHO, 2014), and the concepts developed at this age may affect behavioral relations in adulthood and may have a negative impact on both work and affective dimensions (LOPES NETO, 2005; PEARCE; THOMPSON, 1998; RAVENS-SIEBERER, et al., 2004).

Therefore, although orthodontists have traditionally considered good oral health and proper functioning as the main objectives of clinical interventions, psychological and social effects seem to be the main reasons why patients seek treatment (PAULA JUNIOR, et al., 2009).


HOLMQVIST, K. and FRISÉN, A. “I bet they aren’t that perfect in reality”: appearance ideals viewed from the perspective of adolescent with a positive body image. Body Image [online]. 2012, vol. 9, no. 3, pp. 388-395, ISSN: 1740-1445 [viewed 12 September 2019]. DOI: 10.1016/j.bodyim.2012.03.007. Available from:

LOPES NETO, A.A. Bullying: aggressive behavior among students. J. Pediatr. (Rio J.) [online]. 2005, vol. 81, no. 5, suppl., pp. s164-s172, ISSN: 0021-7557 [viewed 12 September 2019]. DOI: 10.1590/S0021-75572005000700006. Available from:

PAULA JÚNIOR, D.F., et al. Psychosocial impact of dental esthetics on quality of life in adolescents. Angle Orthod. [online]. 2009, vol. 79, no. 6, pp. 1188-1193, e-ISSN: 1945-7103 [viewed 12 September 2019]. DOI: 10.2319/082608-452R.1. Available from:

PEARCE, J.B. and THOMPSON, A.C. Practical approaches to reduce the impact of bullying. Arch Dis Child. [online]. 1998, vol. 79, no. 6, pp. 528-531, e-ISSN: 1468-2044 [viewed 12 September 2019]. DOI: 10.1136/adc.79.6.528. Available from:

RAVENS-SIEBERER, U., KÖKÖNYEI, G. and THOMAS, C. School and health. In: CURRIE, C., et al. (ed.). Young people’s health in context: Health Behavior in School-aged Children (HBSC) study: international report from the 2001/2002 survey. Geneva: World Health Organization, 2004.

SILVA, M.L. de A., TAQUETTE, S.R. and COUTINHO, E.S.F. Senses of body image in adolescents in elementary school. Rev. Saúde Pública [online]. 2014, vol. 48, no. 3, pp. 438-444, ISSN: 0034-8910 [viewed 12 September 2019]. DOI: 10.1590/S0034-8910.2014048005083. Available from:

To read the article, access it

GATTO, R.C.J., et al. The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying, among Brazilian teenagers. Dental Press J. Orthod. [online]. 2019, vol. 24, no. 2, pp. 73-80, ISSN: 2176-9451 [viewed 12 September 2019]. DOI: 10.1590/2177-6709.24.2.073-080.oar. Available from:

External link

Dental Press Journal of Orthodontics – DPJO: <>


Como citar este post [ISO 690/2010]:

GATTO, R.C.J. Malocclusion, bullying and oral health-related quality of life: are they associated? [online]. SciELO in Perspective | Press Releases, 2019 [viewed ]. Available from:


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