Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents

Background: The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. Methods: This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem.Results: A significant correlation was found between self-esteem and self-perceived smile ( r = 0.294; P < 0.001) and dental aesthetics ( r = 0.212; P < 0.001). Adolescents with high self-perceived smile (mean +/- standard deviation, 7.66 +/- 2.20) and dental aesthetics (6.68 +/- 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 +/- 2.73) and dental aesthetics (4.36 +/- 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem.Conclusions: The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.(c) 2022 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.