Association Between Malocclusion Severity and Oral Health‐Related Quality of Life in Children Aged 11–14 Years Using CPQ11‐14 and P‐CPQ

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OBJECTIVES: This study aimed to evaluate the association between malocclusion severity and oral health-related quality of life (OHRQoL) in children aged 11-14 years by simultaneously using the Child Perceptions Questionnaire (CPQ11-14), Parent/Caregiver Perceptions Questionnaire (P-CPQ), and Dental Aesthetic Index (DAI). MATERIAL AND METHODS: This analytical cross-sectional, clinic-based study was conducted on 117 children aged 11-14 years and their parents/guardians referred to a specialized dental clinic in Rasht city, Iran, in 2022. Children with systemic diseases, a history of orthodontic treatment, or craniofacial abnormalities were excluded. OHRQoL was independently assessed using the CPQ11-14 and P-CPQ. Malocclusion severity was determined using the DAI, and children were categorized into normal occlusion, definite, severe, and very severe malocclusion groups. The associations of age and gender with OHRQoL were also examined. Data were analyzed statistically (α = 0.05). RESULTS: The mean OHRQoL score was significantly higher among children with malocclusion compared with those with normal occlusion (p < 0.001), indicating poorer quality of life. Higher malocclusion severity was significantly associated with worse OHRQoL scores (p < 0.001). These associations were significant in both sexes (p < 0.05). A significant association between malocclusion severity and poorer OHRQoL was observed in children older than 12 years (p < 0.001), whereas this association was not statistically significant in children aged 12 years or younger (p > 0.05). Multivariable analysis confirmed that malocclusion severity remained independently associated with OHRQoL after adjustment for demographic factors (p < 0.001). CONCLUSIONS: Greater severity of malocclusion, particularly in older children, is significantly associated with poorer OHRQoL. The relative agreement between child and parent assessments highlights the importance of considering both perspectives in clinical and research settings.

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