The impact of dentofacial characteristics and malocclusions on dissatisfaction with dentofacial appearance.

Objectives: To assess how, and to what extent, dentofacial features and malocclusions affect the perceived dissatisfaction with the appearance of dentofacial region in different age groups.

Materials and methods: Dissatisfaction with dental appearance (DDA) and facial appearance (DFA) of 430 patients were assessed using self-reported 5-point Likert scores (1: very satisfied - 5:very dissatisfied). Number of decayed, filled, and missing teeth, oral hygiene status, crowding in the upper/lower arches, molar relationship, overjet, overbite, posterior-crossbite, upper/lower midline deviations, face type, profile, nasal tip and chin deviations were assessed by an experienced orthodontist. Ordinal logistic regression analysis was performed to determine how the examined variables affected DDA and DFA scores.

Results: The median age of the 430 patients (271 female, 159 male) was 23.0 years. 60.9% of the patients had Angle Class I, 32.3% had Angle Class II, and 6.7% had Angle Class III molar relationship. According to the IOTN (DC), 37.4% of the patients had grade 4 and grade 5. Gender had no impact on DDA and DFA. Being young (teenagers OR = 4.78, CI:2.43-9.40, young adults (OR = 3.15, CI: 1.70-5.83), having poor oral hygiene (OR = 2.32, CI: 1.37-3.92), missing teeth (OR = 1.19, CI:1.10-1.29), convex profile (OR = 1.94, CI:1.03-3.67), diastema (OR = 3.18, CI:1.33-7.61), crowding in the upper arch (moderate: OR = 2.10, CI:1.30-3.68, severe: OR = 5.94, CI:3.15-11.19) affected the DDA scores negatively. Class III malocclusion (OR = 5.60, CI:1.85-16.91), decreased overbite (OR = 2.44, CI:1.21-4.89), and increase in DDA scores (OR = 1.88, CI: 1.50-2.35) all increased the DFA scores.

Conclusion: Certain dentofacial characteristics and age of the patients significantly affect self-reported dissatisfaction with dental and facial appearance levels, with varying degrees of severity.

Clinical relevance: Awareness of the impacts of malocclusions and dentofacial features that result in patient dissatisfaction among those who apply for dental treatment at the clinic enables a deeper understanding of the patient's priorities, expectations from orthodontic treatment, and satisfaction with the outcome.