Objectives: To test whether malocclusion had an impact on adolescents' appearance satisfaction regardless of other physical aspects.
Methods: A cross-sectional study nested in a birth cohort study was carried out in Pelotas, Brazil. A random sample of 900 15-year-old adolescents was selected. WHO criteria were used to define malocclusion and a questionnaire was administered including self-reported skin colour and appearance satisfaction. Dental caries were assessed. Height and weight were measured and body mass index calculated. Data concerning gender and socioeconomic characteristics were obtained from the cohort's perinatal study. Adjusted analyses including all confounding variables investigated were performed using Poisson regression with robust variance in order to identify the potential risk factors for appearance dissatisfaction. All analyses were carried out separately by gender.
Results: The sample included 867 individuals, 54.1% men. The prevalence of moderate or severe malocclusion was 30.6% (95% CI: 26.5-34.7) among boys, and 32.8% (95% CI: 28.2-37.4) among girls (P = 0.524). Dissatisfaction with appearance was reported by 29.8% of the boys and by 46.5% of the girls (P < 0.001). A positive association between malocclusion and appearance dissatisfaction, controlling for other physical, dental caries and socioeconomic characteristics was observed only in girls [prevalence ratio = 1.4 (1.3-1.7)].
Conclusions: Malocclusion is a common condition and is positively associated with appearance dissatisfaction in adolescent girls. The effect of different types of malocclusion on appearance dissatisfaction should be the focus of further investigation.