Review suggests a modest quality of life benefit from orthodontic treatment


There is increasing interest in patient reported outcomes (PROMs) from health care interventions. Oral health–related quality of life (OHRQoL) has been defined as, ‘the absence of negative impacts of oral conditions on social life and a positive sense of dentofacial self-confidence’ and a number of validated tools are available. The aim of this review was to assess the literature related to the impact of orthodontic treatment and orthodontic care on oral health–related quality of life

Searches were conducted in the PubMed, Embase, Cochrane Central Register of Controlled Trials, China Biology Medicine disc and Goggle-Scholar databases with no language restrictions. In addition the journals; American Journal of Orthodontics and Dentofacial Orthopedics, European Journal of Orthodontics, Angle Orthodontist, Journal of Orthodontics, and World Journal of Orthodontics were searched. Two reviewers independently screened assessed and extracted data from the studies. Studies in which patients received fixed or removable appliance, or interceptive orthodontic treatment with outcomes that showed changes in oral health–related quality of life (OHRQoL) from baseline (pre-treatment) to follow-up at least 1 month were included.

  • Eleven studies met the inclusion criteria (6 cohort studies, 4 cross-sectional studies,1 case-control study).
  • The majority of studies (7/11) were conducted among child/adolescent populations
  • Four QoL instruments, generic and oral health specific, were applied to the 11 included papers, namely OHIP (Oral Health Impact Profile), OIDP (Oral Impacts on Daily Living), CPQ (Child Perceptions Questionnaire) and OHQoL-UK.
  • A majority of studies indicated a correlation between orthodontic treatment and QoL no matter what measurement was applied

The authors concluded

Findings of this review suggest that there is an association (albeit modest) between orthodontic treatment and quality of life. There is a need for further studies of their relationship, particularly studies that employ standardized assessment methods so that outcomes are uniform and thus amenable to meta-analysis.


As the authors note the variety of tools used made it difficult to combine the date. The authors chose to include only those studies that used previously validated tools. They also chose to include both short and long terms studies, assessing changes during and after orthodontic treatment. While the findings are consistent the improvements are small and the majority of included studies are observational so potentially at risk of greater bias. Recently we discussed a study by Johal et al (Dental Elf 16th May 2014) that found an iinitial worsening of OHQoL but also a improvement in a pre-treatment control group.


Zhou Y, Wang Y, Wang X, Volière G, Hu R. The impact of orthodontic treatment on the quality of life a systematic review. BMC Oral Health. 2014 Jun 10;14(1):66. [Epub ahead of print] PubMed PMID: 24913619.

Dental Elf 16th May 2014 – Study finds initial stages of fixed orthodontic treatment result in subjective pain experience and impact on oral health-related quality of life

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