Psychosocial well-being of prospective orthognathic-surgical patients

Abstract

Objective. To compare the psychosocial well-being of prospective orthognathic-surgical patients and controls. Materials and methods. Sixty patients referred for assessment of orthognathic-surgical treatment need and 29 controls participated. All participants filled in the modified version of Secord and Jourard’s Body Image Questionnaire, the Orthognathic Quality of Life Questionnaire, the Rosenberg Self-Esteem scale, the Acceptance and Action Questionnaire II and a structured diary developed by the authors. Patients also filled in the Symptom Checklist 90. Patients assessed their dental appearance on a visual analogue scale modified from the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need. Professional assessment was made from study models with the AC. Results. Patients rating their dental appearance as AC grades 5–10 suffered from lower orthognathic quality-of-life and poorer body image than the controls, while those with AC grades of 1–4 only had poorer oral function. Self-perceived dental appearance was more important to orthognathic quality-of-life and body image than an orthodontist’s assessment. Patients and controls had equal psychological flexibility and self-esteem. In all, 23–57% of patients had significant psychiatric symptoms, which explained the adverse emotions patients felt during the day. Fifteen per cent of the patients had been bullied. Conclusions. Many orthognathic-surgical patients cope well with their dentofacial deformities, despite functional masticatory problems. It seems that a subjective view of dental appearance may be a key factor in finding patients with psychosocial problems. It should be a major issue when considering psychosocial support and other treatment options.

Key Words::

• orthognathic
• prospective
• quality-of-life

Acknowledgements

The authors wish to thank the personnel in the Finnish Student Health Service, Turku unit for their kind help in organizing this study. This study was supported by grants from the Finnish Dental Society Apollonia, Orthodontic Division of the Finnish Dental Society, Suomen Naishammaslääkärit r.y., the University Hospital of Turku, and Competitive Research Funding from the Pirkanmaa Hospital District.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.