Psychosocial well-being of orthognathic patients

Outi Alanko

Research output: Book/ReportDoctoral thesis

Abstract

Orthognathic treatment combining orthodontics and surgery aims at correcting severe dentofacial discrepancies and improving patients' quality of life. Several factors motivate patients to seek this treatment as severe dentofacial discrepancies affect patients' oral health and function, and psychosocial well-being. This thesis aimed at analyzing patients' psychosocial well-being before, during, and after orthognathic treatment using a prospective study design.

A systematic literature review on orthognathic patients' motivation for treatment, psychosocial well-being, and satisfaction with treatment outcome was conducted. According to the included studies (n=35), the main motives for treatment were improvements in the stomatognathic system, self-confidence, and appearance. Psychosocial well-being was evaluated using a range of questionnaires, and with varying data collection points. Overall, orthognathic patients did not experience psychiatric symptoms to a greater degree than others. The vast majority of patients were satisfied with treatment outcome.

Prospective orthognathic patients' psychosocial well-being was compared to that of young adults without orthognathic treatment need. Data was collected with questionnaires evaluating psychiatric symptoms (Symptom Checklist-90), self- esteem (Rosenberg Self-Esteem Scale), psychological flexibility (Acceptance and Action Questionnaire II), condition-specific quality of life (Orthognathic Quality of Life Questionnaire), and body image (body image questionnaire). Also, patients' assessed their daily emotions with a structured diary, and graded their own dental appearance on a scale from 1 to 10 -esthetic Component of the Index of Orthodontic Treatment Need). Data was collected before beginning treatment. Most of the patients coped well with their dentofacial deformities despite experiencing evident masticatory problems. Among the patients who graded their dental appearance as worse, quality of life and body image were lower than among controls. Self-esteem and psychological flexibility did not differ between patients and controls.

Orthognathic patients' psychosocial well-being was evaluated in 6 treatment phases: before treatment (T0), after first orthodontic examination (T1), from 6 weeks to 2 months after placement of fixed orthodontic appliances (T2), 3-4 weeks before orthognathic surgery (T3), 6 weeks after surgery (T4), and 1 year after surgery (T5). Control group data was collected at time points corresponding to patients' T0, T4, and T5. The results indicated that treatment produced improvements in patients' psychosocial well-being with regard to condition-specific quality of life, body image, and psychiatric symptoms. The results regarding patients' psychosocial well-being were equal to or even better than for controls 1 year after surgery.

In the future, prospective studies with both general measures of psychological well-being and condition-specific measures are needed to better understand the long- term effects of treatment. Furthermore, in addition to questionnaires, also structured diaries would bring new information about patients' emotions in their daily lives.
Original languageEnglish
Place of PublicationTampere
PublisherTampere University
ISBN (Electronic)978-952-03-1429-3
ISBN (Print)978-952-03-1428-6
Publication statusPublished - 2020
Publication typeG5 Doctoral dissertation (article)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume207
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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