Psychological adjustment and impact of facial and dental appearance on adult patients with craniofacail anomalies and their expectations while seeking orthodontic treatment

Abstract

Objectives: The objectives of this study were to assess the psychological adjustment in relation to facial appearance and dental appearance in patients with craniofacial anomalies. Further to evaluate the expectations of this patient group from orthodontic treatment. Method: The study was conducted in two steps First translation and Validation of the three psychometric instruments- DAS59, PIDAQ and PEOTQ into Nepali and then the main study using these valid questionnaires. The study Design was Cross-sectional. The sampling frame was adult with congenital craniofacial anomalies visiting the department of orthodontics at BP Koirala Institute of health sciences, Dharan, Nepal. One hundred and two patientsarticipated in the study. All the patients were administered with Nepali DAS, Nepali PIDAQ and Patients expectation of orthodontic treatment questionnaire. Results: The reliable and valid Nepali version of DAS59, PIDAQ and PEOTQ were developed with excellent reliability and validity. There was a significant difference between PIDAQ (mean score for patients is 33.25±9.45 while for controls is 27.52±5.67, plt0.001) and DAS59 scores (mean score for patients is 159.16±31.54 while for controls is 77.64±6.57, plt0.001). The total PIDAQ score was significantly higher in females as compared to males (Mean, M=31.25±7.96, F=35.34±10.45) .DAS scores were not associated with gender. There was no association of place of residence with PIDAQ and DAS59 scores in patients. When comparison was made in terms of expectation from orthodontic treatment there were significant differences between patients and controls for various items. Conclusions: There is a significant psychological impact of altered facial and dental appearance in patients with craniofacial anomalies. There are considerable differences among the expectations of craniofacial anomalies patients and controls.