Orthodontic treatment and its impact on psychological and social health: A review of the literature

Abstract

Misaligned teeth can result in a wide range of physical, psychological, and functional impairments influencing both oral and systemic health. This calls for the need for an early orthodontic intervention, which is crucial to prevent these consequences and improve both functions and cosmetic appearance. The objectives of the current article are to identify the role of orthodontic treatment in maintaining psychological well-being and social health, to ascertain the potential challenges in delivering orthodontic treatment, and propose specific recommendations to overcome identified challenges. Orthodontic treatment plays a defining role in improving the psychological well-being of the person, by augmenting self-confidence as they are more comfortable about their appearance. In conclusion, orthodontic treatment is quite effective in improving the psychological and social well-being of people with misaligned teeth. The need of the hour is to identify the existing challenges and provide effective treatment to aid in improving the quality of life of the affected person.

Introduction

Misaligned teeth can result in a wide range of physical, psychological, and functional impairments influencing both oral and systemic health.[1] The most common consequence is difficulty in maintaining oral hygiene as they are not easy to clean, which predisposes individuals to the risk of tooth decay, gum diseases, and halitosis.[1] On a functional note, depending on the extent of malocclusion, the affected person can have chewing problems, resulting in improper digestion and nutritional deficiencies in the long run.[2] In addition, people can also present with speech impairment, and undue strain on jaw muscles and temporomandibular joint, resulting in jaw pain and headaches.[3] Further, it can remarkably impact the self-esteem and ability of social interaction of the affected person, leading to the psychological distress, social withdrawal, and impairment of quality of life.[4] This calls for the need for an early orthodontic intervention, which is crucial to prevent these consequences and improve both functions and cosmetic appearance.[1,2,3,4] The objectives of the current article are to identify the role of orthodontic treatment in maintaining psychological well-being and social health, to ascertain the potential challenges in delivering orthodontic treatment, and propose specific recommendations to overcome identified challenges.

Orthodontic Treatment and Psychological Well- Being

Orthodontic treatment plays a defining role in improving the psychological well-being of the person, by augmenting self-confidence as they are more comfortable about their appearance.[4] People with misaligned teeth might feel self-conscious and anxious in social settings, and this treatment not only minimizes this discomfort but even gives a feeling of positive self-perception, fostering better mental health.[5] It is a possibility that children and adolescents with noticeable misalignment might be bullied and timely treatment can significantly reduce these negative experiences.[6] Further, the risk of depression, embarrassment, and low self-esteem can be avoided, leading to more confidence, emotional resilience, and long-term well-being.[4,5]

Orthodontic Treatment and Social Health

A person with a well-aligned smile leaves a positive first impression, promoting better social and professional relationships.[1] In continuation, a confident smile can improve job prospects, as appearance plays a role in hiring people and workplace interactions. It won’t be an understatement that people with straight teeth are more comfortable and relaxed, while engaging in social interactions.[4] Proper dental alignment can enhance speech clarity and reduce self-consciousness that is quite common among people with misaligned teeth as they are always worried whether other people understand their communication.[3] In-fact, people with well-aligned teeth have better social acceptance among peers, which also encourages friendliness and approachability.[1] Further, as orthodontic treatment improves the teeth alignment, the individual no longer avoids social interactions or remains anxious, and this significantly aids in fostering deeper social connections and improving overall quality of life.[4,5,6]

Identified Challenges and Potential Solutions

Orthodontic treatment has immense potential in improving the psychological well-being and social health of people, nevertheless, multiple challenges have been identified that are preventing people from accessing care.[7,8,9,10,11,12,13,14,15,16] This can be in the form of experiencing initial discomfort, self-consciousness, or being anxious as they adjust their braces or aligners.[7] This will require counselling and introducing patients to support groups to cope with discomfort and anxiety.[8] In addition, patients can be periodically reinforced about the long-term benefits, which will encourage a positive mindset.[8] Further, affordable patients can be encouraged to opt for aesthetic aligners to reduce visibility concerns.[7,8] The next concern is the expensive nature of the treatment, especially for patients who don’t have insurance support.[9] This concern can be handled by offering flexible payment plans to make treatment affordable and expanding insurance coverage for the inclusion of orthodontic procedures.[9,10] Another solution could be increasing access to subsidized programs of the government through which low-cost care can be provided to patients.[10]

The treatment duration varies from months to years depending on the extent of misalignment, requiring lots of patience and strict adherence to offered treatment.[8] This can be dealt with by using accelerated techniques (like vibration devices or self-ligating braces) to reduce that time of overall treatment.[11] Another approach would be to reinforce patients about the need for regular follow-ups during each encounter, and this can be further strengthened with the help of reminder applications or by providing some form of incentives to people who show better compliance.[12] The potential side effects (like pain, oral sores, difficulty in eating, speech alterations, etc.) have also been reported during the treatment course that can influence daily life.[13] This will require proper counselling about the common side effects, administration of medications for pain relief and other ailments, recommending a soft diet, and maintaining proper oral hygiene upon the initiation of treatment.[13,14]

There has been a risk of relapse after treatment, especially in those circumstances when retainers are not worn as prescribed.[15] Once again, a lot will depend upon the counselling and encouragement given to patients keeping in mind the importance and need of wearing these aligners.[15] In addition, regular post-treatment check-up appointments can be scheduled to monitor and prevent back shifting of teeth.[12] The final concern is the limited access to people who are living in rural settings, which will require the constitution of mobile clinics and outreach programs to bridge the gap.[9] Another approach would be to train general dentists to provide basic orthodontist care in such underserved areas.[16] Finally, the option of tele-orthodontics can be explored to ensure the delivery of virtual consultations and monitoring of recommended treatment.[16]

Conclusion

In conclusion, orthodontic treatment is quite effective in improving the psychological and social well-being of people with misaligned teeth. The need of the hour is to identify the existing challenges and provide effective treatment to aid in improving the quality of life of the affected person.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.