What does this research mean for the field?

Greater malocclusion severity is independently associated with higher social anxiety and lower self-esteem in adolescents. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the relationship between malocclusion severity and levels of social anxiety and self-esteem in adolescents, and to explore variables associated with variation in these psychological outcomes.

September 14, 2026MedicineOpen Access

Association between malocclusion severity and social anxiety, self-esteem in adolescents

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Authors

WZWanjun ZhangZhengzhou University YMYongping MaBaoding People's Hospital YGyanming GuoBaoding People's Hospital

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Implication

Cross-sectional study finds severe malocclusion links to higher social anxiety and lower self-esteem in adolescents, highlighting the value of psychological screening during orthodontic care.

Key Points

To evaluate the relationship between malocclusion severity and levels of social anxiety and self-esteem in adolescents, and to explore variables associated with variation in these psychological outcomes.
Cross-sectional study of 190 adolescents aged 12 to 18 years recruited from a hospital orthodontic department between June 2023 and December 2025.
Malocclusion severity was classified using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC), while psychological variables were measured using the Liebowitz Social Anxiety Scale and the Rosenberg Self-Esteem Scale alongside sociodemographic and psychosocial covariates.
Adolescents with severe malocclusion scored significantly higher in social anxiety (48.6 ± 15.8) than those with moderate (33.7 ± 12.5) or mild (28.4 ± 10.2) malocclusion (P < .001), with 64.9% scoring above the clinical risk threshold.
Self-esteem scores were significantly lower in the severe malocclusion group (26.3 ± 6.2) compared to moderate and mild groups (P < .001).
Multivariable linear regression confirmed severe malocclusion was independently associated with higher social anxiety (β = 0.52, P < .001) and lower self-esteem (β = −0.41, P < .001), with stronger associations observed in females, teased adolescents, and those reporting high appearance concern.

Cite This Study

Zhang et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b2c70926e14a848b14fa https://doi.org/10.1097/md.0000000000050445

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Implication

Cross-sectional study finds severe malocclusion links to higher social anxiety and lower self-esteem in adolescents, highlighting the value of psychological screening during orthodontic care.

Association between malocclusion severity and social anxiety, self-esteem in adolescents

Discussion

Member takes

Implication

Key Points

Cite This Study

Association between malocclusion severity and social anxiety, self-esteem in adolescents

Discussion

Member takes

Implication

Key Points

Cite This Study

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Also Consider