ORTHODONTIC AND PSYCHOLOGICAL INTERSECTIONS: ASSESSING THE PSYCHIATRIC RELEVANCE OF MALOCCLUSION – A SYSTEMATIC REVIEW
Abstract
Introduction. Currently, mental health is one of the major social concerns. The etiology of psychiatric disorders is complex and multifactorial. Reduced self-esteem can be considered one of the contributing factors.
The aim of this review is to analyze available literature in order to identify a potential relationship between malocclusion and psychological disorders. It is postulated that dentofacial deformities may contribute to a reduced quality of life and, consequently, to the development of depression and other psychiatric conditions.
Materials and methods. A review of the literature available in the “PubMed” and „Google Scholar” databases was conducted. The search was performed using the following keywords: malocclusion, or-thognathic surgery, mental health, depression, anxiety, eating disorder
Results. According to most authors in available literature, malocclusion has an impact on mental health. It may increase the risk of depression or anxiety disorders and significantly reduce quality of life. Any delays in initiating treatment may also affect mental well-being, particularly in adolescents. A correlation was also found between malocclusion and poorer academic performance in children. Furthermore, attempts were made to examine the relationship between eating disorders (ED) and malocclusion. However, the findings remained unconclusive - study groups were to small and lacked diversity. Nevertheless, it can be noted that oral health issues, both orthodontic and carious, may increase discomfort during eating and in consequence negatively influence dietary habits.
Conclusions. Based on findings from available literature, a correlation between malocclusion and mental health can be inferred. However, the data remain inconsistent; therefore, more research is necessary to clarify this correlation.
References
Alsulaiman, O. A., Alghannam, M. I., Almazroua, D. M., Alamri, A. S., Shahin, S. Y., Nassar, E. A., Almasoud, N. N., Alsulaiman, A. T., & Alsulaiman, A. A. (2025). Mental Health and Malocclusion: A Comprehensive Review. Clinics and Practice, 15(3), 44. https://doi.org/10.3390/clinpract15030044
Ashari, A., Jo, L. W., Peh, J., & Oliver, G. (2025). Facial features of cartoon characters and their perceived attributes. Scientific Reports, 15(1), 1093. https://doi.org/10.1038/s41598-024-82677-0
Avramut, R., Talpos, S., Szuhanek, C., Pricop, M., Talpos, R., Hajaj, T., Nikolajevic-Stoican, N., Maracineanu, R., Ghircau-Radu, R., & Popa, M. (2023). Male and Female Discrepancies in Anxiety, Depressive Symptoms, and Coping Strategies among Orthognathic Patients: A Cross-Sectional Analysis. Journal of Clinical Medicine, 12(22), 7161. https://doi.org/10.3390/jcm12227161
Basha, S., Mohamed, R. N., Swamy, H. S., & Parameshwarappa, P. (2016). Untreated Gross Dental Malocclusion in Adolescents: Psychological Impact and Effect on Academic Performance in School. Oral Health and Preventive Dentistry, 14(1), 63–69. https://doi.org/10.3290/j.ohpd.a35003
Brucoli, M., Baena, R. R. Y., Boffano, P., & Benech, A. (2019). Psychological profiles in patients undergoing orthognathic surgery or rhinoplasty: A preoperative and preliminary comparison. Oral and Maxillofacial Surgery, 23(2), 179–186. https://doi.org/10.1007/s10006-019-00758-1
Burden, D. J., Hunt, O., Johnston, C. D., Stevenson, M., O’Neill, C., & Hepper, P. (2010). Psychological Status of Patients Referred for Orthognathic Correction of Skeletal II and III Discrepancies. The Angle Orthodontist, 80(1), 43–48. https://doi.org/10.2319/022709-114.1
Chiba, F. Y., Chiba, E. K., Moimaz, S. A. S., Matsushita, D. H., Garbin, A. J. Í., & Garbin, C. A. S. (2022). Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders. Dental Press Journal of Orthodontics, 27(2), e2220305. https://doi.org/10.1590/2177-6709.27.2.e2220305.oar
De Ávila, É. D., De Molon, R. S., Loffredo, L. C. M., Massucato, E. M. S., & Hochuli-Vieira, E. (2013). Health-related quality of life and depression in patients with dentofacial deformity. Oral and Maxillofacial Surgery, 17(3), 187–191. https://doi.org/10.1007/s10006-012-0338-5
Kettunen, S., Lappalainen, O.-P., Palotie, T., Furuholm, J., Auro, K., & Snäll, J. (2023). Psychiatric morbidity is common in orthognathic surgery patients—A retrospective study. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 135(6), 716–723. https://doi.org/10.1016/j.oooo.2022.09.009
Koskela, A., Neittaanmäki, A., Rönnberg, K., Palotie, A., Ripatti, S., & Palotie, T. (2021). The relation of severe malocclusion to patients’ mental and behavioral disorders, growth, and speech problems. European Journal of Orthodontics, 43(2), 159–164. https://doi.org/10.1093/ejo/cjaa028
Koukou, M., Javed, F., & Michelogiannakis, D. (2021). Is There an Association Between Fixed Orthodontic Treatment and Initiation of Eating Disorders? A Review of Currently Available Evidence. Frontiers in Oral Health, 2, 707040. https://doi.org/10.3389/froh.2021.707040
Kovalenko, A., Slabkovskaya, A., Drobysheva, N., Persin, L., Drobyshev, A., & Maddalone, M. (2012). The association between the psychological status and the severity of facial deformity in orthognathic patients. The Angle Orthodontist, 82(3), 396–402. https://doi.org/10.2319/060211-363.1
Li, Y., Yang, M., Guo, B., Yang, L., Xiaotian, C., Zhou, J., Wang, K., Wang, S., Tang, P., & Dong, S. (2025). Delayed orthodontic care and its association with depression among Chinese adolescents: A cross-sectional study. Frontiers in Psychiatry, 16, 1541160. https://doi.org/10.3389/fpsyt.2025.1541160
Miyachi, H., Wake, H., Tamaki, K., Mitsuhashi, A., Ikeda, T., Inoue, K., Tanaka, S., Tanaka, K., & Miyaoka, H. (2007). Detecting mental disorders in dental patients with occlusion‐related problems. Psychiatry and Clinical Neurosciences, 61(3), 313–319. https://doi.org/10.1111/j.1440-1819.2007.01657.x
Nicodemo, D., Pereira, M. D., & Ferreira, L. M. (2008). Self-esteem and depression in patients presenting angle class III malocclusion submitted for orthognathic surgery. Medicina Oral, Patologia Oral Y Cirugia Bucal, 13(1), E48-51.
Rafiei, E., Yassaei, S., Ghanezadeh, M., & Eshkevarjiri, A. (2020). Depression in Orthodontic Patients. Journal of Evolution of Medical and Dental Sciences, 9(39), 2880–2883. https://doi.org/10.14260/jemds/2020/630
Sebastiani, A. M., Gerber, J. T., Bergamaschi, I. P., Petinati, M. F., Meger, M. N., Costa, D. J. D., Brancher, J. A., Küchler, E. C., & Scariot, R. (2021). Individuals requiring orthognathic surgery have more depression and pain than controls. Brazilian Oral Research, 35, e091. https://doi.org/10.1590/1807-3107bor-2021.vol35.0091
Silva, L. C. D., Vedovello, S. A. S., Vedovello Filho, M., Meneghin, M. D. C., Ambrosano Bovi, G. M., & Degan, V. V. (2021). Anxiety and oral habits as factors associated with malocclusion. CRANIO®, 39(3), 249–253. https://doi.org/10.1080/08869634.2019.1633492
Stasyuk, O. A., Kuroiedova, V., Sedykh, K., Sokolohorska-Nykina, Y., Vyzhenko, Y., Halych, L., & Korobov, P. (2025). Сonnection and assessment of the psychological status of orthodontic patients with various types of malocclusion. Wiadomości Lekarskie, 2, 336–341. https://doi.org/10.36740/WLek/197129
Vučić, L., Glišić, B., Vučić, U., Drulović, J., & Pekmezović, T. (2020). Quality of Life Assessment in Patients with Malocclusion Undergoing Orthodontic and Orthognathic Treatment. Slovenian Journal of Public Health, 59(3), 137–145. https://doi.org/10.2478/sjph-2020-0018
Views:
27
Downloads:
8
Copyright (c) 2025 Karolina Stępień, Marta Danuta Cendrowska, Łukasz Brzost, Beata Choromańska, Julia Maszewska, Szymon Milnerowicz, Julia Procyk, Barbara Ponitka, Justyna Berent, Paulina Rzepa, Aleksandra Klukowska, Wiktoria Szumlińska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
