Can a malocclusion cause bullying?

orthodontics In summary

Join me for a summary exploring bullying and its relationship with malocclusion, with a contemporary review of evidence showing the psychological effects various malocclusions can cause young people. This podcast is a summary of Andrew DiBiase’s lecture last year at the British Orthodontic Conference. Andrew’s research explores what factors moderate bullying, and what factors can be protective against bullying.

Introduction

· Nearly 1 in 3 patients report teasing or fear of teasing as a motivating factor for orthodontic treatment Bauss 2023 AJODO

· 1 in 7 patients attending our clinics are bullied Seehra et al., 2011

· Most upsetting feature of bullying teeth 60.7% Shaw

· 13, 387 teenagers 25% report bullying

o Around 7% related to teeth

Definition of bullying: Olweus 1984

· Unprovoked and sustained campaign of aggression, towards someone in order to hurt them

· Student exposed repeatedly to negative action on the part of one or more students

o Harm, imbalance of power, organised, repetitive, harm experienced

Who gets bullied and how?

· Younger more – 10 year olds 22%, 15 year olds 7%

· Girls are greater than boys by 5%

· Boys low athletic competence

o Judged on homour as well Langlois 2000

· Girls appearance

o We do judge girls on physical appearance Langlois 2000

o 80% verbal - Cyber bullying – doest stop at the school gate

Consequences of bullying

· Short term and long term effects

o Poorer academic performance

o Crime

o Self harm

§ 26% within young population and teeth occupying the reason in 1 in 5 young people Bitor 2022 AJODO

o Low self esteem

o Structural changes, medulla – related to fear (peer victimisation and its impact on adolescent brain)

What features are more likely to result in bullying Dibiase, Jad Seehra 2014

· Greater rate of bullying

· 2 div 1: 18%

· Increased overjet 16% Tristão SR 2020

· Deep overbite

· Missing teeth, anterior spacing

· IOTN AC 9 and 10

· Regression – younger worse

· Low athletic competence p 0.019

Conclusions

· Relationship between bullying and severe malocclusion

· Schoolchildren who report being bothered by their teeth report being lonelier at school and lower self-esteem

· Malocclusion has a greater impact on females than males

· Malocclusion and peer relations is moderated by self-esteem in girls, but not boys

· Good peer relations protect against the negative impact of malocclusion in girls with low or average self-esteem