Prevalence of bullying in orthodontic patients and its impact on the desire for orthodontic therapy, treatment motivation, and expectations of treatment

Purpose This study aims at investigating the prevalence of bullying due to malocclusions in a sample of German orthodontic patients. Thereby, we analyzed the influence of self-reported bullying on initiation, desire and motivation, and expectations of orthodontic therapy. Patients and methods Patients completed questionnaires by themselves in three orthodontic practices (n= 1020, mean age 11.8 years). The sample was divided into three groups: (1) subjects bullied due to dentofacial features, (2) subjects bullied due to physical features, and (3) non-bullied control group. The effect of bullying on initiation, desire and motivation, and expectation from orthodontic treatment was assessed and compared between these groups. Results Overall prevalence of bullying was 23.7% with male subjects revealing significantly higher values than females (p< 0.001). Subjects from the dentofacial features group (6.3%) initiated orthodontic therapy themselves significantly more often than subjects from the physical features (17.4%; p= 0.030) and control group (76.3%; p< 0.001). The dentofacial features group reported significantly more frequently that `ugly teeth' were the major motivating factor to seek orthodontic treatment (40.4%). Within this group significantly higher mean scores for the expectation `keep me from being bullied' were obtained compared with subjects in the physical features (p< 0.001) or control group (p< 0.001). Conclusion This analysis demonstrated that bullying due to malocclusion impacts attitude towards orthodontic treatment. Victims who experienced bullying due to malocclusion initiate orthodontic treatment more often themselves and expect therapy to prevent them from experiencing further bullying.