Impact of periodontitis and orthodontic treatment on dental anxiety and self-esteem

Background and aims: The concept of dental anxiety related to patients' concerns about the psychosocial impact of their dental appearance has been demonstrated to have a significant influence on the initiation and adherence to certain dental treatments, particularly in adult patients with periodontitis undergoing orthodontic treatment. This study analyze the relationship between dental appearance and self-esteem and anxiety in adult periodontitis patients undergoing orthodontic treatment. Methods: For the study were enrolled 38 patients, divided into test and control groups. The impact of dental appearance was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). State anxiety was assessed with the State Anxiety Inventory (STAI-S) and self-esteem with Rosenberg's self-esteem scale. Results: In both groups, self-esteem correlates negatively with all dimensions of dental appearance impact except for the positive dental self-confidence dimension, where all correlations were positive. Anxiety correlates positively with social impact, psychological impact and aesthetic concern, although it maintains no significant correlations with dental self-confidence. Nevertheless, in patients undergoing orthodontic treatment, anxiety plays a mediating role between dental impact dimensions and self-esteem, whilst for the control group anxiety only plays a mediator role between psychological impact and self-esteem. Conclusion: Anxiety plays a fundamental role in the effect of perceived dental impact on self-esteem in adult patients undergoing orthodontic treatment. These results have important practical implications for the design of bio-psycho-social intervention programs that contemplate cognitive-affective variables as an essential part of orthodontic treatment in adults with periodontitis.