The Cardiff dental study: A 20-year critical evaluation of the psychological health gain from orthodontic treatment

Hdl Handle:
http://hdl.handle.net/10142/35592
Title:
The Cardiff dental study: A 20-year critical evaluation of the psychological health gain from orthodontic treatment
Authors:
Kenealy, Pamela; Kingdon, Anne; Richmond, Stephen; Shaw, William
Abstract:
Objectives: Despite the widespread belief that orthodontics improves psychological well-being and self-esteem, there is little objective evidence to support this (Kenealy et al., 1989a; Shaw, O'Brien, Richmond, & Brook, 1991). A 20 year follow-up study compared the dental and psychosocial status of individuals who received, or did not receive, orthodontics as teenagers. Design: A prospective longitudinal cohort design with four studies of the effect of orthodontic treatment. Secondary analysis of outcome data incorporated orthodontic need at baseline and treatment received in a 2 × 2 factorial design. Methods: A multidisciplinary research programme studied a cohort of 1,018, 11-12 year old participants in 1981. Extensive assessment of dental health and psychosocial well-being was conducted; facial and dental photographs and plaster casts of dentition were obtained and rated for attractiveness and pre-treatment need. No recommendations about orthodontic treatment were made, and an observational approach was adopted. At the third follow-up 337 (30-31 year olds) were re-examined in 2001. Results: Participants with a prior need for orthodontic treatment as children who obtained treatment demonstrated better tooth alignment and satisfaction. However when self-esteem at baseline was controlled for, orthodontics had little positive impact on psychological health and quality of life in adulthood. Lack of orthodontic treatment where there was a prior need did not lead to psychological difficulties in later life. Dental status alone was a weak predictor of self-esteem at outcome explaining 8% of the variance. Self-esteem in adulthood was more strongly predicted (65% of the variance) by psychological variables at outcome: perception of quality of life, life satisfaction, self-efficacy, depression, social anxiety, emotional health, and by self-perception of attractiveness. Conclusions: Longitudinal analysis revealed that the observed effect of orthodontic treatment on self esteem at outcome was accounted for by self esteem at baseline. Prior need for treatment assessed in childhood made a small contribution to the prediction of self-esteem 20 years later in adulthood. Dental status in adulthood, whilst statistically significant, appeared to be of minor importance in a model that included other psychological variables. When prior need for treatment was taken into account there was little objective evidence to support the assumption that orthodontics improves long-term psychological health.
Citation:
British Journal of Health Psychology (2007), 12, 17-49
Publisher:
The British Psychological Society
Journal:
British Journal of Health Psychology
Issue Date:
2007
URI:
http://hdl.handle.net/10142/35592
DOI:
10.1348/135910706X96896
Additional Links:
http://bpsoc.publisher.ingentaconnect.com/content/bpsoc/bjhp/2007/00000012/00000001/art00002;jsessionid=275rt00cf5pmq.alexandra; http://www.bpsjournals.co.uk/journals/bjhp/
Type:
Article
Language:
en
ISSN:
1359107X; 00000000
Sponsors:
This research was funded by the NHS Research and Development Programme RDO/90/13 (PDC97-356)(98-02)
Appears in Collections:
Department of Psychology Collection

Full metadata record

DC FieldValue Language
dc.contributor.authorKenealy, Pamela-
dc.contributor.authorKingdon, Anne-
dc.contributor.authorRichmond, Stephen-
dc.contributor.authorShaw, William-
dc.date.accessioned2008-08-14T14:36:13Z-
dc.date.available2008-08-14T14:36:13Z-
dc.date.issued2007-
dc.identifier.citationBritish Journal of Health Psychology (2007), 12, 17-49en
dc.identifier.issn1359107X-
dc.identifier.issn00000000-
dc.identifier.doi10.1348/135910706X96896-
dc.identifier.urihttp://hdl.handle.net/10142/35592-
dc.description.abstractObjectives: Despite the widespread belief that orthodontics improves psychological well-being and self-esteem, there is little objective evidence to support this (Kenealy et al., 1989a; Shaw, O'Brien, Richmond, & Brook, 1991). A 20 year follow-up study compared the dental and psychosocial status of individuals who received, or did not receive, orthodontics as teenagers. Design: A prospective longitudinal cohort design with four studies of the effect of orthodontic treatment. Secondary analysis of outcome data incorporated orthodontic need at baseline and treatment received in a 2 × 2 factorial design. Methods: A multidisciplinary research programme studied a cohort of 1,018, 11-12 year old participants in 1981. Extensive assessment of dental health and psychosocial well-being was conducted; facial and dental photographs and plaster casts of dentition were obtained and rated for attractiveness and pre-treatment need. No recommendations about orthodontic treatment were made, and an observational approach was adopted. At the third follow-up 337 (30-31 year olds) were re-examined in 2001. Results: Participants with a prior need for orthodontic treatment as children who obtained treatment demonstrated better tooth alignment and satisfaction. However when self-esteem at baseline was controlled for, orthodontics had little positive impact on psychological health and quality of life in adulthood. Lack of orthodontic treatment where there was a prior need did not lead to psychological difficulties in later life. Dental status alone was a weak predictor of self-esteem at outcome explaining 8% of the variance. Self-esteem in adulthood was more strongly predicted (65% of the variance) by psychological variables at outcome: perception of quality of life, life satisfaction, self-efficacy, depression, social anxiety, emotional health, and by self-perception of attractiveness. Conclusions: Longitudinal analysis revealed that the observed effect of orthodontic treatment on self esteem at outcome was accounted for by self esteem at baseline. Prior need for treatment assessed in childhood made a small contribution to the prediction of self-esteem 20 years later in adulthood. Dental status in adulthood, whilst statistically significant, appeared to be of minor importance in a model that included other psychological variables. When prior need for treatment was taken into account there was little objective evidence to support the assumption that orthodontics improves long-term psychological health.en
dc.description.provenanceSubmitted by Pamela Kenealy (p.kenealy@roehampton.ac.uk) on 2008-08-01T01:33:29Z No. of bitstreams: 1 BJHP Outcome paper 2007.pdf: 273976 bytes, checksum: 7a2626daf29dd7f1bbe5d807cc81ab21 (MD5)en
dc.description.provenanceApproved for entry into archive by Pat Simons(p.simons@roehampton.ac.uk) on 2008-08-14T14:36:12Z (GMT) No. of bitstreams: 1 BJHP Outcome paper 2007.pdf: 273976 bytes, checksum: 7a2626daf29dd7f1bbe5d807cc81ab21 (MD5)en
dc.description.provenanceMade available in DSpace on 2008-08-14T14:36:13Z (GMT). No. of bitstreams: 1 BJHP Outcome paper 2007.pdf: 273976 bytes, checksum: 7a2626daf29dd7f1bbe5d807cc81ab21 (MD5) Previous issue date: 2007en
dc.description.sponsorshipThis research was funded by the NHS Research and Development Programme RDO/90/13 (PDC97-356)(98-02)en
dc.language.isoenen
dc.publisherThe British Psychological Societyen
dc.relation.urlhttp://bpsoc.publisher.ingentaconnect.com/content/bpsoc/bjhp/2007/00000012/00000001/art00002;jsessionid=275rt00cf5pmq.alexandraen
dc.relation.urlhttp://www.bpsjournals.co.uk/journals/bjhp/en
dc.subjectCardiff Dental Studyen
dc.subjectLongitudinal studyen
dc.subjectPsychological health gainen
dc.subjectorthodontic treatmenten
dc.subjectCritical evaluation of orthodonticsen
dc.subjectMultidisciplinary researchen
dc.subjectProspective cohort designen
dc.subject20 year follow-up studyen
dc.titleThe Cardiff dental study: A 20-year critical evaluation of the psychological health gain from orthodontic treatmenten
dc.typeArticleen
dc.identifier.journalBritish Journal of Health Psychologyen
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