Perception of facial and dental asymmetries and their impact on oral health-related quality of life in children and adolescents.

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The aim of this study was to investigate the perception of facial and dental asymmetries in children and adolescents and how these asymmetries affect their psychosocial and emotional well-being. The study included 66children and adolescents (7-15years) with adeviation between the maxillary and mandibular dental midlines of > 0.5 mm. The soft tissues of the face were scanned using stereophotogrammetry. Psychosocial and emotional impairments were assessed using the German version of the Child Perceptions Questionnaire (CPQ-G8-10 and 11-14). The mean midline deviation of the study group was 2.3 mmwith no significant gender differences. Girls perceived facial asymmetry significantly more often than boys (p < 0.01). However, stereophotogrammetry showed no significant differences in facial morphology between subjects who perceived their face as asymmetrical and those who perceived it as symmetrical. Interestingly, we observed asignificant correlation between the deviation of the dental midline and the lateral displacement of gonion (p < 0.05) and cheilion (p < 0.01). Psychosocial and emotional impairment was significantly higher in girls than in boys (p < 0.05). However, there was no significant correlation with the measured facial asymmetries. In contrast, the CPQ subscale score was 2.68points higher in individuals with adental midline shift ≥ 3 mm (p < 0.01), independent of age and gender. Although girls perceived facial asymmetries more strongly than boys do, this perception could not be objectified by extraoral measurements. Amidline shift of 3 mm or more had anegative impact on the oral health-related quality of life of affected children and adolescents.