Child Perceptions Questionnaire Scores Research Articles

The impact of craniofacial and dental osteogenesis imperfecta manifestations on oral health-related quality of life of children and adolescents.

Craniofacial and oral manifestations of Osteogenesis Imperfecta (OI) can affect the functioning of the stomatognathic system and impact the patient's quality of life. The objective of the study was to evaluate the relationship between craniofacial and oral manifestations and the Oral Health-related Quality of Life (OHRQoL) of OI children and adolescents. A total of 30 OI patients aged eight to fourteen years old followed up at the Oral Care Center for Inherited Diseases were enrolled in the research. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ) for eight to ten-year-olds (CPQ8-10) and 11 to 14-year-olds (CPQ11-14). The relationship between the OHRQoL index and its assessment domains, OI types, and the presence of dentinogenesis imperfecta (DI), class III malocclusion, and dental agenesis were evaluated. The median CPQ score of patients was 5, and there was no significant difference in OHRQoL between children and adolescents, nor associated with the disease severity or the presence of DI. The oral manifestations evaluated did not directly impact the patients' OHRQoL. The study demonstrated that the perception of OHRQoL is similar for both adolescents and children. The oral symptom was the most relevant domain for the index among patients aged eight to fourteen years while the emotional well-being was the most impacted. this study makes contributions by indicating that addressing dental care for children and adolescents with OI is important in clinical management and better OHRQoL for this population.

Tobacco use and oral health related quality of life among Indian adolescents.

The present study was conducted to assess tobacco use and its effect on Oral Health-Related Quality of Life (OHRQoL) in Indian adolescents. The present study was conducted on 1,600 13-14 year old adolescents from the schools of Modinagar, western Uttar Pradesh, India selected using stratified random sampling technique. OHRQoL was assessed using Hindi version of Child Perceptions Questionnaire (CPQ). Information regarding demographic, socioeconomic and oral health measures was also collected from the study participants. Tobacco use was assessed through questions derived from Global Youth Tobacco Survey (GYTS) questionnaire. Influence of predictor variables on tobacco use was evaluated using multilevel Poisson regression model. The tobacco use among the study population was 8.1 % and CPQ scores were 9.15±0.32. Adolescents who used tobacco had worse OHRQoL scores. Low socioeconomic status, presence of dental caries, absence of regular dental visits (last 6months) were associated with increased regular consumption of tobacco products. The findings of the present study play an important role in planning public health strategies to improve adolescent OHRQoL and reduce tobacco use.

Changes in oral health-related quality of life after treatment of molar incisor hypomineralisation using Glass Hybrid Restorations.

To assess the changes in children's oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry, Istanbul, Turkey.. Children aged 11-14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children's MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ11?14) prior to their dental treatment and 6 months after the treatment. Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 ±1.02 years. The overall CPQ score ranged from 3-83 (average 33.27 ± 16.46) at baseline and 0-61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation.

Hat die Molaren-Inzisiven-Hypomineralisation einen Einfluss auf die mundgesundheitsbezogene Lebensqualität betroffener Kinder?

Background: In dentistry, the assessment of oral health-related quality of life (OHRQoL) has gained considerable importance in clinical practice and research in recent years. In pediatric dentistry, the clinical picture of molar incisor hypomineralization (MIH) has also been the focus of attention for some time due to a steady increase in prevalence. The aim of this study was to determine the influence of MIH on OHRQoL using the Child Perceptions Questionnaire (CPQ) 8-10.Methods: Children aged 6-11 years diagnosed with MIH were asked to complete the German version of the CPQ8-10 to measure OHRQoL. MIH was classified according to the criteria of the EAPD (European Academy of Paediatric Dentistry) and the MIH-TNI (MIH-Treatment Need Index). Children were recruited from the Competence Center for Mineralization Disorders at the Medical University of Vienna.Results: 139 children aged 6-11 years (52.5 % female; 47.5 % male) were included in the study. The average CPQ score was 8.1 (± 7.3). Children with a mild form of MIH (opacities) showed a better OHRQoL (7.6 [± 7.1]) than children with a more severe form (posteruptive enamel breakdown [8.9 (± 7.3]). Conclusion: The results showed that MIH negatively impacts the OHRQoL of affected children.

Relationships of Dental Caries and Malocclusion with Oral Health-Related Quality of Life in Lithuanian Adolescents Aged 15 to 18 Years: A Cross-Sectional Study.

There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged 15 to 18 years. A survey in a representative sample of adolescents included a clinical examination to assess dental health status using the DMFT (Decayed, Missing, and Filled Permanent Teeth) index, and malocclusion using the Index of Complexity, Outcome, and Need (ICON). The Child Perceptions Questionnaire (CPQ) was used to evaluate respondents’ OHRQoL. Negative binomial regression was fitted to associate the clinical variables with the CPQ scores. A total of 600 adolescents were examined. The overall mean DMFT score was 2.7. A need for orthodontic treatment was detected among 27.7% of adolescents. Subjects with caries lesions (DMFT > 3) had higher CPQ scores in the domains of functional limitations and social wellbeing (relative risks were 1.35 (95% confidence interval: 1.09–1.67) and 1.30 (1.03–1.64), respectively), while subjects with a need for orthodontic treatment (ICON > 43) had higher CPQ scores in the domains of emotional wellbeing and social wellbeing (relative risks were 1.81 (1.40–2.22), and 1.69 (1.34–2.14), respectively). It was concluded that both dental caries and malocclusion have negative relationships with OHRQoL in adolescents above 15 years, but their effects occur differently in each OHRQoL domain.

Oral health and school performance in a group of schoolchildren from the Federal District, Brazil.

To evaluate whether an association exists between school performance, quality of life, dental caries, and dental pain in children between 6 and 8 years of age. All 6- to 8-year-old children enrolled in the second year of the six public schools in Paranoá-FD were invited to participate in this cross-sectional study. In total, 374 consented. Dental caries was recorded according to the Caries Assessment Spectrum and Treatment (CAST) index by two trained examiners. Dental pain was assessed during clinical examination. The Child Perceptions Questionnaire (CPQ) was used to assess the oral health-related quality of life, and sociodemographic data were collected. The child's school performance was measured through Provinha Brasil according to the regulations of the Ministry of Education. Descriptive statistics, bivariate analysis, and a multivariate regression model were used for data analysis. 185 boys and 189 girls participants with a mean age of 7.2 (±0.5) years were included in the study. The prevalence of dentin carious lesions for this group was 40.6 and 49.2 percent, including enamel-only lesions. The prevalence of dental pain was 2.8 percent. A high performance in reading (63.6 percent) and in mathematics (79.4 percent) was observed and were not associated with the presence of cavitated dentin carious lesions or dental pain. A significant association was found between school performance and the final CPQ score. School performance as measured by the Provinha Brasil examination was not associated with carious lesions or dental pain. Students with lower school performance had higher CPQ scores.

Translation and validation of the French version of the Child Perceptions Questionnaire for children aged from 8 to 10 years old (CPQ 8-10).

BackgroundThe Child Perceptions Questionnaire (CPQ) belongs to a set of questionnaires measuring Child Oral Health Quality of Life (COHQOL). The CPQ is used to collect the perceptions of children on the impact of oral diseases on their quality of life. This cross-sectional study was aimed to translate the CPQ8-10 into French language and evaluate its psychometric properties.MethodsThe translation process complied with international recommendations. The final French version was tested on children aged 8-10 years old attending consultations in a Parisian public hospital and divided into three groups: children with oral-facial clefts, children with dental anomalies linked to a rare disease other than clefts and children presumed to be healthy and without anomalies. The internal consistency relating to the reliability of CPQ8-10 was evaluated by Cronbach’s alpha. The intra-class correlation was used to measure reproducibility at the test-retest level. Construct validity was evaluated by Spearman’s correlation and tested using factor analysis. The discriminant validity was assessed using Kruskall Wallis test. Criterion validity was calculated using Spearman’s correlation.ResultsOne hundred seventy-six children participated in this study. During the translation process, minor changes were made. The French version showed good reliability with a Cronbach’s alpha of 0.81 for the total scale. The ICC of the test-retest was excellent (=0.90) demonstrating good reproducibility. The construct validity was acceptable with a statistically significant correlation between the scores of the French-CPQ8-10 and the evaluation of oral health (r = 0. 381 and p < 0.001) and its impact on oral health quality of life (r = 0.363 and p < 0.001). The loading weights obtained in the Exploratory Factor Analysis showed that this model revealed seven factors with eigenvalue greater than 1, explaining the 63,89% of the cumulative variance. The differences observed between the scores of the study groups revealed good discriminant validity. Criterion validity was supported by significant association between CPQ scores and pain.ConclusionThe French-CPQ8-10 is reliable and valid for use with the children of this age group.

Cross-cultural adaptation and validation of the child perceptions questionnaire (CPQ11\u201314) among children in Lebanon

The aim of this study was to assess the reliability, reproducibility, and convergent and discriminant validity of the Child Perceptions Questionnaire (CPQ)11–14 in a group of 11–14-year-old Lebanese children. This was a cross-sectional study. Children aged between 11 and 14 were recruited between March and June 2014 from five schools in Beirut and the surrounding region: a central public school and four private schools. Data were collected from self-administered questionnaires and a clinical intraoral examination was conducted. In addition to the CPQ11–14, the questionnaires included socio-demographic characteristics, questions about each child’s perception of oral and general health status and dental aesthetics, satisfaction with dental conditions and the need for dental treatment. The oral examination included the number of teeth affected by caries (D3 level), fillings, the number of missing teeth and an orthodontic assessment of malocclusion using the Dental Aesthetic Index (DAI). The final number of children included was 693 and their mean age was 13.14 ± 0.82 years; 54.4% were boys. The mean CPQ score was 15.60 ± 14.55, range 0 to 110. Cronbach’s alpha of the global CPQ score was 0.880 and varied from 0.897 to 0.908. The reproducibility of the overall CPQ score was good, as was the CPQ score for each of the four domain scores (ICC > 0.682; p < 0.001). Higher CPQ scores were found for children with self-perceived poor general health (p < 0.001) or oral health (p < 0.001), unsatisfactory oral health (p < 0.001), need for dental treatment (p < 0.001) and perception of dental aesthetic problems (p < 0.001). Multiple linear regression models showed that the recruitment setting, the DMFT index and the DAI index were significantly associated with the CPQ global score (p = 0.004). The Lebanese version of the CPQ11–14 showed excellent psychometric properties and was able to distinguish children with different oral conditions. Additional longitudinal studies should be performed to test the properties of this questionnaire in clinical samples.

Association Between the Severity of Malocclusion, Assessed by Occlusal Indices, and Oral Health Related Quality of Life: A Systematic Review and Meta-Analysis.

To assess whether different levels of malocclusion have different effects on the oral health-related quality of life (OHRQoL) and which domains of OHRQoL could be affected. Nine electronic databases were searched. To make studies comparable, studies using the Child Perceptions Questionnaire (CPQ) to measure OHRQoL, and the Dental Aesthetic Index, Index of Orthodontic Treatment Need, and Index of Complexity, Outcome and Need to measure malocclusion were selected for systematic review. Meta-analysis was performed to calculate the weighted mean scores of CPQ. The two independent samples t-test was used to detect whether different severity groups of malocclusion have different CPQ scores. A total of 22 studies were included in this review and 6 were included in the meta-analysis. Most studies used a cross-sectional design and convenience sampling. Meta-analysis showed that the weighted mean scores of CPQ increased with malocclusion severity. The t-test showed nearly all levels of malocclusion affected the domains of functional limitation and social well-being; only very severe malocclusion affected the domains of oral symptoms, emotional well-being and the overall OHRQoL (p < 0.05). When OHRQoL was assessed by CPQ11-14 and malocclusion was assessed by orthodontic indices, children with malocclusion could have oral functional limitations and worse social lives; children with very severe malocclusion could further develop oral symptoms and had worse emotional experiences. Future longitudinal population-based studies would be helpful to confirm these results.

The impact of tooth agenesis on oral health-related quality of life in children

The purpose of this cross-sectional survey was to evaluate the psychosocial impact of tooth agenesis in children and to investigate the potential influence of gender, socioeconomic status, severity of tooth absence, and the number of retained primary teeth on their quality of life. A total of 86 children (36 male, 50 female) with tooth agenesis, aged 11-14 years were recruited from the Birmingham Dental Hospital, United Kingdom. Thirty subjects with a complete dentition and having a low treatment need acted as controls. Children completed the validated Child Perceptions Questionnaire (CPQ) and their parents completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ). The median number of missing teeth in the sample population was 6. There were significant differences in the oral symptoms, functional limitations and the social and emotional well-being reported between the agenesis and control groups. The overall CPQ scores were significantly higher in children with tooth agenesis (P<0·001). No significant correlation was detected between the number of missing teeth and the quality of life score. There was no influence found on the CPQ score from gender, socioeconomic status, the site of agenesis or the presence of retained primary teeth. There was moderate correlation between parental and child reported quality of life. Tooth agenesis can have a significant impact on the quality of life of children, resulting in oral symptoms, functional limitation and also affecting emotional and social well-being. This does not appear to be related to the number of missing teeth. This study has implications for our understanding of the effect of tooth absence on the quality of life of children and their parents and addressing these reported impacts may help to improve patient satisfaction.

Oral health-related quality of life among children undergoing cancer therapy.

e12006 Background: Despite much interest in oral complications in cancer patients and studies reporting their prevalence, aetiology and management, there has been little understanding of how they affect the patients and the family. The aim of this study was, therefore, to assess the impact of oral complications on life quality for children undergoing cancer therapy. Methods: Seventy 6 - 14 years old paediatric patients undergoing cancer therapy in the Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong participated in this study. A clinical examination of the dentition and oral soft tissues was performed using criteria suggested by the World Health Organization. Clinical examination evaluated the status of: i) dental caries (DMFT/dmft Index), ii) periodontal health (CPI Index), iii) infection, such as herpes and candidiasis, iv) thrombocytopathy in the form of oral petechiae and spontaneous gingival bleeding, v) xerostomia, and vi) mucositis (WHO Mucositis Scale). Two questionnaires were filled by the children and their parents: i) the Child Perceptions Questionnaire (CPQ), and ii) a questionnaire contained simple closed questions to collect the information of oral health habits of children and demographic data from the parents. Results: Higher CPQ scores were found in children with mucositis (p &lt; 0.001), dental caries (p &lt; 0.001), children who were born in mainland China (p &lt; 0.05), or parents of lower education or income level (p &lt; 0.05). In multiple regression analyses, mucositis and dental caries were the significant predictors (p &lt; 0.001) of the higher CPQ scores among the various parents and children characteristics collected in this survey. Conclusions: The findings of this study showed that paediatric cancer patients with mucositis and dental caries had poorer oral health-related quality of life.

Level of agreement between self‐administered and interviewer‐administered CPQ8–10 and CPQ11–14

The aim of the present study was to assess the psychometric properties and level of agreement between the self-administered and interviewer-administered Child Perceptions Questionnaire (CPQ) for children between 8 and 10 years of age (CPQ(8-10) ) and between 11 and 14 (CPQ(11-14) ) years of age. A randomized cross-over study was carried out, involving 180 children (Group 1 - 90 children between 8 and 10; Group 2 - 90 children between 11 and 14 years of age) in the state of Minas Gerais, Brazil. All children completed both administration modes of the CPQ; half of each group received interviewer-administered mode first [Subgroup A (CPQ(8-10) n = 45) and Subgroup C (CPQ(11-14) n = 45)], and the other half performed the self-administered mode first [Subgroup B (CPQ(8-10) n = 45) and Subgroup D (CPQ(11-14) n = 45)]. Test-retest reliability of each mode of administration was tested on 60 children (30 for CPQ(8-10) ; 30 for CPQ(11-14) ), who were not included in the other analyses. The level of agreement between scores on the self-administered and interviewer-administered versions of the CPQ(8-10) and CPQ(11-14) was established using the intraclass correlation coefficient (ICC). The order of presentation of both instruments was tested considering the four subgroups (A, B, C and D). The calculation of effect size proposed by Cohen (1992) was used to test the clinical significance of the findings. Both the self-administered and interviewer-administered versions of CPQ(8-10) and CPQ(11-14) demonstrated acceptable psychometric properties. Agreement between the administration modes for the CPQ(8-10) and CPQ(11-14) was 0.90 and 0.88 (ICC), respectively. With the exception of the functional limitation subscale, the scores of the subscales and overall score on the CPQ(8-10) were significantly higher in the group of children who responded to the interviewer-administered measure first. With the CPQ(11-14) , statistically significant differences were found only for the emotional well-being subscale. Both administration modes of the CPQ(8-10) and CPQ(11-14) demonstrated satisfactory psychometric properties and a high level of agreement. Although statistically significant differences were observed for oral symptoms, emotional well-being and social well-being, with the first administration of the interviewer-administered version, the effect of the order of administration had small to medium effects on the CPQ scores.

Oral health-related quality of life among survivors of childhood cancer

BACKGROUND. Childhood cancer survivors may have experienced a high number of invasive medical and dental procedures, which may affect their oral health-related quality of life (OHRQoL). AIM. To compare children who have survived cancer and children without cancer with respect to OHRQoL. DESIGN. In a cross-sectional study, we compared the OHRQoL of children treated for cancer at Aalborg Hospital with the OHRQoL of classmates without cancer. All children answered The Danish version of the Child Perceptions Questionnaire (CPQ). Children aged 8-10 (n = 95) answered CPQ(8-10) , with 27 questions, and children aged 11-14 (n = 138) answered the CPQ(11-14,) with 39 questions. RESULTS. Children with cancer rated their OHRQoL better or equal to those without cancer. The mean overall CPQ(8-10) score was 5.6 (95% CI: 2.5-8.6) among 18 children who have survived cancer and 8.8 (95% CI: 7.3-10.3) among those without cancer (n = 77); the mean difference was -3.3 (95% CI: -6.5 to 0.1). The overall mean CPQ(11-14) score was 12.5 (95% CI: 6.8-18.2) among 24 children who have survived cancer and 11.8 (95% CI: 10.3-13.3) among those without cancer (n = 114); the mean difference was -0.7 (95% CI: -4.9 to 6.3). CONCLUSION. Cancer and cancer treatment during childhood was not associated with a decreased OHRQoL.

Psychosocial impact of hypodontia in children

The purpose of this cross-sectional study was to determine the psychosocial impact of hypodontia (multiple dental agenesis) in children and the influence of factors such as severity of hypodontia, number of retained deciduous teeth, age, and sex. The implications of hypodontia for affected patients have been poorly investigated; this, in part, relates to the lack of appropriate measurements to assess the impact of oral conditions on quality of life, particularly among children and adolescents. A total of 123 children (49.6% boys, 50.4% girls; mean age, 13.6 years; SD, 1.6 years) were recruited on the basis of predetermined inclusion criteria to either a hypodontia group or a routine orthodontic group of similar treatment need (index of orthodontic treatment need, dental health component 4 or 5) but without hypodontia. Each patient completed the child perceptions questionnaire and 2 visual analog scales to determine the global effects of hypodontia on esthetics and function. The mean number of missing teeth in the hypodontia group was 4.52 (SD, 3.33). There were no statistically significant differences in child perceptions questionnaire scores (overall or at domain level) or visual analog scores between the hypodontia and the routine orthodontic groups (P >0.05). Univariable linear regression analyses provided some evidence that difficulty with chewing was associated with the severity of hypodontia (P = 0.030). In this sample, hypodontia did not appear to affect the psychosocial status of patients any more than other features of a malocclusion measured with the index of orthodontic treatment need, dental health component 4 or 5. Patients with hypodontia did, however, have more difficulty in chewing when the deciduous teeth associated with the missing permanent teeth had been exfoliated. This highlights the possible importance of retaining deciduous teeth in patients with severe hypodontia.

Development of Danish version of child oral-health-related quality of life questionnaires (CPQ8–10 and CPQ11–14)

BackgroundThe Child Perceptions Questionnaire (CPQ) is a self-reported questionnaire developed to measure oral health-related quality of life in children. The CPQ aims to improve the description of children's oral health, while taking into consideration the importance of psychological aspects in the concept of health. The CPQ exists in two versions: the CPQ8–10 for children aged 8–10 years and the CPQ11–14 for those aged 11–14 years. The aim of this study was to develop a Danish version of the CPQ8–10 and the CPQ11–14 and to evaluate its validity for use among Danish-speaking children.MethodsThe instruments were translated from English into Danish in accordance with a recommended translation procedure. Afterwards, they were tested among children aged 8–10 (n = 120) and 11–14 years (n = 225). The validity was expressed by the correlation between overall CPQ scores and i) self-reported assessment of the influence of oral conditions on everyday life (not at all, very little, some, a lot, very much) and ii) the self-reported rating of oral health. Furthermore, groups of children with assumed decreased oral health-related quality of life were compared with children with healthy oral conditions. Finally, we examined the internal consistency.ResultsThe correlation between overall CPQ scores and global assessments of the influence of oral conditions on everyday life showed Spearman correlation coefficients of 0.45, P < 0.001 for CPQ8–10 and 0.50, P < 0.001 for CPQ11–14. The correlation between overall CPQ scores and the self-reported rating of oral health showed Spearman correlation coefficients of 0.45, P < 0.001 for CPQ8–10 and 0.17, P = 0.010 for CPQ11–14.The median overall CPQ8–10 scores were 7 for individuals with healthy oral conditions, 5 for individuals with cleft lip and palate, and 15 for individuals with rare oral diseases. The median overall CPQ11–14 scores were 9 for individuals with healthy oral conditions, 9 for individuals with cleft lip and palate, 17.0 for individuals with rare oral diseases, and 22.0 for individuals with fixed orthodontic appliances. There were statistically significant differences between the groups of children with healthy oral conditions and each of the subgroups, except for children with cleft lip and palate.Chronbach'α were 0.82 for CPQ8–10 and 0.87 for CPQ11–14.ConclusionThe results of this study reveal that the Danish CPQ8–10 and CPQ11–14, seem to be valid instruments for measuring oral health-related quality of life in children although its ability to discriminate between children with cleft lip and palate and healthy children seem to be limited.

Comparing a quality of life measure and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in assessing orthodontic treatment need and concern

To compare the use of the Aesthetic Component (AC) of IOTN and the Child Perceptions Questionnaire (CPQ) in assessing orthodontic treatment need and concern. Cross-sectional observational study. The subjects were 204 children aged 10-12 years studying in 10 schools in Bristol, UK. They completed a questionnaire comprising the CPQ and questions regarding orthodontic concern. AC scores as rated by the child and by the calibrated examiner were recorded. CPQ scores were calculated from the responses in the questionnaire. AC scores and responses to questions regarding orthodontic concern were recorded. The children gave themselves lower AC scores compared to the examiner (p<0.001). The only section of the CPQ that correlated significantly with Examiner AC was the emotional impacts section (rho=0.151). CPQ scores had a slightly higher correlation with self-perceived AC than Examiner AC. However, the correlations were still very low. The emotional impacts section of CPQ (rho=0.332) and overall CPQ score (rho=0.282) were better than the examiner AC (rho=0.209) at reflecting how bothered the children were by the alignment of their teeth, and how upset they would be if they couldn't receive orthodontic treatment (rho=0.464, 0.428 and 0.214, respectively). Children with a normative need for orthodontic treatment, based on examiner AC did not have a worse oral health-related quality of life. The CPQ and IOTN AC measure different attributes. There should be a shift towards using quality of life measures to supplement the IOTN in assessing the perceived need for orthodontic treatment.