Association between Malocclusion, Self-perception, Self-esteem and Socio-demographic Factors among Primary Schoolchildren in Dar es Salaam, Tanzania

The aim of this study was to assess the association between malocclusion, self-perception, self-esteem, and socio-demographic factors among primary schoolchildren in Dar es Salaam, Tanzania.

This was an analytical cross-sectional study that involved children aged 10-12 years from primary schools in Dar es Salaam. A questionnaire was used to obtain information about the participants’ socio-demographics, self-perception and self-esteem. Clinical examination was done to determine their occlusal statuses. Data were analyzed using SPSS software (version 22.0), and Chi-square test and logistic regression model were used to assess statistically significant differences between variables. P<0.05 was considered as significant.

A total of 620 schoolchildren participated in this study. The overall prevalence of malocclusion was 66.5%. Undesirable self-perception was reported in 34.0% and self-esteem issues in 30.0% of the schoolchildren. Significantly, many participants with less educated fathers had malocclusion compared with their counterparts (p=0.002). Furthermore, most children with malocclusion perceived themselves negatively and reported lower self-esteem compared with those who had no malocclusion (78.7% vs. 21.3%, p=0.000 and 75.8% vs. 24.2%, p=0.001, respectively). In the logistic regression model, the presence of malocclusion remained as a significant determinant of schoolchildren perceiving themselves negatively and reporting lower self-esteem (OR: 2.4, CI: 1.62-3.54, p= 0.000 and OR: 1.82, CI: 1.23-2.7, p= 0.003, respectively).

The presence of malocclusion was associated with children's negative self-perception and lower self-esteem. Malocclusion prevention and early interventions in children are highly recommended.