Psychosocial impact of self-perceived malocclusion on oral health-related quality of life in Nigerian adolescents and young adults: a cross-sectional study

Abstract Background Malocclusion can negatively impact psychosocial well-being and oral health-related quality of life (OHRQoL), particularly during adolescence and young adulthood. This study evaluated the prevalence and severity of psychosocial burden associated with self-perceived malocclusion and its relationship with OHRQoL among adolescents and young adults in Kano State, Nigeria. Methods This cross-sectional study included 316 participants aged 13–25 years recruited from secondary schools and a university in Kano metropolis using convenience sampling. Data were collected using self-administered questionnaires comprising the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN-AC), the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and the Oral Health Impact Profile (OHIP-14). Descriptive statistics, Wilcoxon rank-sum tests, Pearson’s chi-squared tests, and Spearman’s correlations were used. Multivariable logistic regression identified predictors of high psychosocial impact (PIDAQ grade). Statistical significance was set at p < 0.05. Results Of 316 participants (mean age 16.9 ± 3.6 years; 55% male), 45.2% perceived a need for orthodontic treatment (34.8% moderate, 10.4% definite). High psychosocial impact (PIDAQ > 31) was recorded in 63.3% ( n = 200), with male participants showing significantly higher median PIDAQ scores than females (38 vs. 34, p = 0.03). A negative impact on OHRQoL (OHIP-14 > 14) was reported by 32.9% ( n = 104). IOTN-AC showed mild positive correlations with aesthetic concern (ρ = 0.13) and psychological impact (ρ = 0.18). OHIP-14 was strongly correlated with psychological impact (ρ = 0.62) and social impact (ρ = 0.59). In multivariable analysis, male sex (OR = 2.65, 95% CI:1.48–4.83), higher OHIP-14 score (OR = 1.14, 95% CI:1.10–1.19), and higher IOTN-AC score (OR = 1.30, 95% CI:1.12–1.53) were independent predictors of high psychosocial impact, while tertiary education was protective (OR = 0.07, 95% CI:0.02–0.31). Conclusion Self-perceived malocclusion is associated with reduced dental self-confidence, impaired OHRQoL, and adverse social and psychological well-being among Nigerian adolescents and young adults. These associations vary by sex and education level. Early orthodontic assessment and integrated oral health education may mitigate psychosocial burdens.