Patient-Reported Oral Health-Related Experiences in Children and Adolescents Treated with Fixed Appliances or Clear Aligners: A Cross-Sectional Study

This study compared oral health-related quality of life (OHRQoL)-related questionnaire scores according to appliance type in Korean children and adolescents undergoing orthodontic treatment with fixed appliances or clear aligners. This crosssectional study included 138 participants aged 10 – 16 years (fixed appliance, n = 70; clear aligner, n = 68). An 18-item modified Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19)-based questionnaire assessed OHRQoL-related experiences across five content-based conceptual item groups. Between-appliance comparisons of individual-item, item-group, and total scores were performed using Mann-Whitney U tests. The total score was the primary outcome, whereas item-group and individualitem comparisons were exploratory. Cohen’s d, Pearson’s correlation analysis, and multiple linear regression adjusted for age, gender, and treatment duration were performed. At the time of the survey, the clear aligner group had a higher total score than the fixed appliance group (p < 0.0001). Oral health, functional, social/emotional, and self-image-related scores were also higher, whereas school environment scores did not differ. The adjusted associations remained significant for the total and four item-group scores. In conclusion, at the time of the survey, higher questionnaire scores were observed in children and adolescents using clear aligners, particularly for functional well-being and self-image-related items. These preliminary cross-sectional associations should not be interpreted as evidence of treatment-related improvement or appliance superiority but may help identify patient-reported aspects relevant to discussions with pediatric patients and their guardians.