Psychological impact of malocclusion and orthodontic treatment on oral health-related of life: A systematic review

The assessment of orthodontic treatment outcomes has progressively shifted from purely occlusal parameters toward patient-centered measures, particularly Oral Health-Related Quality of Life (OHRQoL) and psychosocial well-being. This systematic review aimed to evaluate the psychosocial impact of malocclusion and orthodontic treatment, analyzing how different therapeutic approaches influence quality of life, emotional well-being, and social functioning. A systematic search of PubMed, Scopus, and Web of Science was performed according to PRISMA guidelines for studies published between January 2016 and February 2026. After screening 1445 records, 12 studies met the inclusion criteria and were included in the qualitative synthesis. The available evidence showed that malocclusion negatively affects OHRQoL, particularly in emotional and social domains, with adolescents and females appearing more vulnerable. Orthodontic treatment was associated with an initial temporary decline in quality of life, mainly related to pain and functional limitations during the early treatment stages. Clear aligners generally provided greater short-term comfort and aesthetic satisfaction compared with fixed appliances, although medium- and long-term psychosocial outcomes were comparable between treatment modalities. Most longitudinal studies reported progressive adaptation and significant improvement in OHRQoL following treatment completion. Psychological traits, self-perception, and social influences also emerged as relevant factors affecting treatment experience. Despite methodological heterogeneity among studies, current evidence supports the positive long-term psychosocial benefits of orthodontic treatment and highlights the importance of integrating patient-reported outcomes into contemporary orthodontic practice.