# Prevalence and Awareness of Mucogingival Conditions and Deformities and Their Impact on Oral Health-Related Quality of Life Among Orthodontic Patients at a Tertiary Dental Care Center in Tamil Nadu, South India: A Questionnaire-Based Study

## TL;DR

This study examines mucogingival conditions in orthodontic patients in India, finding low awareness and no strong link between malocclusion types and oral health quality of life.

## Contribution

The study provides new insights into mucogingival deformity prevalence and awareness among orthodontic patients in a South Indian population.

## Key findings

- Prevalence of mucogingival conditions was highest in Class I malocclusion but differences across malocclusion types were not statistically significant.
- Patient awareness of mucogingival signs like bleeding gums was low despite high awareness of tooth alignment.
- OHIP-14 scores varied by malocclusion type but differences were not statistically significant.

## Abstract

Background

Mucogingival conditions and deformities (MGCDs) are frequently encountered around malposed teeth and may predispose individuals to attachment loss during or after orthodontic treatment. Therefore, a comprehensive pre-orthodontic evaluation of mucogingival status is essential to prevent potential complications. Enhancing patient awareness can reduce anxiety related to mucogingival corrective procedures and improve treatment acceptance. Furthermore, malocclusion can substantially influence oral health-related quality of life (OHRQoL). The aim of the present study was to assess the prevalence of specific MGCD by Angle's class of malocclusion, awareness of preexisting MGCDs, as well as OHRQoL, among orthodontic patients with different types of malocclusion.

Methodology

A cross-sectional questionnaire-based study was conducted among 150 pre-orthodontic patients (92 females and 58 males) within the age group of 15-35 years attending a private dental institution in Tamil Nadu, from October 2024 to December 2024. Patients were classified into Class I, Class II, and Class III malocclusion by Angle's classification. A pilot-tested and validated questionnaire comprising 14 closed-ended questions (Cronbach’s alpha = 0.86) was used to assess patients’ awareness of MGCDs. A clinical examination was performed to determine the presence of mucogingival deformities. OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Statistical analyses were conducted using IBM SPSS Statistics for Windows, Version 27 (Released 2019; IBM Corp., Armonk, New York, United States). A p-value < 0.05 was considered statistically significant, and values < 0.01 were considered highly significant.

Results

The study revealed that the prevalence of mucogingival conditions was highest among individuals with Angle’s Class I malocclusion, followed by those with Class II and Class III malocclusion. However, no statistically significant association was observed between Class I, Class II, and Class III malocclusion and the presence of any mucogingival deformity (p > 0.05). The overall awareness of mucogingival conditions was low, with a mean awareness score of 5.2 ± 1.62 (median: 4.4) out of 14. While awareness of orthodontic tooth alignment was high (92.7%), recognition of mucogingival signs such as bleeding gums (27.3%), swollen gums (18.7%), and gingival thinning (16.7%) remained poor. The mean OHIP-14 score and its subscale scores varied across the different malocclusion groups, with the highest mean score recorded in Class II malocclusion (9.77 ± 8.83). Nevertheless, these differences were not statistically significant (p > 0.05).

Conclusion

Awareness of mucogingival deformities was generally poor, underscoring the need for targeted educational programs. Although the prevalence of MGCDs was more in Class I malocclusion compared to other malocclusions, the difference was not statistically significant. This underscores the need for a preorthodontic evaluation of mucogingival status in all patients seeking orthodontic treatment. The type of malocclusion did not appear to substantially influence OHRQoL, suggesting integration of psychological and emotional well-being of patients into comprehensive treatment planning.