Self-esteem as a key psychological factor in comprehensive orthodontic assessment

Relevance. Contemporary orthodontic practice increasingly requires a biopsychosocial approach that takes into account not only anatomical and functional abnormalities but also the patient’s psychological status. Self-esteem is particularly important as an indicator of psychosocial adjustment, as it may affect motivation and clinical outcomes. However, its objective evaluation is rarely incorporated into routine orthodontic assessment.

Objective. To compare the level and structure of self-esteem in children with and without dentofacial anomalies using Harter’s Self-Perception Profile for Children (SPPC).

Materials and methods. The study included 30 children aged 8–12 years, divided into two groups: the study group (n = 15) comprised children with dentofacial anomalies, and the control group (n = 15) comprised children without clinically significant dentofacial abnormalities. All participants underwent a standard orthodontic examination and psychological assessment using the Russian-language adaptation of Harter’s SPPC, which evaluates six domains of self-esteem. Between-group comparisons were performed using Student’s t test for independent samples. Differences were considered statistically significant at p < 0.05.

Results. Significant between-group differences were identified. Children with dentofacial anomalies had lower global selfworth and lower scores for physical appearance, social acceptance, close friendship, scholastic competence, and behavioral conduct than children in the control group. The most pronounced differences were observed for physical appearance and social acceptance. No significant between-group differences were found for professional competence.

Conclusion. Dentofacial anomalies in children may be regarded as an important psychosocial risk factor associated with reduced self-esteem, a distorted physical self-image, and difficulties in social acceptance. The inclusion of validated psychological assessment tools such as the SPPC in comprehensive orthodontic assessment may support individualized treatment planning, improve treatment effectiveness, and promote a truly patient-centered approach aimed at enhancing quality of life.

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