Objectives: The objectives of this study is to explore the relationship between pediatric patients' orthodontic treatment need, the patients' assessments of their smile-related quality of life (QoL), their parents' proxy assessment of their child's QoL and own assessments of their child's smile, and the patients' objectively assessed smiling patterns.
Methods: Survey data were collected from 102 patients (53 boys/49 girls; age range: 9–13 years) and their parents. Orthodontic treatment need was assessed with the Index of Complexity, Outcome, and Need (ICON). Smiling patterns were determined by videotaping patients' smiles while they watched a cartoon. Thirty predetermined sections of these tapes were then assessed by two independent raters to measure the patients' smiling patterns.
Results: The aesthetic component and total ICON scores correlated with the patients' smile-related QoL (r = 0.25; P = 0.014/r = 0.23; P = 0.024), parental proxy assessments of the child's smile-related QoL (r = 0.29; P = 0.004/r = 0.26; P = 0.009), the parents' own assessments of their child's smile (r = 0.32; P = 0.002/r = 0.29; P = 0.005), and the number of negative adjectives chosen by the parents to describe their child's smile (r = 0.32; P = 0.002/r = 0.30; P = 0.004). Although the smiling patterns were correlated with the patients' smile-related QoL responses (height of smile: r = 0.29; P = 0.005/number of teeth shown: r = 0.30; P = 0.004), the ICON scores were not correlated with the patients' smiling patterns.
Conclusions: Objectively assessed orthodontic treatment need correlates with the patients' and parents' assessments of the child's smile-related QoL scores. However, while objective smiling patterns are related with the patients' smile-related QoL, they are not correlated with the patients' orthodontic treatment need.