A Cross-Sectional Study of Dietary Patterns and Helicobacter pylori Infection Among American Indian Adults in the Southwest.

Hypodontia is a congenital condition characterized by the absence of one or more permanent teeth, excluding third molars. The prevalence varies by continent and gender [], with an estimated global prevalence ranging from 2.6 to 11.3%. The incidence is also 1.37 times higher in females compared to males [, ]. The prevalence of hypodontia in Germany was stated between 3.5 and 6.5% []. The etiology of hypodontia is multifactorial and includes genetic and environmental factors [, ]. Tooth development is primarily regulated by genetic factors and involves complex molecular interactions []. Disruptions in these pathways can lead to conditions like hypodontia. Recent theories on tooth agenesis range from evolutionary changes to anatomical principles. The evolutionary changes are linked to the shortening of the maxillomandibular complex during human evolution, resulting in a corresponding decrease in the number of teeth. The anatomical principles are based on the hypothesis that certain regions of the dental lamina are more susceptible to environmental factors during tooth development [, ]. Patients with hypodontia may encounter problems such as reduced masticatory ability, pronunciation problems, esthetic concerns, and periodontal problems [, ]. Management of hypodontia differs from other medical interventions because patients are mostly young and healthy. Unlike their peers these patients and their families often make long-term commitment to complex treatment including orthodontics, prosthodontics, and oral surgery. On the other hand, patients and their families should understand the implications of treatment, preferably based on patient-centered outcome measures []. Unfortunately, commonly used outcome measures for treatment of hypodontia are clinician-focused and have limited value in supporting patients during decision making []. Oral health-related quality of life (OHRQoL) measures the impact of oral health on daily life in terms of oral symptoms, functional limitations, and emotional and social wellbeing []. Several instruments have been developed to measure OHRQoL in children, but most of these focus on overall oral health rather than specific dental issues []. Hence, there is a growing demand for condition-specific questionnaires. A hypodontia-specific questionnaire was applied in Dutch children with and without hypodontia []. However, the groups were difficult to compare because of the small sample size. Also, when the questions for the affected group were applied to the unaffected group, half of the questions could not be answered. The impact of malocclusion is usually not taken into consideration when assessing OHRQoL. A frequently used instrument is the more general CPQ11-14 questionnaire. In the study of Bhatia et al. [], malocclusion had a significant impact on the emotional, social, and functional well-being, while problems such as dental caries and periodontal disease were less important. It can be assumed that a questionnaire developed specifically for malocclusion will provide advantages of having a limited number of questions, being less time-consuming, and providing better understanding of the patients’ concerns []. Thereto, the Malocclusion Impact Questionnaire (MIQ) was developed for children aged 10–16 years with malocclusion [, ]. Assessment of OHRQoL in children with hypodontia is valuable in clinical practice and decision-making as malocclusion severity may affect their quality of life and contribute to psychological stress and anxiety []. Several studies have examined OHRQoL in children aged 11–17 with and without hypodontia, but findings have been inconsistent [, , , ]. Some studies found worse OHRQoL in children with hypodontia compared to nonaffected children [, ], while others found no difference in psychosocial status between affected and nonaffected individuals with a comparable treatment need [, ]. Furthermore, the use of different questionnaires has contributed to heterogeneity of data and difficulty in making conclusive statements. As a result, there is insufficient comprehensive research available on how malocclusion and hypodontia affect the OHRQoL in children. To address this gap, this study aimed to assess the impact of malocclusion on OHRQoL and to compare the perceived impact of malocclusion on the lives of children, aged 10–16, with hypodontia to that of peers of the same age who are in need for regular orthodontic treatment.