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Seehra J, Padhraig S et al. J Orthod 2011; 38: 247–256

Is it an oversimplification to say that those with a less than ideal oro-dental appearance are bullied? After all, these victims may have 'low esteem, self-concept and a negative body image'. Could not these characteristics be at the heart of such abuse, with the sufferer hesitant to access services including orthodontic care? This cross-sectional study used data from adolescents referred for orthodontic assessment to three UK hospitals (only ca. 5% seen in one hospital). When compared to normative data, those who were bullied reported lower levels of 1) social competence, 2) athletic competence, 3) self-esteem, and 4) overall oral-health-related quality of life and Index of Orthodontic Treatment Need (both components). Yet these observations should be balanced with findings from a 20-year longitudinal study that found 'no negative association between malocclusion and social or psychological well-being.'