A study published in the American Journal of
Orthodontics & Dentofacial Orthopedics, aimed to look into the incidence of
bullying in a representative sample of Jordanian schoolchildren in Amman, and
to assess its consequences and effects on school performance, and the
contribution of general physical appearance and dentofacial features. The
prevalence of bullying turned out to be 47%, and teeth were the number 1
physical feature targeted by bullies. The three most commonly reported
dentofacial features targeted by bullies were spacing between the teeth or
missing teeth, shape and color of the teeth, and prominent upper anterior teeth
[17].
Another recent study aimed to investigate bullying's
prevalence owing to malocclusions and how it affects people's desire for
orthodontic treatment in a sample of German orthodontic patients, the final
sample involved 1020 patients (females = 547, males =473), 23.7% reported that
they had been bullied at least 2 or 3 times a month in the past 2 months, teeth
and weight were pointed out to be the main features targeted by bullies, the
three highly reported dentofacial features targeted for bullying were: crooked
teeth, prominent teeth and gaps between the teeth. The subjects were separated
into three categories based on the occurrence and cause of bullying: subjects
bullied due to dentofacial features, subjects bullied due to general physical
features, and subjects who didn’t experience bullying (control group). Subjects
from the dentofacial features group (6.3%) initiated orthodontic treatment
themselves significantly more often when compared to subjects from the other 2
groups, and the dentofacial features group stated that ‘ugly teeth’ were their
main reason to seek orthodontic treatment (40.4%), in addition, significantly
higher mean scores for the expectation ‘keep me from being bullied’ were
obtained from this group in comparison to subjects from other groups [18]. One
study was held among Saudi schoolchildren to determine bullying's prevalence
and consequences and the associated sociodemographic, physical, and dentofacial
features, the final sample included 1028 parents of schoolchildren aged 8-18
years old who were asked to fill questionnaires for their children. The study
revealed that (89.2%) of schoolchildren experienced bullying. Teeth were the
number one targeted physical feature for bullying, followed by the shape of the
lips and strength. The three most commonly reported dentofacial features
targeted by bullies were tooth shape and color, followed by anterior open bite
and protruded anterior teeth [19]. A cross-sectional study was conducted to
assess the severity and frequency of bullying reported by adolescents referred
for orthodontic treatment at three UK hospitals and to investigate the relation
between levels of self-reported bullying, malocclusion and requirement for
orthodontic therapy, Three hundred and thirty-six subjects aged between 10 and
14 years participated and questionnaires were used to calculate the
self-reported frequency and severity of bullying, self-esteem and OHRQoL (Oral
Health-Related Quality of Life). Orthodontic treatment need was assessed using
IOTN (Index of Orthodontic Treatment Needed). The results revealed that (12.8%)
of the subjects experienced bullying, and the most commonly reported
dentofacial features targeted by bullies were class II Division 1 incisor
relationship, increased overbite and increased overjet. A higher need for
orthodontic treatment assessed using the AC of IOTN (P50.014) was also targeted
by bullies. The study reported the presence of a significant relation between
bullying and certain occlusal traits, self-esteem and OHRQoL [20]. An
investigation into the frequency of self-harm among a sample of eighth-grade
children aged 13-14 years was conducted in a cross-sectional study, it aimed to
evaluate the contribution of dentofacial appearance and being bullied because
of dentofacial appearance to self-harm, the subjects were requested to fill out
anonymous questionnaires, and the final sample included 699 children with the
mean age being 13.3 years. The results of this study stated that the prevalence
of self-harm was 26.9%, and 47.9% of all subjects who admitted to self-harm did
so because of their dentofacial characteristics. 41 subjects reported self-harm
because of bullying targeted at dentofacial features, The three most commonly
reported dentofacial features contributing to self-harm and bullying-related
self-harm were: tooth color and shape, spacing between the teeth or missing
teeth, and prominent maxillary anterior teeth [21]. One study looked at the
relationship between bullying and malocclusion in high school students from
Olinda, Pernambuco public schools. The sample included 236 subjects aged
between 14 to 19 years, and data was collected through a questionnaire with
questions regarding PeNSE-based sociodemographic characterization and bullying.
The results indicated that (24.9%) of adolescents reported being bullied, and
(42.5%) of those who reported being bullied had malocclusion, mostly Class II
malocclusion was the prevalent. However, according to this study, bullying of
any kind did not statistically correlate with malocclusion, and malocclusion
did not correlate with bullying as a practice [22]. Another recent study sought
to qualitatively evaluate Twitter posts for common themes concerning
dentofacial features, orthodontic appliances and bullying. Keywords related to
bullying, teeth and orthodontics were used to search Twitter’s database from
2010 to 2014. 321 posts were incorporated into the final sample, and 4 main
categories relevant to ‘dental-related bullying’ were recognized: (i)
morphological features, (ii) psychological and psychosocial impact, (iii)
coping mechanisms, (iv) role of family. Subjects that experienced bullying
reported a diverse range of psychological impacts and coping mechanisms, in
addition, family members were discovered to play a contributing as well as a
mediating role in bullying. Twitter users reported that ‘morphological features
of teeth or malocclusion’ were targeted by bullies, and victims of bullying
reported that bullies used adjectives such as ‘messed up’, ‘ugly’, ‘horrible’
or ‘shitty’ to describe their teeth, other users included words such as
‘bunny’, ‘goofy’, ‘horse’, ‘monster’, ‘vampire’, ‘rabbit’, ‘crooked’, ‘missing’
or ‘gap’ to describe their teeth [23]. A study was held to compare the crowding
of anterior teeth in children who had experienced bullying and those who had
not, the sample included 218 subjects aged between 11 and 16 years, little's
irregularity index was used to assess dental crowding. A questionnaire was
completed to diagnose bullying. The U-Mann Whitney statistical test was used to
compare crowding in patients who had experienced bullying and those who had
not. According to the findings, there was considerably more dental crowding in
schoolchildren who had experienced bullying than in those with no bullying. The
average crowding for the group subjected to bullying was 11.6 +/- 9.4 mm and in
the group without bullying was 9.1 +/- 7.9 mm [24].