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A school\u2010based 6\u2010month cohort study was conducted with 376 12\u2010year\u2010old deprived adolescents. Measures at baseline included malocclusion (DAI score), dental caries, sociodemographic characteristics, psychosocial traits (self\u2010esteem, sense of coherence, oral health beliefs), and social support. The oral health\u2010related functional limitations and symptoms (social well\u2010being) domains of the CPQ<jats:sub>11\u201014<\/jats:sub>, self\u2010perceived health, and HRQoL (Kiddo\u2010KINDL) were evaluated at the 6\u2010month follow\u2010up. Associations between observed and latent variables (social support, psychosocial factors, and HRQoL) were evaluated using structural equation modelling, according to the Wilson and Cleary theoretical model. Malocclusion was indirectly associated with worse HRQoL, mediated by functional limitations, social well\u2010being, and self\u2010perceived health. Better psychosocial status was directly associated with better HRQoL, and higher social support was indirectly associated with better HRQoL via psychosocial factors. Dental caries experience, female sex, and lower family income were indirectly associated with worse HRQoL. The impact of malocclusion on HRQoL was mediated by oral health\u2010related functional limitations, social well\u2010being, and self\u2010perceived health. Sociodemographic and psychosocial factors, and social support also impacted HRQoL.<\/jats:p>","DOI":"10.1111\/eos.12960","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T03:41:43Z","timestamp":1699587703000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The association between malocclusion and health\u2010related quality of life in adolescents: A mediation analysis"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3867-2289","authenticated-orcid":false,"given":"Sarah Debora Camardella","family":"Leite","sequence":"first","affiliation":[{"name":"School of Dentistry Federal University of Amazonas  Manaus Amazonas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4439-0189","authenticated-orcid":false,"given":"Fernando 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