{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:21:18Z","timestamp":1785824478898,"version":"3.56.0"},"reference-count":70,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prevalence of bullying in schoolchildren and its relationship with malocclusion, accounting for demographic and psychosocial factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional study on 10\u201314-year-old schoolchildren in the United Kingdom. Clinical examination was undertaken measuring Index of Orthodontic Treatment Need (IOTN), overjet, overbite, and crowding or spacing. Questionnaires were used to measure bullying, oral health-related quality of life (OHRQoL), self-esteem (SE), loneliness, and behavioral and emotional difficulties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 698 participants, 68 reported being bullied (9.7%). No difference was found in prevalence for gender, ethnicity, or age. Increased prevalence was found in participants with overjet &gt; 6 mm (\n                      <jats:italic>P<\/jats:italic>\n                      = .02) and great need for treatment (IOTN Dental Health Component 5\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001, Aesthetic Component 9\u201310\n                      <jats:italic>P<\/jats:italic>\n                      = .008). Bullied participants reported lower OHRQoL (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and SE (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and higher levels of loneliness (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), emotional symptoms (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), conduct problems (\n                      <jats:italic>P<\/jats:italic>\n                      = .002), and peer problems (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Multivariate analysis showed that being bullied was related to higher levels of loneliness (\n                      <jats:italic>P<\/jats:italic>\n                      = .007), poor peer relations (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and increased overjet (\n                      <jats:italic>P<\/jats:italic>\n                      = .032).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Accounting for psychosocial factors, risk of being a victim of bullying was related to malocclusion, specifically an increased overjet.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/122724-1064.1","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:17Z","timestamp":1752537617000},"page":"663-669","source":"Crossref","is-referenced-by-count":2,"title":["Bullying in schoolchildren and its relationship to malocclusion accounting for demographic and psychosocial factors: a cross-sectional study of 10- to 14-year-olds in the United Kingdom"],"prefix":"10.2319","volume":"95","author":[{"given":"Andrew","family":"DiBiase","sequence":"first","affiliation":[{"name":"Consultant Orthodontist, Maxillofacial Unit, East Kent Hospitals University NHS Foundation Trust, Ashford, Kent, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaffie","family":"Cox","sequence":"additional","affiliation":[{"name":"Research Assistant, School of Psychology, University of Kent, Canterbury, Kent, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Rea","sequence":"additional","affiliation":[{"name":"Research Assistant, Department of Psychology, Goldsmiths, University of London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cane","sequence":"additional","affiliation":[{"name":"Principal Lecturer, School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Cameron","sequence":"additional","affiliation":[{"name":"Associate Professor, School of Psychology, University of Kent, Canterbury, Kent, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Rutland","sequence":"additional","affiliation":[{"name":"Professor of Social Developmental Psychology, Psychology, University of Exeter, Exeter, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-95-6-663-b01","article-title":"The Annual Bullying Survey 2020","author":"Ditch the Label","unstructured":"Ditch the Label. The Annual Bullying Survey 2020. Available at: https:\/\/www.ditchthelabel.org\/wp-content\/uploads\/2020\/11\/The-Annual-Bullying-Survey-2020-2.pdf. Accessed June 3, 2022."},{"key":"i1945-7103-95-6-663-b02","series-title":"Community Dent Health","first-page":"166","article-title":"I want braces: factors motivating patients and their parents to seek orthodontic treatment","volume":"25","author":"Fleming","year":"2008","unstructured":"Fleming PS,\nProczek K,\nDiBiase AT. I want braces: factors motivating patients and their parents to seek orthodontic treatment. Community Dent Health. 2008;25:166\u2013169."},{"key":"i1945-7103-95-6-663-b03","series-title":"J Child Psychol Psychiatry","first-page":"1171","article-title":"Bullying at school: basic facts and effects of a school based intervention program","volume":"35","author":"Olweus","year":"1994","unstructured":"Olweus D. Bullying at school: basic facts and effects of a school based intervention program. J Child Psychol Psychiatry. 1994;35:1171\u20131190."},{"key":"i1945-7103-95-6-663-b04","series-title":"UNESCO(2019) Behind the Numbers: Ending School Violence and Bullying. Paris, France: United Nations Educational, Scientific and Cultural Organization, Paris, France","unstructured":"UNESCO(2019) Behind the Numbers: Ending School Violence and Bullying. Paris, France: United Nations Educational, Scientific and Cultural Organization, Paris, France. ISBN 978-92-3-100306-6. Available at https:\/\/doi.org\/10.54675\/TRVR4270"},{"key":"i1945-7103-95-6-663-b05","author":"Department for Education. Bullying in England","unstructured":"Department for Education. Bullying in England, April 2013 to March 2018. 2018; https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/919474\/Bullying_in_England_2013-2018__1_.pd.pdf. Accessed May 2, 2022."},{"key":"i1945-7103-95-6-663-b06","series-title":"School Psychol Q","first-page":"65","article-title":"Predictors of bullying and victimization in childhood and adolescence: a meta-analytic investigation","volume":"25","author":"Cook","year":"2010","unstructured":"Cook CR,\nWilliams KR,\nGuerra N. Predictors of bullying and victimization in childhood and adolescence: a meta-analytic investigation. School Psychol Q. 2010;25:65\u201383."},{"key":"i1945-7103-95-6-663-b07","series-title":"Aggression Violent Behav","first-page":"65","article-title":"School bullying: a systematic review of contextual-level risk factors in observational studies","volume":"22","author":"Azeredo","year":"2015","unstructured":"Azeredo CM,\nRinaldi AEM,\nde Moraes CL,\nLevy RB,\nMenezes PR. School bullying: a systematic review of contextual-level risk factors in observational studies. Aggression Violent Behav. 2015;22:65\u201376."},{"key":"i1945-7103-95-6-663-b08","series-title":"J Adolesc","first-page":"134","article-title":"A meta-analysis of predictors of bullying and victimisation in adolescence","volume":"49","author":"Kljakovic","year":"2016","unstructured":"Kljakovic M,\nHunt C. A meta-analysis of predictors of bullying and victimisation in adolescence. J Adolesc. 2016;49:134\u2013145."},{"key":"i1945-7103-95-6-663-b09","series-title":"Adolescent Res Rev","first-page":"261","article-title":"Bullying victimization due to racial, ethnic, citizenship and\/or religious status: a systematic review","volume":"8","author":"Sapouna","year":"2023","unstructured":"Sapouna M,\nde Amicis L,\nVezzali L. Bullying victimization due to racial, ethnic, citizenship and\/or religious status: a systematic review. 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Aggression Violent Behav. 2016;31:186\u2013199."},{"key":"i1945-7103-95-6-663-b12","series-title":"World J Psychiatry","first-page":"60","article-title":"Consequences of bullying victimization in childhood and adolescence: a systematic review and meta-analysis","volume":"7","author":"Moore","year":"2017","unstructured":"Moore SE,\nNorman RE,\nSuetani S,\nThomas HJ,\nSly PD,\nScott JG. Consequences of bullying victimization in childhood and adolescence: a systematic review and meta-analysis. World J Psychiatry. 2017;7:60\u201376."},{"key":"i1945-7103-95-6-663-b13","series-title":"Int J Environ Res Public Health","first-page":"2209","article-title":"How can bullying victimisation lead to lower academic achievement? A systematic review and meta-analysis of the mediating role of cognitive-motivational factors","volume":"18","author":"Samara","year":"2021","unstructured":"Samara M,\nDa Silva Nascimento B,\nEl-Asam A,\nHammuda S,\nKhattab N. How can bullying victimisation lead to lower academic achievement? A systematic review and meta-analysis of the mediating role of cognitive-motivational factors. Int J Environ Res Public Health. 2021;18:2209."},{"key":"i1945-7103-95-6-663-b14","series-title":"Arch Dis Child","first-page":"879","article-title":"Long-term effects of bullying","volume":"100","author":"Wolke","year":"2015","unstructured":"Wolke D,\nLereya ST. Long-term effects of bullying. Arch Dis Child. 2015;100:879\u2013885."},{"key":"i1945-7103-95-6-663-b15","series-title":"J Orthod","first-page":"247","article-title":"Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life","volume":"38","author":"Seehra","year":"2011","unstructured":"Seehra J,\nFleming PS,\nNewton T,\nDiBiase AT. Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life. J Orthod. 2011;38:247\u2013256."},{"key":"i1945-7103-95-6-663-b16","series-title":"Prog Orthod","first-page":"26","article-title":"Is there a relationship between malocclusion and bullying? A systematic review","volume":"21","author":"Tristao","year":"2020","unstructured":"Tristao S,\nMagno MB,\nPintor AVB, et al. Is there a relationship between malocclusion and bullying? A systematic review. Prog Orthod. 2020;21:26."},{"key":"i1945-7103-95-6-663-b17","series-title":"J Orthod","first-page":"258","article-title":"Prevalence and nature of bullying in schoolchildren aged 10\u201314 years and its association with malocclusion: a cross-sectional study in the South East of the UK","volume":"51","author":"DiBiase","year":"2024","unstructured":"DiBiase A,\nCox Z,\nRea M,\nGonidis L,\nCameron L,\nRutland A. Prevalence and nature of bullying in schoolchildren aged 10\u201314 years and its association with malocclusion: a cross-sectional study in the South East of the UK. J Orthod. 2024;51:258\u2013269."},{"key":"i1945-7103-95-6-663-b18","series-title":"Children (Basel)","first-page":"934","article-title":"Association between dentofacial features and bullying from childhood to adulthood: a systematic review","volume":"10","author":"Broutin","year":"2023","unstructured":"Broutin A,\nBlanchet I,\nCanceill T,\nNoirrit-Esclassan E. Association between dentofacial features and bullying from childhood to adulthood: a systematic review. Children (Basel). 2023;10:934."},{"key":"i1945-7103-95-6-663-b19","series-title":"Children Youth Serv Rev","first-page":"106636","article-title":"Impact of malocclusion on bullying in school children and adolescents: a systematic review and meta-analysis","volume":"142","author":"Miranda e Paulo","year":"2022","unstructured":"Miranda e Paulo D,\nNavarro de Oliverra MN,\nVieira W, et al. Impact of malocclusion on bullying in school children and adolescents: a systematic review and meta-analysis. Children Youth Serv Rev. 2022;142:106636"},{"key":"i1945-7103-95-6-663-b20","series-title":"Br Dent J","first-page":"415","article-title":"The orthodontic condition of children in England, Wales and Northern Ireland 2013","volume":"221","author":"Rolland","year":"2016","unstructured":"Rolland SL,\nTreasure E,\nBurden DJ,\nFuller E,\nVernazza CR. The orthodontic condition of children in England, Wales and Northern Ireland 2013. Br Dent J. 2016;221:415\u2013419."},{"key":"i1945-7103-95-6-663-b21","series-title":"The Revised Olweus Bully\/Victim Questionnaire","author":"Olweus","year":"1996","unstructured":"Olweus D. The Revised Olweus Bully\/Victim Questionnaire. Bergen: University of Bergen; 1996."},{"key":"i1945-7103-95-6-663-b22","series-title":"Aggressive Behav","first-page":"239","article-title":"Prevalence estimation of school bullying with the Olweus Bully\/Victim Questionnaire","volume":"29","author":"Solberg","year":"2003","unstructured":"Solberg M,\nOlweus D. Prevalence estimation of school bullying with the Olweus Bully\/Victim Questionnaire. Aggressive Behav. 2003;29:239\u2013268."},{"key":"i1945-7103-95-6-663-b23","series-title":"J Public Health Dent","first-page":"302","article-title":"Reliability and validity testing for the Child Oral Health Impact Profile-Reduced (COHIP-SF 19)","volume":"72","author":"Broder","year":"2012","unstructured":"Broder HL,\nWilson-Genderson M,\nSischo L. Reliability and validity testing for the Child Oral Health Impact Profile-Reduced (COHIP-SF 19). J Public Health Dent. 2012;72:302\u2013312."},{"key":"i1945-7103-95-6-663-b24","series-title":"J Orthod","first-page":"7","article-title":"Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 1\u2014qualitative inquiry","volume":"43","author":"Patel","year":"2016","unstructured":"Patel N,\nHodges SJ,\nHall M,\nBenson PE,\nMarshman Z,\nCunningham SJ. 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Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965."},{"key":"i1945-7103-95-6-663-b27","series-title":"Child Dev","first-page":"350","article-title":"Loneliness and peer relations in young children","volume":"63","author":"Cassidy","year":"1992","unstructured":"Cassidy J,\nAsher SR. Loneliness and peer relations in young children. Child Dev. 1992;63:350\u2013365."},{"key":"i1945-7103-95-6-663-b28","series-title":"Br J Dev Psychol","first-page":"283","article-title":"Group identity and peer relations: a longitudinal study of group identity, perceived peer acceptance, and friendships amongst ethnic minority English children","volume":"30","author":"Rutland","year":"2012","unstructured":"Rutland A,\nCameron L,\nJugert P, et al. Group identity and peer relations: a longitudinal study of group identity, perceived peer acceptance, and friendships amongst ethnic minority English children. 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London: SAGE Publications Ltd; 2014."},{"key":"i1945-7103-95-6-663-b31","series-title":"Dental Press J Orthod","first-page":"73","article-title":"The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying, among Brazilian teenagers","volume":"24","author":"Gatto","year":"2019","unstructured":"Gatto RCJ,\nGarbin AJI,\nCorrente JE,\nGarbin CAS. The relationship between oral health-related quality of life, the need for orthodontic treatment and bullying, among Brazilian teenagers. Dental Press J Orthod 2019;24:73\u201380."},{"key":"i1945-7103-95-6-663-b32","series-title":"Angle Orthod","first-page":"677","article-title":"Correlation between malocclusion and history of bullying in vulnerable adolescents","volume":"92","author":"Ramos","year":"2022","unstructured":"Ramos ITM,\nNabarrette M,\nVedovello-Filho M,\nde Menezes CC,\nde C Meneghim M,\nVedovello SAS. Correlation between malocclusion and history of bullying in vulnerable adolescents. Angle Orthod. 2022;92:677\u2013682."},{"key":"i1945-7103-95-6-663-b33","series-title":"Am J Orthod Dentofacial Orthop","first-page":"734","article-title":"Impact of bullying due to dentofacial features on oral health-related quality of life","volume":"146","author":"Al-Omari","year":"2014","unstructured":"Al-Omari IK,\nAl-Bitar ZB,\nSonbol HN,\nAl-Ahmad HT,\nCunningham SJ,\nAl-Omiri M. Impact of bullying due to dentofacial features on oral health-related quality of life. Am J Orthod Dentofacial Orthop. 2014;146:734\u2013739."},{"key":"i1945-7103-95-6-663-b34","series-title":"Dev Rev","first-page":"31","article-title":"Does peer victimization predict low self-esteem, or does low self-esteem predict peer victimization? Meta-analyses on longitudinal studies","volume":"49","author":"Geel","year":"2018","unstructured":"Geel M,\nGoemans A,\nZwaanswijk W,\nGini G,\nVedder P. Does peer victimization predict low self-esteem, or does low self-esteem predict peer victimization? Meta-analyses on longitudinal studies. Dev Rev. 2018;49:31\u201340."},{"key":"i1945-7103-95-6-663-b35","series-title":"Int J Adolesc Youth","first-page":"320","article-title":"Adolescent loneliness and social anxiety as predictors of bullying victimisation","volume":"21","author":"Acquah","year":"2016","unstructured":"Acquah EO,\nTopalli P-Z,\nWilson ML,\nJunttila N,\nNiemi PM. Adolescent loneliness and social anxiety as predictors of bullying victimisation. Int J Adolesc Youth. 2016;21:320\u2013331."},{"key":"i1945-7103-95-6-663-b01","article-title":"The Annual Bullying Survey 2020","author":"Ditch the Label","unstructured":"Ditch the Label. The Annual Bullying Survey 2020. Available at: https:\/\/www.ditchthelabel.org\/wp-content\/uploads\/2020\/11\/The-Annual-Bullying-Survey-2020-2.pdf. Accessed June 3, 2022."},{"key":"i1945-7103-95-6-663-b02","series-title":"Community Dent Health","first-page":"166","article-title":"I want braces: factors motivating patients and their parents to seek orthodontic treatment","volume":"25","author":"Fleming","year":"2008","unstructured":"Fleming PS,\nProczek K,\nDiBiase AT. I want braces: factors motivating patients and their parents to seek orthodontic treatment. Community Dent Health. 2008;25:166\u2013169."},{"key":"i1945-7103-95-6-663-b03","series-title":"J Child Psychol Psychiatry","first-page":"1171","article-title":"Bullying at school: basic facts and effects of a school based intervention program","volume":"35","author":"Olweus","year":"1994","unstructured":"Olweus D. Bullying at school: basic facts and effects of a school based intervention program. J Child Psychol Psychiatry. 1994;35:1171\u20131190."},{"key":"i1945-7103-95-6-663-b04","series-title":"UNESCO(2019) Behind the Numbers: Ending School Violence and Bullying. Paris, France: United Nations Educational, Scientific and Cultural Organization, Paris, France","unstructured":"UNESCO(2019) Behind the Numbers: Ending School Violence and Bullying. Paris, France: United Nations Educational, Scientific and Cultural Organization, Paris, France. ISBN 978-92-3-100306-6. Available at https:\/\/doi.org\/10.54675\/TRVR4270"},{"key":"i1945-7103-95-6-663-b05","author":"Department for Education. Bullying in England","unstructured":"Department for Education. Bullying in England, April 2013 to March 2018. 2018; https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/919474\/Bullying_in_England_2013-2018__1_.pd.pdf. Accessed May 2, 2022."},{"key":"i1945-7103-95-6-663-b06","series-title":"School Psychol Q","first-page":"65","article-title":"Predictors of bullying and victimization in childhood and adolescence: a meta-analytic investigation","volume":"25","author":"Cook","year":"2010","unstructured":"Cook CR,\nWilliams KR,\nGuerra N. Predictors of bullying and victimization in childhood and adolescence: a meta-analytic investigation. School Psychol Q. 2010;25:65\u201383."},{"key":"i1945-7103-95-6-663-b07","series-title":"Aggression Violent Behav","first-page":"65","article-title":"School bullying: a systematic review of contextual-level risk factors in observational studies","volume":"22","author":"Azeredo","year":"2015","unstructured":"Azeredo CM,\nRinaldi AEM,\nde Moraes CL,\nLevy RB,\nMenezes PR. School bullying: a systematic review of contextual-level risk factors in observational studies. 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Aggression Violent Behav. 2016;31:186\u2013199."},{"key":"i1945-7103-95-6-663-b12","series-title":"World J Psychiatry","first-page":"60","article-title":"Consequences of bullying victimization in childhood and adolescence: a systematic review and meta-analysis","volume":"7","author":"Moore","year":"2017","unstructured":"Moore SE,\nNorman RE,\nSuetani S,\nThomas HJ,\nSly PD,\nScott JG. Consequences of bullying victimization in childhood and adolescence: a systematic review and meta-analysis. World J Psychiatry. 2017;7:60\u201376."},{"key":"i1945-7103-95-6-663-b13","series-title":"Int J Environ Res Public Health","first-page":"2209","article-title":"How can bullying victimisation lead to lower academic achievement? A systematic review and meta-analysis of the mediating role of cognitive-motivational factors","volume":"18","author":"Samara","year":"2021","unstructured":"Samara M,\nDa Silva Nascimento B,\nEl-Asam A,\nHammuda S,\nKhattab N. How can bullying victimisation lead to lower academic achievement? A systematic review and meta-analysis of the mediating role of cognitive-motivational factors. Int J Environ Res Public Health. 2021;18:2209."},{"key":"i1945-7103-95-6-663-b14","series-title":"Arch Dis Child","first-page":"879","article-title":"Long-term effects of bullying","volume":"100","author":"Wolke","year":"2015","unstructured":"Wolke D,\nLereya ST. Long-term effects of bullying. Arch Dis Child. 2015;100:879\u2013885."},{"key":"i1945-7103-95-6-663-b15","series-title":"J Orthod","first-page":"247","article-title":"Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life","volume":"38","author":"Seehra","year":"2011","unstructured":"Seehra J,\nFleming PS,\nNewton T,\nDiBiase AT. Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life. 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