Changes in Dietary Stress during Surgical Orthodontic Treatment for Patients with Dentofacial Deformities

Introduction: Eating is not only necessary for life but is also considered an enjoyable element of human experience, encompassing sensory enjoyment and affecting social aspects of celebrations. However, some patients with dentofacial deformities have dietary frustration and stress due to challenges associated with eating. The stress perceived by a patient with dentofacial deformity with respect to diet （hereafter referred to as “dietary stress”） has not been sufficiently investigated. In this study, we conducted a questionnaire survey on dietary stress to understand the stressors that patients with dentofacial deformities have at each treatment stage during the surgical orthodontic treatment period, and to clarify whether dietary stress improves following treatment. <br>Patients and Methods: Thirty-three patients （6 males, 27 females） with dentofacial deformity, who underwent bilateral sagittal splitting ramus osteotomy at the Department of Oral and Maxillofacial Surgery, Kanazawa University Hospital in the past 4 years, were included. The questionnaire was evaluated on a 5-point scale with 15 items, and was conducted by speech-language-pathologists at 8 treatment stages: at the first visit; at initiation and on completion of presurgical orthodontic treatment; 1 week after surgery; and 1, 3, 6, and 12 months after surgery. The control group had normal occlusion （13 males, 20 females）. <br>Results: The dietary stress of the study group was significantly higher than that of the control group before presurgical orthodontic treatment. After treatment initiation, the stress was increased compared to that prior to treatment, but decreased after treatment completion. The stress improved to the preoperative level 3 months after the operation, and continued to improve 12 months after the operation, although no significant difference was observed when compared with the controls. <br>Discussion: Among the stressors affecting the study participants, malocclusion was found to be prevalent in the first examinations, and for these patients, dental compensation was considered in addition to multi-bracket appliances after preoperative treatment. Postoperatively, intermaxillary elastic traction, use of multi-bracket appliances, mouth-opening restrictions, dietary restrictions, restriction of masticatory muscle activity, and decrease in the bite force quotient were all considered stressors. <br>Conclusion: It was hypothesized that dietary stress was higher in patients with dentofacial deformity than in those with normal occlusion. The stress of the participants improved to normal levels 12 months after surgery. In order to support recovery, it is important to understand the time needed to address each stressor at each treatment stage, and to construct a treatment system that emphasizes changes in function and patient psychology.