Federal College of Dental Technology and Therapy, Enugu
Dear Participant,
I am a 500 level dental technology student from Federal College of Dental Technology and
Therapy, Enugu (in affiliation with Federal University of Technology, Owerri) conducting a
study on the impact of malocclusion (misaligned teeth) on quality of life among secondary
school students in Orba, Enugu State. This study has been approved by the College’s Research
Ethics Board. Your participation is completely voluntary and you may withdraw at any time.
Your responses are anonymous and confidential. No identifying information about you will be
collected or shared. There are no known risks to participation beyond those encountered in
everyday life. Your completion of the questionnaire indicates your consent. The questionnaire
will take about 5 minutes to complete. Your honest responses will help provide insights to guide
policies and initiatives to promote the oral health and well-being of adolescents in Nigeria.
Thank you for your time.
Eze, Juliana Ogechukwu
Section A: Demographics: Please tick as appropriate
1. Age Range: 9–13 [ ] 14–18 [ ] 19 –23 [ ] 24 and above [ ]
2. Gender: Male [ ] Female [ ]
3. Grade Level: JSS1 [ ] JSS2 [ ] JSS3 [ ] SS1 [ ] SS2 [ ] SS3 [ ]
Section B: Malocclusion Assessment
Oral examination done by researcher to determine type of malocclusion based on Angle’s
classification.
1. Class I [ ]
2. Class II Division 1 [ ]
3. Class II Division 2 [ ]
4. Class III [ ]
Section C: Impacts on Daily Living
Federal College of Dental Technology and Therapy, Enugu
Rate how malocclusion impacts these areas of your life:
1. Chewing difficulty: No impact [ ] Mild [ ] Moderate [ ] Severe [ ]
2. Speech clarity: No impact [ ] Mild [ ] Moderate [ ] Severe [ ]
3. School performance: No impact [ ] Mild [ ] Moderate [ ] Severe [ ]
4. Social interactions: No impact [ ] Mild [ ] Moderate [ ] Severe [ ]
Section D: Psychosocial Impacts
1. Have you avoided smiling due to the appearance of your teeth?
Yes [ ] No [ ] Sometimes [ ]
2. Have you been teased or bullied about the appearance of your teeth? Yes [ ] No [ ]
If yes, how often in the past year? Never [ ] Rarely [ ] Sometimes [ ] Often [ ]
3. Compared to your peers, how would you rate your self-confidence related to dental
appearance? Very low [ ] Low [ ] Average [ ] High [ ] Very high [ ]
Section E: Knowledge and Attitudes
1. Were you aware of having malocclusion prior to this study? Yes [ ] No [ ] Unsure [ ]
2. Do you feel malocclusion impacts quality of life? Yes [ ] No [ ] Unsure [ ]
3. Are you interested in orthodontic treatment to correct malocclusion?
Yes [ ] No [ ] Unsure [ ]
Thank you for your participation!
