Self-esteem level of Brazilian teenagers victims of bullying and its relation with the need of orthodontic treatment

Abstract
Objective: The aim of this study was to analyze self-esteem among Brazilian adolescents and also verify possible associations between the variables: the need for orthodontic treatment and bullying. Methods: The cross-sectional, population-based epidemiological study consisted of a sample composed of adolescents from 11 to 16 years of age, enrolled in the public school system of a medium-sized municipality in the northwest of the State of São Paulo, Brazil. A dental examination was performed using the Dental Aesthetic Index (DAI) in order to verify the need for orthodontic treatment and a self-administered questionnaire containing the Global Self-Evaluation (GSE) indices to identify the level of self-esteem and Kidscape in order to detect bullying. Data analysis was performed using descriptive statistics, association analysis and multivariate logistic regression. Results: A total of 815 adolescents participated in the study. There was a statistically significant association between self-esteem and the variables: sex (p <.0001), willingness to straighten teeth to improve appearance (p = 0.0006), bullying victim (p <.0001), frequency of bullying = 0.0111) and consequences of bullying (p <.0001). A significant risk factor for non-white adolescents' very negative self-esteem (OR = 1.914) was present together with bullying victims who had had negative consequences after the episode (OR = 3.343). Conclusion: There was an association between the self-esteem and bullying variables. Those who reported negative consequences on bullying were three times more likely to present very negative self-esteem, and the chances of non-white adolescents to show negative self-esteem were almost twice as high. There was no statistically significant association between self-esteem and the need for orthodontic treatment.