Abstract
<title>Abstract</title> <p>Background Malocclusion may negatively affect adolescents’ psychosocial well-being, particularly when dentofacial characteristics are perceived as unattractive. This study assessed the association between malocclusion and bullying related to dental appearance among adolescents. Methods A cross-sectional study was conducted with a representative sample of 1,015 adolescents aged 12–15 years enrolled in public and private schools. Malocclusion was assessed using Angle’s classification, the Dental Aesthetic Index (DAI), and additional occlusal characteristics. Bullying related to dental appearance was assessed through a structured questionnaire. Associations were evaluated using hierarchical logistic regression models, and results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). Results The prevalence of bullying related to dental appearance was 10.2%. After adjustment, adolescents from lower socioeconomic groups and those attending public schools were more likely to report bullying. Among the occlusal characteristics evaluated, disabling malocclusion (OR = 1.86; 95%CI: 1.10–3.15), anterior crowding (OR = 2.47; 95%CI: 1.47–4.14), maxillary anterior misalignment (OR = 2.70; 95%CI: 1.43–5.10), mandibular anterior misalignment (OR = 2.52; 95%CI: 1.09–5.80), very severe maxillary overjet (OR = 2.58; 95%CI: 1.49–4.47), and deep overbite (OR = 1.76; 95%CI: 1.10–2.81) were associated with bullying related to dental appearance. Conclusions Bullying related to dental appearance affected approximately one in ten adolescents and was associated with socioeconomic factors, school context, and malocclusions characterized by greater aesthetic impairment. These findings highlight the psychosocial impact of visible occlusal traits during adolescence.</p>