Patient own quality of life is an important aspect in providing holistic and well-balance treatment to patient. Any dental treatment done should not be detrimental to patient's daily life and normal routine. Orthodontic therapy has been known to influence patient's mental and psychical health during treatment. This study explored the relationship between quality of life and fixed appliances (braces) by adopting a set of questionnaires. A total of 102 (83% females and 17% males) patients were randomly invited and consented to this study. They were asked to answer questions regarding diet changes, pain perception, physical changes and psychological effect. The results showed that 76.5% have difficulties in eating, 74.5% experience pain in the mouth, 45% could not pronounce words correctly and 41% complaint that their meal routine were interrupted. In conclusion, this study shows that fixed appliances (braces) have some detrimental effect to patient's quality of life and will influence their oral health impact profile. � 2019 Journal of International Dental and Medical Research.

A 45-year-old female with Class III incisor relationship on Class I skeletal pattern came to orthodontic specialist clinic after referral from prosthodontic department. She requested to have lower dentition spaces to be closed before dental implant to be fitted. She had upper and lower dentures previously but not quite happy with the aesthetic. She is fit and healthy with diabetes mellitus type 2. Fixed appliance was done on the lower arch as the upper teeth were nicely aligned. Lower retainer was fitted after fixed appliance was removed (debonded). Several week later, she came with the complain of exposed bone on her lingual oral mucosa. The aetiology of sequestration, oral osteonecrosis and the association to diabetes mellitus is discussed in this case report.