Introduction: Bullying and cyberbullying are major global health challenges, usually associated with
visible physical characteristics, particularly dentofacial features. Among which, malocclusion has been
associated with peer victimization, social well-being, and psychological health.
Methods: A cross-sectional study was conducted, where 175 children aged 10-14 years were examined
for recording Index of Orthodontic Need (IOTN) and bullying questionnaire was filled out. Chi-square and
fisher exact tests were used as statistical methods, with P value <0.05 was considered as statistically
significant.
Results: The prevalence of self-reported bullying was 33.14%. Bullying was significantly higher among
children with severe malocclusion (IOTN-DHC grades 4–5 and IOTN-AC grades 7–10). Specific
dentofacial features strongly associated with bullying included Class III skeletal pattern(64.7%), Class
II malocclusion (53.6%), overjet >6 mm (84.6%), crossbite (up to 100%), gummy smile, and abnormal
incisor display. Younger children (age 11) reported the highest bullying prevalence (56.8%). Gender and
ethnicity were not statistically significant predictors. Types of bullying varied, with verbal, social, and
cyberbullying most prevalent, while physical, racial, and sexual bullying were significantly higher
among males.
Conclusion: Bullying prevalence among 10–14-year-olds in Erbil was 33.4%, strongly associated with
class III skeletal pattern, increased overjet, gummy smile, shallow smile-line, crossbite, and severe
malocclusion (IOTN-DHC 4–5, IOTN-AC 7–10). Early orthodontic intervention may reduce
psychological burden and improve self-esteem and social well-being.
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