Perceptions of dental attractiveness and orthodontic treatment need among Tanzanian children

Applicability of the IOTN-AC index in a bimaxillary protrusion population

Objective

The objective of this study was to assess the validity of the IOTN-AC in the assessment of aesthetic impairment in bimaxillary protrusion patients.

Materials and methods

A cross-sectional study was conducted and involved 110 patients comprising 52 males (47.3%) and 58 females (52.7%) who were accepted for fixed appliance treatment at The University of the West Indies Dental Hospital and provided consent for the use of their records. The mean age was 13.45 years. Participants were asked to complete a questionnaire regarding their reasons for seeking orthodontic treatment and score their self-perceived IOTN-AC. An orthodontist also scored the malocclusion using the IOTN (AC and DHC).

Results

Spearman’s correlation between patient IOTN-AC and orthodontist IOTN-AC was r = 0.435, (p < 0.001). However, the patient IOTN-AC and the ‘normative’ need (p = 0.198), as well as the orthodontist IOTN-AC and the ‘normative’ need (p = 0.334), were not correlated (r = 0.124 and r = 0.094, respectively). Both patient and the orthodontist IOTN-AC scores were not in agreement with ‘normative’ need (IOTN-DHC). Cohen’s kappa test determined an agreement between the patient’s IOTN- AC and an orthodontist’s IOTN AC score, k = 0.395, p < 0.001. The questionnaire revealed aesthetics as the primary reason for seeking treatment but there was poor correlation between the questionnaire items and the patient or orthodontist IOTN-AC score, an AC score of 3 being the most common score for both.

Conclusion

The IOTN-AC is not a valid tool to determine patient perception of the need for treatment in a bimaxillary protrusion population when scored by either patients or orthodontists.

Perception and attitude of Mongolians on malocclusion

Background/purpose

This study assessed the perception and attitude of Mongolians on malocclusion and compared the perceptions with researchers’ perceptions on malocclusion, and this study aimed to determine factors influencing the self-perception of laypeople.

Materials and methods

In addition, we evaluated the correlation between the subjective and objective perceptions of participants. In a random sample of 133 people (39.8% men and 60.2% women) aged 18–55 years, subjective perceptions were assessed using a questionnaire (oral aesthetic subjective impact scale), and objective perceptions were assessed using 10 intraoral frontal photographs of the aesthetic component of index of orthodontic treatment need (AC-IOTN) and six intraoral lateral photographs of the aesthetic component of lateral occlusion (AC-LO).

Results

A significant association was observed between participants' self-perception and researchers' ratings (P < 0.001). The appearance of teeth was significantly correlated with participants’ self-rating by using AC-IOTN and AC-LO. Most people (74%) believed that well-aligned teeth improve the overall facial appearance. Sex, monthly income, and education level significantly influenced the self-perception of participants on malocclusion.

Conclusion

Patients’ perception and attitude cannot be overlooked because they are some of the crucial aspects of the entire treatment.

Determining Orthodontic Knowledge and Awareness in Young Adults

Aim and Objective:

To assess the level of awareness among local adult population (orthodontically untreated) regarding orthodontic treatment and procedures.

Materials and Methods:

A cross-sectional study was planned by accessing 100 subjects comprising of 2 groups (50 male and 50 female). After due ethical clearance, a self-structured questionnaire consisting of 17 questions was given to a group of randomly selected 100 individuals with an age range of 20 to 30 years.

Results:

The overall awareness of orthodontics as a speciality among both the groups was only 52% to 56%. Statistically insignificant difference was found in the knowledge and awareness of orthodontic treatment among both male and female subjects, that is, Group I and II. Also, those who knew about the orthodontic treatment did not opt for it because of high cost and longer duration involved.

Conclusion:

More than half of the population is unaware of the scope of orthodontic treatment, and thus, they do not seek any assistance. Hence, more efforts are needed to create awareness about orthodontics and the associated benefits.

Thresholds of Abnormality Perception in Facial Esthetics among Laypersons and Dental Professionals: Frontal Esthetics

Aim

To find thresholds at which laypersons and dental professionals perceive abnormalities in two facial frontal esthetics variables: facial symmetry and vertical harmony.

Materials and Methods

A baseline frontal image of a young male face with optimum facial proportions was generated from a real image using a photo editing software. Different facial asymmetry images were then generated from this image by manipulating the chin point position at 2 mm increment to the left side. Vertical harmony was perceived through manipulating lower anterior facial height (LAFH) at a ratio of 2% of increased and decreased heights. A total of 120 raters divided equally into four groups of laypersons, general dental practitioners (GDPs), orthodontists, and oral and maxillofacial surgeons (OMFSs) rated these images using an analog scale of 100 mm long. Using ANOVA and Tukey post hoc tests at P < 0.05, the image that showed the first statistical difference compared to the baseline was considered as a threshold of abnormality.

Results

The image of 4 mm asymmetry was defined by the laypersons and GDPs as the threshold of abnormality, while the orthodontists and OMFSs realized that at 2 mm. Laypersons and GDPs defined a threshold of 46% as an abnormal decrease in the LAFH and the other 2 groups at 48%. All dental professionals groups rated the image of 54% as an abnormal increase in the LAFH while laypersons perceived that at 56%.

Conclusion

These thresholds regarding frontal esthetics may contribute to the process of establishing proper orthodontic treatment planning that suits the highest facial esthetic standards.

Epidemiology of orthodontic treatment need in southwestern Ethiopian children: a cross sectional study using the index of orthodontic treatment need

Background

The planning of orthodontic treatment within a public health system requires information on the orthodontic treatment needs of the population. It is important to have epidemiological data to estimate the total need for orthodontic care in any region. The present study aimed to determine the orthodontic treatment need in 12 years old Southwestern Ethiopian children.

Methods

The institution-based cross-sectional study was conducted which involved 347 twelve years old school children randomly selected from seven different public schools in Jimma Town, Southwestern Ethiopia. A structured interview and clinical examination were used to assess the subjects. One examiner used Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) to estimate the treatment need. Descriptive statistics and chi-square tests were used for data analysis with statistical significance set at P < 0.05.

Results

According to the DHC of IOTN, almost half of the subjects in the sample were in moderate to the great need for orthodontic treatment. About 15% of the children had a great need for orthodontic treatment based on IOTN-AC. The most prevalent occlusal traits for defining the DHC categorization include increased Overjet (30.8%) and Crowding (23.3%). There was no statistical difference in the distribution of DHC grades and AC scored based on gender.

Conclusion

This study revealed that the need for orthodontic treatment was high. The percentage of the need for orthodontic treatment is higher in comparison to most of the studies conducted in African regions. Therefore, publicly subsidized orthodontic treatment should be planned and provided to those who are in great need for orthodontic treatment. Besides, awareness about orthodontic treatment should also be considered.

The global prevalence of dental healthcare needs and unmet dental needs among adolescents: a systematic review and meta-analysis

OBJECTIVES

Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.

METHODS

PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.

RESULTS

The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).

CONCLUSIONS

The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.

Prevalence and factors related to malocclusion, normative and perceived orthodontic treatment need among children and adolescents in Bangladesh

OBJECTIVE

The purpose of the present study was to assess the prevalence of normative and perceived orthodontic treatment need in schoolchildren and adolescents, related risk factors, and children/parent's aesthetic perception, compared to orthodontist's opinion, in Dhaka city, Bangladesh.

METHODS

A random sample of 800 schoolchildren aging 11-15 years was selected from different schools in the city of Dhaka, Bangladesh. The Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) were assessed as normative treatment need. The Decayed, Missing, Filled Teeth (DMFT) index was used to record caries experience. Children were interviewed on the perception of orthodontic treatment need. Parents also completed a questionnaire on the perception of their child's orthodontic treatment need, assessed by AC/ IOTN.

RESULTS

According to the DHC/IOTN, only 24.7% were in the category of definite need (grade 4-5) for orthodontic treatment. A significant difference was found between the clinician/children and clinician/parents perceived AC score of IOTN (p= 0.0001). Multiple logistic regression showed children with a higher DMFT were significantly more likely to need orthodontic treatment, according to the DHC of IOTN.

CONCLUSION

A low proportion of schoolchildren needs normative orthodontic treatment in the city of Dhaka, Bangladesh. Children with a higher DMFT score were significantly more likely to need orthodontic treatment, according to the DHC of IOTN.

Negative effect of malocclusion on the emotional and social well-being of Brazilian adolescents: a population-based study

Background/objectives

The aesthetic impact of malocclusion can have negative repercussions on quality of life, social interaction, interpersonal relationships, and psychological well-being. The aim of this study was to evaluate the impact of malocclusion on the quality of life of Brazilian adolescents.

Methods

A representative cross-sectional study of 1612 adolescents from Belo Horizonte, Minas Gerais was conducted. The adolescents responded to the Brazilian version of the Child Perception Questionnaire (CPQ11-14-ISF:16) to assess the impact of the condition on quality of life. Cases of malocclusion were diagnosed using the Dental Aesthetic Index while clinical examination was performed by three calibrated examiners. Data regarding traumatic dental injuries, dental caries, gender, type of school, age and social vulnerability was collected. Data analysis was performed using bivariate and multivariate Poisson regression with robust variance (P < 0.05).

Results

The prevalence of malocclusion was 31.3%. The presence of definite malocclusion (PR = 1.28; CI = 1.13-1.45), severe malocclusion (PR = 1.24; CI = 1.04-1.47) and handicapping malocclusion (PR = 1.55; CI = 1.31-1.84) was associated with a greater negative impact on Emotional Well-Being. The presence of definite malocclusion (PR = 1.18; CI = 1.02-1.36), severe malocclusion (PR = 1.46; CI = 1.21-1.76) and handicapping malocclusion (PR = 1.61; CI = 1.35-1.94) was also associated with a greater negative impact on Social Well-Being.

Conclusions

Adolescents with handicapping malocclusion, where the need for treatment was mandatory, suffered from a greater negative impact on quality of life, with emotional and social aspects most affected.

Adult Perceptions of Different Orthodontic Appliances

Introduction: Pursuing an esthetically-pleasing orthodontic outcome, orthodontic patients must consider and choose from the different available options of orthodontic appliance. Practitioners need to be better informed of their customers' preferences to make better practice management decisions and satisfy their patients' needs.

PURPOSE

To explore adult laypeople's perceptions of the attractiveness, acceptability, preference and economic value of different orthodontic appliances when they consider these appliances for themselves and for their children.

PATIENTS AND METHODS

This cross-sectional survey included 199 adults (110 females). The average age of participants was 27.7 years. Participants answered a questionnaire evaluating and comparing multiple smiling images of an adult wearing different orthodontic appliances. Participants rated each appliance for: (1) attractiveness on a Likert scale; (2) acceptability of having the appliance placed for themselves and their children (with a yes/no response); (3) preference (by ranking all appliances in order); and (4) economic value (by providing the additional amount they are willing to pay for each appliance for themselves and their children).

RESULTS

We found a statistically significant difference in the attractiveness scores between the different orthodontic appliances (p< 0.0001). The most attractive appliances were clear aligners and lingual brackets. The least attractive appliances were colored o-tied-brackets followed by shaped-brackets. Clear aligners were the most acceptable appliances among our participants to have placed on themselves (86.9%) and their children (84.9%). Shaped brackets were the least acceptable appliances among our participants to have placed on themselves (24.1%) and their children (36.2%). The most preferred appliances were lingual brackets (39.2%), followed by clear aligners (34.17%). The least preferred appliances were colored o-tied-brackets (4%). Participants varied with regards to how much more they were willing to pay for each of the different orthodontic appliances. The majority were willing to pay more for clear aligners and lingual brackets to have them placed on themselves but not to have them placed on their children.

CONCLUSION

Adults preferred more innovative esthetic appliances over traditional ones and were willing to pay more to have them placed on themselves but not on their children.

Agreement of young adults and orthodontists on dental aesthetics & influencing factors of self-perceived aesthetics

BACKGROUND

The aim of this study is to assess the agreement between orthodontist's and Chinese young adult's self-perceived aesthetics, the normative treatment need based on the Index of Orthodontic Treatment Need (IOTN), and the main factors affecting the self-perceived aesthetics.

METHODS

A random sample of 348 Chinese young adults (116 males and 232 females) aged 17-24 years were recruited in this study. Two orthodontists were involved in rating the cases. Orthodontic treatment need was assessed according to the Index of Orthodontic Treatment Need, including Aesthetic components and Dental Health Components (AC and DHC). Personality traits were assessed according to Eysenck Personality Questionnaire (EPQ). Cohen's kappa test was used to assess the agreement, and spearman's correlation coefficient was used to analyze the association among all variables.

RESULTS

A statistically significant level of agreement was observed between young adult's perception and orthodontist's perception in IOTN (kappa = 0.14). A positive relationship (p < 0.001)existed between the young adult's AC and the orthodontist' s AC (r = 0.275), and between the young adult' s AC and the normative need DHC (r = 0.195). The orthodontist's AC was strongly related to the normative need (r = 0.743, p < 0.001). Association between the young adult's AC and gender and EPQ-E were also observed.

CONCLUSIONS

Young adults tend to be less critical in assessing orthodontic treatment needs than orthodontists. The orthodontist's AC reflecting subjective treatment need is strongly connected to the normative need. The adult's perception of aesthetic component is affected by factors such as gender and personality traits.

Evaluation of black spaces between maxillary central incisors by dentistry students and laypeople

This study aimed to compare the perception of smile esthetics and alterations among dentistry degree students and laypeople to identify differences in the esthetic perception of black spaces between the maxillary central incisors among Turkish laypeople and students in different study years. Photographs altered to include black spaces of various sizes at the midline were evaluated by 208 dentistry students in years 1-5 and 45 Turkish laypeople. Perceptional differences in different photographs were statistically significant. The students in years 2-5 were more aware of differences between photographs than year 1 students and laypeople. The proportion of participants who decided the most attractive photograph as A was highest among 3rd year students, followed by 5th year students. However, the proportion of students agreeing on the least attractive image was highest among 4th year students, followed by 3rd year students. Photographs A and H were selected as the most and least attractive, respectively, by all participants. The esthetic perception of 1st and 2nd year dentistry students was very different from that of laypeople. To increase esthetic perception among dentistry students, specific lessons with clinical photography should be included in dental education.

Influence of sense of coherence on adolescents' self-perceived dental aesthetics; a cross-sectional study

Background

Sense of coherence (SOC) is a psychosocial factor capable of influencing perception of health, improving one’s ability to manage life. It is the central construct of salutogenesis. SOC allows for identification and mobilization of resources to effectively manage or solve problems, promoting health and quality of life. Using Wilson-Cleary’s conceptual model we hypothesized that SOC might contribute to self-perception of dental aesthetics. The aim of this study was to investigate whether SOC levels were related to self-perception of dental aesthetics against assessed normative orthodontic treatment need among adolescents.

Methods

A cross-sectional study was conducted with 615 male and female adolescents aged 12 to 15 years. Data collection comprised socio-demographic and socio-economic characteristics, SOC (SOC 13), self-perceived dental aesthetics (Oral Aesthetic Subjective Impact Scale), and assessment of orthodontic treatment need (Dental Aesthetic Index). Statistical analysis involved Pearson’s chi-square test, Kruskal-Wallis test, Mann-Whitney test and multiple linear regression. Spearman’s correlation coefficient was calculated for the determination of the strength of correlations among the numerical variables. The level of significance was set at 5% (p < 0.05).

Results

50.1% of the participants were classified as having a high SOC (≥ median). Overall, SOC was associated with self-perceived dental aesthetics (p = 0.048). In the adolescents with no orthodontic treatment need, those with a low SOC perceived their dental aesthetics more negatively than those with high levels of SOC. The multiple regression analysis demonstrated an inverse relationship between SOC and: 1) age (p = 0.007), SOC being higher in the younger age group; 2) self-perceived dental aesthetics (p = 0.001), a higher SOC being associated with those who had a positive dental self-perception.

Conclusions

SOC was associated with self-perceived dental aesthetics and adolescents with a high SOC were more likely to perceive their dental aesthetics more positively. SOC did not seem to influence self-perception of dental aesthetics in adolescents who were clinically assessed as having an orthodontic treatment need, however, in those where there was no orthodontic treatment need, a low SOC was associated with a negative self-perception of dental appearance.

Patient/parent expectations of orthodontic treatment

BACKGROUND

Expectations of orthodontic treatment may differ between the patient and their parents, as the parents' expectations may not reflect those of the child.

OBJECTIVES

The aim of this study, therefore, was to determine the expectations of patients and their parents.

MATERIALS AND METHODS

This was a clinic-based, comparative, cross-sectional study involving 110 patients aged between 10 and 19 years, as well as their accompanying parents or guardians. The expectations of both patients and parents were determined using a questionnaire developed by Sayers and Newton.

RESULTS

Results showed that the expectations of the patients and parents differed significantly in a number of areas with the parents' expectations often exceeding those of the patients. Both patients and parents were found to be ignorant about some aspects of orthodontic treatment, with 47.3% of patients and 39.1% of parents unaware of the duration of orthodontic treatment and, as such, requiring information from their clinicians.

CONCLUSION

The results highlight the importance of patient education and counseling as well as the need to focus on the individual patient and not assume that their expectations mirror those of the accompanying parent.

Normative and self-perceived orthodontic treatment need in Nigerian school children

OBJECTIVE

The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age.

MATERIALS AND METHODS

The sample consisted of 441 randomly selected school children, aged 11-18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11-13 years old and 195 14-18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need.

RESULTS

A definite need for orthodontic treatment was found among 21.5% (grades 4-5 of DHC) and 6.3% (grades 8-10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8-10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05).

CONCLUSION

The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.

Translation and validation of a Nepalese version of the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ)

OBJECTIVE

The aim of this study was to develop a reliable and valid Nepali version of the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ).

DESIGN

Cross-sectional descriptive validation study.

SETTINGS

B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

METHODS

A rigorous translation process including conceptual and semantic evaluation, translation, back translation and pre-testing was carried out. Two hundred and fifty-two undergraduates, including equal numbers of males and females with an age ranging from 18 to 29 years (mean age: 22·33±2·114 years), participated in this study. Reliability was assessed by Cronbach's alpha coefficient and the coefficient of correlation was used to assess correlation between items and test-retest reliability. The construct validity was tested by factorial analysis. Convergent construct validity was tested by comparison of PIDAQ scores with the aesthetic component of the index of orthodontic treatment needs (IOTN-AC) and perception of occlusion scale (POS), respectively. Discriminant construct validity was assessed by differences in score for those who demand treatment and those who did not.

RESULTS

The response rate was 100%. One hundred and twenty-three individuals had a demand for orthodontic treatment. The Nepali PIDAQ had excellent reliability with Cronbach's alpha of 0·945, corrected item correlation between 0·525 and 0·790 and overall test-retest reliability of 0·978. The construct validity was good with formation of a new sub-domain 'Dental self-consciousness'. The scale had good correlation with IOTN-AC and POS fulfilling convergent construct validity. The discriminant construct validity was proved by significant differences in scores for subjects with demand and without demand for treatment.

CONCLUSION

To conclude, Nepali version of PIDAQ has good psychometric properties and can be used effectively in this population group for further research.

Orthodontic treatment: need and demand in north karnataka school children

OBJECTIVES

To assess the normative need, demand and knowledge of/for/on orthodontic treatment in Karnataka school children who were aged 12-16 years.

METHOD

A simple random selection of a sample of 1000 students who were aged 12-16 years was made. Informed consents were obtained from each subject. The dental health component (DHC) and aesthetic component (AC) of the index of orthodontic treatment need (IOTN) and the index of complexity, outcome and need (ICON) were assessed by using the index. The knowledge and demand on/for orthodontic treatment were assessed by using a questionnaire.

RESULTS

The survey population showed 49.3%, 44.4%, and 7.1% of samples needed definite orthodontic treatment need on basis of DHC, ICON, AC respectively. In terms of treatment need, boys were more likely to seek orthodontic treatment need than girls. There was fair agreement between operator and students. A high percentage of students clearly expressed a 'definite need' of orthodontic treatment. Only 40% of children had some knowledge on orthodontic treatment.

CONCLUSION

The present study showed that the awareness, need and demand for orthodontic treatment were less among school children. So, we need to enlighten the students regarding aesthetics among children.

Assessment of the Self-Perception of Dental Appearance, Its Comparison with Orthodontist's Assessment and Demand for Treatment in Eastern Nepalese Patients

Aims. The aim of this study was to assess the self-perception of dental appearance among Eastern Nepalese patients using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) and to compare it with that of an orthodontist's assessment using the same scale and determine whether gender, area of residence, and level of education influence subject's self-perception and orthodontist's ratings. Methods. A total of 252 subjects (equal number of male and female) were conveniently selected. The average ages of subjects were 22.33 ± 2.114 years. The level of subject's perception and orthodontist's assessment was analyzed by nonparametric Chi square test. Kappa coefficient was done to verify its agreement. The Spearman's correlation test was used to check the association of educational level and age. Mann-Whitney test was used to check the associations of sex and areas of residence. Results. The demand for treatment was significantly associated with the perception of the subject and orthodontist's assessment. However, age, gender, and educational level were statistically insignificant in influencing subject perception and orthodontist's assessment. Conclusion. Patient's self-perception should be given equal importance while planning orthodontic treatment.

Esthetic perception and economic value of orthodontic appliances by lay Brazilian adults

OBJECTIVE: To evaluate the esthetic perception of different appliances by Brazilian lay adults and its influence in the attributed value of orthodontic treatment, considering evaluators' socioeconomic status, age and gender. METHODS: Eight different combinations of orthodontic appliances and clear tray aligners were placed in a consenting adult with pleasing smile. Standardized frontal photographs were captured and incorporated into a research album. A sample of adults (n = 252, median = 26 years old) were asked to rate each image for (1) its attractiveness on a visual analog scale and (2) the willingness to pay (WTP) for a cosmetic appliance when compared to a standard metalic appliance and a clear tray aligner. Comparisons between the appliances' attractiveness were performed using the Friedman's test and Dann's post-hoc test. Correlation between appliances' attributed value, socioeconomic status, age, gender, and esthetic perception was assessed using Spearman's correlation analysis. RESULTS: Attractiveness ratings of orthodontic appliances varied significantly in the following hierarchy: Clear aligners>sapphire brackets>self-ligating/conventional stainless steel brackets>and golden metal appliances. The correlation between WTP and esthetic perception was week. However, for individuals with better socioeconomic status and aged between 17-26 years old significantly, a significantly higher WTP was found. CONCLUSION: Clear aligners and sapphire brackets with esthetic archwire were considered better esthetic options in this sample. Nevertheless, patients were not willing to pay more money for appliances they deemed more esthetic, however, they were significantly influenced by their socioeconomic level and age.

Influence of orthodontic treatment on adolescents' self-perceptions of esthetics

INTRODUCTION

The aim of this prospective evaluation was to assess changes in esthetic self-perception of Brazilian adolescents who were receiving fixed orthodontic treatment during a 2-year period.

METHODS

The treatment group consisted of 92 patients, ages 12 to 15 years, treated at the Rio de Janeiro State University orthodontic clinic. The control group consisted of 226 untreated adolescents; 124 subjects were waiting for treatment at this clinic, and 102 subjects were attending public school and had never undergone or sought treatment. The index of orthodontic treatment need was used to assess malocclusion severity, esthetic status (measured by an orthodontist), and esthetic self-perception. All subjects were interviewed 3 times during the study: at baseline; 1 year after placement of the fixed appliance for the treatment group and 1 year after the first interview for the school and waiting groups; and 2 years after placement of the fixed appliance for the treatment group and 2 years after the first interview for the school and waiting groups. The index of orthodontic treatment need scores were analyzed by using negative binomial regression in generalized estimating equations for correlated data.

RESULTS

During the follow-up period, the treatment group's esthetic self-perception scores had a statistically significant decrease (P <0.01), the waiting group's scores had an increase (P = 0.08), and the school group's scores were stable (P = 0.79). At baseline, the treatment group had an esthetic self-perception score of 96% (risk ratio = 1.96; 95% confidence interval, 1.70-2.26) higher than the school group, but at the final interview, the treatment group's score was 20% lower (risk ratio = 0.81; 95% confidence interval, 0.68-0.96) than the initial score of the school group. Age; sex; the index of decayed, missing, and filled teeth; and socioeconomic position did not affect the adolescents' esthetic self-perceptions at follow up, but malocclusion severity and the group had a significant interaction.

CONCLUSIONS

Fixed orthodontic treatment in patients 12 to 15 years of age significantly improved their esthetic self-perceptions.

Self-Perception of Malocclusion Among Nigerian Adolescents Using The Aesthetic Component of The IOTN

Introduction:

The practice of orthodontics is very young in South-South Nigeria and there is need for base line data for informed planning. This study was carried out to investigate the self-perception of malocclusion among Nigerian school children aged 12 to 18 years in order to compare their perception with that of an orthodontist and also to determine the influence of gender and age on self-perception.

Materials and Methodology:

A total of 612 randomly selected schoolchildren comprising 299 (48.9%) males and 313 (51.1%) females with a mean age of 15 + 2.0 years were included in the study, the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was the instrument used to measure the perception of malocclusion by both the school children and the orthodontist.

Results:

Majority of the students (82.5%) rated their teeth towards the more attractive end of the scale (Grades 1-4). Although self - perception was not found to be related to gender, older children (16-18 years) had an increased level of perception of need. Males and older children were found to be more in need of treatment by the orthodontist.

Conclusions:

A significant difference was found between the orthodontist’s rating and the students’ ratings of the attractiveness of their occlusions. Age and gender were not found to influence self- perceived orthodontic treatment need. Therefore, for effective orthodontic care, self- perception and not only professional assessment must be taken into consideration when formulating treatment plans to ensure patient satisfaction.

Perception of the esthetic impact of mandibular incisor extraction treatment on laypersons, dental professionals, and dental students

OBJECTIVE

To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction.

MATERIALS AND METHODS

Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n  =  90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0  =  hardly attractive, 5  =  attractive, and 10  =  very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%.

RESULTS

The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators.

CONCLUSIONS

It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available.

Orthodontic Treatment Need and Complexity among Nigerian Adolescents in Rivers State, Nigeria

Introduction. The assessment of orthodontic treatment need and complexity are necessary for informed planning of orthodontic services. The aim of this cross-sectional study was to assess these parameters using the Index of Complexity, Outcome, and Need (ICON) in a Nigerian adolescent population in a region where orthodontic services are just being established. Methods. Six hundred and twelve randomly selected Nigerian adolescents aged 12 to 18 years were examined using the ICON in their school compounds. Descriptive statistics were employed in the data analysis. Results. Out of a total of 38.1% of the population found to need orthodontic treatment, there were more males and older adolescents. The overall mean ICON score for the population was 39.7 ± 25.3 SD with males having statistically higher mean ICON score. The grades of complexity of the population were 21.6% for very difficult and difficult, 7.5% moderate, and 70.9% mild/easy. Conclusions. Although just over a third of the adolescents were found to have a need for treatment, about a quarter of them were found to have difficult and very difficult complexity grades indicating a need for specialist care. The authors recommend the training of more specialist orthodontists in this region.

Effect of anterior teeth display during smiling on the self-perceived impacts of malocclusion in adolescents

OBJECTIVE

To investigate the impact of the anterior teeth display during smiling (ATDDS) on the self-perceived psychosocial impacts of malocclusion in adolescents.

MATERIALS AND METHODS

This cross-sectional study included a convenience sample of 301 adolescents (mean age 16.1 years, SD 1.8 years; 58.1% female). Two instruments were used for data collection: (1) the Dental Aesthetic Index (DAI) and (2) the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). In addition, ATDDS was assessed in posing smiling, and adolescents' satisfaction with their dental appearance was investigated. Data analysis included descriptive statistics, Kruskal-Wallis test and Mann-Whitney U-test, Spearman correlation, and multiple linear regression analysis.

RESULTS

Significant associations were observed between independent variables (ATDDS, DAI scores, and satisfaction with dental appearance) and total PIDAQ score (R(2)  =  0.37) and dental self-confidence (R(2)  =  0.37), psychological impact (R(2)  =  0.30), esthetic concern (R(2)  =  0.20), and social impact (R(2)  =  0.15).

CONCLUSION

The excessive anterior teeth display during smiling may potentially influence the self-perceived psychosocial impacts of malocclusion in adolescents depending on the severity level of malocclusion and the self-reported satisfaction with dental appearance.

Relationship between impacts attributed to malocclusion and psychological stress in young Japanese adults

Identifying risk factors is important to prevent a wide range of health-damaging behaviours and to improve the quality of life of young people. The aim of this study was to investigate the relationship between impacts on daily performance attributed to malocclusion and psychological stress in healthy young Japanese adults. Medical and oral health data were collected during a cross-sectional examination conducted by the Health Service Center of Okayama University. Systemically healthy non-smoking students aged 18 and 19 years (n = 641; 329 males and 312 females) were included. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need (IOTN). The impacts on daily performance attributed to malocclusion and psychological stress were assessed using self-reported questionnaires, the condition-specific oral impacts on daily performances (CS-OIDP), and the Hopkins Symptoms Checklist. Mann-Whitney U- and chi-square tests and structural equation modelling (SEM) were used for statistical analysis. Forty per cent of subjects had a malocclusion (n = 255). Subjects with impacts on daily performance had a significantly higher prevalence of malocclusion than those without impacts (P < 0.001). SEM showed that psychological stress, especially interpersonal sensitivity and depression, was significantly correlated with CS-OIDP and malocclusion. Negative impacts on daily performance attributed to malocclusion may contribute to psychological stress in young Japanese adults.

Orthodontic concerns of Brazilian children and their parents compared to the normative treatment need

The objective of the present study was to evaluate the interest of both children and parents towards orthodontic treatment and compare it to the normative treatment need as well as to determine the factors related to such an interest. The sample consisted of 407 schoolchildren aged between 9 and 12 years and their parents from Nova Friburgo (Rio de Janeiro), Brazil. The orthodontic concern expressed by children and parents was obtained by means of a questionnaire. The normative need was evaluated using two components of the Index of Orthodontic Treatment Need (IOTN). Data analysis involved multiple logistic regression. Normative treatment need was greater than the children's self-perceived treatment need. The parents expressed more interest towards orthodontic treatment of their children than the children themselves. The orthodontic concern expressed by both groups was greater than the normative need for orthodontic treatment, and such a finding was associated with gender of the children (female) and self-perceived treatment need expressed by them. The lack of a relationship between the normative treatment need and the orthodontic concern of children and parents shows that such assessments should be performed when orthodontic treatment is indicated, particularly in terms of public health, as the demand is greater than the services supplied.

Association between normative and self-perceived orthodontic treatment need among 12- to 15-year-old students in Shiraz, Iran

Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. The purpose of this study was to investigate the association between normative and self-perceived orthodontic treatment need and to evaluate the influence of gender and socioeconomic background such as family size, parental education and father's employment. The subjects were 900 male and female junior high school students (450 males, 450 females) aged 12-15 years, from four districts in the city of Shiraz, Iran. The participants were asked to complete a questionnaire and then underwent a dental examination. Normative treatment need was assessed clinically using the Dental Aesthetic Index (DAI) according to the World Health Organization guidelines. Statistical analysis was undertaken using t- and chi-squared tests. There was no statistically significant correlation between DAI scores and demographics. The results showed a significant correlation between DAI scores and a subject's awareness of malocclusion and their satisfaction with dental appearance. There were no differences between genders concerning the questionnaire data. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment.

Malocclusion, psycho-social impacts and treatment need: A cross-sectional study of Tanzanian primary school-children

Background

studies on the relationship between children's malocclusion and its psycho-social impacts are so far largely unexplored in low-income countries. This study aimed to assess the prevalence of malocclusion, reported dental problems and dissatisfaction with dental appearance among primary school children in Tanzania. The relationship of dissatisfaction with socio-demographic characteristics, clinically defined malocclusion and psychosocial impacts of dental anomalies was investigated. Orthodontic treatment need was estimated using an integrated socio-dental approach.

Method

One thousand six hundred and one children (mean age 13 yr) attending primary schools in the districts of Kinondoni and Temeke completed face to face interviews and a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child Oral Impact on Daily Performance (Child-OIDP) frequency score, reported dental problems, dissatisfaction with dental appearance/function and socio-demographic characteristics.

Results

The prevalence of malocclusion varied from 0.9% (deep bite) to 22.5% (midline shift) with a total of 63.8% having at least one type of anomaly. Moderate proportions of children admitted dental problems; ranging from 7% (space position) to 20% (pain). The odds ratio of having problems with teeth position, spaces, pain and swallowing if having any malocclusion were, respectively 6.7, 3.9, 1.4 and 6.8. A total of 23.3% children were dissatisfied with dental appearance/function. Children dissatisfied with their dental appearance were less likely to be Temeke residents (OR = 0.5) and having parents of higher education (OR = 0.6) and more likely to reporting problem with teeth position (OR = 4.3) and having oral impacts (OR = 2.7). The socio-dental treatment need of 12% was five times lower than the normative need assessment of 63.8%.

Conclusion

Compared to the high prevalence of malocclusion, psycho social impacts and dissatisfaction with appearance/function was not frequent among Tanzanian schoolchildren. Subjects with malocclusion reported problems most frequently and malocclusion together with other psycho-social impact scores determined children's satisfaction with teeth appearance- and function.

Orthodontic treatment need and demand in Senegalese school children aged 12-13 years. An appraisal using IOTN and ICON

OBJECTIVE

To assess the normative need, knowledge of, and demand for orthodontic treatment in Senegalese schoolchildren aged 12-13 years.

MATERIALS AND METHODS

The sample consisted of 665 Senegalese schoolchildren randomly selected from different ethnic and socioeconomic backgrounds. The normative orthodontic treatment need was assessed using the Dental Health Component (DHC) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and the Index of Complexity, Outcome, and Need (ICON). Knowledge of and demand for orthodontic treatment were assessed with a questionnaire.

RESULTS

The DHC and the AC of the IOTN and the ICON classified respectively 42.6%, 8.7%, and 44.1% of the children as having a definite need for orthodontic treatment. There were no ethnic or gender differences with respect to normative orthodontic treatment need. The mean ICON score ranged from 42.31 to 44.46 according to the ethnic group. Only 10% of the children had some knowledge of orthodontics. However, between 17% and 30% of the children clearly expressed a need for orthodontic treatment, and the distribution between ethnic groups was significant. In contrast, there were no significant gender differences concerning this demand for treatment.

CONCLUSIONS

The present study shows that the need for orthodontic treatment far exceeds the actual available supply.

Prevalence and factors related to malocclusion and orthodontic treatment need in children and adolescents in Italy

BACKGROUND

The purpose of this study was to determine prevalence of malocclusions, normative and perceived orthodontic treatment need and related risk factors in schoolchildren in Italy.

DESIGN

A random sample of 1000 11-15 years old children was selected from randomly selected schools in Catanzaro (Italy). Parents completed a questionnaire on sociodemographic, orthodontic history and perception of their child orthodontic treatment need. Children were interviewed on utilization of dental services, perception of orthodontic treatment need and use of orthodontic devices. The Decayed, Missing, Filled Teeth (DMFT) index and the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) were assessed. The Aesthetic Component (AC) of IOTN was assessed by parents, children and dentist.

RESULTS

A total of 546 children participated in the study. Three hundred and twenty-five subjects (59.5%) were assigned a 4 or 5 IOTN score, thus requiring orthodontic treatment. Definite treatment need (AC score 8-10) was reported for 8.6% of subjects by the orthodontist, 5.4% by parents and 3.2% by children. Higher DMFT significantly predicted orthodontic treatment need according to IOTN. Perceived orthodontic treatment need was significantly predicted by orthodontic treatment need for crowding/spacing and overjet.

CONCLUSION

A high proportion of children needs normative orthodontic treatment and perceptions of orthodontic treatment do not overlap with normative need.

Orthodontic treatment needs in the western region of Saudi Arabia: a research report

BACKGROUND

Evaluation of self perceived and actual need for orthodontic treatment helps in planning orthodontic services and estimating the required resources and man power. In the present study, the perceptive need as evaluated by patients and the actual need to orthodontic treatment, as assessed by orthodontists, were evaluated at two types of dental practices in the city of Jeddah using the Index of Orthodontic Treatment Need (IOTN).

METHODS

A consecutive sample of 743 adults seeking orthodontic treatment at two different types of dental practices in Jeddah; King Abdulaziz University, Faculty of Dentistry (KAAU) (Free treatment) and two private dental polyclinics (PDP) (Paid treatment), was examined for orthodontic treatment need using the dental health component (DHC) of the IOTN. The self-perceived need for orthodontic treatment was also determined using the aesthetic component (AC) of the IOTN. The IOTN score and the incidence of each variable were calculated statistically. AC and DHC categories were compared using the Chi-Square and a correlation between them was assessed using Spearman's correlation test. AC and DHC were also compared between the two types of dental practices using the Chi-Square.

RESULTS

The results revealed that among the 743 patients studied, 60.6% expressed no or slight need for treatment, 23.3% expressed moderate to borderline need and only16.1% thought they needed orthodontic treatment. Comparing these estimates to professional judgments, only 15.2% conformed to little or no need for treatment, 13.2% were assessed as in borderline need and 71.6% were assessed as in need for treatment (p < 0.001). Spearman's correlation test proved no correlation (r = -.045) between the two components. Comparing the AC and the DHC between the KAAU group and PDP group showed significant differences between the two groups (p < 0.001).

CONCLUSION

Patient's perception to orthodontic treatment does not always correlate with professional assessment. The IOTN is a valid screening tool that should be used in orthodontic clinics for better services especially, in health centers that provide free treatment.