The relationship between dental aesthetic index (DAI) and perceptions of aesthetics, function and speech amongst secondary school children in Ibadan, Nigeria

An Assessment of the Subjective Psychological and Social Effects of Malocclusion-Related Dental Aesthetics and Its Influence on Body Self-Image and Oral Health-Related Quality of Life in Young Adults

INTRODUCTION

 Malocclusion has a psychological impact related to the patient's age. It also influences the quality of life. This research aims to test the null hypothesis that there is no association between the self-perceived psychosocial impacts of dental aesthetics with the severity of malocclusion, oral health-related quality of life (OHRQoL), and self-image of the body in young adults seeking orthodontic treatment.

MATERIALS AND METHODS

A convenience sample of young adults between 19 and 30 years old was selected for the study. The severity of malocclusion and orthodontic treatment needs were evaluated using the Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile-14 (OHIP-14), and Body Satisfaction Scale (BSS) were used to evaluate the self-perceived effects of malocclusion.

STATISTICAL ANALYSIS

 The Kruskal-Wallis test is used to analyze the distribution of components with different grades of DAI. Spearman's correlation test evaluated the correlation between independent variables and their domains. The study utilized stepwise multiple linear regression analysis to assess the predictive value of independent factors on the PIDAQ and its domains.

RESULTS

 A total of 181 subjects with a mean age of 24.4 ± 1.5 years, 42% males and 58% females, participated in this study. There was a significant correlation (p < 0.05) between all variables (OHIP-14, DAI, and BSS) and PIDAQ. There were significant correlations between the independent variables and the total score of PIDAQ (R2 = 0.16), psychological impact (R2 = 0.09), and social impact (R2 = 0.18), as well as dental self-confidence (R2 = 0.21) and aesthetic concern (R2 = 0.16).

CONCLUSION

In young adults, the self-perceived impact of dental aesthetics is moderated by the severity of malocclusion, oral health-related quality of life, and body satisfaction. The null hypothesis is rejected.

Validity and Reliability of the Arabic Version of the Psychosocial Impact of Dental Aesthetics Questionnaire for Yemeni Adolescents

(1) Objectives: This paper aimed to cross-culturally adapt the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) into an Arabic language version (PIDAQ(A)) for measuring the oral health related quality of life related to dental aesthetics among 12-17-year-old Yemeni adolescents. (2) Material and methods: The study comprised three parts, which were linguistic validation and qualitative interview, comprehensibility assessment, and psychometric validations. Psychometric properties were examined for validity (exploratory factor analysis (EFA), partial confirmatory factor analysis (PCFA), construct, criterion, and discriminant validity) and reliability (internal consistency and reproducibility). (3) Results: The PIDAQ(A) contained a new item. EFA extracted three factors (item factor loading 0.375 to 0.918) comprising dental self-confidence, aesthetic concern, and psychosocial impact subscales. PCFA showed good fit statistics (comparative fit index (CFI) = 0.928, root-mean-square error of approximation (RMSEA) = 0.071). In addition, invariance across age groups was tested. Cronbach's α values ranged from 0.90 to 0.93 (intraclass correlations = 0.89-0.96). A criterion validity test showed that the PIDAQ(A) had a significant association with oral impacts on daily performance scores. A construct validity test showed significant associations between PIDAQ(A) subscales and self-perceived dental appearance and self-perceived need for orthodontic braces (p < 0.05). Discriminant validity presented significant differences in the mean PIDAQ(A) scores between subjects having severe malocclusion and those with slight malocclusion. No floor or ceiling effects were detected.

Relationship between normative and self-perceived criteria for orthodontic treatment need and satisfaction with esthetics and mastication in adolescents

INTRODUCTION

Orthodontic treatments are performed to improve esthetics and masticatory functions. In general, clinical criteria are used to recommend such treatments without considering the opinion of the patient. This study aimed to evaluate the relationship between technically defined orthodontic need (normative criteria) and the need for treatment perceived by adolescent patients.

METHODS

A total of 215 students aged between 15 and 19 years were selected and asked to respond to a questionnaire concerning their perception of need for orthodontic treatment and their satisfaction with their own esthetics and mastication. One trained and calibrated examiner obtained normative data using the Dental Aesthetic Index (DAI) on the need for orthodontic treatment of these students.

RESULTS

Associations were found between the DAI score and the patient's perception of need for orthodontic treatment (P <0.001), satisfaction with esthetics (P = 0.003), and satisfaction with mastication (P = 0.047). When occlusal characteristics were analyzed separately, associations between several normative and perceived needs, as well as for satisfaction with esthetics, were found. Satisfaction with mastication analysis was only found to be associated with open bite malocclusion (P = 0.003).

CONCLUSIONS

The DAI revealed a consistent opinion in adolescents to link their perceived malocclusion-related conditions to esthetics.

Impact of Malocclusion on Oral Health-Related Quality of Life of 8-12 Years Old Schoolchildren in Southern Brazil

Abstract The aim of this study was to estimate the impact of malocclusion on the oral health-related quality of life (OHRQoL) of schoolchildren aged 8-12 years old in Southern Brazil. A two-stage cluster procedure was used to select 1,199 children in 20 public and private schools in Pelotas/Brazil. Cross-sectional data was collected, consisting of a socioeconomic questionnaire to parents, children’s interview and clinical oral examination. The clinical variables were obtained from clinical examination, and the Child Perceptions Questionnaire (CPQ) was assessed during children’s interview. To measure malocclusion and orthodontic treatment need the Dental Aesthetic Index was used. For data analysis multiple Poisson regression models estimating the rate ratios (RR) and their respective confidence intervals (95%CI) were used. Among 1,206 participants, 789 were aged 8-10 years and 417 between 11-12 years. The orthodontic treatment need was higher among the younger children (44.6%) than in the older ones (35.0%) (p value ≤0.05). There was a significant association in the CPQ social and emotional domains with malocclusion in the older schoolchildren. In the adjusted analysis (for socioeconomics and clinical variables) the effect of very severe malocclusion on OHRQoL was confirmed in both 8-10 and 11-12 age groups (RR(95%CI) of 1.24(1.02;1.51) and 1.28(1.01;1.62), respectively). The findings demonstrated that children with very severe malocclusion experienced greater negative impact on OHRQoL compared to those with mild or no malocclusion. The results suggest that malocclusion impacts the quality of life. The higher impact occurs in the social and emotional well-being domains.

Perception of parents and caregivers regarding the impact of malocclusion on adolescents' quality of life: a cross-sectional study

Objective:

The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL).

Methods:

This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance.

Results:

Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables.

Conclusions:

Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

Association of overjet and overbite with esthetic impairments of oral health-related quality of life

OBJECTIVE

Esthetics is an important part of quality of life and a frequent reason for orthodontic treatment demand. It was the aim of this study to investigate whether esthetic impairments, related to overjet and overbite, can be assessed with an established oral health-related quality of life instrument.

MATERIALS AND METHODS

Data from 1968 participants (age: 16-90 years; 69.8% female) from three German surveys were analyzed. Esthetic impairments of oral health-related quality of life were measured with four questions of the Oral Health Impact profile (OHIP), which comprise esthetic aspects of oral health-related quality of life. Higher values represent greater esthetic impairment (sum score: 0-16). Overbite and overjet values were categorized (≤ - 1 mm, 0-1 mm, 2-3 mm, 4-5 mm, ≥ 6 mm). The specific impact of each category on esthetic impairment, in relation to the reference category (2-3 mm), was calculated in linear regression analyses. The type of relationship and the specific impact of overbite and overjet were evaluated in regression analyses with fractional polynomials.

RESULTS

Overbite ranged from - 5 to 15 mm (mean: 3.2 mm) and overjet from - 7 to 19 mm (mean: 3.1 mm). Both an increase and a decrease in overjet, in relation to the reference category, resulted in more esthetic-related oral health-related quality of life impairments. However, in this model, only the effect for increased overjet was statistically significant (4-5 mm: + 0.4 OHIP points; ≥ 6 mm: + 0.9 OHIP points). In the regression analysis with fractional polynomials, both an increase and a decrease in overjet resulted in more esthetic impairments, characterized by a U-shaped relationship. No association could be verified for overbite.

CONCLUSION

A substantial increase or decrease of overjet from the reference values is associated with esthetic impairments of oral health-related quality of life, whereas the extent of overbite seems to have no impact on esthetics.

Effects of fixed labial orthodontic appliances on speech sound production

OBJECTIVE

To explore the impact of fixed labial orthodontic appliances on speech sound production.

MATERIALS AND METHODS

Speech evaluations were performed on 23 patients with fixed labial appliances. Evaluations were performed immediately prior to appliance insertion, immediately following insertion, and 1 and 2 months post insertion. Baseline dental/skeletal variables were correlated with the ability to accommodate the presence of the appliances.

RESULTS

Appliance effects were variable: 44% of the subjects were unaffected, 39% were temporarily affected but adapted within 2 months, and 17% of patients showed persistent sound errors at 2 months. Resolution of acquired sound errors was noted by 8 months post-appliance removal. Maladaptation to appliances was correlated to severity of malocclusion as determined by the Grainger's Treatment Priority Index. Sibilant sounds, most notably /s/, were affected most often.

CONCLUSIONS

(1) Insertion of fixed labial appliances has an effect on speech sound production. (2) Sibilant and stopped sounds are affected, with /s/ being affected most often. (3) Accommodation to fixed appliances depends on the severity of malocclusion.

Relationship of the Dental Aesthetic Index to the oral health-related quality of life

OBJECTIVE

To assess the impact of malocclusion on the quality of life.

MATERIALS AND METHODS

This cross-sectional study involved 150 subjects attending the Primary Care Unit with no history of orthodontic treatment. The Dental Aesthetic Index (DAI) with 10 occlusal characteristics were measured on study models. Oral health-related quality of life (OHRQoL) was assessed with the Malaysian version of the Oral Health Impact Profile questionnaire (OHIP-14). The Spearman rank-order correlation coefficient was used to evaluate the relationship between the malocclusion and quality of life.

RESULTS

Significantly weak correlations (r = .176) were found between the DAI and the OHRQoL. Females and the younger age group (12-19 years) tended to score higher on the OHIP-14 than their counterparts. For males, domain 3 (psychological discomfort; r = .462), domain 4 (physical disability; r = .312), domain 7 (handicap; r = .309), and overall score (r = .289) were weak correlates but significant to the DAI compared with females. The older age group showed a significant weak correlation in domain 3 (psychological discomfort; r = .268) and domain 7 (handicap; r = .238), whereas the younger age group showed no correlation with any domain.

CONCLUSIONS

The DAI score does not predict the effect of malocclusion on the OHRQoL.

[Need for orthodontic treatment among Brazilian adolescents: evaluation based on public health]

OBJECTIVE

To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents.

METHODS

This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003). Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable - need orthodontic treatment - was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated.

RESULTS

The majority of the adolescents needed orthodontic treatment (53.2%). In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad.

CONCLUSIONS

There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system.

Desire for orthodontic treatment and associated factors among adolescents in Southern Brazil

OBJECTIVE

To estimate the prevalence of the desire for orthodontic treatment and investigate associated factors among adolescents in southern Brazil.

MATERIALS AND METHODS

A cross-sectional study was carried out with 704 adolescents aged 12 and 13 years at municipal public schools in the city of Balneário Camboriú (southern Brazil). The adolescents answered a previously tested questionnaire addressing satisfaction with their dental appearance, speech function, chewing function, and the desire for orthodontic treatment. The parents/guardians answered a questionnaire addressing satisfaction with their child's dental appearance and socioeconomic variables. A trained and calibrated orthodontist collected clinical data on malocclusion using the Dental Aesthetic Index (DAI). Statistical analysis was performed using multivariate Poisson regression with robust variance.

RESULTS

The prevalence of the desire for orthodontic treatment was 69.6% (490/704). In the adjusted analysis, the outcome was significantly more prevalent among girls (P < .001), those with difficulty chewing (P  =  .026), those dissatisfied with their dental appearance (P < .001), and those with greater malocclusion severity (P < .001). The following orthodontic characteristics were associated with the desire for orthodontic treatment in the multivariate model: diastema in anterior segment (P < .001), anterior maxillary irregularity (P < .001), maxillary overjet ≥6 mm (P < .001), and mandibular overjet (P  =  .047).

CONCLUSIONS

The desire for orthodontic treatment among 12- and 13-year-old adolescents is influenced by gender, dissatisfaction with one's dental appearance, difficulty chewing, malocclusion severity, and orthodontic characteristics. These findings should be considered together with normative indications regarding the need for orthodontic treatment in adolescents.

Relationship between perception of malocclusion and the psychological impact of dental aesthetics in university students

Introduction and Objectives: The objectives were to assess the relationship between perceived smile aesthetics and perceived psychological impact as measured by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and their own perception of it using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a Visual Analog Scale (VAS); relate the IOTN-AC and VAS to the PIDAQ; and study the predictive capacity of the scales for psychological impact. Material and Methods: A cross-sectional study was conducted in 447 college students in Spain and Portugal (average age 20.4 years, 33.1% men and 66.9% women). The online self-completed surveys used the recently-validated Spanish and Portuguese versions of the PIDAQ to assess the self–reported psychological impact of the students’ dental aesthetics and IOTN-AC and an ad hoc 100 mm VAS for their perception of their dental aesthetics. Results: PIDAQ was linearly correlated with IOTN AC and VAS. Pearson’s coefficient was 0.55 for PIDAQ and IOTN-AC (CI 95% 0.48-0.61) and -0.72 for PIDAQ and VAS (CI 95% -0.66 - -0.76). VAS and IOTN-AC were predictive variables in a linear regression model of the total PIDAQ score. The VAS diagnosed individuals whose dental aesthetics had a self-perceived psychological impact (area under the curve 0.827, CI 95% 0.787-0.868) more precisely than the IOTN-AC (area under the curve 0.742, CI 95% 0. 696-0.788). Conclusions: In adults patients, there is a significant linear relationship between perceived smile aesthetics and self-perceived psychological impact.

Key words:Visual Analog Scale, Index of Orthodontic Treatment Need, malocclusion, psychological, aesthetics.

The influence of normative and subjective oral health status on schoolchildren's happiness

Background

Traditional methods to measure oral health based on clinical standards are limited because they do not consider psychosocial and functional aspects of oral health. It has been recommended that these measures need to be supplemented by data obtained from patients regarding their individual perceptions on oral health-related quality of life (OHRQoL). Happiness is a multidimensional construct comprising both emotional and cognitive domains, and has been defined as “the degree to which an individual judges the overall quality of his or her life as a whole favorably”. It has been associated with several health outcomes, including oral health. The aim of this study was to assess the impact of oral health conditions, oral health-related quality of life (OHRQoL), and socioeconomic factors on the subjective happiness of Brazilian adolescents.

Methods

A cross-sectional study was conducted in 2012 on a representative sample of 12-year-old schoolchildren in Santa Maria-RS, Brazil. The data were collected through dental examinations and structured interviews. The participants underwent an evaluation aimed at detecting dental caries, traumatic dental injuries, malocclusion, and gingival bleeding. They also completed the Brazilian versions of the Child Perceptions Questionnaire-short form (CPQ11–14 – ISF: 16) and the Subjective Happiness Scale (SHS), which was our outcome variable. Socioeconomic conditions were evaluated through a questionnaire that was completed by the participants’ parents. Poisson regression analysis was used to determine the association between the explanatory variables and the outcome. Moreover, a correlation analysis was performed to determine the relationship between the SHS scores and the overall and domain scores of the CPQ11–14 –ISF: 16.

Results

A total of 1,134 children were evaluated. Unadjusted analyses showed that happiness was associated with socioeconomic indicators, the use of dental services, clinical status, and scores on the OHRQoL measure. After adjustment, household overcrowding (RR: 0.96; 95% CI: 0.93-0.98), dental caries (RR: 0.98; 95% CI: 0.97-0.99), malocclusion (RR: 0.98; 95% CI: 0.96-0.99), and the severity associated with the CPQ11-14 (RR: 0.95; 95% CI: 0.93-0.97) still showed a significant association with lower levels of the mean SHS score.

Conclusions

Happiness is influenced by oral conditions, socioeconomic status, and OHRQoL.

The prevalence of malocclusion and its association with dental caries among 12-18-year-old disabled adolescents

BACKGROUND

To assess the prevalence of malocclusion among 12-18-year-old disabled adolescents in Chennai, Tamil Nadu, India, by using the Dental Aesthetic Index (DAI) and to determine the association of malocclusion with dental caries.

METHODS

This cross-sectional study included 243 children with various mental disabilities with or without physical infirmities. The Dental Aesthetic Index (DAI) and the dentition status were recorded using the World Health Organization Oral Health Surveys - Basic Methods (1997) Pro-forma. The Decayed (D), Missing (M) and Filled (F) components of the DMF index were calculated using the Dentition Status and Treatment Need (DSTN). A Chi-square test, ANOVA, and t-test were used to derive inferential statistics.

RESULTS

The mean DAI score ± standard deviation was 39.0 ± 12.3. A total of 123 (50.6%) participants (74 males and 49 females) had DAI scores of 36 and above, which indicated a handicapping malocclusion requiring mandatory orthodontic treatment. Sixty-nine (28.4%) adolescents (36 males and 33 females) had DAI scores between 31 and 35, which indicated severe malocclusion, for which orthodontic intervention was desirable. Incisal segment crowding (84.8%) was the most common aspect of the malocclusion. The mean DMFT score was 4.36 ± 3.81, and 82.8% of the participants had a DMFT score > 0. There was no statistically significant correlation between the mean DAI and DMFT scores (r = 0.090, p = 0.15). Only 16 (6.6%) of the adolescents had minor or no anomaly not needing orthodontic treatment.

CONCLUSIONS

The prevalence of malocclusion and dental caries was found to be high. However, there was no positive correlation between the severity of malocclusion and dental caries among the surveyed disabled adolescents.

Malocclusion impacts adolescents' oral health-related quality of life

OBJECTIVE

To test the hypothesis that malocclusion does not have an independent and negative effect on quality of life of adolescents.

MATERIALS AND METHODS

The cross-sectional design study comprised a sample of 519 children, aged 11 to 14 years, attending public schools in Osorio, a city in southern Brazil. One calibrated examiner carried out clinical examinations and recorded dental caries (decayed/missing/filled teeth), malocclusion (Dental Aesthetic Index), and dental trauma. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14), Impact Short Form, and their parents or guardians answered questions about socioeconomic status. Simple and multivariate linear regressions were performed to assess covariates for the overall CPQ11-14 scores.

RESULTS

Greater impacts on oral health-related quality of life were observed for girls (P  =  .007), children with a lower household income (P  =  .016), those living in nonnuclear families (P < .001), and those with more decayed/missing/filled teeth (P  =  .001). Malocclusion was also associated with oral health-related quality of life: the severity of malocclusion was significantly related to higher scores of CPQ11-14 even after scores were adjusted for control variables. CPQ11-14 increased by approximately 1 point for each increase in the severity of malocclusion.

CONCLUSIONS

Malocclusion has a negative effect on adolescents' quality of life, independent of dental caries or traumatic dental injuries. Socioeconomic inequalities and clinical conditions are important features in adolescents' quality of life.

Prevalence of malocclusion and its relationship with caries among school children aged 11 - 15 years in southern India

Objective

To assess the prevalence of malocclusion and its relationship with dental caries among school children in southern India.

Methods

This cross-sectional study included 1,800 students aged 11 - 15 years whose Dental Aesthetic Index (DAI) and dentition status were recorded and analyzed. The chi-square test, ANOVA, and Spearman's correlation tests were carried out.

Results

The mean DAI score ± the standard deviation was 18.61 ± 6.1. Approximately 85% of the students (83.0% males, 86.8% females) had DAI scores of < 26 and were classified as not requiring orthodontic treatment. One tenth of the sample had mean DAI scores between 26 - 30 (indicating definite malocclusion and elective treatment), while about 3% had mean scores between 31 - 35 (indicating severe malocclusion and treatment desirability). Only 29 children (1.6%; 16 boys, 13 girls) had a DAI score of > 35, which suggested very severe or handicapping malocclusion requiring mandatory treatment. The mean decayed, missing, filled teeth (DMFT) was 2.28 ± 1.47. A DMFT of > 0 was observed in 91.8% of the study subjects. Children with a DAI score of > 35 were found to have significantly (p < 0.001) higher caries experience as compared to other children. Moreover, the DAI scores showed a significant correlation with the mean DMFT scores (r = 0.368, p < 0.05).

Conclusions

A positive correlation was found between the severity of malocclusion and dental caries.

Validation of the psychosocial impact of dental aesthetics questionnaire (Pidaq) in Spanish adolescents

Objectives: The purpose of this study was to assess the validity and reliability of the Spanish version of PIDAQ for application in adolescents. Study Design: The questionnaire was translated, cross-culturally adapted and completed by 627 adolescents (366 12-year-olds and 261 15-year-olds). The adolescents were also examined by 4 examiners who had been calibrated against a gold standard and relative to each other (Kappa >0.85) in determining treatment need with the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN) DHC and AC components. Results: Cronbach´s alpha of the translated PIDAQ was 0.90. The 23 items of the questionnaire were divided into four domains that explained 60% of the variance. The test-retest reliability of the questionnaire was 0.93. Discriminant validity revealed a significant association between the scores for the questionnaire and its subscales or domains and those for the DAI, IOTN-DHC and IOTN-AC treatment need indices. Adolescents with orthodontic treatment need scored higher in the questionnaires. Conclusions: The results show that the Spanish version of PIDAQ has a very similar internal structure and psychometric properties to those of the original questionnaire and demonstrate its validity for use with Spanish adolescents.

Key words:Orthodontics, epidemiology, quality of life, malocclusion.

Self-perception and malocclusion and their relation to oral appearance and function

The aim of this study was to evaluate the relationship between malocclusion and self-perception of oral appearance/function, in 12/15-year-old Brazilian adolescents. The cluster sample consisted of 717 teenagers attending 24 urban public (n=611) and 5 rural public (n=107) schools in Maringá/PR. Malocclusion was measured using the Dental Aesthetic Index (DAI), in accordance with WHO recommendations. A parental questionnaire was applied to collect information on esthetic perception level and oral variables related to oral health. Univariate and multiple logistic regression analyses were performed. Multiple logistic regression confirmed that for 12-year-old, missing teeth (OR=2.865) and presence of openbite (open occlusal relationship) (OR=2.865) were risk indicators for speech capability. With regard to 15-year-old, presence of mandibular overjet (horizontal overlap) (OR=4.016) was a risk indicator for speech capability and molar relationship (OR=1.661) was a risk indicator for chewing capability. The impact of malocclusion on adolescents' life was confirmed in this study. Speech and chewing capability were associated with orthodontic deviations, which should be taken into consideration in oral health planning, to identify risk groups and improve community health services.

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.

Psychosocial impact of dental esthetics on quality of life in adolescents

OBJECTIVE

To test the hypothesis that several dimensions of the self-perceived psychosocial impacts of dental esthetics are not associated with grades of malocclusion, oral health-related quality-of-life measures, and body self-image in adolescents.

MATERIALS AND METHODS

This cross-sectional study included a convenience sample of 301 adolescents (mean age 16.1 +/- 1.8 years, 58.1% female subjects). Demographic data were collected and dental conditions were assessed. The Dental Aesthetic Index (DAI) was used for assessment of malocclusion and determination of orthodontic treatment needs. The short form of the Oral Health Impact Profile (OHIP-14), the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and the Body Satisfaction Scale (BSS) were used to measure adolescents' self-perceived variables.

RESULTS

All variables (DAI, OHIP-14, and BSS) were correlated with PIDAQ (P < .001). Stepwise multiple regression analysis revealed significant associations (P < .001) of independent variables with the total score of PIDAQ (R(2) = 0.29) and dental self-confidence (R(2) = 0.30), social impact (R(2) = 0.14), psychological impact (R(2) = 0.23), and esthetic concern (R(2) = 0.13).

CONCLUSION

The hypothesis is rejected. A broad range of adolescents' self-perceived impact of dental esthetics is influenced by severity of malocclusion, oral health-related quality of life, and body satisfaction.

Dental aesthetics assessed against orthodontic treatment complexity and need in Nigerian patients with sickle-cell anemia

This study investigates the relationship between dental aesthetics and orthodontic treatment complexity and need in a group of patients with sickle-cell anemia (SCA) in Nigeria. The study sample consisted of 176 individuals - 77 (43.8%) male and 99 (56.3%) female subjects with SCA (aged 10 to 35 years) who were coming for routine medical care to two outpatient clinics. Dental aesthetics were assessed using the Standardized Continuum of Aesthetic Need component of the Index of Orthodontic Treatment Need. Treatment complexity and need were assessed according to the Index of Complexity, Outcome and Need and Dental Aesthetic Index. Both parametric and nonparametric statistics were employed in the data analysis. Significant positive relationships were found between dental aesthetics and orthodontic treatment complexity as well as treatment need according to both indices (p= .000). The correlations of the scores for dental aesthetics and the objectively derived treatment complexity and need were significant (p= .01). About 50% of the subjects had poor dental aesthetics and this correlated with their high orthodontic treatment complexity and need.

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.

The relationship of dental aesthetic index with dental appearance, smile and desire for orthodontic correction

Objective: The purpose of this study was to determine the relationship between dental aesthetic index (DAI) and self – satisfaction with dental appearance, smile and desire for orthodontic care.

Methods: A survey of 103 school children, 51 boys and 52 girls was carried out in Annamalai Nagar, Chidambaram. The subjects were interviewed using a questionnaire consisting of questions concerning smile, dental appearance and desire for orthodontic treatment. They were also assessed using the dental aesthetic index.

Results: Statistically significant correlations were between subjective assessments of dental appearance and DAI (P = 0.042) and need for orthodontic treatment and DAI (P = 0.045). The strongest correlations were found between DAI and comparative evaluations of dental appearance (P < 0.005).

Conclusion: This study has shown significant correlations between DAI and subjective perceptions of dental appearance.

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.

A preliminary evaluation of pre-treatment hypodontia patients using the Dental Aesthetic Index: how does it compare with other commonly used indices?

There is currently no specific occlusal index related to hypodontia and there is a paucity of published literature on this subject. The aim of this study was to determine the relationship, if any, between the Peer Assessment Rating (PAR) Index, the Index of Complexity, Outcome and Need (ICON), and the Dental Aesthetic Index (DAI) score and the severity of hypodontia. All new patients attending the Newcastle Dental Hospital hypodontia clinic between February 2002 and March 2003 were included in the study. Of the 60 patients, two were excluded as the models were unavailable and one because they were predominantly in the primary dentition, making scoring impractical. The patient casts were scored with respect to PAR, ICON, and DAI. The mean patient age at presentation was 12 years, with a standard deviation of 1.89 and a range of 9-16 years, and a female to male ratio of 1.1:1. A significant positive correlation, using Kendall tau b, was found between the number of missing teeth, excluding third molars, and the DAI score (tau = 0.215, P = 0.027). There was no significant positive correlation between PAR (tau = -0.186, P = 0.056) and ICON (tau = 0.017, P = 0.861) score and the number of missing teeth. The results of this investigation indicate that further research is required in order to assess if the DAI could be used to determine whether or not to refer hypodontia patients for specialist advice.

The impact of malocclusion and its treatment on quality of life: a literature review

AIM

The aim of this paper is to review the literature relating to the impact of malocclusion, and the treatment of malocclusion, on physical, social and psychological health (i.e. quality of life, QoL).

DESIGN

English-language papers, including cross-sectional studies, retrospective and prospective longitudinal studies, randomized controlled trials, and reviews and meta-analyses were reviewed to determine the impact of malocclusion and its treatment on QoL.

RESULTS

Malocclusion and its treatment can affect physical health in terms of pain (e.g. temporomandibular disorders, and dental and gingival trauma), speech and mastication. In terms of psychological health, malocclusion and its treatment is reported to affect self-concept. Socially, malocclusion and its treatment can affect perceived attractiveness by others, social acceptance and perceived intelligence. However, the evidence is conflicting owing to differences in study designs, population's studied and methods of assessment of psychical, social and psychological health.

CONCLUSION

Much controversy exists about the impact of malocclusion and its treatment on QoL. There is a need for a more comprehensive and rigorous assessment of the impact of malocclusion and its treatment on QoL, employing standardized, valid and reliable data collection instruments.

Pilot survey of oral health-related quality of life: a cross-sectional study of adults in Benin City, Edo State, Nigeria

Background

Oral health studies conducted so far in Nigeria have documented prevalence and incidence of dental disease using traditional clinical measures. However none have investigated the use of an oral health-related quality of life (OHRQoL) instrument to document oral health outcomes. The aims of this study are: to describe how oral health affects and impacts quality of life (QoL) and to explore the association between these affects and the oral health care seeking behavior of adults in Benin City, Edo State, Nigeria.

Methods

A cross-sectional survey recruited 356 adults aged 18–64 years from two large hospital outpatient departments and from members of a university community. Closed-ended oral health questionnaire with "effect and impact" item-questions from OHQoL-UK^© instrument was administered by trained interviewers. Collected data included sociodemographic, dental visits, and effects and impact of oral health on QoL. Univariate and bivariable analyses were done and a chi-square test was used to test differences in proportions. Multivariable analyses using ANOVA examined the association between QoL factors and visits to a dentist.

Results

Complete data was available for 83% of the participants. About 62% of participants perceived their oral health as affecting their QoL. Overall, 82%, 63%, and 77% of participants perceived that oral health has an effect on their eating or enjoyment of food, sleep or ability to relax, and smiling or laughing, respectively. Some 46%, 36%, and 25% of participants reported that oral health impact their daily activities, social activities, and talking to people, respectively. Dental visits within the last year was significantly associated with eating, speech, and finance (P < 0.05). The summary score for the oral health effects on QoL ranged from 33 to 80 with a median value of 61 (95% CI: 60, 62) and interquartile range of 52–70. Multivariable modeling suggested a model containing only education (F = 6.5, pr>F = 0.0111). The mean of effects sum score for those with secondary/tertiary education levels (mean = 61.8; 95% CI: 60.6, 62.9) was significantly higher than those with less than secondary level of education (mean = 57.2; 95% CI: 57.2, 60.6).

Conclusion

Most adults in the study reported that oral health affects their life quality, and have little/no impact on their quality of life. Dental visits within the last year were associated with eating, speech, and finance.

Perception of personal dental appearance in Nigerian adolescents

BACKGROUND

The purpose of this study was to investigate the relationship among Nigerian adolescents' awareness of malocclusion, their satisfaction with personal dental appearance, and the severity of their occlusal irregularities.

MATERIAL

The sample consisted of 577 randomly selected secondary school adolescents-306 (53%) boys and 271 (47%) girls aged 12 to 17 years (mean age, 14.73 +/- 1.12). A pretested questionnaire was used to assess the subjects' awareness of malocclusion and satisfaction with personal dental appearance; the actual severity of malocclusion was determined by using the dental aesthetic index (DAI), performed by an orthodontist in a school environment under natural illumination.

RESULTS

Statistically significant, negative, weak correlations were found between awareness of malocclusion and satisfaction at the various DAI scores as follows: < or =25 (r = -0.3774, P < .001), 26 to 30 (r = -0.4305, P < .001), 31 to 35 (r = -0.5137, P < .001), and > or =36 (r = -0.5104, P < .001). Analysis of variance (ANOVA) did not show a significant value of any of the 3 factors. Multivariate analysis with age as the covariate did not show a significant effect. Also, the association between socioeconomic status and the variables was not significant ( P > .05). Generally, no statistically significant sex differences were found in relation to the DAI scores, awareness, or satisfaction ( P > .05).

CONCLUSIONS

Significant, negative, weak correlations were found between Nigerian adolescents' awareness of malocclusion and satisfaction with personal dental appearance at the various severity levels of malocclusion. It would be worthwhile to assess such a relationship with the index of orthodontic treatment need in the Nigerian population.