Differences in need for orthodontic treatment between Native Americans and the general population based on DAI scores

An Anthropological Investigation of the Sociocultural and Economic Forces Shaping Dental Crowding Prevalence

OBJECTIVE

The aim of the current study is to explore country of origin and social race category differences in dental crowding prevalence through an anthropological approach.

DESIGN

Data were collected from individuals within five countries (Australia, China, Japan, South Africa, United States; n = 1008) and seven social race groups in two countries (American Black, American White, Latinx, and Indigenous in the United States, South African Black, South African White, and South African Coloured; n = 654). Statistical significance between groups was assessed with a Kruskal-Wallis test, while a Dunn's post-hoc test identified which groups significantly differed.

RESULTS

Results indicate South Africa is characterized by the lowest frequencies of dental crowding, with Coloured South Africans yielding the highest and Black South Africans displaying the lowest frequencies. Individuals in the United States exhibited relatively high levels of minor dental crowding. American Blacks had lower crowding levels, while the Indigenous group had high levels of severe crowding. Individuals within China and Japan exhibited higher relative prevalence of severe crowding.

CONCLUSIONS

Overall, significant differences exist in dental crowding prevalence across countries and social race categories using an anthropological grading system to assess crowding. These differences are likely impacted by sociocultural (aesthetic preferences) and economic (access to dental care) factors.

Need for Orthodontic Treatment in Pupils Aged between 12 and 15 in the Valencian Region (Spain)

The World Health Organization recommends carrying out periodic epidemiological studies in order to provide a basis for the evaluation of the state of health of the population at any given time; in doing so, action strategies can be established for the treatment of different pathologies. The objective of this study is to evaluate the need for orthodontic treatment in adolescents at school aged between 12 and 15 in the Spanish autonomous region known as Comunidad Valenciana (hereafter: Valencian Region). A cross-sectional study was carried out on a sample of 539 12-year-old schoolchildren and 460 15-year-olds, respectively, selected by cluster sampling and representative of the school-aged population of the Valencian Region, using the IOTN-DHC, IOTN-AC, and DAI indices. The need for specific orthodontic treatment according to the IOTN-DHC was 12.6% at 12 years and 7% at 15. For the IOTN-AC and DAI indices, the treatment needs were 4.3% and 0.9% at 12 years and 30.1% and 20.9% at the age of 15. These results were similar to those obtained in the previous study carried out on the same target population. There was no significant association between the need for treatment and gender or social class. We conclude that the need for orthodontic treatment presents values similar to those obtained in 2010.

Esthetic impact of malocclusions in the anterior segment on children in the mixed dentition

INTRODUCTION

To assess the esthetic subjective effect of malocclusions in the anterior segment on children in the mixed dentition.

METHODS

A cross-sectional study was carried out with a population-based sample of 787 children aged 8-10 years in the late mixed dentition (n = 787). Orthodontic Aesthetic Subjective Impact Score determined the esthetic subjective effect. For assessing the malocclusions in the anterior segment (anterior crowding, anterior spacing, diastema, anterior open bite, and anterior maxillary overjet), the following Dental Aesthetic Index criteria were used. Sex, family income, and education level were used as control variables. The variables were analyzed using a simple logistic regression model, estimating crude odds ratios. The variables with P <0.20 in the simple analyses were tested in multiple regression models, estimating adjusted odds ratios with the respective 95% confidence intervals.

RESULTS

Increased overjet was 1.54 (95% CI: 1.08-2.17) times more likely to cause greater esthetic concern (P <0.05), especially in girls (P <0.05).

CONCLUSIONS

Increased overjet negatively affected children's esthetic self-perception in the mixed dentition.

Assessment of malocclusion and orthodontic treatment needs among subjects with dental aesthetic index: A clinical study

Background:

Malocclusion is commonly seen condition in young adults. This study aimed to assess malocclusion and orthodontic treatment needs among subjects with dental aesthetic index (DAI).

Materials and Methods:

This study comprised 486 subjects with an age range of 16–24 years of either genders. A careful oral examination was performed and all findings were recorded based on Oral Health Survey—Basic Methods. DAI was used to assess orthodontic treatment needs among subjects.

Results:

A maximum of 129 (26.5%) patients (male, 47 [22.8%], female, 82 [29.2%]) had DAI score of >36. Missing teeth was the most commonly observed condition, especially in females. There was a significant difference in spacing, crowding, maxillary, mandibular irregularity, overjet, and spacing between both genders.

Conclusion:

It was found that maximum patients had severe malocclusion with DAI score >36. This indicates the orthodontic treatment needs among subjects.

Correlation coefficients of three self-perceived orthodontic treatment need indices

Background:

To determine patient orthodontic treatment need, appropriate self-perceived indices are required. The aim of this study was to assess the sensitivity and specificity of esthetic component (AC) of the index of orthodontic treatment need (IOTN), oral esthetic subjective index scale (OASIS), and visual analog scale (VAS) through dental health component (DHC) IOTN as a normative index to determine the more appropriate self-perceived index among young adults.

Materials and Methods:

In this cross-sectional study, a sample of 993 was randomly selected from freshman students of Isfahan University. Those with a history of orthodontic treatment or current treatment were excluded. DHC was evaluated by two inter- and intra-calibrated examiners. Data for AC, OASIS, and VAS were collected through a questionnaire completed by students. Descriptive statistics, Mann–Whitney U-test, and Spearman correlation test, were used for data analyses. Sensitivity, specificity, positive and negative predictive values of self-perceived indices were calculated through DHC.

Results:

Sensitivity of AC, OASIS, and VAS for evaluating definite orthodontic treatment need was calculated at 15.4%, 22.3%, and 44.6%, respectively. Specificity of these indices for evaluating definite orthodontic treatment need was calculated at 92.7%, 90.5%, and 76.2% percent, respectively. All self-perceived indices had a significant correlation with together and with DHC (P < 0.01). Among demographic factors, there was weak but significant correlation only between mother's educational level and VAS (P < 0.01).

Conclusion:

Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning.

Orthodontic treatment need of Yemeni children assessed with dental aesthetic index

OBJECTIVE

The aim of this study was to estimate the orthodontic treatment need in a sample of 12-year-old Yemeni school children using the dental aesthetic index (DAI).

MATERIALS AND METHODS

The sample comprised 3003, 12-year-old children attending school in six of the governorates of Yemen. For each subject, the standard demographic information such as gender and age was collected, after which an intraoral examination for occlusal status using the DAI was performed.

RESULTS

The mean (SD) of DAI score was 24.86 (8.44) points (95% CI, 24.07-25.65). Overall, 36.6% of the sample found to have a dental appearance that requires orthodontic treatment, ranging from 'selective' to 'mandatory'. Of whom, 19.0% presented with severe and handicapping malocclusion, requiring 'definite' and "mandatory' treatment according to the DAI (DAI ≥ 31). Although there was no gender difference in the mean DAI score (P > 0.05), the sex distribution of the DAI treatment categories was significantly different (Chi-square = 13.258, df = 3, P = 0.004). The results of the individual DAI components showed that about 8% of the sample had more than one missing permanent teeth. Anterior maxillary and mandibular irregularity occurred in more than 33% of the sample. More than 30% of the children examined showed signs of crowding. Spacing in the incisal segments occurred in almost 25% of the sample. Almost 30% of the sample had an antero-posterior molar relation discrepancy.

CONCLUSION

According to the findings of this study, almost one in five of the evaluated Yemeni school children had a DAI score above or equal to 31 points, suggesting highly desirable or mandatory orthodontic treatment need.

Cross-sectional study of malocclusion in Spanish children

Objectives: This study was conducted to determine the orthodontic treatment need of the child population of the Valencia region of Spain, employing the DAI and the IOTN, to examine the relations between treatment need, socio-economic data and gender and to assess the diagnostic agreement between the two indices. Study Design: A cross-sectional descriptive study was conducted in a random representative sample of the schoolchild population of the Valencia region of Spain. The sample size was a total of 765 children aged 12 and 15 years at 39 schools. Results: The orthodontic treatment need assessed by the DAI was 21.7% at 12 years of age and 14.1% at 15 years. The orthodontic treatment need assessed by the IOTN DHC was 20.9% at 12 years of age and 12.7% at 15 years. The diagnostic agreement between the DAI and the modified IOTN was moderate, with Kappa scores of 0.426 at 12 years of age and 0.415 for the 15-year-old group. Conclusions: Approximately 20% of the children needed orthodontic treatment. Neither gender nor social class appeared to exert a significant influence on orthodontic treatment need.

Key words:Orthodontics, epidemiology, children, malocclusion.

Occlusal characteristics and orthodontic treatment need in black adolescents in Salvador/BA (Brazil): an epidemiologic study using the Dental Aesthetics Index

OBJECTIVE

The objective of this article is to evaluate the need of orthodontic treatment, prevalence and severity of the malocclusions in individuals of black ethnicity in a representative sample of schoolchildren of the city of Salvador/Brazil, as well as to verify if the malocclusion was affected by socio-demographic conditions such as age and gender.

METHODS

The reference population was constituted of schoolchildren with age between 12 and 15 years, enrolled in public and private schools. The malocclusion was evaluated in 486 students of black ethnicity, with ages varying from 12 to 15 years, selected in random sample in multiple stages. The adopted significance level was 1% and the power of the test was 90%. A questionnaire registering demographic characteristics was filled out by each individual. The Dental Aesthetics Index (DAI) was used by previously calibrated examiners (kappa 0.89), according to criteria of the World Health Organization.

RESULTS

It was verified that most of the individuals (76%) had little or any need for orthodontic treatment. About 24% showed a condition of severe malocclusion, culminating in a vital need for orthodontic treatment. The main occlusal characteristics found in the group with high need of orthodontic treatment were dental crowding and accentuated overjet. The age was positively related to the improvement of the maxillary overjet and to the presence of crowding.

CONCLUSION

The development of public politics that aim the insertion of orthodontic treatment among the procedures of health programs, with the implementation and development of specialized centers, is fundamental.

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.

Socio-environmental factors associated with dental occlusion in adolescents

INTRODUCTION

Information about the distribution of malocclusion in the population and identification of factors and conditions associated with it could help researchers build models to understand its occurrence and help public-health policy makers improve interventions. The aim of this study was to assess the severity of occlusal disorders in Brazilian adolescents, 12 and 18 years old, and to investigate associations between occlusal disorders and demographic, socio-environmental, and clinical variables.

METHODS

Secondary data from a cross-sectional study, including 13,801 dental occlusion status records from a probabilistic sample randomly selected from public and private schools in 131 cities in the state of São Paulo, Brazil, were analyzed according to the dental aesthetic index (DAI). The proportion of DAI scores greater than 30 were compared between ages, sexes, white and nonwhite students, urban and rural dwellers, and private and public school students; and they were compared with variables such as access to fluoridated tap water and city population, and with clinical aspects such as the care index (CI) and the decayed, missing, filled teeth (DMFT) index. Data analysis included frequency distribution calculation and multiple logistic regression modeling.

RESULTS

The mean DAI score for the sample was 24.33 (SD 7.54), and 16.5% of the subjects had DAI scores of 30 or more (severe or very severe malocclusion). The rate of DAI >31 was significantly higher among 12-year-olds, nonwhites, public-school students, those from smaller municipalities, those without fluoridated tap water, and those with a CI <51%, a DMFT score >4 at age 12 years, or a DMFT score >6 at age 18 years. At age 18, fewer subjects had DAI scores >30; the components responsible for this reduction were spacing in at least 1 incisal segment, midline diastema > or =1, and anterior maxillary overjet > or =4.

CONCLUSION

Some socio-environmental factors are associated with severity of malocclusion in adolescents.

Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the Dental Aesthetic Index

OBJECTIVE

To evaluate the prevalence of malocclusion and orthodontic treatment need among Spanish adolescents and compare with other populations.

METHODS

The study sample comprised 744 schoolchildren from urban and rural populations in Granada province (Southern Spain), aged from 14-20 years, who had received no orthodontic treatment. The measurement instrument was the Dental Aesthetic Index (DAI).

RESULTS

The mean DAI score of the whole series was 25.6 (SD, 7.94). The distribution of the four DAI grades was: DAI 1, no anomaly or malocclusion, 58.6%; DAI 2, definite malocclusion, 20.3%; DAI 3, severe malocclusion, 11.2%; DAI 4, very severe or disabling malocclusion, 9.9%. There were no statistically significant differences in DAI score between genders or those in rural vs. urban residence, but a significant difference was found between social classes, with subjects of low social class presenting the worst scores (p<0.05).

CONCLUSION

The distribution of DAI scores among Spanish adolescents is similar to that reported in other populations.

Orthodontic treatment outcome in a First Nations population in Alberta, Canada: a comparative study

The primary objective of this study was to determine whether there was a significant difference in the degree of improvement after orthodontic treatment between a sample of First Nations orthodontic patients and a control sample of non-First Nations orthodontic patients. The secondary objective was to determine whether there was a difference in the severity of malocclusions being treated in a sample of the First Nations patients compared with a control sample of the non-First Nations patients. Several factors that might affect treatment outcome, such as missed appointments, treatment duration, oral hygiene, extractions, dental classification, and geographic location, were also studied. A sample of 60 First Nations patients and a control group of 60 non-First Nations patients between the 11 and 18 years of age who had been treated with full fixed orthodontic appliances were evaluated. The weighted peer assessment rating (PAR) index was applied to pretreatment and posttreatment study models to address the study's main objectives. The results showed that the First Nations group had greater PAR scores pretreatment than did the controls, and their weighted PAR scores improved more with treatment. Posttreatment PAR scores were similar between the 2 groups. In addition to First Nations status, only extractions and geographic location affected PAR improvement scores.

Indexes for orthodontic treatment need

Orthodontic treatment need indexes are used extensively in Northern Europe, especially in selecting patients for treatment in public orthodontic health services and in determining the level of third party copayment. This article describes certain treatment need indexes and their uses in everyday practice. The reliability and validity of indexes are discussed.

Potential application of the dental aesthetic index to prioritize the orthodontic service needs in a publicly funded dental program

Resources for publicly funded dental programs may never be sufficient to accommodate unlimited orthodontic service demands. There is therefore an obligation to ensure that they are preferentially provided to those patients most likely to derive the greatest benefits. To address this strategic concern, the pretreatment records of 38 patients were prioritized on a visual-analog scale relative to their differential orthodontic service needs by 16 independent orthodontic specialists. Unfortunately, inconsistencies in these assessments were unacceptable for a publicly funded program. When these same records were prioritized relative to their scores derived from the Dental Aesthetic Index, their assessments proved more consistent, especially when based on a modified Dental Aesthetic Index. The relevance of such Dental Aesthetic Index scores proved controversial, because the need for orthodontic services is dependent on other factors in addition to esthetics. The lack of established clinical guidelines to delineate the most appropriate service and timing for specific occlusal discrepancies further hampers the prioritization of orthodontic service needs. Dental Aesthetic Index case-scores may therefore be considered as just 1 of many criteria to prioritize orthodontic service needs, although the potential impact of the others has yet to be quantified.

A comparison of DAI scores and characteristics of occlusal traits in three ethnic groups of Asian origin

The Dental Aesthetic Index (DAI) is an orthodontic index based on socially defined aesthetic standards. The primary aim of this study was to compare the prevalence of malocclusion using the DAI among three ethnic groups of Asian origin; Japanese, Chinese in Taiwan and Native Americans with white Americans. A secondary goal was to consider the possibility that genetic factors might be the cause of the characteristics of malocclusion in the ethnic groups of Asian origin. Malocclusion was evaluated in 1029 Japanese and 176 Chinese in Taiwan students utilising the DAI, and the findings were compared with those of Native Americans and white Americans. The DAI values of Japanese and Native Americans were significantly higher than those of Chinese in Taiwan and white Americans. The mean DAI values showed no common tendency among the three ethnic groups. The characteristics of malocclusion in each ethnic group were also evaluated by analysis of each of the 10 DAI component scores. The results revealed common characteristics of malocclusion in the three ethnic groups of Asian origin using white Americans as the standard. The findings in the present study suggest the possibility that genetic factors might have an influence on the characteristics of malocclusion.

Evaluation of orthodontic treatment using the Dental Aesthetic Index

This investigation evaluates dental esthetic differences of orthodontic patients before and after treatment. The orthodontic treatment provided for patients in this investigation involved the use of removable appliances in 85% of the cases, use of fixed appliances in 2% of the cases, and a combination of fixed and removable appliances in 13% of the cases. Records of patients treated at a dental school clinic between 1959 and 1984 were reviewed. Inclusion criteria for this study included complete patient records, and the presence of dental casts for estimation of the Dental Aesthetic Index (DAI). Of the 932 patients, 116 patient records were included. Fifty patients began treatment during the mixed dentition (age < or = 144 months), and 66 were treated during the permanent dentition (age > 144 months). Pretreatment DAI values and component factors were measured and compared with posttreatment values. The DAI scores improved significantly (p < or = 0.0001) in both age groups (paired t test; Bonferroni correction). However, 20% of the patients showed a worsening or no change in the DAI with treatment. In the mixed dentition group, maxillary anterior irregularities, diastema, and overjet showed statistically significant improvement after treatment (p < or = 0.0001). Patients in the permanent dentition showed statistically significant improvement in the crowding of lower incisors, maxillary anterior alignment, and overjet (p < or = 0.0001). Logistic regression analysis defined five statistically significant factors (p < or = 0.05) that could differentiate patients with successful and unsuccessful treatment outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of malocclusion in high school students in Japan according to the Dental Aesthetic Index

The Dental Aesthetic Index (DAI) was used to evaluate malocclusion in Japanese high school students (n = 409, ages 15-18 yr). The purpose of this study was to obtain basic data concerning malocclusion in Japanese high school students. This study used a sample of students from randomly selected urban and rural high schools in Japan's Kyushu district. The DAI scores for urban and rural high school students, as well as the total DAI scores from these two areas were significantly higher than that of American high school students. These results showed that the number of students with an acceptable dental appearance among Japanese high school students is significantly lower than among American high school students. This indicates a higher need for orthodontic treatment among Japanese high school students.