Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index and Oral Health Status in Spanish Adolescents

BACKGROUND

Our aim was to analyze the relationship between OHRQoL (Oral-Health-Related Quality of Life) assessed by the C-OIDP (Child-Oral Impacts on Daily Performances) indexand oral health status in 13-15 years old Spanish population.

METHODS

A cross-sectional study was designed in a random sample of 337 adolescents. The C-OIDP and an oral health perception questionnaire were applied. ICDAS II (International Caries Detection and Assessment System) classification was used for assessing caries status, CPI (Community Periodontal Index) for periodontal status and discrepancy in the three planes for occlusal evaluation. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Spearman correlation tests.

RESULTS

The prevalence of impact was 48.1%. The most frequently affected dimension was eating (21.4%). The overall mean C-OIDP index was 3.28. Higher DMFT (Decayed Missed Filled Tooth) was significantly associated with C-OIDP index (p = 0.03). Participants with CPI > 0 showed an impact index almost twice as high as those with CPI = 0 (p > 0.05). Significant association was found between quality of life and CPI for women (p < 0.01). Only the molar Angle's class was associated with the impact index (p = 0.04).

CONCLUSIONS

The OHRQoL in Spanish adolescents is good. The DMFT index had an impact on adolescents' quality of life, showing a greater impact in men than in women. Periodontal status had a greater impact in women. No association between the extent of the caries lesion and the impact index was found.

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.

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.

Comparison of Digital and Paper Assessment of Smile Aesthetics Perception

Objectives:

Despite the widespread of assessment of smile aesthetic perception in many areas, there has yet to be a direct comparison of digital and paper-based photographs for the assessment of smile aesthetics. Here we compared digital and paper-based photographs representing different smile aesthetic features using visual analog scale (VAS) scoring.

Materials and Methods:

One hundred students were randomly recruited from a university campus. Participants were asked to record their perception of smile aesthetics via paper and digital-based platforms. The minimum clinically important difference between platforms was set at 15 mm. The percentage of participants who rated smile attractiveness worse on digital images was recorded. The paired one-tailed Student’s t test was used to determine differences between digital and paper platforms, and Bland–Altman analysis and intraclass correlations (ICCs) were used to test for agreement between paper and digital photographs.

Results:

Ninety-nine subjects participated, 55 men (mean age = 22.05, standard deviation [SD] = 1.91) and 44 women (mean age 22.05, SD = 1.84). There were statistically significant differences between paper-based and digital photographs for all images except one (paired t test; P < 0.05). Digital ratings were lower than paper-based ratings for all images, and differences were clinically significant in four out of eight images. A high percentage of participants (50.5%–85.9%) rated smile attractiveness worse on digital images than on paper for all images. There was poor agreement between the two methods as assessed by ICCs and Bland–Altman analysis.

Conclusion:

Equivalence between paper and digital images for smile aesthetics cannot be assumed, and paper-based photographs may lead to clinically relevant overestimations of perceived attractiveness. As academic dentistry increasingly relies on digital imaging and sharing in the post-COVID-19 world, further validation of digital platforms for smile aesthetics assessment is warranted, and care should be taken when interpreting the results of studies assessing smile perception based on different platforms.

Esthetic perception of facial profile changes in Class II patients treated with Herbst or Forsus appliances

OBJECTIVE

To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances.

MATERIALS AND METHODS

Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used.

RESULTS

In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047).

CONCLUSIONS

Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.

Self perceived oro-facial behaviour and malocclusion among young adults in Hyderabad city

BACKGROUND

Aesthetic alterations in the face can be self-perceived and can affect quality of life in young adults.

OBJECTIVE

To assess the impact of malocclusion on self- perceived oro-facial behaviour among young adults.

METHODS

A Cross sectional study was conducted among 638 young adults (aged 18-21 years) of Hyderabad city. One college from each of the five zones of the Hyderabad city (five colleges) were selected by simple random sampling procedure. A 21-item Oro-facial investment scale (OFIS) questionnaire assessing self-perceived oral health knowledge, attitude, practice and Dental Aesthetic Index (DAI) assessing the severity of malocclusion was used. Data were analysed with standard statistical software (SPSS, Statistical package for the social sciences, version 20.0). p < 0.05 was considered statistically significant.

RESULTS

Males had higher mean scores for knowledge (2.90 ± 0.49) than females (2.73 ± 0.82) and was statistically significant (p = 0.002^*). No statistically significant gender differences were found in relation to attitude and practice. Analysis of variance (ANOVA) showed that there was a significant difference in all the three scores (knowledge, attitude, practice) with respect to age, with significantly high score for knowledge and practice among 18 year old subjects (p = 0.0001^*; p = 0.0003^* respectively) and attitude among 21 year old subjects (p = 0.0049^*). No statistically significant age, gender differences were found in relation to DAI scores. Upon correlation, DAI significantly and positively correlated with knowledge (p = 0.03^*) and attitude (p = 0.0001^*).

CONCLUSION

This study has shown significant impact of malocclusion on the self-perceived oro-facial behaviour.

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.

[Orthognathic surgery of mandibular asymmetry: which results can we expect with and without chin wing? A cohort out of 51 cases]

INTRODUCTION

The aim of this retrospective cohort is to evaluate the amount of postsurgical correction of soft and hard tissues in patients with mandibular asymmetries and to compare the results with and without surgery of the lower mandibular contour (chin wing…).

MATERIAL AND METHOD

Mandibular asymmetries cases of three surgeons were systematically included. The angles of deviation of the chin, bi-commissural, bi-gonic and occlusal were measured on face photography and radiography. A pre and post-surgical comparison was performed and the amount of correction was analyzed via the Wilcoxon statistical test.

RESULTS

51 patients (44 women and 7 men) were included. After surgery, the correction is significant for all measurements with an improvement of 44 to 60% depending on the measured angles. No patient is normalized but the small initial mandibular asymmetries are the closest to normal after surgery. The correction of the bi-commissural angle is controlled without being optimal (60% correction). The difficulty remains the horizontalization of the bi-gonial plan which is only corrected at 45%. Patients with mandibular margin surgery (chin wing…) showed the greatest improvement in bi-gonial (p = 0.0142) and occlusal (p = 0.0154) angles.

CONCLUSION

If surgery allows a significant correction of facial dissymmetry, this is not complete. Surgical procedures on the lower edge of the mandible such as the chin wing could provide a better correction especially for bi-gonial and occlusal angles.

Peer Assessment Rating (PAR) Index as an Alternative for Orthodontic Treatment Need Decision in Relation to Angle Classification

OBJECTIVE

This study aimed to determine cut-off points for the Peer Assessment Rating (PAR) index in relation with Angle classification to use as an alternative index for the treatment need assessment.

METHODS

This study included 607 orthodontic patients aged between 9 and 18 years. Angle classification, PAR, and dental aesthetic index (DAI) scores were determined. The DAI was used as the gold standard to evaluate the subjects for treatment need. The receiver operating characteristics (ROC) analysis was used to evaluate the PAR index in relation to treatment need assessed by DAI.

RESULTS

The mean PAR scores for Class I, II, and III malocclusions and total sample were 17.54, 14.27, 18.7, and 20.04, respectively. The areas under the ROC of PAR scores in relation to the DAI assessment were found as 68.3% for the total sample, 66.6% Class I, 59.2% Class II, and 71.3% Class III malocclusions. For the total sample, the optimum cut-off PAR score was 14 in relation to DAI assessment. The cut-off scores for Class I, II, and III malocclusions were 13, 11, and 16, respectively, but considering psychosocial aspects, the recommended score is 14 for Class III.

CONCLUSION

The PAR index can be considered to have an acceptable level of validity for the assessment of orthodontic treatment need regarding Angle classification.

[Discontinuation of Orthodontic Treatment: what are the early predictive factors?]

INTRODUCTION

Discontinuation of orthodontic treatment has iatrogenic, psychological, ergonomic and financial consequences. The objective of this study was to investigate early risk factors (prior to installation) of discontinuation of orthodontic treatment.

MATERIALS AND METHODS

We performed a case-control study between a group of patients who dropped their orthodontic treatment ("A") and a randomly selected group of patients who had completed their orthodontic treatment ("NA"). The two groups were compared, with descriptive, uni and multivariate analyzes. The risk factors assessed were age, gender, socioeconomic status, type of treatment, dysmorphism, malocclusion, need for treatment, compliance.

RESULTS

In the dropout group 55 patients were included ("A") and 100 in the non-abandoned ("NA") group randomly selected. The subject at risk of abandonment was a girl of less than 11 years of age with a low socio-economic level with antero-posterior and vertical skeletal dysmorphisms, a molar class II, a teeth crowding, a small aesthetic prejudice or, on the contrary, very important, complex treatment (with extractions or with surgery) and having delays or missed appointments before the installation of the orthodontic appliance.

CONCLUSION

Patients' motivation needs to be strengthened for both extremes: treatments that appear simple and conversely for complex cases requiring strong cooperation.

[Mandibular asymmetry: determination of a reliable skin measurement technique]

INTRODUCTION

Clinical measurements in the frontal view underevaluate chin deviation in mandibular asymmetry. The aim of this descriptive study is to search for a reliable method of measuring deviant chins using a facial X-ray as reference.

MATERIAL AND METHOD

Seventy patients with mandibular asymmetry who had consulted a maxillofacial surgeon were systematically included. Age, sex, cephalometric characteristics, reasons for patient consultation and type of surgery were collected. Two cephalometric methods were tested with respect to the medial sagittal plane (PSM) to compare the assessment of mandibular asymmetry on soft tissue and by cephalometry.

RESULTS

On average, the patients selected were young (26 years +/- 9), women (75% of cases), presented open bite (average FMA: 28° +/- 8°), a skeletal class III tendency, a left-side shift of the chin (63% of cases). They consulted for both aesthetic and functional reasons (51% of cases) and required bimaxillary surgery (66% of cases). Comparison between the photographic angle (formed by the PSM and the line passing through the nasion and reaching the chin point) and the radiographic angle (formed by the PSM and the line passing through the Crista Galli process and the bony chin point angle) showed no significant difference (p = 0.937) and is thus reliable.

Aspectos sociodemográficos relacionados à gravidade da maloclusão em crianças brasileiras de 12 anos

Resumo Estudo transversal e analítico para caracterizar a maloclusão em crianças brasileiras de 12 anos e identificar os aspectos sociodemográficos associados, utilizando dados do SB Brasil 2010. Foram incluídas 5539 crianças dentre as quais 41% possuíam algum grau de maloclusão, de acordo com o índice Dental Aesthetic Index (DAI). Conduziu-se análises descritivas, bivariadas e múltiplas por regressão logística multinomial. A maloclusão definida foi maior entre os que avaliaram sua saúde bucal como nem satisfeito/nem insatisfeito (OR 1,24; IC 95%; 1,03-1,50) e insatisfeito (OR 1,76; IC 95%; 1,50-2,08). A maloclusão grave foi maior entre crianças do Sudeste (OR 1,44; IC 95%; 1,06-1,96) e Sul (OR 1,52; IC 95%; 1,05-2,19), sexo masculino (OR 1,24; IC 95%; 1,03-1,48), raça negro/pardo (OR 1,39; IC 95%; 1,14-1,69) e que avaliaram sua saúde bucal como nem satisfeito/nem insatisfeito (OR 1,79; IC 95%; 1,41-2,26) e insatisfeito (OR 2,20; IC 95%; 1,77-2,72). O nível muito grave foi maior entre os residentes de capitais (OR 1,36; IC 95%; 1,07-1,71) e que avaliaram sua saúde bucal como nem satisfeito/nem insatisfeito (OR 1,58; IC 95%; 1,22-2,05) e insatisfeito (OR 2,44; IC 95%; 1,96-3,03). A prevalência da maloclusão é alta entre crianças brasileiras, sendo suas diferentes gravidades associadas a aspectos sociodemográficos.

Exploring the impact of malocclusion and dentofacial anomalies on the occurrence of traumatic dental injuries in adolescents

OBJECTIVE

To investigate the association between malocclusion/dentofacial anomalies and traumatic dental injuries (TDI) in adolescents.

MATERIALS AND METHODS

The sample of this cross-sectional study comprised 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório, southern Brazil. Parents answered a structured questionnaire addressing demographic and socioeconomic characteristics. An examiner who had undergone a training and calibration exercise recorded malocclusion/dentofacial anomalies (Dental Aesthetic Index, DAI), TDI (Andreasen), and dental caries (World Health Organisation). Statistical analyses (SPSS software) involved Poisson regression with robust variance.

RESULTS

The prevalence of TDI was 11.6%, and the prevalence of defined, severe, and handicapping malocclusion was 24.0%, 21.6%, and 22.0%, respectively. The multivariate analysis demonstrated that the probability of TDI was approximately twofold higher among adolescents with severe malocclusion (prevalence ratio [PR] 2.22; 95% confidence interval [CI] 1.14-4.31) and handicapping malocclusion (PR 1.95; 95% CI 1.01-3.85) in comparison to those with normal occlusion or minor malocclusion. Defined malocclusion was not significantly associated with the outcome. Among the dentofacial anomalies evaluated, the probability of TDI was nearly twofold higher among adolescents with overjet greater than 3 mm (PR 1.96; 95% CI 1.14-3.37) and 2.2-fold higher among those with an abnormal molar relationship (PR 2.24; 95% CI 1.17-4.32), after controlling for confounding variables.

CONCLUSIONS

Severe and handicapping malocclusion, accentuated overjet, and abnormal molar relationship were strongly associated with the occurrence of TDI. Future studies should investigate whether the treatment of these conditions can help reduce the occurrence of TDI in adolescents.

Prospective Evaluation of Psychosocial Impact after One Year of Orthodontic Treatment Using PIDAQ Adapted for Indian Population

INTRODUCTION

The impact of dental appearance, malocclusion and treatment for the same on psychological and functional well-being has drawn increasing attention over the past decade. Various psychometric instruments alongside normative indices have been used to predict orthodontic concerns. Evaluating the patients' experience during the orthodontic treatment can help us understand the true benefits and advantages of orthodontic therapy.

AIM

The aim of the present study was to evaluate the change in the psychosocial impact of malocclusion using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) adapted for the Indian population after one year of fixed orthodontic treatment.

MATERIALS AND METHODS

This interventional study was conducted on 93 patients requiring fixed orthodontic treatment. Brazilian, Chinese, Spanish, Nepali and Moroccan versions of the PIDAQ have been published but the questionnaire is not available in Hindi. In the present study, the original PIDAQ was translated into Hindi language to adapt it for the Indian population and was validated by back translation and pretest. All the subjects answered the Hindi version of the questionnaire at pretreatment (T1) and at one year of orthodontic treatment (T2). Additionally, the Index of Orthodontic Treatment Need (IOTN) was applied to measure the severity and self-perception of malocclusion. The data were analysed using paired t-test, Wilcoxon signed rank test and Kruskal-Wallis test.

RESULTS

Significant reduction was found in the total PIDAQ score and each factor's score (p<0.001) after one year of orthodontic treatment. There was a positive association of the psychosocial impact of malocclusion with the IOTN-AC (IOTN-Aesthetic Component). Adolescent females were found to be most concerned with their dentofacial appearance.

CONCLUSION

Results showed significant improvement in the psychosocial impact of malocclusion with a reduction in the self-perceived needs of patients with orthodontic treatment. The psychometric instrument used may be recommended as an Oral Health Related Quality of Life (OHRQoL) assessment tool for the population in India for further research.

Prevalence of malocclusion in individuals with and without intellectual disability: A comparative study

OBJECTIVE

The aim of this study was to compare the prevalence malocclusion between individuals with intellectual disability (ID) and a control group without disability (NID).

METHODS

A total of 202 individuals (123 with ID and 79 with no impairment) were included in the study. Data were collected through oral examinations using the Angle classification of malocclusion and the dental aesthetic index (DAI).

RESULTS

According to Angle's classification of malocclusion, it was found that 37.6% of all participants presented malocclusion. Class II malocclusion was the most common form of malocclusion in both groups, whereas class III cases were present almost exclusively in ID group (91.7%). The mean DAI score was 30.85 (± 13.7), being higher in the ID group (32.80) than in the control group (27.81; p = 0.003). A total of 45 (22.3%) participants had DAI scores of 36 and above, which indicate a handicapping malocclusion requiring mandatory orthodontic treatment. From those needing mandatory orthodontic treatment, the majority (84.4%) belonged to ID group. Mandibular irregularity (56.4%) and incisal segment crowding (45%) were the most common features of the malocclusion. Linear regression indicates that having an intellectual disability predicts severe or very severe malocclusion.

CONCLUSIONS

In this study, the prevalence of malocclusion was found to be higher and more severe in intellectual disabled participants. The dental practitioner should understand the particular relevance of this problem especially in patients with intellectual disabilities where impaired oral functions and poor appearance may further complicate oral health and increase negative social responses.

A comparative study of aesthetic perceptions of malocclusion among general practice dentists, orthodontists and the public using a visual analogue scale (VAS) and the IOTN-AC

Background

Perception of malocclusion varies among individuals and among patients and practitioners. Although several indices that tend to coincide in many aspects and unify criteria, no single index has been recognised as the most suitable for assessing orthodontic treatment need. Moreover, orthodontists are not always aware of the differences in perception of malocclusion between patients and practitioners.

Objetives

To examine the perception of dental anaesthetics amongst dentists, orthodontists and the general population, study the relationship between the perception of dental aesthetics and the severity of the malocclusion, using the visual analogue scale and the IOTN-AC, and investigate relationships among the resulting data.

Study Design

Frontal intraoral photographs of 24 cases were classified by the severity of their malocclusion according to the DAI index. The photographs were examined by 150 individuals (30 orthodontists, 30 general dental practitioners and 90 members of the general population), who assessed them on a visual analogue scale and according to the IOTN-AC.

Results

The orthodontists gave the lowest scores on the visual analogue scale, although the differences between the three groups were not significant. For DAI grades 1, 3 and 4, significant differences were found in the IOTN-AC assessments. Here too, the orthodontist group was the most critical.

Conclusions

In general, in all three groups, both the visual analogue scale and IOTN-AC scores increased or decreased in line with the severity of the malocclusion according to the DAI. However, the correlation between these scores was low. The orthodontists scored the malocclusions more critically than the general dentists or the general population with the IOTN-AC, but this difference was not found with the visual analogue scale.

Key words:IOTN-AC, DAI, malocclusion.

Self-Evaluated Dental Appearance Satisfaction among Young Adults

BACKGROUND

Dental appearance satisfaction is important among young adults because judgment concerning the personal characteristics of individuals is influenced by their dental appearance in the absence of other information.

AIM

The aim of the study was to determine the self-evaluated dental appearance satisfaction among young adults.

SUBJECTS AND METHODS

This cross-sectional survey of financial industry prone undergraduates of University of Benin was conducted between July and September, 2010. The self-administered questionnaire which assessed information on demographic characteristics, smoking habit, alcohol use, previous dental visit, dental appearance satisfaction, tooth shape, size, arrangement and strength was the tool of data collection. The data was subjected to descriptive, Chi-square and regression statistics using statistical package for the social sciences version 17.0 (Chicago, IL, USA). (P < 0.05) was considered to be significant.

RESULTS

A total of 399 undergraduates which are made up of 179 (44.9%) males and 220 (55.1%) females with mean age of 24.66 (4.20) years participated in this study. Self-evaluated dental appearance satisfaction was expressed by 79.4% (317/399) of the participants. The significant predictors of self-evaluated dental appearance satisfaction were skin color (P = 0.03, odds ratio [OR] =2.57, 95% confidence interval [CI] =1.09-6.09) and perceived tooth strength (P = 0.02, OR = 5.83, 95% CI = 1.40-24.28) among males and alcohol consumption (P = 0.04, OR = 0.45, 95% CI = 0.21-0.95] and perceived size of tooth (P = 0.02, OR = 2.37, 95% CI = 1.15-4.89) among females. The significant predictors of self-evaluated dental appearance satisfaction among the participants were ethnicity (P = 0.04, OR = 0.55, 95% CI = 0.32-0.96), skin color (P = 0.04, OR = 1.74, 95% CI = 1.03-2.93), perceived tooth size (P = 0.03, OR = 1.82, 95% CI = 1.07-3.09) and strength (P = 0.01, OR = 3.42, 95% CI = 1.58-7.41).

CONCLUSION

Ethnicity, tooth arrangement, size and strength need to be given detailed consideration in tooth replacement as they emerged as the significant predictors of self-evaluated dental appearance satisfaction among young adults.

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.

Evaluation of orthodontic treatment needs using the dental aesthetic index in Iranian students

BACKGROUND

In the contemporary orthodontics, the number of people who demand orthodontic treatment to improve their psychosocial issues related to facial esthetic is constantly increasing. Even in treatment plans, appearance and esthetic gain more attention.

OBJECTIVES

The purpose of this study was to determine the need for orthodontic treatment on the basis of the dental aesthetic index (DAI) in the Iranian students of Ahvaz city.

MATERIAL AND METHODS

This cross sectional study was performed on 900 students aged between 11 - 14 years (450 boys, 450 girls). Schools were selected based on random cluster sampling from different parts of the city. Students\ who had or were having orthodontic treatment including those on interceptive orthodontics, were excluded from the study. Two questionnaires were used; the first one included different DAI criteria, and the second one included two questions about orthodontic treatment need and satisfaction of personal dental appearance. The results were analyzed by Chi-Square and T test.

RESULTS

In 70.9% of the students, DAI score was 13 - 25, 19.2% of the samples had a DAI score of 26 - 30, the DAI score of 7.8% was 31 - 35, and in 2.1% the DAI score was greater than 35. The association between the DAI score and sex was not statistically significant (P = 0.778). In relation to orthodontic treatment need, 44.8% of students answered positively, while in 55.2% the answer was negative. In relation to satisfaction with appearance, 21% of the students were satisfied with their appearance, 59% were relatively satisfied, and 19.9% were not satisfied with their appearance. The association between DAI score and the need for orthodontic treatment and satisfaction of dental appearance was significant (P = 0.000).

CONCLUSION

In comparison to other studies, the students in Iran (Ahvaz) have a better dental appearance and less need for orthodontic treatment. Significantly positive correlations were found between the DAI and satisfaction of dental appearance, orthodontic treatment need and student's perception.

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.

Malocclusion, dental aesthetic self-perception and quality of life in a 18 to 21 year-old population: a cross section study

BACKGROUND

Aesthetic alterations in the face can be self-perceived and can affect quality of life. For young people, physical attractiveness is an important factor affecting social relationships. The aim of this study was to estimate the prevalence of malocclusion, identify the most common types and test its association with oral aesthetic self-perception in 18 to 21 year-old population of male young adults.

METHODS

A cross-sectional study was carried out involving 138 Brazilian Army soldiers. Data collection included socio demographic profile, malocclusion status through the Dental Aesthetic Index (DAI) and oral aesthetic self-perception as indicated by the Oral Aesthetic Subjective Impact Scale (OASIS). The chi-square and Fisher's exact test were used to test for homogeneity of proportions. The stepwise multivariate logistic regression analysis was used to test for the relationship between the poorer oral aesthetic self-perception and parental and soldier's education, per capita income, history of caries in all teeth and only on anterior teeth, dental trauma, previous orthodontic treatment and malocclusion.

RESULTS

The prevalence of malocclusion was 45.6%. Incisor teeth crowding and misalignment of lower incisors were the most common types of malocclusions. A statistically significant and independent association between malocclusion and poorer oral aesthetic self-perception in the multivariate analysis was observed. Subjects with severe malocclusion conditions showed 88% higher prevalence [prevalence ratio =1.88 (95% CI, 1.30 - 2.72); p = 0.001] of poorer aesthetic self-perception comparing to those with minor malocclusion.

CONCLUSIONS

A high prevalence of malocclusion was observed. The young adults presenting severe malocclusion had a higher and independent prevalence of poorer oral aesthetic self-perception.

Orthodontic treatment need in a Spanish young adult population

Objectives: Orthodontic treatment need has often been assessed in child populations, but few studies employing internationally-recognized indices have been conducted in adult or young adult populations. The aim of this study was to determine the orthodontic treatment need of a young adult population in Spain by means of the Dental Aesthetic Index (DAI), the Index of Orthodontic Treatment Need (IOTN) and the need perceived by the patients. Study design: A cross-sectional epidemiological study was conducted in a broad, representative sample of 671 adults aged between 35 and 44 years using health centers in the Valencia Region of Spain, following the recommendations of the World Health Organization (WHO). Results: Orthodontic treatment was required by 31.3% of the sample according to the DAI and 19.2% according to the IOTN (DHC). The orthodontic treatment need perceived by the patients was 21.1%. On relating treatment need to different variables, significant differences in patient perception were encountered by gender, as women perceived a greater need (23.9%) than men (14.4%). Significant differences in previous orthodontic treatment history were found between middle/high (15%) and low (9%) social class and between secondary/tertiary (14%) and primary (3.3%) education. Conclusions: There was no agreement between the treatment need assessed objectively by the indices and that perceived by the patient, or between the indices themselves. The decision to undergo orthodontic treatment can depend on socioeconomic and psychological factors and on values and principles that do not easily lend themselves to objective measurement.

Key words:Orthodontics, epidemiology, adult, malocclusion.

Negative self-perception of smile associated with malocclusions among Brazilian adolescents

This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.

An Overview of Orthodontic Indices

Analysis of prevalence of various types of malocclusion is an important aspect of today's evidence-based dentistry. Orthodontic indices are a tool in the hands of an epidemiologist to analyze the prevalence and severity of various kinds of malocclusion. The aim of this article is to look into the various qualitative and quantitative methods of grading and assessing malocclusion and their evolution over the years along with their advantages and limitations have also been analyzed. The article also compares the commonly used indices—DAI and IOTN.

How to cite this article

Agarwal A, Mathur R. An Overview of Orthodontic Indices. World J Dent 2012;3(1):77-86.

Oral health and social and emotional well-being in a birth cohort of Aboriginal Australian young adults

Background

Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aboriginal adults residing in the northern region of Australia's Northern Territory.

Methods

Data were collected on five validated domains of social and emotional well-being: anxiety, resilience, depression, suicide and overall mental health. Independent variables included socio-demographics, dental health behaviour, dental disease experience, oral health-related quality of life, substance use, racial discrimination and cultural knowledge.

Results

After adjusting for other covariates, poor oral health-related items were associated with each of the social and emotional well-being domains. Specifically, anxiety was associated with being female, having one or more decayed teeth and racial discrimination. Resilience was associated with being male, having a job, owning a toothbrush, having one or more filled teeth and knowing a lot about Indigenous culture; while being female, having experienced dental pain in the past year, use of alcohol, use of marijuana and racial discrimination were associated with depression. Suicide was associated with being female, having experience of untreated dental decay and racial discrimination; while being female, having experience of dental disease in one or more teeth, being dissatisfied about dental appearance and racial discrimination were associated with poor mental health.

Conclusion

The results suggest there may be value in including oral health-related initiatives when exploring the role of physical conditions on Indigenous social and emotional well-being.