Unmet orthodontic treatment need in rural Nigerian adolescents

Orthodontic treatment need of children and adolescents with special healthcare needs resident in Ile-Ife, Nigeria

OBJECTIVES

This study determined differences in the orthodontic treatment need of children and adolescents with and without special healthcare needs (SHCN) resident in Ile-Ife.

METHODS

Participants were children and adolescents aged 6 to 19 years with and without SHCN recruited from regular and special schools in Ile-Ife, Nigeria, respectively. SHCN were categorised as hearing impairment (HI), visual impairment (VI), physical impairment (PI) or intellectual disability (ID). The orthodontic treatment need was determined using the aesthetic component (AC) and dental health component (DHC) of the index of orthodontic treatment need (IOTN) and the dental aesthetic index (DAI). Chi-squared tests were used to determine differences in orthodontic treatment need; one-way analysis of variance was used to compare participants' mean DAI scores. Statistical significance was inferred at p < 0.05.

RESULTS

The data of 164 participants with SHCN and 208 participants without SHCN were analysed. Significantly more children and adolescents with SHCN than those without SHCN had great need for treatment on the AC (15.2% vs. 4.3%; p<0.001) and the DHC (28.0% vs. 18.3%; p = 0.005) of IOTN and mandatory need for treatment using the DAI (28.0% vs. 12.0%; p < 0.001). The orthodontic treatment need of participants with intellectual disability, visual impairments and multiple SHCN differed significantly from the control group, those with intellectual disability also had greater need for orthodontic treatment compared with those with physical and hearing impairments (p < 0.05) CONCLUSION: Children and adolescents with SHCN, resident in Ile-Ife, are at greater risk of having malocclusion traits that require orthodontic treatment when compared with their peers without SHCN, especially those with intellectual disability.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Association between normative and self-perceived orthodontic treatment need in a Lebanese population

The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150 subjects (81 males and 69 females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Unmet contraceptive need among married Nigerian women: an examination of trends and drivers

OBJECTIVE

The aim of this study is to examine trends in and drivers of unmet need for contraceptives among married Nigerian women between 2003 and 2013.

METHODS

This analysis utilized combined data from the 2003, 2008 and 2013 cross-sectional Nigerian Demographic Health Surveys, resulting in a sample size of 54,873 currently married women. Multinomial logistic regression examined associations between trends in unmet need for spacing and limiting, and the demographic, socioeconomic, and reproductive profiles of the respondents.

RESULTS

Women in 2008 were 30% more likely to have an unmet need for spacing, relative to women in 2013. Despite these significant declines in unmet need to space fertility between 2008 and 2013, the adjusted results show that between 2003 and 2013, there was no significant change in the trends in unmet need to space fertility. Unmet need to limit fertility was significantly higher in 2003, adjusted, and 2008 relative to 2013. Younger, low-parity, Muslim women were significantly less likely than older, high-parity, non-Muslim women to have an unmet need to limit fertility. Women residing in the northeast and northwest of the country were significantly less likely than women residing in the south of the country to have an unmet need to limit fertility. Women whose most recent child had died were significantly less likely to have an unmet need to space and limit fertility.

CONCLUSIONS

These data suggest that interventions to increase the knowledge of modern contraceptives, to reduce child mortality, and to improve women's decision-making power would all serve to increase demand for contraceptives, even in areas with high-fertility preferences.

IMPLICATIONS

Nigeria has set a goal of a 36% contraceptive prevalence rate by 2018. With a current contraceptive prevalence rate of 15% reaching the additional 16% of women, who have articulated a demand for contraception, will almost reach that goal. Contraceptive use directly reduces maternal risk; implementing interventions to increase demand for contraception and meeting articulated demands for contraception would not only support women's (and men's) ability to realize their reproductive rights but also, ultimately, may reduce the burden of maternal deaths in Nigeria.

Prevalence of Malocclusion and its Psycho-Social Impact among 12 To 15-Year-old School Children in Lucknow City

BACKGROUND

Facial aesthetics affects how people are perceived by society and how they perceive themselves. Anterior malocclusion can have an impact on the overall facial appearance.

AIM

The aim of the study was to assess the prevalence of malocclusion and its psycho-social impact among 12 to 15 yrs old school children in Lucknow city.

MATERIALS AND METHODS

The study consisted of collection of information for psychosocial assessment using a questionnaire and clinical examination of malocclusion. Data regarding psychosocial impact of dental aesthetics was collected using a Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) given by Klages et al., (2006).

RESULTS

15.57% children belonged to the definite malocclusion category and 5.41% to the handicapped malocclusion category. The mean Dental self confidence score differed significantly among both male (p≤0.001) and female children (p≤0.001) across the age groups. The mean Social impact score did not differ significantly among both male (p≤0.31) and female children (p≤0.12) across the age groups.

CONCLUSION

The results of the present study imply that dental aesthetics had a significant impact on the psychosocial aspects of human life irrespective of the gender.

Orthodontic treatment: need and demand in north karnataka school children

OBJECTIVES

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

METHOD

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

RESULTS

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

CONCLUSION

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

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

Introduction:

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

Materials and Methodology:

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

Results:

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

Conclusions:

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

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.

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

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

Orthodontic treatment need in a 12-year-old population in the Western Sahara

The aim of this study was to establish orthodontic treatment need according to the Dental Aesthetic Index (DAI) and Aesthetic Component (AC) and Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and to determine its association with gender among Saharan schoolchildren. The study was carried out in accordance with World Health Organization (WHO) recommendations for oral health surveys at 12 years of age. The sample comprised 248 Sahrawi children (135 girls and 113 boys) living in refugee camps in Tindouf, Algeria. None of the children had previously received any orthodontic treatment. A chi-square test was used to analyse the IOTN results by gender, and a Student's t-test was employed for the DAI results. The mean DAI was 23.32 with a standard deviation of 6.05, 4 percent with a very severe and 9.2 per cent with severe malocclusion. Orthodontic treatment need was 16.1 and 2.0 percent, respectively, according to grades 4 and 5 of the IOTN DHC, 13.7 percent according to the IOTN AC, and 28.6 percent according to the modified IOTN (IOTN DHC grades 4-5 and/or IOTN AC grades 8-10). There were no statistically significant differences by gender. The orthodontic treatment need of Western Saharan schoolchildren is similar to that reported by many recent studies in European and in Sub-Saharan countries.

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.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Oral health in Nigeria

Most oral health surveys in Nigeria have been sporadic and based on convenience samples. Periodontal disease with deep pocketing occurs in Nigerians at an early age, the prevalence being 15-58% in those aged above 15 years. Caries experience has been reported to vary between very low and low in most studies, but is moderate in some urban communities. Although mean DMFT is below 4 in most communities, the restorative index is extremely low, most carious teeth remaining unrestored. The higher caries prevalence in second than first permanent molars that has been reported is most likely due to a change from traditional to Western-type diet. Other oral health problems include malocclusion, truamatised teeth, dental fluorosis, and oral tumours. The scanty oral health services available in the country are mainly in urban areas. There is, therefore, a need to develop sustainable strategies for national preventive and therapeutic oral health services in Nigeria.

Perceptions of dental attractiveness and orthodontic treatment need among Tanzanian children

The aim of this study was to assess the opinions of Tanzanian children on dental attractiveness and their perceptions of orthodontic treatment need in relation to their own dental attractiveness as measured by the aesthetic component (AC) of the index of orthodontic treatment need (IOTN). In a random sample of 386 school children (48% boys, 52% girls), aged 9 to 18 years, the subjective need was assessed by using a prestructured questionnaire, and attractiveness was scored by using 18 intraoral frontal photographs. Orthodontic treatment need was measured with the IOTN, and 11% of the children definitely needed orthodontic treatment (grades 8-10 of the AC with 4-5 of the dental health component [DHC]). The AC indicated that 11% of the children needed orthodontic treatment, whereas the DHC indicated 22%. Although 38% of the children said they needed treatment, 33% and 31% were unhappy with the arrangement and the appearance of their teeth, respectively. Most children (85%) recognized well-aligned teeth as important for overall facial appearance. Photographs showing severe deviations including crowding were regarded as the most unattractive, with older children tending to dislike them the most (P <.0005). This suggests that, from the children's point of view, grades 8-10 of the AC and 4-5 of the DHC could be given the first priority when considering an orthodontic treatment policy in Tanzania.

Orthodontics in Nigeria: journey so far and the challenges ahead

The practice of orthodontics in Nigeria has witnessed a gradual, but steady development since its introduction about three decades ago. The undergraduate orthodontic training that was fashioned after the British model has evolved from a concentrated course of lectures to a more clinical/practical orientated programme. The local postgraduate training, however, needs to be restructured and strengthened in order to face the challenges ahead. The importance of constant upgrading of knowledge and skills in all areas of orthodontics is also emphasized.

Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the dental aesthetic index (DAI)

The aims of this study were to measure the distribution, prevalence and the severity of malocclusion and treatment need amongst randomly selected (n = 703) rural and urban Nigerian children aged 12-18 years (mean 14.0 +/- 1.84) using the dental aesthetic index (DAI), and to assess whether malocclusion was affected by age, gender and socio-economic background. Data were collected according to the method recommended by WHO. Most of the children (77.4 per cent) had a dental appearance which required no orthodontic treatment. Over 13 per cent fell into the group where treatment for malocclusion is considered to be 'elective'. However, a substantial proportion (9.2 per cent) of the population had severe to handicapping malocclusion where treatment is 'highly desirable' or 'mandatory'. There were no statistically significant differences (P > 0.05) in DAI scores between age groups, gender and socio-economic background. This study also found that Nigerian adolescents had better dental appearance and less orthodontic treatment need compared with the Caucasian and Oriental populations.