Orthodontic status and treatment need of 13 to 15 year-old children in Kwa-Zulu Natal South Africa: An epidemiology study using the Dental Aesthetic Index (DAI)

Kiran Ramson,Shenuka Singh

doi:10.17159/2519-0105/2021/v76no7a4

Abstract

The prevalence of malocclusion among school going children in KwaZulu-Natal remains poorly defined despite the known physiological and psychological impact of this dental occurrence. The aim and objectives of this study was to determine the prevalence of malocclusion and possible treatment need in 13-15 year-old school going children in Durban, Kwa-Zulu Natal. This was a descriptive, cross-sectional epidemiological study conducted on 270 school-going children aged 13 to 15 years, in the Umlazi and Pinetown school districts. A two-staged clustered and systematic random sampling technique was used to draw the study sample. Data was collected through an intraoral examination of occlusal status and the malocclusion and orthodontic treatment need was assessed through use of the Dental Aesthetic Index (DAI). Questionnaires were developed to collect information on the learners’ health status and socio demographic profile. The results indicated that 144 (53.3%) of the 270 learners had DAI scores <25 (no abnormality or minor malocclusion not requiring orthodontic treatment); 26 learners (9.6%) had DAI scores of between 26-30 (definite malocclusion requiring elective orthodontic treatment); 59 learners (21.9%) had DAI scores of between 31-35 (severe malocclusion requiring orthodontic treatment); and 41 learners (15.2%) had DAI scores >36 (very severe or handicapping malocclusion requiring mandatory orthodontic treatment). There was an increase in the proportion of malocclusion in older children. The age group of 15 years old had a mean and standard deviation of 30.02+8.9 when compared to the age group 13 years old (27.76+12.17). The association between gender distribution and severity of malocclusion was found to be statistically significant (p=0.01). The present study primarily indicated a significant prevalence of malocclusion in the identified children. Although 53.3% of children did not require treatment, 37.1% presented with severe and handicapping malocclusion. This suggests a definite and mandatory treatment need for this group of children. The study could provide useful baseline epidemiological data that could inform oral health planning on the prevalence of malocclusion and orthodontic treatment need for 13-15 year-old school going children in the identified geographical area.

Highlights

The prevalence of malocclusion among school going children in KwaZulu-Natal remains poorly defined despite the known physiological and psychological impact of this dental occurrence
Data was collected through an intraoral examination of occlusal status and the malocclusion and orthodontic treatment need was assessed through use of the Dental Aesthetic Index (DAI)
There was an increase in the proportion of malocclusion in older children

Summary

Introduction

The prevalence of malocclusion among school going children in KwaZulu-Natal remains poorly defined despite the known physiological and psychological impact of this dental occurrence. Malocclusion is a highly prevalent dental occurrence, with social and psychological impact that can have physical and economic implications for the individual.[1,2,3] Malocclusion can influence the quality of life, including functional ability, appearance and aesthetic self-evaluation, and inter www.sada.co.za / SADJ Vol 76 No 7. The World Health Organisation (WHO) has included malocclusion under the heading of Handicapping Dentofacial Anomaly[9] which is defined as an anomaly which causes disfigurement or impedes function, and that treatment is required should the functional disability impact on the individual’s well-being.[10,11] Malocclusion is listed as the third priority of oral health problems, after dental caries and periodontal disease, in children and young adults.[12,13,14]. The orthodontic status (prevalence of malocclusion) and treatment need of the population varies among different countries, as well as among the different age and gender groups within the respective populations.[15,16,17] Various orthodontic epidemiological studies have been conducted internationally[8,18] but there is a lack of published or recent data on the prevalence and severity of malocclusion and the orthodontic treatment need for children aged 13 to 15 years in KwaZulu-Natal.[19,20] very little has been done to quantify the proportion of the population that could benefit from orthodontic treatment[21,22] or identify measurement tools that could increase consistency and accuracy in the reporting methods.[23]

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Conclusion