Prevalence and severity of malocclusion in Israeli Arab urban children 13 to 15 years of age

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Israeli Arab children between the ages of 13 and 15 years, living in the town of Nazareth, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. The survey encompassed 803 children, of whom 2.5 percent were under orthodontic treatment at the time of the study and 0.3 percent showed ideal occlusion. The remainder showed various measures of deviation from normal, distributed as follows: 85 percent had Angle Class I malocclusion, 8.5 percent had Angle Class II, Division 1 malocclusion, 1.7 percent had Angle Class II, Division 2 malocclusion, and 1.3 percent belonged to the Angle Class III category. The severity of malocclusion was appraised qualitatively by subjective evaluation, while for quantitative determination the Handicapping Malocclusion Assessment Record (HMAR) was used. There was a positive correlation between the two modes of assessment as expressed in the 12.4 percent of the children who were classified "treatment highly desirable or mandatory" and who scored 30 or more points on the HMAR chart. Further examination of the deviations underlying the scoring revealed that the 52.1 percent of the children with scores of 15 points or more would benefit greatly from orthodontic treatment. Selected items of the TPI and OI charts were incorporated into the HMAR to evaluate the latter's sensitivity. Supplementing the HMAR with some deviations from normal, such as cusp-to-cusp relationships, amplifies the sensitivity of this record.