Abstract
This study compared adolescents' self-perceived need for orthodontic treatment with the normative need for such treatment and investigated associations between socioeconomic and demographic variables and self-perceptions of dental malocclusion. This cross-sectional study involved 1015 schoolchildren aged 12-15 years in São Luís, Maranhão, Brazil. The following data were collected using a questionnaire and an orthodontic examination card: demographic and identifying data, socioeconomic data, educational levels of family, household income, economic classification criteria, and self-reported skin color behavioral data, and oral health data. Normative occlusal condition was examined using the Angle classification and Dental Aesthetic Index (DAI). Data were analyzed using the chi-squared test (to analyze differences in the frequency distribuition of qualitative variables) and Poisson regression (to stimate associations between the perceived need of orthodontic treatment and study covariates), with a 5% significance level. Schoolchildren's self-perceived need for orthodontic treatment was associated with sex (p = 0.022) and the normative need for treatment (p = 0.004). Among socioeconomic, demographic, and oral health variables, only sex [prevalence ratio (PR) = 1.15; 95% confidence interval (95%CI) = 1.04-1.28; p = 0.009] and the normative need for orthodontic treatment (PR = 1.19; 95%CI = 1.08-1.32; p < 0.001) were associated with the perception of malocclusion, with female adolescents reporting a greater need for orthodontic treatment. Female adolescents seems to be more sensitive to oral health problems. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment and the Angle classification might overestimate the orthodontic treatment need.
Highlights
The worldwide prevalence of malocclusion is considered to be high, as exemplified by studies performed in Spain (58.6%), Iran (77.1%), and Italy (93%).[1,2,3] In Brazil, the malocclusion rate is 37.6% among 12-year-old children and 35.6% among children aged 15–19 years.[4]
Female adolescents reported a 15% greater need than males for orthodontic treatment (PR = 1.15; 95% confidence interval (95%CI): 1.04–1.28), and 19% of schoolchildren who reported subjective need had normative need for orthodontic treatment (PR = 1.19; 95%CI: 1.08–1.32), (Table)
The study findings are similar to those of other studies conducted in Brazil,[5,13,21] which have documented greater self-perceived than normative need for treatment; the need for orthodontic treatment could not be justified by objective criteria in about half of adolescents
Summary
The worldwide prevalence of malocclusion is considered to be high, as exemplified by studies performed in Spain (58.6%), Iran (77.1%), and Italy (93%).[1,2,3] In Brazil, the malocclusion rate is 37.6% among 12-year-old children and 35.6% among children aged 15–19 years.[4]. Prevalence in various populations of the world, the malocclusions started to be targeted of researches.[7]. Determination of the need for dental treatment is based on normative measures that do not take into account patients’ expectations or perceptions of what should lead them to seek treatment. They do not know the degree to which malocclusion can negatively affect their day-to-day lives via functional limitations and impacts on psychosocial well-being. I can be rather associated mainly to social, physical and psychological reasons.[8]
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