Sex differences in the uptake of orthodontic services among adolescents in the United States

Abstract

The purpose of this study was to test whether girls are treated orthodontically for milder occlusal issues than are boys, thus accounting for the greater uptake of orthodontic services among girls compared with boys. The dental aesthetic index (DAI) was used to score the severity of esthetic occlusal issues in 357 white adolescents. Half of the subjects were from private practices; the others were from a university specialty clinic. Average DAI scores were statistically significantly lower (milder) in girls than boys in both venues; this confirms the assumption that the actual uptake of services is greater in girls because of heightened concern for their esthetic occlusal issues. Average DAI scores predictably were higher in the teaching setting because of selection for more complex cases, but the sex difference was still evident statistically. There was no association between DAI score and age at the start of treatment among these adolescents. Spacing and incisor irregularity showed the greatest sex differences among the DAI variables, possibly because girls are more attuned to these esthetic issues. These results complement studies that have recorded adolescents' perceptions of orthodontic need. The actual uptake of orthodontic treatment is greater in girls because they (and their parents) seek treatment for milder occlusal issues.