Social acceptability of dental appearance and benefits of fixed orthodontic treatment: A 17‐year observational cohort study

Abstract

This study reports on the social acceptability of dental appearance and benefits of fixed orthodontic treatment (FOT) among a cohort of 13-year-old adolescents in 1988/1989 followed through to age 30 years in 2005/2006. Adolescents were categorized into nominal treatment need groups based on the dental aesthetic index (DAI) score at age 13 (DAI: ≤ 25 "No Need"; 26-30, "Elective"; 31-35, "Desirable"; and ≥36, "Mandatory"). At age 30, calibrated examiners again assessed the DAI of traced participants. A reduction in the baseline DAI score of at least five units was considered a benefit. The change in DAI scores was examined by receipt of FOT. The number needed to treat (NNT) was estimated as an indicator of the efficacy of FOT. Of the 421 cohort participants examined at follow-up, 148 had undergone FOT; 34 percent of those with FOT were classified at age 13 as "No Need" (n = 50); 21 percent as "Elective" (n = 31); 17 percent as "Desirable" (n = 26); and 28 percent as "Mandatory Need" (n = 41). The DAI score reduced significantly for those with and without FOT. The NNT from FOT for those individuals in the "No Need" category was 17 [95 percent confidence interval (CI) - 26-6]; "Elective" 6 (95 percent CI - 27-3); "Desirable" 5 (95 percent CI 3-51) and "Mandatory Need" 14 (95 percent CI - 16-4). FOT provided a significant benefit only for individuals in the "Desirable" group at age 13. FOT appeared to offer little long-term benefits in the social acceptability of dental appearance for the majority of individuals who underwent FOT.