Assessment Of Treatment Need Research Articles

A comparison of attitudes toward orthodontic treatment in British and American communities

Utilization of orthodontic services may be influenced as much by the social and cultural setting as by objective criteria. The public's assessment of dental irregularity and its perceptions of the psychosocial implications of malocclusion may be critical factors in the utilization of available services. To test these assumptions, two communities with historic differences in the availability and utilization of orthodontic services were selected as survey sites (Lexington, Kentucky, and Cardiff, Wales). Three-hundred eighty-five sixth grade children (11 to 12 years of age) and 123 of their parents were interviewed concerning dental esthetics, treatment need, and knowledge about, attitudes toward, and value placed on orthodontic treatment. Although the Lexington respondents had greater personal and indirect knowledge about such services, they did not have more positive perceptions about treatment; nor did they value straight teeth more highly. There were no significant differences between the groups' judgement of dental esthetics or assessment of treatment need. The differences in utilization of services in the two communities could not be explained in terms of differences in attitude toward malocclusion and orthodontic treatment.

A dental-facial attractiveness scale: Part I. Reliability and validity

Since the decision to seek orthodontic treatment is frequently the result of concerns about appearance, assessment of need for treatment should include an impartial evaluation of dental-facial appearance. While some of the standardized techniques for assessing malocclusion have included a consideration of esthetic impairment, they tend to confound this with functional impairment. The purpose of this study was to develop a valid and reliable index that provides relatively objective judgments of dental-facial attractiveness. The subjects in this study were eighth- and ninth-grade children seeking orthodontic treatment and their siblings, and eighth- and ninth-grade children not seeking treatment and their siblings. Photographs of the children were rated for dental-facial attractiveness by lay and dental judges. Children were also assessed for severity of malocclusion by means of the Treatment Priority Index. Children seeking treatment were perceived as significantly less attractive than children not seeking treatment. Dental judges rated children seeking treatment as more attractive than did nondental judges. Intraclass reliability coefficients were moderate to high.

Orthodontic surveys--a critical appraisal.

Surveys of the occlusion in population groups usually include in their objectives the academic assessment of occlusal features, the planning of resources for public health treatment programmes, the comparison of differing populations and the screening of groups for orthodontic treatment. The requirements for these purpose differ. While occlusal features are readily measured by any trained observer, the need for treatment is a largely subjective judgement and the difficulty and practicability of treatment are aspects which can only realistically be assessed by clinical orthodontists. The use of an occlusal index, while standardizing the measurement of the occlusion, still retains the subjectivity of the assessment of treatment need, though this subjectivity is also standardized. No occlusal index at present includes any measure of the difficulty or practicability of treatment. Reports of orthodontic surveys on UK populations in the past 30 years reflect the difficulties of making comparable assessments without standardized criteria, as well as secular changes in judgment of treatment need. If surveys are to be of value either in resource planning, screening or comparison of populations there seems to be a need to develop a suitable index which would use measurements rather than classifications as far as possible.

Utilization of dental care in a Finnish industrial population

Ninety-three percent of the 300 employees of a paper mill in central-eastern Finland answered a questionnaire in the context of a clinical dental survey. One third had visited the dentist annually, 22% once in 2 years and the rest irregularly. Dental visit frequency of females was somewhat higher than that of males. People in younger age groups and higher income groups used more dental services, whereas those who had dentures used clearly less dental services than others. Subjective assessment of treatment need was the main reason for dental visits, more than half of the subjects had attended the dentist the last time because of self-assessed need. Thirty-eight percent went to the dentist because of toothache and only 9% for regular check-up. Although more than one third had gone to the dentist because of toothache only one third of those who had toothache during the preceding year had visited the dentist during that period. People without toothache, in fact, used more dental services than those who had had it.