Perception Of Malocclusion Research Articles

Parental influence in orthodontic treatment: a systematic review.

The reasons for searching orthodontic treatment in pediatric/adolescent patients are multifactorial. The aim of this systematic review was to study the parental influence in this process. This study comprises a systematic review of the literature, based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. We analyzed 41 articles related to the study hypothesis, 29 of which followed the general inclusion criteria, and 21 specific studied the parental influence in orthodontic treatment. The results demonstrated that dental aesthetics and facial appearance were the main triggering factors related to the search for orthodontic treatment. Pair influence also plays an important role. The perception of malocclusion and the motivation are factors that emphasize the importance of parents in this process. Parental support was identified as a positive factor in orthodontic success reported in most of the studies. Parental influence has a positive effect on orthodontic treatment and should be understood by clinicians as a central factor in achieving the desired treatment plans.

Self- Perception of Malocclusion and Perception towards Orthodontic Treatment according to Age in Indian Population: A Questionnaire Study

Self- Perception of Malocclusion and Perception towards Orthodontic Treatment according to Age in Indian Population: A Questionnaire Study

Adolescents’ perception of malocclusion, their motivations, and expectations concerning the orthodontic treatment. Is it all about attractiveness? A qualitative study

In addition to essential clinical parameters, orthodontic treatment outcomes should also consider patients' opinions and perceptions, which could be comprehensively clarified with a qualitative scientific approach. Considering that the information on younger patients' views is scarce, the objective of this study was to investigate how adolescent orthodontic patients perceive malocclusion, and their motivations and expectations concerning orthodontic corrective treatment. In this descriptive qualitative study, 12 adolescents aged 12 to 14 years and of both genders, covering a heterogeneous collection of malocclusions, were recruited from the waiting list of an Orthodontics Graduate Course. They were individually interviewed before the appliance insertion by an experienced researcher using an interview guide and photographic records to stimulate patients' self-perception of their oral condition. The interviews proceeded simultaneously with transcription analyses until saturation. After the transcription evaluation, the framework analysis technique was performed. Data derived from the transcription analyses were grouped into 3 major themes: perceptions concerning the concepts of normality and abnormality regarding oral health; self-perceptions regarding malocclusion and other discrepancies; and motivations for seeking orthodontic treatment and expectations related to the results. Attractiveness was exceptionally relevant among adolescent patients. Most interviewees seemed to focus their attention on esthetically upsetting dentofacial traits, which they expected to be corrected by orthodontic treatment. In addition to self-oriented appearance-driven motivations, parents, other health professionals, friends, and peers also influenced adolescents' perception of their need for treatment. The achievement of a normal dentofacial status seems to be closely attached to social and individual aspirations.

Mediation and moderation effect of the big five personality traits on the relationship between self-perceived malocclusion and psychosocial impact of dental esthetics.

To explore the mediation and moderation effects of personality traits on the relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics. The sample included 252 subjects (62% female) aged 12-39 years. Self-perceived malocclusion was estimated using the 10-point scale Aesthetic Component of the Index of Orthodontic Treatment Need. The Psychosocial Impact of Dental Aesthetics Questionnaire was used to assess the psychological impact and the Big Five Inventory for personality traits. Moderation and mediation effects were evaluated with Pearson correlations and stepwise regression analysis, respectively. Self-perceived malocclusion ranged from 1 to 8 and was the most significant predictor of psychosocial impact of dental esthetics, whose unique contribution accounted for 11%-36.4% of variability, while age and sex accounted for 1.2%-2.5%. Personality traits had no mediating effect on this relationship. The moderating effect of agreeableness was present in the relationship between self-perceived degree of malocclusion and Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC) (ΔR2 = 0.035, 0.020, and 0.013, respectively; P < .001), while conscientiousness affected the relationship between perception of malocclusion and SI and PI (ΔR2 = 0.018 and 0.016, respectively; P < .05). In people with lower agreeableness and conscientiousness, increasing the severity of self-perceived malocclusion leads to less increase in SI and PI. In people with lower agreeableness, the increase influences AC in a similar manner. Extraversion, neuroticism, and openness do not have a moderating effect. The relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics appears to be moderated and not mediated by personality traits. Adolescents and young adults with lower agreeableness and conscientiousness seem to be less affected by the increased severity of self-perceived malocclusion, as demonstrated in reporting some psychosocial impacts.

Self-perceived need for dental treatment and related factors. A cross-sectional population-based study

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.

Dental esthetic perceptions and orthodontic treatment needs among school children aged 9–18 years of South Bengaluru: A cross-sectional study

Introduction: Individual perception of malocclusion may vary from the clinician's point of view. Assessment of individual perception of malocclusion is important for treatment planning, priority setting, allocation of resources, as well as for patient education and motivation. Aim: To assess the perceptions of orthodontic treatment needs of school children and to find out the correlation, if any, between the subjective treatment need perceived by children and the objective need. Materials and Methods: The study was conducted among school children of South Bengaluru aged 9–18 years. The study was cross-sectional in design, and a convenience sampling method was adopted. The clinical examination was conducted using the Index of Orthodontic Treatment Need (IOTN) modified for use in epidemiological surveys (Modified IOTN). Chi-square/Fisher's exact test has been used to find the significance of study variables at 5% level of significance. Results: Among the participated children, 21% needed orthodontic treatment and among 79% of children there was no need for treatment according to the Dental Health Component (DHC) of the IOTN. There was a significant correlation between the subjective need for treatment and the IOTN-DHC. Conclusions: There exists a significant correlation between the subjective need for orthodontic treatment assessed using the index and the objective need perceived by the patient. Hence, it is necessary to evaluate the perceptions of subjects before beginning of any treatment planning to meet the expectations of patients in general as it is the patient who gains satisfaction from treatment.

Relationship between perception of malocclusion and the psychological impact of dental aesthetics in university students.

Introduction and Objectives: The objectives were to assess the relationship between perceived smile aesthetics and perceived psychological impact as measured by the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and their own perception of it using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a Visual Analog Scale (VAS); relate the IOTN-AC and VAS to the PIDAQ; and study the predictive capacity of the scales for psychological impact. Material and Methods: A cross-sectional study was conducted in 447 college students in Spain and Portugal (average age 20.4 years, 33.1% men and 66.9% women). The online self-completed surveys used the recently-validated Spanish and Portuguese versions of the PIDAQ to assess the self–reported psychological impact of the students’ dental aesthetics and IOTN-AC and an ad hoc 100 mm VAS for their perception of their dental aesthetics. Results: PIDAQ was linearly correlated with IOTN AC and VAS. Pearson’s coefficient was 0.55 for PIDAQ and IOTN-AC (CI 95% 0.48-0.61) and -0.72 for PIDAQ and VAS (CI 95% -0.66 - -0.76). VAS and IOTN-AC were predictive variables in a linear regression model of the total PIDAQ score. The VAS diagnosed individuals whose dental aesthetics had a self-perceived psychological impact (area under the curve 0.827, CI 95% 0.787-0.868) more precisely than the IOTN-AC (area under the curve 0.742, CI 95% 0. 696-0.788). Conclusions: In adults patients, there is a significant linear relationship between perceived smile aesthetics and self-perceived psychological impact. Key words:Visual Analog Scale, Index of Orthodontic Treatment Need, malocclusion, psychological, aesthetics.

A systematic review of individual motivational factors in orthodontic treatment: facial attractiveness as the main motivational factor in orthodontic treatment.

Introduction. Physical, mental, and social consequences of malocclusion may impact the quality of life. The aim of this review is to describe main factors motivating parents for orthodontic treatment for their children. Methods. A systematic review study design was used to identify articles analyzing different motivational factors in orthodontic treatment appearing in Medline database, EMBASE, and Google Scholar. The search terms used were teasing, motivating factors, orthodontics, malocclusion, quality of life, smile attractiveness, and perception of malocclusion. Papers selected up to May 2013 included retrospective and prospective longitudinal studies, randomized control trials, cross-sectional studies, reviews, and meta-analyses. Results. 13 articles included in this review identified aesthetics as the main motivational factor in orthodontic treatment. Children mention teeth crowding, large overbite, missing teeth, and largest maxillary anterior irregularities also as motivational factors. Parents want their children to look nice and worry of being accused of neglecting parental duties. Conclusions. Dissatisfaction with one's appearance, dentist recommendation, interest and worries of parents, and the impact of peers who wear braces rank among the main motivation factors of seeking orthodontic treatment. Understanding these factors allows better planning of resources and better assessment of the requirements and priorities of treatment.

Comparison of orthodontic treatment need by professionals and parents with different socio-demographic characteristics

The aim of this study was to compare the socio-demographic features and self-perception of parents concerning the malocclusion of their children with the orthodontist's opinion of normative orthodontic treatment need. The parents of 208 children (101 girls and 107 boys, between 9 and 18 years: mean 12.8 ± 2.5), who sought orthodontic treatment were asked to score the dental attractiveness of their children using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). These scores were then compared with those of the orthodontist, who also scored the Dental Health Component (DHC) of the IOTN. The influence of the socio-demographic features of the parents on both the orthodontist- and parent-rated IOTN scores was assessed. The AC grade of the IOTN and patient characteristics were tested with the Spearman's correlation coefficient (rho). The difference between the two dependent variables (orthodontists' and parents' AC grade) was compared using Wilcoxon's test. A high need for orthodontic treatment was recorded in 74.0 per cent of the subjects. Although orthodontists rated 51.4 per cent of the patients as having a severe malocclusion on aesthetic grounds, only 33.6 per cent of parents rated their child malocclusion as severe. Although socio-demographic factors were not related to the parents' perception of malocclusion, they had an influence on orthodontic treatment need as assessed by the orthodontist. Parents, in this study population, rated their children's orthodontic treatment need less severely than the orthodontist regardless of their socio-demographic characteristics. Thus, orthodontists should involve parents in the orthodontic treatment decision-making process.

The change in the perception of malocclusion using the index of complexity, outcome and need( ICON)

The change in the perception of malocclusion using the index of complexity, outcome and need( ICON)

Perception of orthodontic treatment need in children and adolescents

Patients' and parents' perception of malocclusion are important in determining orthodontic treatment demand, motivation, and cooperation. The aim of this study was to investigate differences in perception of treatment need in currently orthodontically treated, previously treated, and untreated subjects. The sample comprised 3196 children and adolescents (1593 males and 1603 females) aged 8-19 years (mean age 13.0 +/- 3.6 years) from 24 randomly selected public schools in Zagreb, Croatia. Objective treatment need was assessed clinically using the Dental Aesthetic Index (DAI). Subjective treatment need was estimated separately by an orthodontic resident, the child/adolescent and his/her parent using the Standardized Continuum of Aesthetic Need (SCAN) procedure. The children/adolescents completed a questionnaire that had five questions with five-point Likert-type scale answers concerning satisfaction with dental appearance, importance of teeth for facial appearance, and malocclusion-related quality of life. Spearman correlation and logistic regression were used for statistical analysis. Associations between objective and subjective orthodontic treatment need were weak but statistically significant (Rho from 0.20 to 0.50; P < 0.05). Malocclusion-related quality of life was poorly associated with treatment need. Satisfaction with tooth appearance showed the most frequent statistically significant correlation (Rho from -0.14 to -0.35; P < 0.05), while importance of aligned teeth for facial appearance and social contacts had the weakest correlation with treatment need. Perception of treatment need was greater in previously treated subjects. Parents' perception had a low predictive value. The findings of this study show that malocclusion has more impact on emotional well-being than on function or social contacts.

Combining Normative and Psychosocial Perceptions for Assessing Orthodontic Treatment Needs

Whereas perceptions of malocclusion by the public are mainly subjective, currently orthodontic treatment needs are predominantly determined using normative need. There are considerable differences between normative and subjective perceptions of orthodontic need. Yet clinical measures determine current provision of orthodontic services, whereas subjective oral health-related quality of life (OHRQoL) measures are seldom used and play a small part in need assessment despite predicting perceived need. The sociodental approach to assessing orthodontic treatment needs overcomes deficiencies of the sole use of normative need. It is a gradual integration process, estimating orthodontic needs by combining normative and psychosocial perspectives, as well as considering behavioral factors affecting outcomes of orthodontic treatment and scientific evidence about the effectiveness of interventions. To be appropriately used in needs assessment, an OHRQoL measure should provide condition-specific estimates of the impact of malocclusion on daily life. The sociodental approach attempts to replicate the characteristics of good clinical practice using a structured, rational, and coherent system for assessing orthodontic needs and, therefore, is a useful tool in planning oral health services.

Differences in the perception of needs and demands for orthodontic treatment between Koreans and Japanese

The objective of this study was to determine the differences in the perception of the needs and demands for orthodontic treatment between the members of two different countries, Korea and Japan. Based on 10 representative malocclusions, a questionnaire survey was carried out in patients, dental students, and orthodontists from Korea and Japan. After showing the participants frontal, lateral photographs along with the orthodontic casts of the 10 selected malocclusions, the “Needs for Orthodontic Treatment (NOT, 10-point VAS scale)” and the “Demands for Orthodontic Treatment (DOT, yes or no question)” of each malocclusion were scored by the participants. As the result, high needs and demands for orthodontic treatment were associated with severe skeletal and dental discrepancies in all three groups from both countries. In other malocclusion cases, the Patient group indicated lower needs and demands compared to the Orthodontist group while the Dental student group scored an intermediate value. Interestingly, Koreans tended to score higher needs for class I, class II and deep bite malocclusion compared to the Japanese, while reversely they scored lower needs and demands for class III and openbite malocclusion. Overall, it is important to recognize the discrepancies in the perception of malocclusion between different ethnic groups even in neighboring countries as well as between patients and orthodontists of the same racial/ethnic background.

Influence of lips on the perception of malocclusion

The purpose of the study was to determine the influence of variations in the size of the vermilion borders of the upper and lower lips on the perception of the attractiveness of various occlusal traits. Ten occlusal traits and 3 upper and 3 lower vermilion variations, placed in combinations on a facial image, were used in a questionnaire. Statistical analyses for attractiveness and social and sex attributes were performed for various occupational groups. The occlusion, vermilion border of the upper and lower lips separately, and the raters' occupations were all highly significant in influencing attractiveness, social perceptions, and perceived sex of the images (P < .01). All occlusal traits were perceived as more attractive with a thicker vermilion border. Thin vermilion borders and more severe irregularity were associated with unattractiveness, aggressiveness, and masculine traits. This study demonstrates that the thickness of the vermilion border has a profound effect on how people rate the attractiveness of the dentition. Therefore, treatment plans that could affect lip vermilion might result in improved dental alignment but also deterioration in overall attractiveness. Orthodontists placed more emphasis on the teeth than other occupation groups; this demonstrated an occupational bias.

The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice

The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice

ICON and the patient's perceptions of malocclusion

ICON and the patient's perceptions of malocclusion

The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice.

To examine the relationship between the Index of Complexity, Outcome and Need (ICON) and the subjective opinions of patients attending for routine dental care. This study was undertaken at two general dental practices in Cardiff and Bedford. 50 patients aged between 11-14 years and 50 patients aged 30-40 years presenting for routine dental treatment were selected in each. The subjects were assessed objectively using the ICON guidelines by two examiners trained and calibrated in the use of this index. The scores were recorded directly from the patient. Subjective assessments were obtained from the patients by means of a questionnaire consisting of four simple questions addressing aesthetics, function, speech and treatment need using a five point Likert scale. The mean ICON scores for the different genders and age groups participating in this study were; 11-14 year old males 58.4 (SE 3.17); 11-14 year old females 51.8 (SE 3.51); 30-40 year old males 51.2 (SE 2.70); 30-40 year old females 45.3 (SE 2.56). There were statistically significant differences in ICON scores between the younger and older groups (P = 0.024) and females and males (P = 0.04). Adult patients were more likely to reject treatment than younger patients. Analysis of the professional scores in relation to subjective assessments, using the Spearman rank correlation coefficient, for 11-14 and 30-40 year olds, and for the male and female genders, revealed that the ICON has a significant correlation with patients' perceptions of aesthetics, function, speech and treatment need (r2 = 0.01 to 0.28). The only exceptions were patients' perceptions of speech in the 30-40 year old group, and function in the female gender, which did not show a statistically significant correlation to the professional assessments. In this study, the ICON was found to correlate with patients' opinions of aesthetics, function, speech and treatment need. The strength of association, however, was low. It can be concluded that the ICON alone is not necessarily a suitable predictor for appearance, function, speech or treatment need for those individuals attending general dental practice for routine dental care. In combination with a simple question to assess the patients desire for treatment, the shared decision for any particular individual to enter the treatment process can be determined.

ICON and the patient's perceptions of malocclusion

Aim To examine the relationship between the Index of Complexity, Outcome and Need (ICON) and the subjective opinions of patients attending for routine dental care. Materials and methods This study was undertaken at two general dental practices in Cardiff and Bedford. 50 patients aged between 11–14 years and 50 patients aged 30–40 years presenting for routine dental treatment were selected in each. The subjects were assessed objectively using the ICON guidelines by two examiners trained and calibrated in the use of this index. The scores were recorded directly from the patient. Subjective assessments were obtained from the patients by means of a questionnaire consisting of four simple questions addressing aesthetics, function, speech and treatment need using a five point Likert scale. Results The mean ICON scores for the different genders and age groups participating in this study were; 11–14 year old males 58.4 (SE 3.17); 11–14 year old females 51.8 (SE 3.51); 30–40 year old males 51.2 (SE 2.70); 30–40 year old females 45.3 (SE 2.56). There were statistically significant differences in ICON scores between the younger and older groups (P = 0.024) and females and males (P = 0.04). Adult patients were more likely to reject treatment than younger patients. Analysis of the professional scores in relation to subjective assessments, using the Spearman rank correlation coefficient, for 11–14 and 30–40 year olds, and for the male and female genders, revealed that the ICON has a significant correlation with patients' perceptions of aesthetics, function, speech and treatment need (r2 = 0.01 to 0.28). The only exceptions were patients' perceptions of speech in the 30-40 year old group, and function in the female gender, which did not show a statistically significant correlation to the professional assessments. Conclusion In this study, the ICON was found to correlate with patients' opinions of aesthetics, function, speech and treatment need. The strength of association, however, was low. It can be concluded that the ICON alone is not necessarily a suitable predictor for appearance, function, speech or treatment need for those individuals attending general dental practice for routine dental care. In combination with a simple question to assess the patient's desire for treatment, the shared decision for any particular individual to enter the treatment process can be determined.

The need and demand for orthodontic treatment in 13- to 15-year-olds in Nairobi, Kenya

The need for orthodontic treatment in Kenya has previously not been investigated. This study was undertaken to assess the need for orthodontic treatment in 13- to 15-year-old children in Nairobi. The objective need was assessed in 919 children by using the Norwegian treatment need index, and the subjective need was assessed in 739 children by using a structured questionnaire. Objective treatment need was recorded in 29% and subjective need in 33% of the children. Less than 1% were allocated the ‘very great need’ category. Relatively more girls than boys were dissatisfied with the appearance of their teeth, and a significantly higher number of girls (P < 0.001) said they would like to have their teeth straightened. The children's perceived need for treatment correlated significantly with the treatment need index. Fixed appliances were found necessary for correcting malocclusion in 23% of the children and removable appliances in 6%. Future studies in Kenya should be directed at determining the societal perception of malocclusion, upon which treatment standards may be based.

Perception of malocclusion in 11-year-old children: a comparison between personal and parental awareness

In orthodontic counselling an understanding of how individuals perceive their occlusal features is important to ensure effective communication and for provision of adequate advice on treatment need. The purpose of the present study was to assess personal and parental awareness of malocclusion in children, and to examine whether agreement existed between children and their parents on assessments of malocclusion traits. Of 104 randomly selected fourth-grade children 99 presented themselves at a public dental clinic. Ninety-three accompanying parents attended. Awareness was assessed by comparing the opinion of parents and children on the presence or absence of anterior malocclusion with direct measurements on dental study casts. The subjects' abilities to identify a polaroid of the child's dentition in a panel of 17 alternative photographs were also used as a measure of awareness. The findings revealed a moderate level of awareness among both the children and their parents. About half of the children and the parents identified the child's photograph on the first attempt. About three-quarters of the traits recorded as marked/severe malocclusion and about half of the mild/moderate traits were recognized. A significant association existed between the number of correct reports on traits given by the children and the parents. However, agreement across professional, child, and parental assessments varied for the different traits. The results indicated that the individual's comprehension of professional terms may be unclear and that professionally defined cut-off points often do not coincide with norms existing within the actual family unit.