Perception Of Orthodontic Need Research Articles

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

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.

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.

Occlusal traits and perception of orthodontic need in eighth grade students.

In 1994, 1155 eight-grade students in Alachua County, Fla., were asked about self-perception of and level of concern for their occlusal status. Clinical assessments of orthodontic parameters were also recorded. Twenty-five percent of the students had a history of orthodontic treatment. Of the remaining students who had no history of orthodontic treatment, 74% reported satisfaction with the way their teeth looked, 64% expressed no perceived need for braces, and 57% were judged clinically to have optional or no orthodontic needs. Sex, soft tissue profile, overjet, anterior crowding, and molar classification were significantly associated with the perception of need for braces while race and overbite were not. Clinical judgment of orthodontic need differed significantly among levels of satisfaction with teeth. Eighth graders with no history of orthodontic treatment were generally satisfied with the appearance of their teeth and perceived less need for braces than clinicians.