Self-perceived Orthodontic Treatment Need Research Articles

Psychosocial Impact of Malocclusion and Self-Perceived Orthodontic Treatment Need among Young Adult Dental Patients.

To investigate the psychosocial impact of malocclusion and self-rated and clinician-rated orthodontic treatment need on young adult patients in the Western Province of Saudi Arabia. Eighteen- to 30-year-old patients (n=355) attending a tertiary dental care facility were included. Three instruments were used for data collection: (1) Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ), (2) aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC), self-rated and clinician-rated, and (3) clinician-rated Dental Aesthetic Index (DAI). Data analysis included descriptive statistics, Kruskal-Wallis test, Mann-Whitney U-test, and multiple linear regression analysis. Females were significantly more impacted than males on all domains with the exception of the dental self-consciousness domain. For both the self-rated and clinician-rated IOTN and the DAI, it was found that the more severe the malocclusion, the higher the impact on all domains except for the dental self-confidence domain, which showed that patients with mild malocclusions were more affected than those with moderate and severe malocclusions. Significant associations were observed between independent variables (age, sex, self-rated IOTN, and DAI) and total PIDAQ score. Perceived psychosocial impact of dental aesthetics is directly related to severity of malocclusion (self-rated and clinician-rated) for all domains of the PIDAQ accept the DSC, and females showed higher psychosocial impact than males. Clinicians should consider the impact of malocclusion and certain demographic characteristics on the psychosocial well-being of an individual when determining the orthodontic treatment need.

A Cross-Sectional Evaluation of Self-Perceived Orthodontic Treatment Needs Amongst Tribal Adolescent With Remote Access to Orthodontic Treatment Using a Simplified Malocclusion Index

Background: Self-perceived orthodontic treatment need is strongly influenced by what is perceived to be the esthetic norm amongst a community, and reluctance toward treatment amongst adolescents with clinically ascertained malocclusion may often be due to readily remediable factors. Of particular interest is the prevalence of malocclusion amongst such communities as a probable indicator of the role of diet and genetics in establishing a predominant clinical phenotype that may also play a role in the construct of what is perceived as the esthetic norm amongst the community, thereby influencing the self-perceived need for treatment. Studies aimed at evaluating the association between self-perceived esthetics, and self-perceived treatment need have not been performed amongst a population with no prior exposure to orthodontic treatment Objectives: The purpose of this study was to evaluate the self-perceived orthodontic treatment need amongst the tribal adolescents belonging to regions with remote access to orthodontic treatment by way of a verbally assigned index and to also identify the reasons of reluctance toward treatment to better understand how to make orthodontic treatment readily accessible to such populations. Participants, Materials, and Methods: The agency areas of Paderu located at 18.0833°N 82.667°E and Parvathipuram located at 18°46'N 83°25'E are 2 revenue districts of Visakhapatnam and Vizianagaram, respectively, in the state of Andhra Pradesh, India, that are home to various tribal populations with remote access to orthodontic treatment. A total of 2,016 school-going tribal adolescents of the Paderu revenue division and 819 tribal adolescents of the Parvathipuram revenue division were examined to ascertain the prevalence of malocclusion. Necessary consent and permissions were obtained from the tribal authorities, the school authorities, parents, and the institutional ethical clearance committee. The screening was done utilizing natural daylight in compliance with infection prevention and control protocol. Clinical examination aimed at categorizing the observed occlusion into either ideal occlusion or one of the three classes of Angle’s class I, II, and III malocclusions. The Simplified Malocclusion Index For Layperson Evaluation (SMILE) was verbally assigned in the vernacular language while interacting with each child and the findings made note of for calculation of relevant scores related to their orthodontic awareness, self-esteem as related to self-perceived esthetics, and their self-perceived need for treatment. Reasons for reluctance to undergo treatment were noted down if expressed. An initial group of 31 adolescents categorized as presenting with clinical malocclusion were randomly picked up and assigned the SMILE index a second time to assess the reliability of the index by way of Cohen’s kappa statistic. Results: The initial test group of 31 individuals assigned the SMILE twice showed a Cohen’s kappa of 0.93 validating almost perfect intraoperator agreement. The SMILE index revealed that 80.95% of the adolescents of Paderu revenue division had orthodontic awareness and 79.51% had self-perceived esthetics but only 15.97% felt a need for orthodontic treatment. Pearson’s Chi squared statistical analysis indicated a gender bias related to the self-perceived need for orthodontic treatment ( X 2 [1, N = 1,371] = 19.71, P < .001). The Index assigned to the Parvathipuram division revealed that 77.04% had orthodontic awareness and 78.38 had self-perceived esthetics but only 6.95% felt the need for orthodontic treatment. Pearson’s Chi squared statistical analysis indicated a gender bias related to the self-perceived need for orthodontic treatment ( X 2 [1, N = 764] = 4.95, P = .02). Conclusion: The self-perceived need for orthodontic treatment is often based on the self-perceived esthetics of an individual or the self-esteem as influenced by the perceived esthetic norm of the community. Orthodontic treatment of adolescents with borderline malocclusion derangements requires careful ascertaining of the actual perceived need of the patient to enable the rendering of a justifiable orthodontic treatment with the complete trust of the young patient. This helps build community trust in regions where orthodontic treatment has not yet made in roads and may help ensure higher end of treatment satisfaction levels.

Perception of orthodontic treatment need among Swedish children, adolescents and young adults

Objective: Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19.Materials and methods: A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo.Results: The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2 ± 1.5), than among subjects, age 15 (3.6 ± 1.2) (p = .0009), and subjects, age 19 (3.5 ± 1.2) (p = .00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p = .002 and .001, respectively) and (ii) previous orthodontic treatment (p = .005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p = .002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p = .047) than Swedes, age 19.Conclusions: The lower limit for orthodontic treatment need among subjects, age 10, was higher – compared to subjects, ages 15 and 19 – and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.

Correlation coefficients of three self-perceived orthodontic treatment need indices.

To determine patient orthodontic treatment need, appropriate self-perceived indices are required. The aim of this study was to assess the sensitivity and specificity of esthetic component (AC) of the index of orthodontic treatment need (IOTN), oral esthetic subjective index scale (OASIS), and visual analog scale (VAS) through dental health component (DHC) IOTN as a normative index to determine the more appropriate self-perceived index among young adults. In this cross-sectional study, a sample of 993 was randomly selected from freshman students of Isfahan University. Those with a history of orthodontic treatment or current treatment were excluded. DHC was evaluated by two inter- and intra-calibrated examiners. Data for AC, OASIS, and VAS were collected through a questionnaire completed by students. Descriptive statistics, Mann-Whitney U-test, and Spearman correlation test, were used for data analyses. Sensitivity, specificity, positive and negative predictive values of self-perceived indices were calculated through DHC. Sensitivity of AC, OASIS, and VAS for evaluating definite orthodontic treatment need was calculated at 15.4%, 22.3%, and 44.6%, respectively. Specificity of these indices for evaluating definite orthodontic treatment need was calculated at 92.7%, 90.5%, and 76.2% percent, respectively. All self-perceived indices had a significant correlation with together and with DHC (P < 0.01). Among demographic factors, there was weak but significant correlation only between mother's educational level and VAS (P < 0.01). Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning.

Association between normative and self-perceived orthodontic treatment need in a Lebanese population.

The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150subjects (81males and 69females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need.

Normative and self-perceived orthodontic treatment need in Nigerian school children

Objective. The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. Materials and methods. The sample consisted of 441 randomly selected school children, aged 11–18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11–13 years old and 195 14–18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. Results. A definite need for orthodontic treatment was found among 21.5% (grades 4–5 of DHC) and 6.3% (grades 8–10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8–10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). Conclusion. The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.

Subjective Opinions of Dental Attractiveness and Orthodontic Treatment Need among Nigerian Adolescents

Introduction: The aim of this study was to evaluate the opinions of a cross-section of 12-18 year old Nigerians about dental aesthetics and to compare the report with their self – perceived need for orthodontic treatment. Methods: A structured questionnaire was administered to 612 12-18 year old Nigerian adolescents who were randomly selected from 6 secondary schools in SouthSouth Nigeria to assess their opinions of dental aesthetics, whilst the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used to assess their selfperceived orthodontic treatment need. Results: Majority (78.1%) of the population expressed satisfaction with the arrangement of their teeth, whilst 82% did not perceive any need for orthodontic treatment (AC Grades 1-4). Their self – perceived orthodontic treatment need was found to increase as their satisfaction with the arrangement of their teeth decreased. Conclusions and recommendations: Although majority of the adolescents realized the importance of dental aesthetics, there was a general low awareness of the presence of their malocclusions. We are recommending that populations in this area be more enlightened on the presence and treatment of malocclusion.

Normative and self-perceived orthodontic treatment need in 11- to 16-year-old children

To examine the relationship between normative and self-perceived treatment need assessed by different measures, comprising two Oral Health-Related Quality of Life (OHRQoL) scales. This cross-sectional observational study comprised 386 children aged 11-16 years registered for a first consultation at the Orthodontic Department of the University Hospitals of Leuven (Belgium). Normative treatment need was assessed by the Dental Health Component (DHC) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). The children completed questionnaires comprising the Child Perceptions Questionnaire (CPQ₁₁₋₁₄) and the Oral Aesthetic Subjective Impact Scale (OASIS). They also scored the AC of IOTN themselves. Spearman correlations, Mann-Whitney U-tests and signed-rank tests, a Bland-Altman plot, and an intra-class correlation were used to analyze the data. Significant, yet weak correlations (maximum ρ = 0.23 for the CPQ emotional well-being domain) were found between normative orthodontic treatment need (IOTN AC) and most of the OHRQoL measures. Similarly, between the IOTN AC scores of the expert and the IOTN AC ratings given by the child a significant correlation (ρ = 0.37, P < 0.0001) was found, but with very poor agreement (95 per cent limits of agreement -4.3, 5.1). For the DHC of IOTN, only a relation was found with the AC child (ρ = 0.20, P = 0.0001). These results suggest that the commonly used IOTN as a clinical assessment tool for orthodontic treatment need should be reinforced by OHRQoL measures, like the OASIS, expressing patients' perceived treatment need.

The objective and subjective outcome of orthodontic care in one municipal health center

Objective. The aim of this study was to assess the outcome of orthodontic care in one municipal health center. Materials and methods. The material consisted of one age-cohort of 15–16 year-old adolescents (n = 67). Of them, 97% participated in a clinical examination. The final group included in the study consisted of 61 adolescents (91% of the whole age cohort). The occlusions were evaluated applying the Occlusal Morphology and Function Index (OMFI), the Dental Health Component (DHC) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Moreover, all adolescents filled in a semi-structured questionnaire enquiring about their satisfaction with the function and appearance of their own dentition and self-perceived orthodontic treatment need. They also scored their own dental appearance on a Visual Analog Scale (VAS). Results. Of the adolescents, 42% had received orthodontic treatment, while 58% were untreated. All morphological criteria of the OMFI were met by 58% of orthodontically treated and 49% of untreated adolescents and all functional criteria by 67% and 57%, respectively. Treatment need was registered in two of the treated adolescents (7%) and five of the untreated adolescents (14%). Treated adolescents were more often satisfied with their dental appearance than untreated adolescents (p = 0.034). In both groups, satisfaction with the function was high (93%). Conclusions. Orthodontic treatment seems to improve both occlusal morphology and function. The high satisfaction with one's own dental appearance among the treated adolescents is worth noting.

Factors associated with orthodontic treatment seeking by 12–15‐year‐old children at a state university‐funded clinic

To investigate the interrelationships between factors involved in orthodontic treatment seeking by children aged 12-15 years. State funded orthodontic clinic at the Faculty of Dentistry of the Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil, and a nearby public school. One hundred and ninety-four adolescents aged 12-15 years took part in the study; 92 had sought orthodontic treatment at UERJ (orthodontic group) and 102 were from a nearby public school and had never undergone or sought orthodontic treatment (comparison group). Each participant underwent a comprehensive oral examination, and both parent and child were questioned about who had initiated the orthodontic referral. Normative need assessed with IOTN DHC; clinician and self-perceived aesthetic perception assessed with IOTN AC, previous caries experience was determined using the decayed, missing and filled teeth index (DMFT) and WHO diagnostic criteria. The 'Brazil Economic Classification Criteria' was used to classify the socioeconomic status. Intra-examiner repeatability and inter-examiner agreement were assessed with kappa statistics. Univariate and multiple logistic regression analyses were used to investigate the association between orthodontic treatment seeking (dependent variable) and the independent variables (i.e. aesthetic impairment, malocclusion severity, socioeconomic status, gender, age and DMFT). Univariate analyses showed that self-perceived aesthetics (P<0.001), examiner-assessed aesthetics (P = 0.01) and treatment need (P<0.001), socioeconomic status (P<0.001) were significantly associated with orthodontic treatment seeking, but gender (P = 0.22) and DMFT (P = 0.41) were not. Multiple logistic regression analyses showed that poor self-perceived aesthetics (OR = 16.7; 95% CI: 4.17-61.9), more severe malocclusion (OR = 3.4; 95% CI 1.64-7.14) and better socioeconomic position (OR = 39.1; 95% CI: 5.47-280.54) significantly influenced the decision to seek orthodontic treatment. Concern about dental appearance and the desire for treatment, together with normative orthodontic need, should be carefully assessed by dentists before referring patients to specialized orthodontic care in publicly-funded clinics. In a publicly-funded oral health care system, self-perceived orthodontic treatment need is the key to establishing treatment priority.

Association between normative and self-perceived orthodontic treatment need among 12- to 15-year-old students in Shiraz, Iran

Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. The purpose of this study was to investigate the association between normative and self-perceived orthodontic treatment need and to evaluate the influence of gender and socioeconomic background such as family size, parental education and father's employment. The subjects were 900 male and female junior high school students (450 males, 450 females) aged 12-15 years, from four districts in the city of Shiraz, Iran. The participants were asked to complete a questionnaire and then underwent a dental examination. Normative treatment need was assessed clinically using the Dental Aesthetic Index (DAI) according to the World Health Organization guidelines. Statistical analysis was undertaken using t- and chi-squared tests. There was no statistically significant correlation between DAI scores and demographics. The results showed a significant correlation between DAI scores and a subject's awareness of malocclusion and their satisfaction with dental appearance. There were no differences between genders concerning the questionnaire data. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment.

Acceptability of Dental Appearance in a Group of Finnish 16- to 25-Year-Olds

To define a grade in the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) that would differentiate between esthetically acceptable and unacceptable occlusions and that would also be both subjectively and objectively meaningful. Dental appearance and self-perceived orthodontic treatment need were analyzed in a group of Finnish young adults (171 males, 263 females, age range 16-25 years). Subjective data were gathered using a questionnaire, and the respondents were requested to score their dental appearance on a visual analog type 10-grade scale. Professional assessment of dental appearance was performed by two orthodontists using the AC of the IOTN. The cutoff value between esthetically acceptable and unacceptable occlusions was defined using receiver operating characteristic curves. Sixty-six percent of orthodontically treated and 74% of the untreated respondents were satisfied with their own dental appearance. Every third respondent reported one or more disturbing traits in their dentition. The most frequently expressed reason for dissatisfaction was crowding; girls expressed dissatisfaction more often than boys did (P = .005). A self-perceived treatment need was reported infrequently by 8% of orthodontically treated and 6% of untreated respondents. In the logistic regression analysis, self-perceived need for orthodontic treatment was the only significant factor explaining dissatisfaction with own dental esthetics. On the applied scales, grades 1 and 2 fulfilled the criteria for satisfactory dental esthetics. The results suggest that the AC grade 3 could serve as a cutoff value between esthetically acceptable and unacceptable occlusions.

Factors determining perceived orthodontic treatment need in adolescents of Swedish and immigrant background

The aim of this study was to evaluate the association between self-perceived orthodontic treatment need and malocclusion in 12 to 13-year-old-adolescents of Swedish and immigrant background. The sample consisted of 379 students, stratified according to geographic background: both parents born in A/Sweden (n=269), B/Eastern Europe (n=56), and C/the Middle East (n=54). Registrations were based on a questionnaire, a clinical examination, radiographs, and patient records. Treatment need was classified according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Logistic regression analysis was used for comparison of the results. There was a strong association between subjects who thought that they needed an orthodontic appliance and IOTN-DHC grades 4 and 5, an anterior crossbite, those who avoided smiling because of their teeth, and those who considered their teeth to be somewhat worse or much worse than those of their peers. The self-perceived need for orthodontic treatment was significantly (P<0.05) higher in the Swedish than in the eastern European group.

Normative and self-perceived orthodontic treatment need of a Peruvian university population

BackgroundPrevious studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults.Methods281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05.ResultsAn intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4–5 was 29.9% whereas the percentage of students with AC grades 8–10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons.ConclusionNormative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need.

Self-perceived orthodontic treatment need and culturally related differences among adolescents in Sweden

The aim of this investigation was to compare Swedish and immigrant groups of 12- and 13-year-old boys and girls with respect to: (1) self-perceived need for and attitude to orthodontic treatment, (2) attitude to own teeth and general appearance, (3) behaviour pattern and psychosocial functioning, and (4) self-perceived need for orthodontic treatment in relation to psychosocial functioning. The subjects comprised 508 students, aged 12 and 13 years, living in Sweden, who were grouped according to nationality: (A) both parents born in Sweden (139 girls and 131 boys); at least one parent born in: (B) eastern Europe (27 girls and 34 boys); (C) Asia (66 girls and 61 boys) and (D) other countries (23 girls and 27 boys). Each student answered a questionnaire in the classroom. The questions concerned demographic data, self-perceived treatment need, attitude to orthodontic treatment, own teeth and general appearance, behaviour pattern and psychosocial functioning. The results showed that, on average, 20 per cent of the students had a self-perceived treatment need, more girls than boys, 24 per cent of Swedes (A), 12 per cent from eastern Europe (B), 18 per cent from Asia (C) and 14 per cent from other countries (D). Seventy-two per cent of the Swedish students were prepared to undergo fixed appliance therapy, compared with 58 per cent of immigrant students. Nine per cent of the Swedish students considered their general appearance to be less favourable compared with 7 per cent of their peers (not significant). While some differences in behaviour pattern were observed, these did not seem to influence the well-being of the subjects. The conclusion is that perceived orthodontic treatment need is lower in immigrant students than in Swedish students.

Self-perceived orthodontic treatment need evaluated through 3 scales in a university population

To evaluate the self-perceived orthodontic treatment need in a university population evaluated through 3 scales that used different approaches. Cross-sectional survey. University dental clinic, Lima, Peru, 2001. Questionnaires that gathered perceptions on dentofacial aesthetic perception and orthodontic treatment need were applied to a randomly selected sample (329) of first year university students (729). Subjects undergoing orthodontic treatment at the time of examination were excluded. Aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN), Oral Aesthetics Subjective Index Scale (OASIS) and a visual analogue scale (VAS) were used. Descriptive statistics, Spearman correlation test, Kruskall-Wallis test and Mann-Whitney U-test were used. For the AC, 87.5% were in the "without treatment need" category, 10.6% in the "borderline need" category and 1.8% in the "treatment need" category. The mean AC score was 3.02 (+/-1.49). The mean OASIS score was 11.81 (+/-4.84), and the VAS score was 40.16 (+/-18.16). Correlations between the 3 self-assessment scales were moderate (AC-OASIS 0.416, AC-VAS 0.541 and OASIS-VAS 0.457). Gender or previous orthodontic treatment had no influence (p<0.05) on the scales. Differences in the approaches used by each scale to evaluate the self-perception of the aesthetical arrangement of the front teeth may explain the moderate correlation values.

Association between normative and self-perceived orthodontic treatment need among Arab high school students

The aim of this study was to investigate whether there was an association between normative and self-perceived orthodontic treatment need, and to evaluate the influence of sex and socioeconomic background on treatment need. A total of 139 high school students, aged 14 to 18 years, from 2 districts in Kuwait were included. The study consisted of a questionnaire and a clinical examination. Normative need for treatment was assessed clinically by using the index of orthodontic treatment need (IOTN). Both the dental health component (DHC) and the aesthetic component (AC) of the IOTN correlated positively with self-perceived treatment need. In 53% of the subjects, there was agreement between self-perceived treatment need and the DHC score. Between the AC component and self-perceived need, the agreement was 77%. The odds of self-perceived treatment need were 10-fold for subjects having AC scores higher than 4, indicating moderate or definite need. Sex and socioeconomic factors did not significantly affect the normative treatment need. These results suggest that the AC component of the IOTN clearly reflects the self-perceived need for treatment.