Subjective Orthodontic Treatment Need Research Articles

Parental perception of malocclusion, its severity and aesthetic concerns in children with mixed dentition: A cross-sectional study

This study aimed to associate the parents' perception of the need for treatment and the children's aesthetic concern, considering the influence of malocclusion severity levels. A population-based cross-sectional study was conducted with 770 children aged 8 to 10 years in the mixed dentition stage. A closed question sent to parents assessed the subjective orthodontic treatment need (outcome). Orthodontic Aesthetic Subjective Impact Score (OASIS) evaluated children's aesthetic concerns, and the Dental Aesthetic Index (DAI) diagnosed the anterior characteristics and malocclusion severity levels. Individual analyses were performed relating the outcome as independent variables. The variables with P<0.20 in the individual analyses were tested in multiple logistic regression models, and those with P<0.10 remained in the model. The adjusted odds ratio was estimated with a 95% confidence interval. Parents of children with higher aesthetic concerns are 1.82 times more likely to believe that their child needs orthodontic treatment (P<0.05). Parents of children with very severe malocclusion are 1.91 times more likely to perceive their child's need for orthodontic treatment (P<0.05). Parents of children with greater aesthetic concerns are more likely to perceive the need for orthodontic treatment, and very severe malocclusion also influences parents' perception of the need for orthodontic treatment.

The value of the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in the Assessment of Subjective Orthodontic Treatment Need

Background: Malocclusion is the most common dental problem. Its correction needs assessment before planning Orthodontic treatment. The index of orthodontic treatment need (IOTN) is one of the most valuable method of grading and evaluating malocclusion. A number of studies stated; using the IOTN have reported that there is limited use of aesthetic component in school going children. Objectives: To estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Materials and Methods: This study was carried out in school going children of 12 year of age in kpk Pakistan. This study was based on a questionnaire and clinical examination. The questionnaire consists of various items. On the basis of these item questionnaire was filled. Clinical examination was done at the schools each time by the same orthodontist. Statistical analysis was done. Results: Out of total children, 29 were female and 58 were male. Most of the children were satisfied with dental aesthetics. Most of them wanted to change colour of the teeth. Most of the enrolled students were classified in “no treatment need’ category” followed by “need borderline treatment” category. Satisfaction with aesthetic were also evaluated (P-value &lt;0.090). Conclusion: It was concluded that large number of people were in need of the orthodontic therapy as per the aesthetic component of IOTN. Key words: Index of Orthodontic Treatment Need, Aesthetic Component, Scan scale

Validation of the Psychosocial Impact of Dental Aesthetics Questionnaire in the Australian population

The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception need for orthodontic treatment. The study aimed to determine the psychometric validity and reliability of PIDAQ in Australian adults. Data were collected from the National Dental Telephone Interview Survey in 2013. The PIDAQ was used, comprising 4 conceptual domains: self-confidence, social impact, psychological impact, and esthetic concern. Psychometric sensitivity was estimated for each item. Confirmatory factor analysis was performed to determine factorial validity in which the ratio of chi-square by degrees of freedom, comparative fit, and root mean square error of approximation were used as indexes of the goodness of fit. Convergent validity was estimated from the average variance extracted and composite reliability, whereas internal consistency was estimated by Cronbach standardized alpha. The dataset comprised 2936 Australian adults aged ≥18 years and separated randomly into 2 subdata sets. The kurtosis and skewness values indicate an approximation to a normal distribution for each item, with acceptable thresholds for the goodness of fit and convergent validity (average variance extracted ≥0.50 and composite reliability ≥0.70), and discriminant validity was also demonstrated. Internal consistency was adequate in the 4 conceptual domains for PIDAQ for both subdata sets, with Cronbach standardized alpha being ≥0.70. The psychometric sensitivity, validity, and reliability of the PIDAQ instrument in a sample of the Australian adult population were found to be adequate. Both subdata sets drawn from the sample demonstrated acceptable goodness of fit and internal consistency.

Do preterm-born adolescents have a poorer oral health-related quality of life?

BackgroundTo evaluate oral health-related quality of life (OHRQoL) over a period of five years using the Oral Health Impact Profile (OHIP-14) questionnaire in a population of Swedish adolescents born preterm and full term.MethodsIn a longitudinal study of adolescents aged 12–14 and 17–19, changes over time in OHRQoL were measured by using OHIP-14. The OHIP-14 score, self-reported chronic illness, temporomandibular disorder (TMD pain) and subjective orthodontic treatment need were compared between 98 extremely and very preterm born (< 32 gestational week) and 93 full-term controls (≥ 37 gestational week) at two ages. The chi-square test was used for comparisons within the extremely-, very-, and full-term control groups, and to contrast the differences of mean scores of OHIP-14, the ANOVA test was used for comparisons within the study groups of extremely preterm, very preterm and full term-born adolescents.ResultsAll adolescents reported a good self-perceived OHRQoL. No significant differences in the comparisons of the total mean scores were revealed between the groups, between gender or in domain-specific scores over the 5-year period. Very preterm adolescents with reported chronic illness at 12–14 years of age showed significantly higher mean scores of OHIP-14 compared with those without chronic illness (p = 0.015). At age 17–19, significantly higher mean scores of OHIP-14 were reported by very preterm adolescents with TMD pain compared to those without TMD pain (p = 0.024). Significantly higher mean scores of OHIP-14 were found among the extremely preterm (p = 0.011) and very preterm born adolescents (p = 0.031) with a subjective need of orthodontic treatment compared with those without orthodontic treatment need.ConclusionsPoor OHRQoL measured with OHIP-14 in very preterm adolescents aged 12–14 was related to chronic illness and aged 17–19 to TMD pain. In addition, extremely and very preterm-born adolescents with subjective orthodontic treatment need at 17–19 years of age also reported poor OHRQoL. To improve the dentist–patient relationship and achieve more successful treatment results, it is important for dental clinicians to understand the impact that chronic illness, TMD pain and orthodontic treatment need has on OHRQoL in preterm-born adolescents.

Association Between Psychosocial Status and Orthodontic Treatment Needs in Indonesian High School Students

Objective: To determine whether psychosocial status is associated with orthodontic treatment needs in high school students using the Psychosocial Impact of the Dental Aesthetic Questionnaire (PIDAQ) and the Index of Orthodontic Need (IOTN). Material and Methods: This cross-sectional study comprised 95 adolescents, both genders, aged 15–17 years old. PIDAQ was used to assess psychosocial status. The IOTN Aesthetic Component (IOTN-AC) and the IOTN Dental Health Component (DHC) was used to assess treatment needs . Examination of the oral cavity was carried out with the help of the IOTN ruler by observing the MOCDO components: missing teeth, overjet, crossbite, displacement, and overbite. The Chi-square test was used to determine the association of psychosocial status and orthodontic treatment need. The reliability test was carried out by using Cronbach’s Alpha test (0.978). Results: There was an association between psychosocial status and orthodontic treatment need based on the IOTN-AC (p=0.001) and between psychosocial status and orthodontic treatment need based on the IOTN-DHC (p=0.140) . Conclusion: There is an association between psychosocial status based on the PIDAQ and subjective orthodontic treatment need based on the IOTN-AC, but there is no association between psychosocial status based on the PIDAQ and objective orthodontic treatment need based on the IOTN-DHC in students of SMAN 27 Jakarta.

The evolution of self-esteem before, during and after orthodontic treatment in adolescents with dental malocclusion, a prospective cohort study.

This study aimed (1) to investigate the evolution of self-esteem through orthodontic treatment, and (2) to study how key demographic factors would affect these evolutions and to assess relationships between self-esteem and orthodontic treatment need. This longitudinal prospective cohort study comprised of 326 adolescents (172 girls and 154 boys) aged 11-16 years; data were obtained from 325 adolescents at T0 and 123 at T2. Three hundred twenty-one adolescents filled in questionnaires at T0, whereas 118 at T2. They were selected in the University Hospitals Leuven, Belgium, where they all received orthodontic treatment. Self-esteem was assessed with the Dutch adaptation of the Harter's test and treatment need was defined by the Index of Orthodontic Treatment Need (IOTN). Data were analysed with multivariate linear models and Spearman correlations. There was no evidence of a change in global self-esteem during orthodontic treatment. A significant gender by time interaction for scholastic competence (P < 0.05), a decrease in self-esteem for females, and an increase for males between T0 and T1 was observed. A significant age (at T0) by time interaction for physical appearance and global self-worth (P < 0.05) and a negative correlation between self-esteem and self-assessed IOTN aesthetic component for the subdomain of close friendship (P < 0.05) were found. Global self-esteem acts as a stable construct during orthodontic treatment. The subdomains of self-esteem could be influenced by age and gender. Self-esteem and the subjective need for orthodontic treatment were found to be negatively correlated.

Agreement and association between normative and subjective orthodontic treatment need using the Index of Orthodontic Treatment Need.

AIMS:To determine the association and level of agreement between young adults’ perception of orthodontic treatment need (subjective need) and the orthodontists’ assessment of treatment need (normative objective need).METHODOLOGY:For this study, 670 students [280 males and 390 females; mean age (standard deviation) of 15.32 (1.81) years] were selected from public and private schools from different demographic areas of Jeddah city, Saudi Arabia, and divided into two age groups (12–15 years) and (16–19 years). All the participants were examined, and the Index of Orthodontic Treatment Need (IOTN) components [dental health component (DHC) and aesthetic component (AC)] were recorded.RESULTS:Kappa statistics showed a statistically significant but fair agreement between clinician AC (CAC) and student AC (SAC) assessments in both age groups (k = 0.343 and 0.334, respectively; P < 0.001), whereas Spearman's correlation coefficient showed a statistically significant but moderate association (r = 0.487 and 0.517, respectively; P < 0.001). The degrees of agreement were 76.4% and 76.7% at the no-need and mild-need levels of treatment, respectively. There was a statistically significant but weak association between the subjective and normative needs (SAC and IOTN-DHC) in both age groups (r = 0.336 and 0.360, respectively; P < 0.001). However, the degrees of agreement were 58.9% and 61.5% at the no-need and mild-need levels of treatment, respectively.CONCLUSION:Significant but weak positive association was found between the normative and subjective orthodontic treatment needs, indicating a lack of understanding of the nature of malocclusion and its consequences. Thus, promoting further knowledge and awareness of malocclusion are indicated.

A PhD completed. Factors subjectively and objectively influencing children's need for orthodontic treatment and their related quality of life

Oral health can be measured from the perspective of the professional (objectively) and from the perspective of the patient (subjectively). However, objective and subjective oral health do not match well. The focus of this research, then, is the relationship between objective oral health, subjective oral health and oral health-related quality of life (OHRQoL) in children. These relationships were considered in connection with orthodontic problems. The research was carried out as part of the Generation R Study, a prospective study of the health of 10,000 children in Rotterdam, the Netherlands. Besides malocclusions and caries, several non-clinical factors, such as environmental factors and personal qualities, seemed to have an influence on the subjective need for orthodontic treatment and OHRQoL. Age, gender, ethnicity, and a feeling of self-worth are just like socio-economic factors that result in a variable relationship between subjective and objective oral health. This knowledge cannot only help to support effective communication between professional and patient, but also to develop targeted interventions to promote children's oral health.

The association of subjective orthodontic treatment need with oral health-related quality of life.

The existing body of evidence reports an inconsistent association between subjective and objective orthodontic treatment need. The concept of oral health-related quality of life (OHRQoL) might help to explain the differences in subjective and objective orthodontic treatment need. Our aim was to investigate the association of subjective orthodontic treatment with OHRQoL in children. This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort study. OHRQoL and subjective orthodontic treatment need were assessed by parental questionnaires. Questionnaire items were individually compared among children with no, borderline and definite subjective orthodontic need. The association between subjective orthodontic treatment need and OHRQoL was investigated in multivariate regression analysis with weighted least squares. Differences by sex and levels of objective orthodontic treatment need were evaluated. In total, 3774 children were included in the analysis. Children with borderline subjective orthodontic treatment need and those with definite subjective orthodontic treatment need had significantly poorer OHRQoL based on the fully adjusted model (adjusted regression coefficient (aβ)=-0.49, 95% CI: -0.75, -0.30; (aβ)=-1.58, 95% CI: -1.81, -1.58, respectively). The association between subjective orthodontic treatment need and OHRQoL was stronger in girls than in boys and stronger in children with objective orthodontic treatment need than in those with none. Oral health-related quality of life is poorer in children with subjective orthodontic treatment need. This has not been investigated before in such a large-population-based study and clearly offers an explanation for the lack of concurrence between objective and subjective orthodontic treatment need.

Normative and subjective need for orthodontic treatment within different age groups in a population in Turkey.

To evaluate and compare the normative and subjective need for orthodontic treatment within different age groups in Turkey. One thousand and sixteen patients from seven different demographic regions of Turkey (Marmara, Black Sea, East Anatolia, Southeastern Anatolia, Mediterranean, Aegean, and Central Anatolia Region) (mean age ± SD: 12.80 ± 3.57 years) were randomly selected and divided into six age groups (7-8,9-10,11-12,13-14,15-16, and 17-18 year-olds) and categorized according to the dental health component (DHC) of the index for orthodontic treatment need (IOTN). Additionally, the patients were asked to indicate the photograph that was most similar to their own dentition from the 10-point scale of the aesthetic component of IOTN. The DHC of IOTN was not significantly different between the six age groups (P > 0.05). However, no/slight need (aesthetic component 1-4) for orthodontic treatment according to AC of IOTN was significantly higher in 13-14,15-16, and 17-18 age groups than 7-8, 9-10, and 11-12 age groups (P < 0.05). No sex differences were found in both DHC and aesthetic component of IOTN between age groups (P > 0.05). The normative need distribution was homogeneous within all the age groups according to DHC. However, the subjective need for orthodontic treatment was higher in the younger age groups.

Extraction protocols for orthodontic treatment: A retrospective study.

Background and Objectives:Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics.Materials and Methods:One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance.Results:The descriptive statistics of the study revealed a total of 40 (29%) patients in protocol 1, 43 (31.2%) in protocol 2, 18 (13%) in protocol 3, 16 (11.6%) in protocol 5, and 12 (8.7%) in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals.Conclusion:Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors.

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.

Dental esthetic impact of malocclusion and orthodontic treatment need based on self-perception among university students

AimsThe objectives of this study were to assess the self-perceived esthetic orthodontic treatment need, to determine esthetic impact of malocclusion and investigate the effect of factors including gender and courses to the need of orthodontic treatment among university students. MethodsA random study of 275 subjects among 18–25 year old university students from International Medical University (IMU) were evaluated using 2 scales; the Aesthetic Component of Index of Orthodontic Treatment Need (AC) and Oral Aesthetic Subjective Impact Scale (OASIS) and one direct question. ResultsThe data were analyzed to evaluate the subjective orthodontic treatment need, aesthetic impact of malocclusion, and perceived orthodontic treatment need.In the study, 55.7% of the students experienced negative perception and 44.3% have positive self-perception. Female perceived more negative perception (AC-OASIS) as compared to male, 35.3% and 20.4% respectively. The Mann–Whitney U Test was used to compare the total AC-OASIS score between males and females showed positive significance, p=0.05. The comparison between dentistry and non-dentistry students shows no significant difference in perception, p>0.05. ConclusionThere was no difference in the level of orthodontic treatment need among students from different courses, but impact of malocclusion was higher in females compared to males.

The subjective orthodontic treatment need assessed with the aesthetic component of the Index of Orthodontic Treatment Need

Abstract Objective The objective of this research was to evaluate the subjective orthodontic treatment with the aesthetic component (AC) of the Index of Orthodontic Treatment Need among a sample of Yemeni population. Materials and methods The investigation was carried out in Sana’a city, a total of 368 participants were randomly selected from a list of 1376 university students excluding dentistry students, among them 165 responded (92 females and 73 males) based on a questionnaire. The questionnaire checked items concerning the subjective assessment of dental appearance, demand for orthodontic treatment, and any functional disorders (speech, mastication, muscular pain). For statistical analysis chi-square test was used. A probability at the 5% level or less (P Results Overall, 96.4% of the sample classified themselves in the ‘no treatment need’ category, 3% classified themselves in the ‘great treatment need’ category. Satisfaction with dental aesthetics was expressed by 65.5% of respondents. Out of the total sample, 41.8% said that they should have orthodontic treatment, the sex distribution was significantly different (chi-square = 4.279, df = 3, P = 0.001). Conclusion According to the AC of IOTN, almost 3.6% of the evaluated Yemeni subjects had a ‘borderline need’ to a ‘great need’ for orthodontic treatment. If the answers of those who said that they should have orthodontic treatment are considered, the need would increase to two-fifth (41.8%) of the sample.

Reliability of Aesthetic component of IOTN in the assessment of subjective orthodontic treatment need

Reliability of Aesthetic component of IOTN in the assessment of subjective orthodontic treatment need

Factors Influencing Subjective Orthodontic Treatment Need and Culture‐related Differences among Chinese Natives and Foreign Inhabitants

AimThe aim of this survey was to compare Chinese natives and foreign inhabitants in Chengdu, China, with respect to: (1) attitudes towards dental appearance, (2) subjective orthodontic treatment need, and (3) the main factors influencing orthodontic treatment need.MethodologyA total of 522 subjects, including 227 foreign inhabitants and 295 Chinese natives in Chengdu participated in the survey. A simple random sampling method was adopted and a face-to-face interview was conducted at some public sites using a questionnaire. Data was entered by two persons synchronously using Epidata 3.0, and SPSS 13.0 was used to analyze these data.Results89.0% of foreign inhabitants were satisfied with their teeth compared to only 46.8% of Chinese natives. Females were more dissatisfied with their teeth than males. Chinese natives put improving appearance as the top priority (55.9%) for seeking orthodontic treatment; however, in foreign inhabitants, the main reason for seeking treatment was to improve masticatory function (44.1%), followed by ”to be pretty“ (35.2%). The importance of well-aligned teeth and self-perception of psycho-social impact of malocclusion were the same two main factors influencing subjective orthodontic treatment need (P<0.05) in foreign inhabitants and Chinese natives. Subjective orthodontic treatment need between the two target groups was significantly different (P<0.05).Conclusion(1) It was very common that Chinese natives were dissatisfied with their dental appearance, and their subjective orthodontic treatment needs were high. (2) There were some differences in orthodontic treatment motives between the two target groups. (3) There were differences in subjective orthodontic treatment needs between foreign inhabitants and Chinese natives. However, the prominent influential factors were almost the same. There may be benefit to understanding subjective orthodontic needs of different races.

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.

Preadolescent orthodontic treatment need: Objective and subjective provider assessments and patient self-reports

In the age of evidence-based dentistry, an interesting question is whether dentists' subjective or general assessments of preadolescent orthodontic treatment need are correlated with objectively determined need. In addition, because children from socioeconomically disadvantaged and underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment, it is worthwhile to investigate whether unmet orthodontic treatment need is correlated with preadolescent smile assessments and desire for braces. Our objectives were to explore (1) whether pediatric residents' objective and subjective assessments of preadolescent orthodontic treatment need are correlated and also correlate with the treatment recommendations made, (2) whether preadolescent responses concerning their smile-related quality of life and desire for braces are correlate, and (3) whether dentist and patient assessments are related. Data were collected from 1566 preadolescents (age range, 8-11 years; 47.3% boys, 52.7% girls; 55.7% black, 39.7% white, 2.9% Hispanic) in oral examinations and face-to-face interviews. Malocclusion was determined with the index of orthodontic treatment need. Objective and subjective orthodontic treatment need indicators were correlated (r = .719, P <0.001). Pediatric residents' recommendations for orthodontic treatment were correlated with both the objective assessment of treatment need (r = .547, P <0.001) and the subjective assessment of treatment need (r = .522, P <0.001). Both sets of malocclusion indicators correlated with the patients' self-perceptions (r = -.145, P <0.001; r = -.177, P <0.001) and their desire for braces (r = .106, P = 0.001; r = .141, P <0.001). Patient desire for braces was significantly correlated with smile-related quality-of-life scores (r = .665, P <0.001). Although subjective and objective assessments of preadolescent orthodontic treatment need are rather consistent, the percentage of actual treatment recommendations exceeded both the subjective and objective assessments of treatment need. Preadolescent self-assessments and desire for braces were significantly correlated, and also correlated with the treatment recommendations and the objective and subjective components of the index of orthodontic treatment need score.

Awareness and concern about malocclusion among 12-15 year-old children in Moshi, Tanzania

To assess awareness and concern about malocclusion in 12-15 year-olds in Moshi, Tanzania. A cross-sectional study. Moshi Municipality in Kilimanjaro region, Tanzania. Two hundred and ninety eight randomly selected Public primary school children aged 12-15 years (158 males and 140 females). About 56% of the respondents thought their teeth were properly aligned. However only 29.1% of the respondents reported being dissatisfied with the way their teeth appeared in their mouth. About 25% of the respondents found their teeth to have been worse than most of their age-mates. Children who reported to have been teased due to their malocclusion comprised 25.8%. Those who thought it was unpleasant to stay with malaligned teeth constituted 55.7% of the respondents. Subjective orthodontic treatment need was reported by 69.1% of the sample. Majority of the children (75%) were ready to accept orthodontic treatment. There were significant correlations between factors of awareness and those of concern about malocclusion among the subjects. In spite of very little orthodontic treatment exposure in this population, awareness and concern about malocclusion was reported by a significant proportion of the children. These findings form a baseline line for future studies on the trends of awareness and concern towards malocclusion in this population. They will also be useful in the planning of orthodontic services in Tanzania.

The value of the aesthetic component of the Index of Orthodontic Treatment Need in the assessment of subjective orthodontic treatment need.

Previous studies carried out using the Index of Orthodontic Treatment Need (IOTN) have reported that the Aesthetic Component (AC) has limited use in schoolchildren. The purpose of this study was to estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Such a correlation would indicate if the AC of the IOTN may help to identify individuals interested in orthodontic treatment who would co-operate well, and consequently who might derive the greatest benefits. The investigation was carried out in north-west Poland among 84 schoolchildren (42 girls and 42 boys) aged 12 years and was based on a questionnaire and clinical examination. The questionnaire contained items relating to the subjective assessment of dental appearance, demand for orthodontic treatment, the influence of the dentition on the general appearance, and any functional disorders (speech, mastication, muscular pain, etc.). Clinical examination was carried out at the schools each time by the same dentist. For statistical analysis chi-square (Yates corrected) and McNemar tests were used. A probability at the 5 per cent level or less (P < 0.05) was considered statistically significant. The outcome shows that the AC of the IOTN moderately reflects the subjective perception of dental aesthetics and demand for orthodontic treatment. The results indicate that using professional rating the AC scale does not seem to be more precise or reliable than self-evaluation. The correlation between dental concern and the AC would be higher if the 'no treatment need' category was split into two parts (e.g. 1-2 'no need', 3-4 'slight need') or the 'borderline need' category was moved two grades lower. The AC would then help to identify patients interested in treatment who would potentially be co-operative.