Prevalence and factors related to malocclusion, normative and perceived orthodontic treatment need among children and adolescents in Bangladesh

ABSTRACT Objective: The purpose of the present study was to assess the prevalence of normative and perceived orthodontic treatment need in schoolchildren and adolescents, related risk factors, and children/parent's aesthetic perception, compared to orthodontist's opinion, in Dhaka city, Bangladesh. Methods: A random sample of 800 schoolchildren aging 11-15 years was selected from different schools in the city of Dhaka, Bangladesh. The Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) were assessed as normative treatment need. The Decayed, Missing, Filled Teeth (DMFT) index was used to record caries experience. Children were interviewed on the perception of orthodontic treatment need. Parents also completed a questionnaire on the perception of their child's orthodontic treatment need, assessed by AC/ IOTN. Results: According to the DHC/IOTN, only 24.7% were in the category of definite need (grade 4-5) for orthodontic treatment. A significant difference was found between the clinician/children and clinician/parents perceived AC score of IOTN (p= 0.0001). Multiple logistic regression showed children with a higher DMFT were significantly more likely to need orthodontic treatment, according to the DHC of IOTN. Conclusion: A low proportion of schoolchildren needs normative orthodontic treatment in the city of Dhaka, Bangladesh. Children with a higher DMFT score were significantly more likely to need orthodontic treatment, according to the DHC of IOTN.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar a prevalência de necessidade real e percebida de tratamento ortodôntico em crianças e adolescentes em idade escolar, bem como de fatores de risco relacionados, e comparar a percepção estética das crianças e responsáveis com a percepção de ortodontistas na cidade de Dhaka, Bangladesh. Métodos: uma amostra aleatória composta por 800 crianças, com idades entre 11 e 15 anos, foi selecionada em diferentes escolas da cidade de Dhaka, Bangladesh. Para avaliação da necessidade real de tratamento, utilizou-se o Dental Health Component (DHC) e o Aesthetic Component (AC) do Index of Orthodontic Treatment Need (IOTN). O índice de Dentes Cariados, Perdidos e Obturados (CPO-D) foi usado para registrar a prevalência de cáries dentárias. As crianças foram entrevistadas sobre sua percepção da necessidade de tratamento ortodôntico, e os pais também responderam a um questionário sobre a percepção da necessidade de tratamento ortodôntico de seus filhos, avaliada pelo AC do IOTN. Resultados: de acordo com o DHC, apenas 24,7% das crianças foram alocadas na categoria de necessidade real (notas 4-5) de tratamento ortodôntico. As pontuações no AC foram significativamente diferentes entre os ortodontistas, as crianças e os responsáveis (p= 0,0001). A análise da regressão múltipla mostrou que as crianças com maiores pontuações no CPO-D tinham chance significativamente maior de precisar de tratamento ortodôntico, segundo o DHC. Conclusão: um número reduzido de crianças em idade escolar necessita realmente de tratamento ortodôntico em Dakha, Bangladesh. Além disso, as crianças com maior CPO-D apresentaram chance significativamente maior de precisar de tratamento ortodôntico, segundo o DHC.

Malocclusion prevalence and orthodontic treatment need in central Anatolian adolescents compared to European and other nations' adolescents

Abstract Objective: To determine the prevalence of malocclusion and orthodontic treatment need in a large sample of Central Anatolian adolescents and compare them with European-other nations' adolescents. Methods: The sample included 1125 boys and 1204 girls aged between 12 and 16 years with no previous orthodontic treatment history. Occlusal variables examined were molar relationship, overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite. The dental health (DHC) and aesthetic components (AC) of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment for the total sample. Results: The results indicated a high prevalence of Class I (34.9%) and Class II, Division 1 malocclusions (40.0%). Moreover, increased (18%) and reduced bites (14.%), and increased (25.1%) and reversed overjet (10.%) were present in the sample. Conclusion: Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment need (grades 4 and 5) was 28.%. However, only 16.7% of individuals were in need (grades 8-10) of orthodontic treatment according to the AC.

Resumo Objetivo: determinar a prevalência de má oclusão e a necessidade de tratamento ortodôntico em uma amostra extensa de adolescentes da Anatólia Central, e compará-los a adolescentes europeus de outras nacionalidades. Métodos: a amostra consistiu de 1125 meninos e 1204 meninas, com idades entre 12 e 16 anos, sem histórico de tratamento ortodôntico prévio. As variáveis oclusais avaliadas foram a relação entre molares, overjet,overbite, apinhamento, diastema na linha média, mordida cruzada posterior e mordida em tesoura. O Componente de Saúde Dental (DHC) e o Componente Estético (AC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN) foram utilizados para avaliar a necessidade de tratamento ortodôntico de toda a amostra. Resultados: os resultados sugerem uma alta prevalência de má oclusão de Classe I (34,9%) e Classe II, subdivisão 1 (40,0%). Além disso, overbiteaumentado (18,3%) e reduzido (14,4%), e overjet aumentado (25,1%) e reduzido (10,4%) também foram observados na amostra. Conclusão: com base no uso do DHC do IOTN, observou-se que a proporção dos indivíduos avaliados com necessidade grande e muito grande de tratamento (notas 4 e 5) foi de 28,7%. Porém, de acordo com o AC, apenas 16,7% dos indivíduos apresentaram necessidade (notas 8-10) de tratamento ortodôntico.

Orthodontic manpower requirements of Trinidad and Tobago / Necesidades de personal de ortodoncia en Trinidad y Tobago

OBJECTIVE: A study was done to estimate the orthodontic manpower requirements of Trinidad and Tobago. METHODS: A questionnaire was administered via e-mail to 9 of 11 orthodontists. Information from a population census, a report on the orthodontic treatment needs of children in Trinidad and Tobago and this questionnaire were used to calculate the number of orthodontists and chairside orthodontic assistants needed in Trinidad and Tobago. RESULTS: On average, 50 per cent of the 289 patients treated by each orthodontist in Trinidad and Tobago annually are children. Approximately, 13 360patients can be expected to demand orthodontic treatment every year in this country. The number of orthodontists and chairside assistants required to treat these patients was estimated to be 44 and 154, respectively. CONCLUSIONS: Currently, Trinidad and Tobago only has a quarter of the number of orthodontists and orthodontic chairside assistants required to treat the number of patients in need. As the demand is relatively high in Trinidad and Tobago and the number of orthodontists has increased slowly and inadequately for the past decade, the orthodontists are likely to remain adequately employed and happy with their job unlike dentists who are currently in private practice for less than a year.

OBJETIVO: Se realizó un estudio con el propósito de calcular la necesidad de personal para el trabajo de ortodoncia en Trinidad y Tobago. MÉTODOS: Se administró una encuesta via correo electrónico a 9 de 11 ortodoncistas. La información de un censo de población, un reporte sobre las necesidades de tratamiento ortodóncico de los niños en Trinidad y Tobago, así como esta encuesta, se usaron para calcular el número de ortodoncistas y asistentes dentales de ortodoncia necesitados en Trinidad y Tobago. RESULTADOS: Como promedio, el 50 por ciento de los 289 pacientes tratados anualmente por cada ortodoncista en Trinidad y Tobago son niños. Puede esperarse que aproximadamente 13360pacientes pidan tratamiento de ortodoncia todos los años en este país. Estimados indicaron que el número de ortodoncistas y asistentes ortodoncistas requeridos para tratar a estos pacientes es 44 y 154, respectivamente. CONCLUSIONES: Actualmente, Trinidad y Tobago sólo tiene un cuarto del número de ortodoncistas y asistentes de ortodoncia requeridos para tratar al número de pacientes con necesidades. Como que la demanda es relativamente alta en Trinidad y Tobago y el número de ortodoncistas ha aumentado lenta e inadecuadamente en los últimos diez años, es probable que los ortodoncistas permanezcan adecuadamente empleados y felices con su trabajo, a diferencia de los dentistas que están actualmente en la práctica privada por menos de un año.

Orthodontic treatment need of children in Trinidad and Tobago / Necesidad de tratamiento ortodóntico de los niños en Trinidad y Tobago

OBJECTIVE: This prospective cross-sectional study was undertaken to determine the normative and perceived orthodontic treatment needs of children aged 11-12 years in a Caribbean country, Trinidad and Tobago. METHODS: One author, an experienced orthodontist, examined 367 children using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) to assess the normative need. The same orthodontist administered the questionnaire to assess the patient's perceived needs using the Aesthetic Component (AC) of the IOTN and the Oral Aesthetic Subjective Impact Scale (OASIS). RESULTS: The DHC and the AC of the IOTN and the OASIS showed respectively that 61.4%, 2.5% and 0.6% of the children had definite need for orthodontic treatment. The female proportion of the sample was more than the target population but the perceived need and normative need for orthodontic treatment did not depend significantly (p < 0.05) on the gender or ethnicity of the subjects of this study. The perception of need for orthodontic treatment differed inversely from the normative need and this is seen to be significant (p < 0.05) when OASIS was used. CONCLUSIONS: Approximately three out of five children in Trinidad and Tobago have a great (or very great) need for orthodontic treatment for dental health reasons.

OBJETIVO: Este estudio prospectivo transversal fue emprendido con el objeto de determinar las necesidades del tratamiento ortodóntico normativo y percibido para niños de 11-12 años de edad en un país caribeño - Trinidad y Tobago. MÉTODOS: Un autor - ortodoncista experimentado - examinó a 367 niños usando el Componente de Salud Dental (DHC) del Índice de Necesidad del Tratamiento Ortodóntico (IOTN) para evaluar la necesidad normativa. El mismo ortodoncista aplicó la encuesta para evaluar las necesidades percibidas del paciente usando el Componente Estético (CA) del IOTN y Escala ortodóntica de impacto estético subjetivo (OASIS). RESULTADOS: El DHCy el CA del IOTNy el OASIS mostraron respectivamente que 61.4%, 2.5% y .6% de los ninos tenían una necesidad definida de tratamiento ortodóntico. La proporción de hembras de la muestra fue mayor que la población objetivo, pero la necesidad percibida y la necesidad normativa de tratamiento ortodóntico no dependia significativamente (p < 0.05) del género o etnicidad de los sujetos de este estudio. La percepción de la necesidad de tratamiento ortodóntico difería inversamente de la necesidad normativa y puede verse que es significativa (p < 0.05) cuando el OASIS fue usado. CONCLUSIONES: Aproximadamente tres de cada cinco ninos en Trinidad y Tobago tienen una necesidad grande (o muy grande) de tratamiento ortodóntico por razones de salud dental.

Associations between normative and self-perceived orthodontic treatment needs in young-adult dental patients / 대한치과교정학회지

OBJECTIVE: Our aim was to determine the correlation between dental treatment need as assessed by the components of the index of orthodontic treatment need (IOTN) and a self-evaluation questionnaire in a population selected from the dental clinics of Shiraz, Iran. METHODS: The dental treatment needs of 240 participants (120 men and 120 women) were measured on the basis of the IOTN dental health component (IOTN-DHC), IOTN aesthetic component (IOTN-AC), IOTN AC determined by the examiner (IOTN-ACE), and a self-evaluation questionnaire (SEQ). The correlations between the treatment needs assessed by all the methods as well as the correlations of the treatment needs with age and gender were assessed using a Spearman's correlation coefficient (alpha = 0.01). RESULTS: All methods were significantly correlated (p 0.06). CONCLUSIONS: The correlations between the self-evaluation and the IOTN components in young adults were close to those reported in children, and IOTN-ACE was more reliable than IOTN-AC.

An analysis of reproducibility of DAI and IOTN indexes in a brazilian scene / Análise da reprodutibilidade dos índices DAI e IOTN em um cenário brasileiro

The aim of this study was to evaluate the ability of the indexes DAI and IOTN in predicting the need of orthodontic treatment based in one property: reproducibility. The index DAI was developed in USA in 1989 and can identify 10 occlusal alterations that result, mathematically, in scores, with weights based in its relative importance according with the judgment of laypeople. The IOTN was developed in England also in 1989 and incorporates an aesthetic component AC and a component of dental health DHC. The AC component consists on a scale illustrated with 10 photos which had been divided in bands of degrees in accordance with a hierarchic scale and classifies the patients in degrees of treatment needed. The instruments of collection of the data were: plastic rule of DHC component and an aesthetic visual scale of component AC praised for the IOTN and one periodontal OMS probe praised for DAI. The sample was composite by 60 patients. The results indicated that both indexes were highly reproducible in accordance with Pearson and Spearman coefficients, which were strengthened by t-tests of Student and Wilcoxon, respectively. The correlation results between the examiners had varied between r=0.85 and r=1.00.

O objetivo deste estudo foi avaliar a capacidade dos índices DAI e IOTN em predizer a necessidade de tratamento ortodôntico baseado em uma propriedade: reprodutibilidade. O índice DAI foi desenvolvido nos Estados Unidos (1989) e identifica dez alterações oclusais que resultam, matematicamente, em escores, com pesos específicos baseados em um determinado grau de importância de acordo com o julgamento de pessoas leigas. O IOTN foi desenvolvido na Inglaterra ( 1989) e possui um componente estético - AC - e um componente dentário - DHC. O componente AC consiste em uma escala ilustrada com 10 fotos as quais representam um escala hierárquica de necessidade de tratamento ortodôntico. Os instrumentos para coleta de dados foram uma régua plástica do componente DHC e a escala visual do componente AC para o índice IOTN; sonda periodontal da OMS utilizada no índice DAI . A amostra foi composta por sessenta pacientes. Os resultados indicam que ambos os índices foram altamente reprodutíveis de acordo com os coeficientes de Pearson e Spearman. Para esses coeficientes, foram utilizados, respectivamente, teste t de Student e Wilcoxon. O resultado de correlação entre os examinadores variou entre r = 0,85 e r = 1,00.