A 15-year follow-up study of 30-year-old Danes with regard to orthodontic treatment experience and perceived need for treatment in a region without organized orthodontic care

Abstract – It was the aim to study orthodontic treatment experience and past and present perceived need for treatment in 30-year-old Danes who, at adolescence, had no access to organized orthodontic care. In order to identify the malocclusion traits which elicited treatment or need for treatment, the findings were related to the occurrence of various I rails which had been registered in the same individuals 15 years earlier. From questionnaires (response rate 86%, n = 841) it appeared I hat 10% had received treatment and 20% perceived need for treatment either in childhood or at present. At adolescence, the subjects who had subsequently received treatment, displayed relatively high frequencies of ectopic eruption, anterior cross-bite, extreme maxillary overjet, deep bile, and crowding; among those who perceived need for treatment, extreme maxillary overjet, mandibular overjet and crowding were relatively prevalent.     

Prevalence of malocclusion and need for orthodontic treatment in Saudi Arabia

Abstract The prevalence of different malocclusion features was investigated in 500 14-yr-old male Saudi Arabian children, using a modification of the registration method described by Björk . et al. (3). Most of the children were in dental stage DS4 (all permanent teeth anterior to the first molars erupted). Totally 62.4% of the children had one or more malocclusion features related to dentition, occlusion, or space. The treatment need was evaluated according to the guidelines used in the Norwegian Health Service. About 40% were found to need treatment with fixed appliances, and for 33% extraction of permanent teeth would be part of the treatment. Only about 2.5% would benefit from treatment with simple removable appliances.     

Assessment of orthodontic treatment need: a comparison of study models and facial photographs

Abstract – Objectives: The current study aims to examine how orthodontic treatment need is prioritized depending upon whether dental study models or facial photographs are used as the means of assessment. Methods: A group of three orthodontists and three postgraduate orthodontic students assessed: (i) dental attractiveness; and (ii) need for orthodontic treatment in 40 subjects (19 males, 21 females). The 40 subjects displayed a range of malocclusions. Separate assessments were made from study models and facial photographs. Results: There was a bias towards higher scores for dental attractiveness from facial photographs compared with assessment of study casts, for all examiners. This was statistically significant for five of the six examiners (P = 0.001–0.101). The need for orthodontic treatment was rated as 20% higher from study models compared with facial photographs (P < 0.001); overall the level of need for orthodontic treatment was rated as 18.9% higher from study models compared with facial photographs (P < 0.001). Reproducibility analyses showed that there was a considerable variation in the intra‐ and inter‐examiner agreement. Conclusions: This study shows that a group of three orthodontists and three postgraduate students in orthodontics: (i) rated orthodontic treatment need higher from study models compared with facial photographs and; (ii) rated dental attractiveness higher from facial photographs compared with study models. It is suggested that the variable intra‐examiner agreement may result from the assessment of orthodontic treatment need and dental attractiveness in the absence of any specific assessment criteria. The poor reproducibility of assessment of orthodontic treatment need and dental attractiveness in the absence of strict criteria may suggest the need to use an appropriate index.     

Patient-centered evaluation of orthodontic care: a longitudinal cohort study of children's and parents' attitudes.

As health services are adapted to meet consumers' needs, patient-centered evaluation of quality of care as well as informed consent to treatment decisions become increasingly important concepts in orthodontics. In an attempt to assess the orthodontic service in a region, this study focused on attitudes among children and their parents. The attitudes were recorded both before and after the period in which orthodontic treatment is usually carried out. Changes in children's and parents' attitudes were applied to measure outcome of care, and to evaluate the relevance of informed consent in decisions about treatment. Seventy-nine family units were interviewed with the use of questionnaires when the child was 11 years of age and again at 16 years. Both orthodontically treated and untreated subjects were included. Responses to questions about satisfaction with dental appearance and desire for treatment were transformed to a score for orthodontic concern. A significant decrease in the concern score was observed over the 5-year period among the treated subjects, and the care system apparently identified and provided treatment to the majority of those children concerned at 11 years. Intra-unit disagreement in concern was observed among 25% of the child/parent units at the 11-year stage, whereas at 16 years nearly all units agreed. Informed consent as a tool to ensure patients' autonomy when decisions about treatment are made did not appear to be negatively affected by conflicting attitudes between children and their parents.     

Dentists' attitudes toward chairside screening for medical conditions

BackgroundResults of previous studies demonstrated the effectiveness of chairside medical screening by dentists to identify patients at increased risk of experiencing cardiovascular-associated events. In this study, the authors assessed dentists' attitudes, willingness and perceived barriers regarding chairside medical screening in the dental office.MethodsA national, random sample of U.S. general dentists was surveyed by mail by means of an anonymous questionnaire that involved a five-point Likert scale (1 = very important/very willing; 5 = very unimportant/very unwilling). Friedman nonparametric analysis of variance was used to compare response items within each question.ResultsOf 1,945 respondents, most were male (82.3 percent), white (85.7 percent) and 40 to 60 years old (59.4 percent) and had practiced for more than 10 years (84.5 percent). The majority thought it was important for dentists to conduct screening for hypertension (85.8 percent), cardiovascular disease (76.8 percent), diabetes mellitus (76.6 percent), hepatitis (71.5 percent) and human immunodeficiency virus infection (68.8 percent). Respondents were willing to refer patients for consultation with physicians (96.4 percent), collect oral fluids for salivary diagnostics (87.7 percent), conduct medical screenings that yield immediate results (83.4 percent) and collect blood via finger stick (55.9 percent). Respondents were significantly more willing (P < .001) to collect saliva than height and weight measurements or blood via finger stick (mean ranks: 2.05, 2.96 and 3.05, respectively). Insurance was significantly less important (P < .001) than time, cost, liability or patients' willingness (mean ranks: 3.51, 2.96, 2.94, 2.83 and 2.77, respectively).ConclusionsDentists considered medical screening important and were willing to incorporate it into their practices. Additional education and practical implementation strategies are necessary to address perceived barriers.Clinical ImplicationsThe findings of this study regarding chairside medical screening may lead to changes in our approach to dental education and may help define the practice of dentistry in the future.     

Dental professionals' knowledge and perceived need for education in bioterrorism preparedness

Dental professionals should be well prepared to provide care during bioterrorist events. In this study, we assessed the knowledge, opinions about playing various roles during a bioterrorist event, and perceived need for education of dental professionals (dentists and dental hygienists) from one region (Oregon) that had been exposed to bioterrorism and from another region (New England) not exposed. This cross-sectional study used an eighteen-item pretested, self-administered questionnaire distributed at the 2005 Oregon Dental Conference (n=156) and 2005 Yankee Dental Conference (n=297). Dental professionals' knowledge and perceived need for education on bioterrorist preparedness were quantified by multivariate linear and logistic modeling. More than 90 percent of the dental professionals were willing to provide care during bioterrorist events. Perceived knowledge was high; however, actual knowledge was low. Dental professionals who wanted to attend a continuing education course and who thought dental professionals should play more roles during a bioterrorist attack had higher actual knowledge. Willingness to provide care was not supported by adequate knowledge. No significant differences between New England and Oregon dental professionals were observed in terms of actual knowledge or perceived need for bioterrorism education. Integrating training and education into the predoctoral dental and dental hygiene curricula and developing continuing education courses would improve knowledge and better prepare dental professionals to effectively perform American Dental Association-recommended roles during any future bioterrorism events.     

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

Abstract

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.     

A new Norwegian index of orthodontic treatment need related to orthodontic concern among 11-year-olds and their parents

A new index of orthodontic treatment need was introduced in Norway in 1990. On a morphologic and functional basis the four groups very great (A), great (B), obvious (C) and little/no (D) need were defined for social insurance refunding. The purpose of the present study was to investigate to what extent the new index corresponded with orthodontic concern among potential orthodontic patients and their parents. Of 104 randomly selected fourth grade children, 99 (48 girls, 51 boys, mean age 10.7 yr) presented themselves for clinical examination and interview. One parent was asked to accompany the child, and 93 parents attended. On the basis of clinical examination, morphologic measurements on study casts, and X-rays, the children were allocated to one of the four groups defined by the index. In separate questionnaires the children and the parents were asked to assess satisfaction with own/child's dental arrangement and desire for orthodontic treatment. The interview data were transformed into a composite measure representing orthodontic concern. The results indicated that orthodontic concern was significantly related to index group. For the individuals who expressed concern the new index seemed to be meaningful for allocation of public subsidies, as most individuals (85%) who expressed concern exhibited malocclusions fulfilling the criteria for receiving public subsidies of treatment costs. However, more than 50% of the individuals allocated to group B (great need) did not experience a need for treatment.     

Variability in recording and grading the need for orthodontic treatment using the handicapping malocclusion assessment record, occlusal index and dental aesthetic index

Abstract This investigation evaluates three malocclusion treatment need indices, the Handicapping Malocclusion Assessment Record (HMAR), the Occlusal Index (OI) and the Dental Aesthetic Index (DAI), for reliability and inter-index correlation. Pretreatment study models of 30 cases (mean age 12.9 years, SD 1.2) were assessed using each index. All the indices demonstrated a high level of reliability and non could be selected over the other with regards intra-examiner differences. The DAI, however, was more time-saving (2.68 mins, SD 0.41) and simple lo use. The highest correlation was between HMAR and OI (r=0.87, P<0.001) which is a reflection of the similarity in their design. This study also discusses the limitations of the three indices.     

Patient attitudes toward retention and perceptions of treatment success

Objective:To discern patients'' opinions regarding responsibility for orthodontic retention and to determine whether patient attitudes toward retention are related to perceptions of treatment success.Materials and Methods:Questionnaires regarding orthodontic retention were distributed to first-year undergraduate college students (n  =  158), first-year dental students (n  =  183), and retention patients at orthodontic offices (n  =  214). Items included treatment satisfaction, perceived responsibility for retention, type of retainer prescribed, reasons for discontinuing use of retainers, and relapse experienced.Results:Four hundred twenty-eight of 555 participants indicated that they had received orthodontic treatment. Most indicated they were either “satisfied” or “very satisfied” with their teeth, both at the end of treatment (96%) and currently (84%). There was a strong relationship between the perception of stability of tooth position and current satisfaction level (P < .0001). Most individuals (88%) indicated that they themselves were responsible for maintaining the alignment and fit of their teeth. Those who indicated that someone else was responsible were nearly twice as likely to be dissatisfied with their teeth (P  =  .0496). Patients who had been prescribed clear, invisible retainers were significantly more likely to be “very satisfied” currently (50%) compared to those with Hawley (35%) or permanently bonded (36%) retainers (P  =  .0002). Patients with Hawley retainers were significantly less likely to be wearing them currently as prescribed (45%) than those with invisible (65%) or bonded (68%) retainers (P < .0001).Conclusions:Satisfaction with orthodontic results after treatment is related to patient perceptions of responsibility for retention and perceived stability of tooth position. Patients should play a contributory role in formulating orthodontic retention plans.     

正畸治疗难度、结果、需要指数的相关研究

正畸治疗难度、结果、需要指数(ICON)是由9个国家的97位正畸学者共同研究制定的指数,并于2001年正式提出,旨在通过对患者及其模型进行评价,评价患者的治疗需要、治疗难度、治疗的改善程度及治疗结果的可接受度等。近年来ICON在欧美国家得到了广泛的采用,然而国内尚无相关研究报道。本文就近年来对ICON的研究进展作一综述,并探讨该指数在国内应用的研究方向。     

Factors influencing perceived need for dental care by United States military recruits

This study explores factors that influence perceived need for dental care among US military recruits. The data were collected on a systematic random sample of 2711 US Army, Air Force, Navy, and Marine Corps recruits between February and July 1994. Participants received a comprehensive oral examination from a dentist and answered perceived need queries on self-administered questionnaires. Using bivariate and logistic regression analyses, we examined the association between demographic and clinical measures and perceived need for dental care. Bivariate results show that, overall, 61% of US military recruits perceive a need for dental care, with statistically significant differences across many demographic and clinical factors. Logistic regression results show that the likelihood of perceived need is influenced by gender, branch of service, dental health class, home region of the US, calculus, bleeding gums, level of decay, and dental utilization. Received: 17 December 1996 / Accepted: 24 November 1997     

Patients' attitudes toward screening for medical conditions in a dental setting

Objectives: Previous studies demonstrated the efficacy of chairside medical screening by dentists to identify patients who are at increased risk for developing cardiovascular‐associated events and the favorable attitude of dentists toward chairside medical screening. This study assessed patient attitudes toward chairside medical screening in a dental setting. Methods: A self‐administered questionnaire of eight five‐point response scale questions was given to a convenience sample of adult patients attending an inner‐city dental school clinic and two private practice settings. Wilcoxon–Mann–Whitney tests and t‐tests were used to compare responses between study groups. Friedman nonparametric analysis of variance was used to compare response items within each question. Results: Regardless of setting, the majority of respondents was willing to have a dentist conduct screening for heart disease, high blood pressure, diabetes, human immunodeficiency virus infection, and hepatitis infection (55‐90 percent); discuss results immediately (79 percent and 89 percent); provide oral fluids, finger‐stick blood, blood pressure measurements, and height and weight (60‐94 percent); and pay up to $20 (50‐67 percent). Respondents reported that their opinion of the dentist would improve regarding the dentist's professionalism, knowledge, competence, and compassion (48‐77 percent). The fact that the test was not done by a physician was ranked as the least important potential barrier. While all respondents expressed a favorable attitude toward chairside screening, the mean score was significantly lower among clinic patients across most questions/items. The priority rankings within an item were similar for both groups. Conclusions: Acceptance by patients of chairside medical screening in a dental setting is a critical element for successful implementation of this strategy.     

壮族青年牙外观满意度及正畸治疗需要指数的调查研究

目的：通过对广西壮族青年行问卷调查确定牙外观满意度、测量牙科美学指数（DAI）确定正畸治疗需要量,从而为口腔卫生资源的合理配置提供参考依据。方法：随机抽取77名壮族青年行牙外观满意度问卷调查,制取石膏模型并测量DAI。结果：广西壮族青年具有较高的牙外观满意度（男性80．8％,女性70．6％）,较大的正畸治疗需要量（男性76．9％,女性84．3％）。错骀畸形的主观评价均不高于50％。壮族女青年（96．1％）较男青年（73．1％）更介意牙齿被染色。部分壮族青年更愿意通过牙齿美白提高牙外观（男性50．0％,女性74．5％）。结论：广西地区部分壮族青年未能客观地认识自身牙外观、对改善牙外观的治疗方式了解不足、正畸治疗需要量较大,应增大对该群体的口腔卫生资源调配及错胎畸形的防治力度。     

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安氏Ⅲ类错是一种发育性畸形,受环境和遗传因素的影响,临床检查呈现不同程度的错表现,其治疗和预后随着骨性畸形的严重程度而变化。明确诊断、合理评估错的严重程度是治疗成功的基本前提。同时选择合适的治疗时机,恰当的拔牙以及个体化矫治力系的设计是治疗取得成功的关键。本文旨在探讨安氏Ⅲ类错的分类诊断、治疗时间及方法选择。     

Effect of socioeconomic status on normative and perceived orthodontic treatment need

Objective:To determine the influence of socioeconomic status (SES) on normative and perceived orthodontic treatment need, satisfaction with dental appearance, and regularity of dental attendance.Materials and Methods:The sample consisted of 550 adolescents (232 boys, 318 girls) aged 13 to 17 years who were categorized according to SES into three groups: low, middle, and high SES. Normative treatment need was assessed by using the Index of Orthodontic Treatment Need. Data were collected by clinical examination and face-to-face interview. The χ² test and logistic regression analysis were used for statistical analyses.Results:Approximately 34.0% of the untreated subjects had a definite dental need for treatment and 24.5% had a moderate need; among those, 53.5% were of low SES (P  =  .017). One-third of the sample had a moderate to definite esthetic need, most of whom had a low SES (P  =  .009). Of the subjects who were dissatisfied with their dental appearance and reported a self-perceived need for treatment, around one-third had a low SES. Most subjects with low SES were irregular dental attenders (P < .001). Subjects of low SES, those who had a self-perceived need for treatment, and those who were dissatisfied with their dental appearance were more likely to have a definite normative esthetic need.Conclusions:Subjects of low SES exhibited greater normative and perceived treatment needs than subjects of higher SES. They were less satisfied with their dental appearance and visited a dentist less frequently.     

Norwegian adults' perceived need for coping skills to adjust to dental and non-dental life events

Abstract – Limited attention has been paid to the importance which adults attach to dental, as opposed to other, life events. Consequently, the purpose of the present study was to determine how Norwegain adults rate the need for adjustment to cope with losing teeth or getting dentures, relative to some other life events, and to study effects of age, gender, level of education, place of residence, smoking, drinking and exercise habits. A representative, simple random sample of 400 residents of the County of Hordaland aged 20-69 yr received a mail questionnaire plus one reminder requesting demographic information and completion of a 48-item Social Readjustment Rating Questionnaire (SRRQ) in May 1990. The mean age of the 284 who responded (71%) was 41.1 yr (SD= 13.5 yr). The replies to the SRRQ were given on a graphic rating scale with end points "not difficult at all" (0 cm) and "more difficult than anything" (20 cm). Mean values were calculated and used to rank the life events. "Losing one or more teeth" was ranked 30 (= 11.8; SD = 5.6) and "getting dentures" 33 (= 13.8; SD = 5.5). "Losing one or more teeth" was on a par with life events like "trouble with other relatives" (= 11.7). "Getting dentures" occupied a position between "trouble with wife/husband" (= 14.3) and "wife/ husband stopping work" (= 13.8). Multiple Classification Analysis revealed significant effects of education on "losing one or more teeth"; and of age, sex and education on "getting dentures" ( P <0.05). Furthermore, it was found that these two dental life events required an above average degree of readjustment according to the Social Readjustment Rating Questionnaire.     

Dentists' attitudes and behaviors regarding domestic violence. The need for an effective response

BACKGROUND: The authors examined the attitudes and behaviors of a national sample of dentists regarding domestic violence and the barriers dentists face in intervening to help victims. METHODS: The authors surveyed a national random sample of 321 dentists by mail from November 1997 to March 1998 about their attitudes and clinical practice behaviors related to domestic violence. Survey items were developed based on the domestic violence and health care literature. The authors used the Total Design Method to maximize the response rate and analyzed data to determine differences between dentists who had received domestic violence education and those who had not. RESULTS: Eighty-seven percent of responding dentists never screened for domestic violence; 18 percent never screened even when patients had visible signs of trauma on their heads or necks. Overall, respondents intervened only minimally to help patients whom they had identified as victims. Respondents reported that the major barriers to screening were the presence of a partner or children (77 percent), lack of training (68 percent), concern about offending patients (66 percent) and their own embarrassment about bringing up the topic of abuse (51 percent). Respondents who had received domestic violence education were significantly more likely to screen for domestic violence and to intervene. CONCLUSIONS: Dentists face many barriers to identifying and helping patients who are abuse victims, yet these data suggest that education about domestic violence could help them overcome some of these barriers. CLINICAL IMPLICATIONS: We suggest that dentists follow the AVDR model when approaching abused patients in their practice: Ask about abuse, provide Validating messages, Document presenting signs and Refer victims to domestic violence specialists.     

不同年龄错(牙合)患者机械耳点与解剖耳点的位置关系

目的:研究不同年龄组错(牙合)患者头颅定位侧位片上机械耳点与解剖耳点的位置关系,并探讨其与年龄的关系。方法:选择3～6岁错(牙合)畸形64例,7～12岁错(牙合)畸形210例,大于12岁的错(牙合)畸形156例。以头颅定位侧位片上机械耳点最上缘为原点,以FH平面为X轴,建立直角坐标系,测量3个年龄组的机械耳点与解剖耳点的相互位置关系。结果:不同年龄组错(牙合)畸形患者的机械耳点与解剖耳点的位置关系有显著性差别。随年龄增长,解剖耳点逐渐远离X轴,逐渐靠近Y轴。结论:机械耳点与解剖耳点常不重叠的现象是由外耳道的解剖结构所决定的,随年龄增长,机械耳点与解剖耳点的位置关系发生规律性的变化。