Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the Dental Aesthetic Index

OBJECTIVE: To evaluate the prevalence of malocclusion and orthodontic treatment need among Spanish adolescents and compare with other populations. METHODS: The study sample comprised 744 schoolchildren from urban and rural populations in Granada province (Southern Spain), aged from 14-20 years, who had received no orthodontic treatment. The measurement instrument was the Dental Aesthetic Index (DAI). RESULTS: The mean DAI score of the whole series was 25.6 (SD, 7.94). The distribution of the four DAI grades was: DAI 1, no anomaly or malocclusion, 58.6%; DAI 2, definite malocclusion, 20.3%; DAI 3, severe malocclusion, 11.2%; DAI 4, very severe or disabling malocclusion, 9.9%. There were no statistically significant differences in DAI score between genders or those in rural vs. urban residence, but a significant difference was found between social classes, with subjects of low social class presenting the worst scores (p<0.05). CONCLUSION: The distribution of DAI scores among Spanish adolescents is similar to that reported in other populations.     

Self-perception of malocclusion among north Jordanian school children

This study was undertaken to assess the factors affecting self-perception and the demand for orthodontic treatment among north Jordanian school children. In total, 1404 students randomly selected to represent five geographical areas of northern Jordan were examined. The students were further subgrouped according to gender (858 females, 546 males), age (985 13 year olds, 419 17 year olds) and rural/urban place of residence (212 rural, 1192 urban). The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used as an assessment measure of the need for orthodontic treatment. The self-perception of malocclusion was evaluated by asking each student to identify which photograph on the AC scale most closely matched the appearance of their anterior teeth. The demand for orthodontic treatment was measured by asking the students: "Do you feel it is necessary to have your teeth straightened by an orthodontist?" Differences between the self-perception of malocclusion among the different groups were tested using the chi-squared test.The results showed that the majority of students rated their dentition from grades 1 to 4, with a tendency for the females and older school children to score their teeth as more attractive than males and younger children (P < 0.05, P < 0.001, respectively). Rural and urban school children did not differ in the perception of their own dentition. The self-perception scores of subjects within the no aesthetic need, borderline need and definite need groups differed significantly (P < 0.001). The subjects who reported a definite need perceived their teeth to be worse than the other two groups. The demand for orthodontic treatment was found to be affected by gender (P < 0.01) and rural/urban areas of living (P < 0.05).     

Differences in Need for Orthodontic Treatment Between Native Americans and the General Population Based on DAI Scores

Clinical impressions by Indian Health Service (IHS) dentists of a greater frequency of severe dental malrelations among Native Americans than in the general US population have never been objectively confirmed. This study uses the DAI as the standard to determine whether there is a greater prevalence of severe malocclusions among Native Americans. Four hundred eighty-five Native American students in grades 7-12 from two remote sites--Pine Ridge, SD, and Many Farms, AZ--and one nonremote site--Lapwai, ID--were scored for the DAI. The mean scores from each reservation, as well as the mean score from the three reservations combined, were significantly higher, indicating poorer aesthetics, than the mean DAI score from a large sample of the general US population. These data confirm the clinical impressions of IHS dentists that Native Americans residing on reservations have significantly poorer dental aesthetics than the aesthetics found in the general US population; therefore, Native Americans have greater needs for orthodontic treatment.     

错(牙合)畸形对城市和农村儿童日常生活质量影响的研究

目的 研究错(牙合)畸形对城市和农村儿童日常生活质量的影响.方法 选取1127名11~14周岁城市和农村儿童为研究对象,用安氏(Angle)法进行错(牙合)分类,采用儿童日常生活口腔影响量表(Child-OIDP)中文版评估儿童日常生活受错(牙合)畸形的影响.结果 错(牙合)畸形对儿童日常生活影响的发生率为73.5%;不同畸形类别的Child-OIDP得分差异无统计学意义(P>0.05);农村儿童在饮食、说话和发音、牙齿清洁、情绪方面的得分以及总得分大于城市儿童(P<0.05);日常生活不同方面得分存在差异(P<0.05).结论 错(牙合)畸形对儿童日常生活质量的影响普遍存在,其中对牙齿清洁、饮食和笑容方面的影响相对较严重.农村儿童受影响程度较城市儿童大.     

Assessment of orthodontic treatment needs in Brazilian schoolchildren according to the Dental Aesthetic Index (DAI)

OBJECTIVE: To assess the distribution, prevalence and severity of malocclusion and orthodontic treatment needs in schoolchildren from the northeast of Brazil aged between 13 and 15 years. RESEARCH DESIGN: Cross-sectional study. PARTICIPANTS: A sample of 600 adolescents (264 males and 336 females) randomly selected and representative of schoolchildren living in Recife (Brazil) was obtained from 12 public schools. METHOD: The need for orthodontic treatment was measured using the Dental Aesthetic Index (DAI). RESULTS: Most of the subjects (77%) were deemed to require orthodontic treatment. Only about 5.8% had a handicapping malocclusion that needed mandatory treatment. A severe malocclusion for which treatment was highly desirable was recorded in 47.5% of the adolescents and 23.7% had a definite malocclusion for which treatment was elective. Three main occlusal features were responsible for allocating subjects into the group of "orthodontic treatment required": crowding (47.3%), tooth loss (22.3%) and maxillary overjet of more than 3 mm (21.8%). There were no significant differences (p > 0.05) in mean DAI scores between males and females. CONCLUSIONS: 77% of adolescents from northeast Brazil were in need of orthodontic treatment for dental health reasons. The distribution of DAI scores among Brazilian adolescents is different from that reported in other populations. This study provides baseline data on the need and demand for orthodontic treatment among Brazilian students.     

DAI scores and its relation to self-perceived dental aesthetic and orthodontic concern in Bangladesh and Japan

PurposeTo investigate the relationship between the severity of occlusal irregularities and orthodontic treatment concern among the population of a developing country using DAI score and to compare with the relationship found in a developed country.Materials and methodsThe sample comprised 400 randomly selected university students of Bangladesh, a developing country, 210 males and 190 females, aged 20–27 years. A pretested questionnaire was used to assess the subjects’ satisfaction with own dental appearance and orthodontic treatment concern; the actual severity of malocclusion was determined using the Dental Aesthetic Index (DAI). Statistical analysis was carried out using t-test for gender differences; Spearman rank-order correlation coefficients, Scheffe's post hoc test, one way ANOVA and logistic regression analysis were done for correlation between malocclusion severity and response to questionnaire. The data from a similar study that was carried out on the university students of Japan, a developed country, was compared.ResultIn Bangladeshi sample, males were more affected by malocclusion. Moderate correlation was found between malocclusion, self-satisfaction and treatment concern where satisfaction was decreased and treatment desire was increased with the severity of malocclusion. In Japanese sample, the prevalence of malocclusion was found more in females. Self-satisfaction and malocclusion showed weak correlation and no significant correlation was found between treatment concern and malocclusion.ConclusionAlthough DAI can be used universally to evaluate malocclusion and self-perception, it should be used carefully to determine the subjects’ actual desire for orthodontic treatment where the socio-economic condition can be a provocative factor.     

Perception of personal dental appearance in Nigerian adolescents

BACKGROUND: The purpose of this study was to investigate the relationship among Nigerian adolescents' awareness of malocclusion, their satisfaction with personal dental appearance, and the severity of their occlusal irregularities. MATERIAL: The sample consisted of 577 randomly selected secondary school adolescents-306 (53%) boys and 271 (47%) girls aged 12 to 17 years (mean age, 14.73 +/- 1.12). A pretested questionnaire was used to assess the subjects' awareness of malocclusion and satisfaction with personal dental appearance; the actual severity of malocclusion was determined by using the dental aesthetic index (DAI), performed by an orthodontist in a school environment under natural illumination. RESULTS: Statistically significant, negative, weak correlations were found between awareness of malocclusion and satisfaction at the various DAI scores as follows: < or =25 (r = -0.3774, P < .001), 26 to 30 (r = -0.4305, P < .001), 31 to 35 (r = -0.5137, P < .001), and > or =36 (r = -0.5104, P < .001). Analysis of variance (ANOVA) did not show a significant value of any of the 3 factors. Multivariate analysis with age as the covariate did not show a significant effect. Also, the association between socioeconomic status and the variables was not significant ( P > .05). Generally, no statistically significant sex differences were found in relation to the DAI scores, awareness, or satisfaction ( P > .05). CONCLUSIONS: Significant, negative, weak correlations were found between Nigerian adolescents' awareness of malocclusion and satisfaction with personal dental appearance at the various severity levels of malocclusion. It would be worthwhile to assess such a relationship with the index of orthodontic treatment need in the Nigerian population.     

Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the dental aesthetic index (DAI)

The aims of this study were to measure the distribution, prevalence and the severity of malocclusion and treatment need amongst randomly selected (n = 703) rural and urban Nigerian children aged 12-18 years (mean 14.0 +/- 1.84) using the dental aesthetic index (DAI), and to assess whether malocclusion was affected by age, gender and socio-economic background. Data were collected according to the method recommended by WHO. Most of the children (77.4 per cent) had a dental appearance which required no orthodontic treatment. Over 13 per cent fell into the group where treatment for malocclusion is considered to be 'elective'. However, a substantial proportion (9.2 per cent) of the population had severe to handicapping malocclusion where treatment is 'highly desirable' or 'mandatory'. There were no statistically significant differences (P > 0.05) in DAI scores between age groups, gender and socio-economic background. This study also found that Nigerian adolescents had better dental appearance and less orthodontic treatment need compared with the Caucasian and Oriental populations.     

Social indicators of dental caries among Sierra Leonean schoolchildren

Most of the caries of African child populations is found in limited fractions of that population. The purpose of the present study was to analyze the caries situation of Sierra Leonean schoolchildren in relation to demographic, socioeconomic, and behavioral variables, in order to develop an appropriate index for prediction of caries. A total of 610 students from primary class 1 (mean age: 7 yr) and secondary form 1 (mean age 15 yr) were dentally examined by three examiners and interviewed by their teachers. Intra- and interexaminer reproducibilities were 82 and 70%, and interinterviewer reliability was 67–100% for the individual questions. Urban students had more caries than rural. In class 1, dmfs + DMFS was 4.1 and 1.8, respectively; in form 1, DMFS was 5.3 and 3.5. Two tribes (the Fulas and the Madingos) had higher caries means than the rest, especially in class 1, where dmfs + DMFS was 6.5 and 2.4, respectively. Form 1 students with literate parents had a higher caries mean, and class 1 pupils with defective school uniforms a lower mean. The apparently high-risk groups did not consume more sweet snacks or clean their teeth less frequently. There was clearly more caries among the quartiles of children with most visible plaque on molars, but all social and demographic subgroups had similar amounts of plaque. Multivariate analyses of class 1 children showed that pupils living in urban areas, Fulas and Madingos, and children wearing complete school uniforms had caries significantly more frequently, other factors being equal. In form 1, urban students, rural Fulas and Madingos, students with literate parents, and urban students consuming sweet snacks frequently had significantly more caries. Social criteria were sufficient to identify rural children with high caries experience, but insufficient in urban areas.     

Orthodontic treatment need in Peruvian young adults evaluated through dental aesthetic index

The objectives of this study were to evaluate the frequency and severity of the malocclusion and treatment needs in Peruvian young adults. The second aim was to compare the orthodontic treatment needs according to sex and socio-economic status (SES). This cross-sectional study was conducted at the University Dental Clinic of a private university in Lima, Peru. A total of 267 freshmen (from 16 to 25 years old) were randomly selected from a pool of 780 students. Students wearing an orthodontic appliance or reporting a history of orthodontic treatment were excluded from the study. Clinical examinations were conducted using the Dental Aesthetic Index (DAI). Mann-Whitney and Kruskal-Wallis tests were used to compare the DAI scores according to sex and SES, respectively. The mean DAI score was 28.87 points (IC(95%) 27.77; 29.97, where IC indicates interval of confidence). Around one-third of the sample presented severe or very severe malocclusion, which implies a highly desirable or mandatory orthodontic treatment need. No statistically significant difference was found between the DAI scores according to sex (P = .592) and SES (P = .397). Approximately one-third of the evaluated Peruvian young adults would need orthodontic treatment according to the DAI. In this population, malocclusion was characterized by a relatively high frequency of missing teeth, appreciable dental crowding, and inadequate anteroposterior relationships.     

Malocclusion and TMJ disorders in teenagers from private and public schools in Mexico City

Objective: To identify, among Mexican teenagers from public and private schools, the frequency, severity of malocclusion and orthodontic treatment needs, and their possible association with temporomandibular joint disorders. Material and Methods: Fifteen-year-old students were recruited from public and private schools. Clinical findings were registered as follows: oral hygiene status with the Oral Hygiene Index-Simplified, malocclusion using the Dental Aesthetic Index (DAI), and TMJ disorders following WHO criteria. Negative binomial and logistic regression models were constructed for data analysis. Results: A total of 249 fifteen-year old students were included in the study (118 female 47.4%). 68% had a DAI score ≤ 25 (minor or no occlusal anomalies), 18% scored 26-30 (mild anomalies), 7% scored 31-35 (evident anomalies), and 6% scored ≥ 36 (major malocclusion). The most frequent anomalies were dental crowding in 50%, maxillary dental irregularity in 44.6%, mandible irregularity in 41.2% and excessive maxillary overjet in 37.8%. Among the students, 26.1% had clicking/muscle or TMJ pain, of these 12.3% showed pain during palpation. OHI-S > 1 was found in 34% of the participants. The negative binomial model showed an association between DAI score and TMJ disorders (P=0.041). Also the logistic regression model showed an association between malocclusion (DAI>25) and TMJ disorders (OR=2.58, p=0.002). Malocclusion was associated also with poor oral hygiene (OR=1.65, p=0.007), and with attendance to public schools (OR=1.97, p=0.039). Conclusions: TMJ disorders and DAI scores were significantly associated. Screening/Diagnostic programs for ortho-dontic and TMJ-disorders are needed, to identify and offer treatment to teenagers with major malocclusion and TMJ/muscle pain. Key words:Dental Aesthetic Index, DAI, crowding, Temporo Mandibular Joint disorders (TMJ disorders), Temporo Mandibular Disorders (TMD), occlusal anomalies, OHI-S.     

A Comparison of Dental Caries Experience in Native American and Caucasian Children in Oklahoma

Objectives : In 1989 the Oklahoma Area Indian Health Service conducted an oral health survey of children attending public schools in Oklahoma to determine the extent of caries experience in the Native American population. Results were to be used to establish program priorities, gather baseline data, and compare the oral health status of Native American children with their non-Indian peers. Methods : A total of 934 elementary schoolchildren 5–6 years of age were examined along with 733 high school students 15–17 years of age. The study was designed so that approximately 50 percent of the students examined were Native American. Results : The mean dmfs for the 5–6-year-olds was 5.06 for the Caucasian children and 10.35 for the Native American children, a statistically significant difference (P <. 001). For the 15–17-year-olds the mean DMFS for the Caucasian students (5.99) was significantly lower (P <. 001) than the mean DMFS for the Native American students (10.12). Conclusions : The prevalence and severity of caries in these Native American students appear to be substantially higher than in their non-Indian peers residing in the same communities. Further study is needed to identify factors contributing to these demonstrated differences in caries experience.     

Orthodontic status and treatment need of 12-year-old children in South Africa using the Dental Aesthetic Index.

OBJECTIVE: The aim of this study was to determine the prevalence and severity of malocclusion and orthodontic treatment needs in a sample of 12-year-old South African school children using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and certain socio-demographic variables. METHODOLOGY: The sample comprised 6142, 12-year-old children attending school in seven of the nine provinces of South Africa. For each subject the standard demographic information such as gender, population group, location type and employment status of the parents was collected, after which an intra-oral examination for occlusal status using the DAI was performed. Before the survey, the examiners were calibrated and trained and only examiners with an agreement score greater or equal to 80 per cent were included in the final study. RESULTS: The results showed that 47.7 per cent of the children in the sample presented with good occlusion or minor malocclusion, just over 52.3 per cent presented with identifiable malocclusion, a DAI score larger than 26. Of these, 21.2 per cent had definite malocclusion, 14.1 per cent had severe malocclusion and 16.9 per cent had very severe or handicapping malocclusion. Malocclusion as defined in this study was found to be significantly associated with the different population groups in South Africa, with gender and with dentition stage, but not with the location type or the employment status of parents. CONCLUSIONS: The results of this study show a high prevalence of malocclusion in 12-year-old South African children. The findings provide reliable base-line data regarding the prevalence, distribution and severity of malocclusion as well as useful epidemiological data on the orthodontic treatment needs of 12-year-old children in South Africa.     

芜湖地区5352名中学生口腔健康状况调查分析

目的 了解芜湖地区中学生口腔健康状况以便有针对性地开展牙防工作。方法 采取世界卫生组织口腔健康调查方法,收集2011年12月在我院体检的5 352名中学生口腔健康状况资料,进行统计学分析。结果 5352名中学生患龋率为38.5%,氟牙症指数为0.02,牙龈炎检出率19.1％,受检中学生的错牙合畸形患病率为92.9％。统计分析表明无论市区还是城郊女生患龋情况比男生严重,（市区χ2=64.90,P＜0.01 城郊χ2=16.26,P＜0.01）,来自城郊学生的患龋情况比来自市区的学生严重,有统计学差异（χ2=20.04,P＜0.01）;牙龈炎检出率市区高于城郊有统计学差异（χ2=60.01,P<0.01）,男生高于女生（市区χ2=19.2,P＜0.01 城郊χ2=11.5,P＜0.01）;错牙合畸形患病率男女无统计差异（χ2=0.73,P>0.05）。结论 芜湖地区中学生患龋率与全国相近,口腔卫生状况好于全国水平,错牙合畸形发病率偏高,口腔科就诊率低。     

山东省桓台县中学生口腔健康状况调查

目的 调查山东省桓台县中学生的口腔健康状况,探讨中学生口腔疾病患病特点,为龋病、错((牙合))畸形的防治提供依据.方法 采取世界卫生组织口腔健康调查方法并参考第三次全国口腔健康流行病学调查方案,对桓台县城区所有中学生共中15 893人的口腔健康状况进行普查,检查项目包括冠龋、错((牙合))畸形情况.结果 桓台县中学生恒牙患龋率为 30.58%,龋均为0.69,女生患龋率、龋均高于男生,15～18岁年龄组高于12～14岁年龄组,其中第一、二磨牙龋分别占恒牙龋的53.12%、41.32%.错((牙合))畸形率为60.22%,安氏错牙台畸形构成比为安氏Ⅰ类76.84%、安氏Ⅱ类12.81%、安氏Ⅲ类10.35%.结论 桓台县中学生龋病及错((牙合))畸形发病率较高,应加强口腔健康教育,提高中学生的口腔保健意识.     

2098名大学生错（牙合）因素分析

目的 了解陕西籍大学生错He畸形发生及有关因素。方法 对2998名新入学大学生进行错He畸形调查。结果 安氏Ⅰ类错He发病率最高；女性发病率高于男性；错He发生与城乡、家庭背景、经济状况等因素无明显关系；错He临床症状比较，拥挤和深覆He比例较大；错He者对自身牙颌畸形认识不足，治疗意识淡薄。结论 错He相关因素较多，但关键是加强对错He畸形患者早期宣传教育和诊治。     

基于牙美学指数对青年人群正畸需要的评估

目的：使用牙美学指数评估青年人群的正畸需要,并分析牙外观自我评估值同牙美学指数分值之间的关系。方法：358名大学生参加了牙美学指数检查,同时每位被调查者使用视觉模拟量表对牙外观进行自我评估。对牙美学指数分值和牙外观自我评估进行简单线性相关分析,并基于牙美学指数分组对牙外观自我评估进行秩合检验。结果：37.7%的被调查对象牙美学指数分值≥31,属于需要正畸治疗人群。牙美学指数与牙外观自我评估间呈中度负相关（P〈0.001）,基于牙美学指数分组对牙外观自我评估进行秩合检验表明4组间得分差异有统计学意义（P〈0.001）。结论：本样本中,37.7%的被调查对象需要正畸治疗;牙美学指数与牙外观自我评估呈反向关系。表明牙美学指数可用于青年人群口腔健康相关生活质量的相关研究。     

Establishing malocclusion severity levels on the Dental Aesthetic Index (DAI) scale

The Dental Aesthetic Index (DAI) is an orthodontic index based on socially defined aesthetic standards. It is useful in both epidemiological surveys to identify unmet need for orthodontic treatment and as a screening device to determine priority for subsidized orthodontic treatment. An earlier study established the score of 36 on the DAI scale to identify handicapping malocclusions. The purpose of the present study was to determine decision points on the DAI scale that identify malocclusion severity levels less severe than handicapping. Two sources of data were used: 1) The frequency distribution of DAI scores on a probability sample of 1306 study models representing the untreated occlusions found in half a million adolescents. 2) The per cent distribution of US youths aged 12–17 by specified case severity reported in an assessment of the occlusion of youths? by the National Center for Health Statistics (NCHS). The decision points separating specific case severities on the DAI scale were determined by relating the proportions of the NCHS population with specified case severities to the cumulative percentages of the frequency distribution of DAI scores on the 1306 models. The NCHS report found 45.8 per cent of the sample to have normal or minor malocclusion with no need or slight need for treatment. DAI scores 25 and below corresponded to that proportion of the sample. The NCHS report found 25.2 per cent of the sample to have definite malocclusion with treatment being elective. DAI scores between 26 and 30 corresponded to that proportion of the sample. The NCHS report found 13 per cent of the population to have severe malocclusion with treatment highly desirable. Fifteen per cent were included in this category. DAI scores 31 to 35 corresponded to that proportion of the sample.     

Patterns of tooth vulnerability to caries in South African high school pupils

Caries prevalence and distributions were studied in 761 South African high school pupils aged 17 years in four ethnic groups, living in urban (low F) and rural (low and high F) areas. Mean DMFT values were significantly higher among White pupils than all other groups. Comparison of mean DMFT among the Black pupils showed that urban Black dwellers had a significantly higher score than rural pupils when caries-free individuals were included in the analysis, but not when scores for only those with a DMFT of 1 or more were compared. No significant differences were found between the DMFT values of Black rural pupils living in high or low fluoride areas. Among Black rural pupils, dental caries was approximately three times more common in permanent second molars compared with permanent first molars. In urbanized Black, Coloured, Indian and White subjects, the molars were approximately equally affected.     

兰州地区青少年正畸患者正畸治疗意识的调查分析

目的 调查兰州地区青少年对错牙合畸形的认识及正畸治疗意识。方法 对兰州地区4个城区4 981名在校中学生进行错牙合畸形调查,并向其发放问卷了解治疗动机和正畸意识。结果 4 981名学生中错牙合患者3 168名（65.61%）,其中有452名正在矫治治疗（14.27%）。对2 716名尚未正畸治疗患者调查其未作治疗原因,有21.54%认为没有觉得不齐,20.00%的认为学习紧张。结论 兰州地区青少年错牙合患病率较高,矫治率低,对正畸治疗认识不足。