Relationship of the Dental Aesthetic Index to the oral health-related quality of life

Objective:To assess the impact of malocclusion on the quality of life.Materials and Methods:This cross-sectional study involved 150 subjects attending the Primary Care Unit with no history of orthodontic treatment. The Dental Aesthetic Index (DAI) with 10 occlusal characteristics were measured on study models. Oral health-related quality of life (OHRQoL) was assessed with the Malaysian version of the Oral Health Impact Profile questionnaire (OHIP-14). The Spearman rank-order correlation coefficient was used to evaluate the relationship between the malocclusion and quality of life.Results:Significantly weak correlations (r = .176) were found between the DAI and the OHRQoL. Females and the younger age group (12–19 years) tended to score higher on the OHIP-14 than their counterparts. For males, domain 3 (psychological discomfort; r = .462), domain 4 (physical disability; r = .312), domain 7 (handicap; r = .309), and overall score (r = .289) were weak correlates but significant to the DAI compared with females. The older age group showed a significant weak correlation in domain 3 (psychological discomfort; r = .268) and domain 7 (handicap; r = .238), whereas the younger age group showed no correlation with any domain.Conclusions:The DAI score does not predict the effect of malocclusion on the OHRQoL.     

Malocclusion and orthodontic treatment need evaluated among subjects with Down syndrome using the Dental Aesthetic Index (DAI)

Objective:To determine the prevalence of malocclusion and need for orthodontic treatment among persons with Down Syndrome (DS).Materials and Methods:Study participants were 113 persons with DS from the selected community-based rehabilitation center who fulfilled the inclusion and exclusion criteria. Ten occlusal characteristics of the Dental Aesthetic Index (DAI) were measured on study models to determine the degree of malocclusion. A single score represented the dentofacial anomalies, determined the level of severity, and determined the need for orthodontic treatment.Results:Crowding in the anterior maxillary and mandibular arch was the main malocclusion problems among the subjects with DS. Comparison between age group and genders revealed no significant differences in four categories of orthodontic treatment need (P > .05).Conclusion:Most of the subjects with DS (94; 83.2%) had severe and very severe malocclusion, which indicated a desirable and mandatory need for orthodontic treatment.     

Orthodontic treatment need of 9, 12 and 15 year-old children according to the Index of Orthodontic Treatment Need and the Dental Aesthetic Index

Objective: To assess the differences in occlusal features in three cohorts at 9, 12 and 15 years of age, and compare orthodontic treatment need measured by the Dental Aesthetic Index (DAI) and Index of Orthodontic Treatment Need (IOTN). Design: Cross-sectional study. Setting: School of Dentistry, University of Valencia. Subjects: A total of 1086 children: 321 aged 9, 397 aged 12 and 368 aged 15. Methods: Children were examined to measure their orthodontic treatment need according to IOTN and DAI. The main outcome measure was orthodontic treatment need according to the DAI and IOTN indices. Results: Overbite and inter-incisal diastema were the occlusal features that presented significant differences between the three groups, diminishing with age. Treatment need according to the IOTN was 15.4% at 9 years, 20.9% at 12 years and 12.8% at 15 years. Treatment need according to DAI was 44.8% at 9 years, 21.7% at 12 years and 14.1% at 15 years. The diagnostic agreement between the two indices on the treatment need by age group was very low at 9 years (Kappa 0.18) and moderate at 12 and 15 years (Kappa 0.451 and 0.405, respectively). Conclusions: Orthodontic treatment need is greater in the mixed dentition and falls slightly as the child grows. The greatest variation in results between 9 and 15 years were found in relation to the DAI, which is consequently not recommended for use in the mixed dentition.     

Orthodontic need of treatment of Swedish schoolchildren from objective and subjective aspects

abstract – Of 5,459 schoolchildren in the town of Umeå, Sweden 26.2 % were regarded as not being in need of orthodontic treatment. As judged according to a four-grade scale the need was objectively little in 29.4 % of the children, moderate in 33.6 % and strong for 10.8 %. Of the children with objective need of treatment, 21.2 % were not interested in orthodontic treatment. In 939 children referred from the district of Västerbotten the need of treatment was little in only 3.2 %, while strong in 52.3 %, and very strong in 6.3 %. Only 47.8 % of the children were interested in orthodontic treatment.     

Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation

OBJECTIVES: The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred. METHODS: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment. RESULTS: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment. CONCLUSIONS: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.     

Perceived, desired, and normatively determined orthodontic treatment needs in male US Army recruits

Abstract This study assessed perceived, desired, and normative need for orthodontic care in a systematic random sample of 576 male enlisted Army recruits at one Army post in fall 1990. Perceived and desired need were collected using a pretested questionnaire. Normative need was assessed on all participants by one dentist using the Treatment Priority Index. Results show 16.3% of enlisted male Army recruits have severe or handicapping malocclusions. yet only one-third desire corrective treatment. Preference for orthodontic care is strongly influenced by the recruit's education level. We recommend that military health policymakers consider expanding access to adult orthodontic care for active duty military personnel to keep pace with its widening acceptance by the general public and to keep the military health benefits package competitive with those of civilian employers.     

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.     

Analysis of plaque microbiota and salivary proteins adhering to dental materials

ObjectivesPlaque causes oral diseases and aspiration-pneumonia in the elderly. It is not known whether pellicle-like attached salivary proteins and microbiota on dental materials are identical to those on teeth. The purpose of this study was to determine the properties of salivary proteins and microbiota that attach to dental materials.MethodsEight subjects wore removable oral splints with pieces of pure-titanium, cobalt-chromium alloy, silver-palladium-copper-gold-alloy, denture-base-resin, and hydroxyapatite for 24 h. The bacteria that adhered to each material were analyzed using 16S rRNA sequencing simultaneously. Each material sample was then immersed in pooled saliva, and the attached proteins were collected. Salivary proteins were analyzed using MALDI-TOF/MS, and high molecular weight proteins were identified using peptide mass fingerprinting.ResultsAmong the dental materials, the α- and β-diversity of adherent flora were similar. The bacterial species that adhered easily to materials were Streptococcus sp. oral taxon 058, Neisseria mucosa, Gemella haemolysans, and Rothia dentocariosa. Regardless of material, the peaks or spots of attached salivary proteins had similar patterns, containing functioning proteins such as anchoring receptors for early colonizers.ConclusionsThere were no significant differences in microbiota and protein adherence in hydroxyapatite compared to the dental materials. Therefore, similar microbiota was determined to have formed on the similar pellicle-like proteins. In our study, the characteristics of plaque adhesion on both hydroxyapatite and dental materials were clarified. Based on this study, the creation of new methods of inhibiting plaque adhesion to prevent aspiration-pneumonia and oral infections can be undertaken.     

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。     

Caries increment in the permanent dentition of Mexican children in relation to prior caries experience on permanent and primary dentitions

OBJECTIVE: To evaluate the likelihood of caries increment in schoolchildren, based on their prior caries experience. MATERIAL AND METHODS: We undertook a longitudinal study in 452 six-to-nine year olds between 1999 and 2001 in Mexico, with dental exams conducted by two standardized examiners (kappa>0.85). The dependent variable was the DMFT increment, dichotomized as without increment, and at least one unit of increment. Independent variables estimated caries experience at baseline. Data were analyzed using non-parametric tests and generalized linear models (log-binomial) to calculate relative risk (RR) adjusted for age and sex. RESULTS: The percentage of caries-free children diminished by 20.5% from 1999 to 2001. DMFT index increased two-fold, from 0.25+/-0.70 in 1999 to 0.77+/-1.30 in 2001 (p<0.001). The overall risk for this sample was 24%. The DMFT increment was higher (p<0.001) in children with DMFT>0 and dmft>0 in 1999 (RR=1.89, 95% CI=1.37-2.62; RR=2.71, 95% CI=1.94-3.76, respectively). The likelihood for DMFT increment from the 1999 levels was: (1) 2.78 times higher (95% CI=2.06-3.76) if schoolchildren had caries in any of the first permanent molars and (2) 1.62 times higher (95% CI=1.20-2.19) if schoolchildren were affected by high severity caries at baseline. CONCLUSIONS: Both caries prevalence and mean DMFT had significant increments in 18 months. Dental caries in the primary (dmft) and permanent (DMFT) dentitions at baseline are goods indicators of subsequent caries development in this group of children in a medium income country. This relationship became stronger when the occurrence of caries in the first permanent molars was included.     

用高效液相法研究不同龋敏感人群的唾液蛋白成分

为探讨高效疏水色谱对人腮腺唾液蛋白的分离效果，并利用其分析唾液蛋白与龋病发生的相关性，作者采用高效疏水色谱分离、分析了不同个体及不同龋敏感人群的腮腺唾液蛋白，并做了蛋白定性分析。结果表明，疏水色谱可分出６种腮腺唾液蛋白，其中４种蛋白在所有个体的疏水色谱图上出现。定性分析表明，其中３种为不同表现型的富含脯氨酸蛋白（ｐｒｏｌｉｎｅ－ｒｉｃｈｐｒｏｔｅｉｎｓ，ＰＲＰＳ），另外１种为唾液α－淀粉酶。对比分析１５名无龋者及１０名高龋者的疏水色谱图，发现二组人群的蛋白组成类型无明显差异。３种不同表现型的ＰＲＰＳ与龋病间有不同的相关性，它们在二组间相对比有明显差异。提示蛋白比例失调可能为龋易患性的一个重要因素。     

不同牙龋病状况患者龈上菌斑及龋损组织微生物多样性分析

目的： 探讨不同龋病状况患者龈上菌斑及龋损组织微生物的组成特点及多样性差异。方法： 随机双盲法选择2019年1月—12月于西安医学院第一附属医院口腔科确诊的龋病患者33例（轻度、中度、重度各11例）,无龋病健康者10例。收集龈上牙菌斑和龋损组织,采用细菌DNA测序方法对细菌16S rRNA-cDNA高可变区进行测序,比较各组微生态种属和相对丰度。采用SPSS 23.0软件包对数据进行统计学分析。结果： 与无龋组相比,龋病组龈上菌斑、龋损组织中微生物含量和丰富度均显著降低（P<0.05）。轻、中、重度组患者龋损组织微生物主要为拟杆菌门、螺旋体门、变形菌门、梭杆菌门、厚壁菌门、放线菌门,各组菌属比例有显著差异（P<0.05）。轻、中、重度组患者龈上菌斑微生物主要有21种,其中,梭杆菌、科里亚细菌、奈瑟菌目、放线菌目、乳杆菌目占比高,其他均小于1%,各组5种菌属比例无显著差异（P>0.05）。结论： 龋病的发生由多菌种所致,且为多种细菌的共同作用。不同龋病状况患者龈上菌斑及龋损组织微生物丰度有显著差异,随着龋病的发生,微生物的多样性下降。     

加强全身疾病治疗中的龋病防治

龋病的发展受多种因素影响,患者的全身健康状况可影响患龋病的风险,主要表现为全身疾病的治疗可以改变口腔微生态环境,影响唾液腺功能和唾液成分,直接或间接破坏牙体组织结构,导致龋易感性增加.与全身疾病相关的龋病具有特殊的临床特征,其防治方法也有所不同。本文回顾和分析全身疾病治疗过程中龋病易感的原因和机制,系统介绍全身疾病治疗中的龋病防治和龋病管理的现代理念。     

Prosthetic Status and Prosthetic Need Among the Patients Attending Various Dental Institutes of Ahmedabad and Gandhinagar District, Gujarat

The oral health being an integral part for the healthy living, necessity of disability limitation and rehabilitation in oral health has taken a paramount role. To assess the prosthetic status and to evaluate the prosthetic needs of the patients attending various institutes of Ahmedabad and Gandhinagar district. A total of 510 (264 males and 246 females) subjects at various dental institutes were examined in the study. A survey proforma was prepared with the help of WHO oral health assessment form (1997). Prosthetic status and prosthetic treatment need was recorded. Out of 510, any type of Edentulousness was 322 (63 %). Among them, 254 (49.8 %) were partially edentulous while 68 (13.3 %) were completely edentulous. Only 69 (13 %) were having any prosthesis in upper arch while only 80 (16 %) were having any prosthesis in lower arch. Need for any type of prosthesis in upper and lower arch was 55 and 60 % in males and females, respectively. In lower social class group need of prosthesis in upper and lower arch was 62 and 63 %, respectively. It was found that prosthetic status and prosthetic treatment need increased with increase in age. Steps should be taken to overcome this disparity and more emphasis should be given to meet the felt need of the people through government and non government organizations to improve the oral health. The unmet prosthetic treatment need should be met to rehabilitate needy people so that their disability may be limited.     

Bacteria and salivary profile of adolescents with and without cleft lip and/or palate undergoing orthodontic treatment

BACKGROUND: Patients with cleft lip and/or palate (CL&/P) experience a higher caries prevalence. This study aimed to determine if patients with CL&/P, undergoing and not undergoing orthodontic treatment, have a different salivary biochemical profile and different salivary levels of Mutans Streptococci (MS) and Lactobacilli (LB) compared to patients undergoing and not undergoing orthodontic treatment without CL&/P. METHODS: One hundred and ten subjects aged between 12 and 17 years were recruited into one of four different groups comprising two control groups and two treatment groups. The control groups comprised of subjects with and without CL&/P who were not undergoing orthodontic treatment. The treatment groups comprised of subjects with and without CL&/P undergoing orthodontic treatment. Regular reinforcement of oral hygiene instructions, dietary counselling and debridement, when necessary, were offered to subjects in the treatment groups following their orthodontic adjustment appointments. The salivary secretion time, pH of resting and stimulated saliva, salivary flow rate, buffering capacity, quantity of salivary MS and LB were measured. RESULTS: Subjects with CL&/P undergoing orthodontic treatment at the Children's Oral Health Service tended to present with microbiological and salivary profiles that were less favourable for caries development. There was a significant difference in the percentage of subjects with > or = 10(5) colony forming units (CFU)/mL of MS between the cleft treatment and non-cleft treatment groups. Subjects in the non-cleft treatment group had the highest percentage of subjects (86.7 per cent) with > or = 10(5) CFU/mL of MS whereas subjects in the cleft treatment group had the lowest percentage of subjects (60 per cent) with > or = 10(5) CFU/mL of MS. For LB, there were significantly higher percentages of subjects with > or =10(5) CFU/mL of LB in the non-cleft treatment (76.7 per cent) and cleft treatment (73.3 per cent) groups compared to the non-cleft control (46.7 per cent) and cleft control (40.0 per cent) groups. CONCLUSIONS: Regular oral hygiene reinforcement and dental health education appears to have a positive effect in reducing the percentage of subjects with > or = 10(5) CFU/mL of MS.     

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.     

An assessment of relationship between self-esteem,orthodontic concern,and Dental Aesthetic Index (DAI) scores among secondary school students in Ibadan,Nigeria

OBJECTIVE: To ascertain the correlation between self-esteem, orthodontic concern and orthodontic status using DAI scores in a group of Nigerian potential orthodontic patients. DESIGN: A cross-sectional analytical study. SETTING: Secondary schools reflecting a good socio-economic spread of adolescents in the town. PARTICIPANTS: Randomly selected 520 junior and senior students 276 (53.1%) males and 244 (46.9%) females with mean age of 15.02 +/- 3.26 (SD) years participated in the study. METHODS: Each student was asked to fill in the questionnaire on orthodontic concern and Global Negative Self-Evaluation scale (GSE) with subsequent assessment of the occlusion according to the DAI by one orthodontist. After obtaining consent, thirty students were re-examined to test intra-examiner reliability which was good (r = 0.98, P < 0.001). RESULTS: The correlations between self-esteem, orthodontic concern and DAI scores were tested using Spearman rank order correlation coefficient. Significant positive correlations were observed between self-esteem and orthodontic concern according to DAI treatment category needs (r = 0.274, p<0.01; r = 0.396, p<0.01; r = 0.347, p<0.05) except for the severe malocclusion group which was positive but not statistically significant (r = 0.136, p> 0.05). Significant correlation was equally noted between DAI scores and orthodontic concern (r = 0.191, p<0.01). CONCLUSION: Significant positive correlation existed between self-esteem in a group of Nigerian adolescents and their orthodontic concern as well as between their DAI scores and orthodontic concern. DAI should be a relevant and useful occlusal index for the Nigerian orthodontic population.     

Comparative effects of different chlorhexidine mouth-rinse formulations on volatile sulphur compounds and salivary bacterial counts

AIM: To compare five different commercial mouth rinses with chlorhexidine (CHX) with respect to their anti-halitosis effect and anti-microbial activity on salivary bacterial counts, following a standardised research protocol. And secondly, to validate the study model proposed in the evaluation of patients suffering from halitosis. PATIENTS AND METHODS: Ten volunteers, with a healthy oral status, were enrolled in a double-blind, cross-over design, using sterile saline as negative control and five CHX-containing mouth rinses: 0.12% CHX alone (CHX+NO), plus alcohol (CHX+ALC), plus 0.05% cetylpiridinium chloride (CHX+CPC), plus sodium fluoride (CHX+NaF), and 0.05% CHX plus 0.05% CPC, plus 0.14% zinc lactate (CHX+Zn). The levels of whole-mouth volatile sulphur compounds (VSCs) were measured by means of a sulphide monitor at baseline, 1 and 5 h after rinsing with the assigned product. Baseline measurements also included an organoleptic assessment and the recording of the tongue-coating index. Aerobic and anaerobic salivary bacterial counts were also obtained by collecting unstimulated saliva samples at the same evaluation times, and processed by culturing techniques. Analysis of variance was used to evaluate whether significant differences existed among groups, at each evaluation point, or in changes between evaluations. RESULTS: No significant differences were detected at baseline, with VSC levels ranging between 190 and 227 parts per billion (p.p.b.) After rinsing, VSC levels were reduced with all products (except saline), after 1 h. Significant differences at 1 h were detected (p=0.04), corresponding to a lower amount of p.p.b. (109) in (CHX+Zn) as compared with the other groups (except CHX+NO). At 5 h, VSC levels were lower for CHX+CPC and CHX+Zn (155 and 169, respectively), while the other groups showed levels higher than 220 p.p.b. With respect to aerobic salivary bacterial counts, CHX+CPC demonstrated the lowest percentage of survival (6% after 1 h and 18% after 5 h). For anaerobic bacterial counts, again CHX+CPC demonstrated the lowest percentage of survival (10% at 1 h and 23% at 5 h), together with CHX+ALC (18% of survival at 5 h). However, salivary counts and VSCs were only significantly correlated at baseline, but not after treatment. CONCLUSION: Important differences can be expected from different CHX formulations, in relation to both their anti-halitosis effect and anti-microbial activity in saliva. Formulations that combine CHX and CPC achieved the best results, and a formulation combining CHX with NaF resulted in the poorest.