Subjective and objective orthodontic treatment need among orthodontically treated and untreated Finnish adolescents

Abstract Subjective orthodontic treatment need was studied in a sample of 340 Finnish adolescents with and without previous orthodontic treatment. The subjects, who were attending two schools preparing students for college, first filled in a questionnaire. Of the 340 subjects, 24.4% of the treated and 24.0% of the untreated expressed subjective orthodontic treatment need (NS). For the clinical examination, 110 subjects were systematically sampled from four groups; subjects who had received orthodontic treatment in the past and a) felt, b) did not feel subjective orthodontic treatment need and subjects who had not received orthodontic treatment in the past and c) felt, d) did not feel subjective orthodontic treatment need. A total of 106 subjects were examined by an orthodontist. Objective treatment need was assessed by using the Treatment Priority Index. Of those clinically examined, 29.4% of the treated subjects were still found to be in objective need of orthodontic treatment; among the untreated subjects, the corresponding figure was 54.5% (P < 0.05). The sensitivity of the orthodontist to detect treatment need felt by the adolescents was, among the treated, 40.0% and the specificity 75.0%. Among the untreated subjects the corresponding figures were 75.9% and 69.2%. Of those treated who had objective treatment need, 40.0% expressed the need themselves (NS). However, of the untreated who had objective treatment need, 73.3% expressed such a need (P < 0.001). Subjects judged to have a very attractive denial appearance (IOTN, Aesthetic Component) were more often detected among those treated than among the untreated. As a clear discrepancy can be observed between objective and subjective treatment need estimates, in orthodontic counseling an understanding of how the patient perceives his/her dentition is essential.