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      Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study

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          Abstract

          Background

          The normative orthodontic treatment need, established by dental professionals during the dental appointment, becomes ineffective when it does not evaluate all the factors that influence the decision-making process, including individuals’ perception and satisfaction with their dental appearance. Therefore, the purpose of this study was to investigate the perception of children and their mothers as regards orthodontic treatment need and satisfaction with dental aesthetics and test if these variables are associated with the objective orthodontic treatment needs, assessed by the Dental Aesthetic Index (DAI).

          Methods

          A cross-sectional study was conducted on 308 children aged 12 years, and their mothers were randomly selected by cluster sampling (primary schools). The variables “orthodontic treatment need,” “satisfaction with chewing,” and “dental appearance” were assessed by means of a questionnaire. The questions were answered individually at school or home, in cases of children or mothers, respectively. DAI was assessed to make an objective clinical assessment. The variables were dichotomized and statistically analyzed by the chi-square and Fisher’s exact tests, contingency coefficient C, and logistic regression.

          Results

          The results of the clinical evaluation (DAI) were statistically associated with the perception of orthodontic treatment need and satisfaction with dental appearance in children ( p ≤ 0.01). However, no association was observed with regard to satisfaction with chewing and DAI ( p = 0.10). The children’s perception of orthodontic treatment need and satisfaction with the appearance of their teeth was statistically associated ( p ≤ 0.01) with their mothers’ perception. Maxillary overjet, maxillary and mandibular misalignment, and dental crowding were associated with the orthodontic treatment need by children and their mothers, with p value −0.05 and 5 % level of significance. Maxillary overjet was a significant predictor for the perception of orthodontic treatment need in children (OR 1.86, 95 % CI 0.98–3.55) and mothers (OR 3.02, 95 % CI 1.54–5.92).

          Conclusions

          Children and parents realize the need for orthodontic treatment according to the different types of malocclusion, as noted in the association between orthodontic treatment need and dental appearance perceived by children and their mothers, which was also observed—with low correlation—with regard to DAI.

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          Most cited references26

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          Does orthodontic treatment affect patients' quality of life?

          The oral-facial region is usually an area of significant concern for the individual because it draws the most attention from other people in interpersonal interactions and is the primary source of vocal, physical, and emotional communication. As a result, patients who seek orthodontic treatment are concerned with improving their appearance and social acceptance, often more than they are with improving their oral function or health. Enhancing these aspects of quality of life is an important motive for undergoing orthodontic treatment. Regardless of age, patients' and their parents' or caregivers' expectations about improvements in oral function, esthetics, social acceptance, and body image are important for both general dentists and orthodontists to consider when advising patients about these procedures and during the treatment process. This review of research on the impact of conventional and surgical orthodontics on quality of life examines the association between oral health-related quality of life and severity and type of malocclusion, as well as the impact of treatment and patient characteristics on quality of life. The article will emphasize the importance of clinicians' having a clear understanding, before initiating treatment, of their patients' quality of life and their expectations about improvements in specific domains of quality of life.
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            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 percent 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 percent 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 percent 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 percent of the population to have severe malocclusion with treatment highly desirable. Fifteen percent were included in this category. DAI scores 31 to 35 corresponded to that proportion of the sample.
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              Oral Health Surveys Basic Methods

              (1997)
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                Author and article information

                Contributors
                (05519)2106-5200 , etavaresodonto@gmail.com
                Journal
                Prog Orthod
                Prog Orthod
                Progress in Orthodontics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1723-7785
                2196-1042
                14 November 2016
                14 November 2016
                2016
                : 17
                : 37
                Affiliations
                [1 ]Department of Pediatric Dentistry, Piracicaba Dental School, Campinas University, 901 Limeira Avenue, Areião, Piracicaba, SP 13414-90 Brazil
                [2 ]Department of Clinic and Social Odontology, School of Dentistry, Federal University of Paraiba (Cidade Universitária, s/n), Joao Pessoa, Paraiba 58051-900 Brazil
                Article
                149
                10.1186/s40510-016-0149-6
                5107559
                27747529
                9c080d5c-713b-46e7-8c91-a01f7d3e3f1f
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 10 August 2016
                : 28 September 2016
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                malocclusion,child,parents,orthodontics
                malocclusion, child, parents, orthodontics

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