Comparison of Orthodontic Concern and Treatment Need in Nigerian Children

OBJECTIVES: To investigate the awareness of malocclusion and desire for orthodontic treatment in 11- to 14-year-old Nigerian children and their parents compared with professionally assessed objective orthodontic need. METHODS: The study groups were 240 school children and 153 children referred to the orthodontic unit of the Obafemi Awolowo University Teaching Hospital Complex Ile-Ife. The children and their parents were asked their opinions in separate questionnaires, The children's occlusion were also assessed with the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). The dental casts of all the children were assessed for treatment need using the IOTN and the Dental Aesthetic Index (DAI). RESULTS: There were no gender differences in perception of facial appearance, dental appearance and desire for orthodontic treatment. Statistically significant differences were found between the children and their parents on desire for treatment. Orthodontic concern was greater in the school children compared with their parents. The children and their parent's assessment of the AC of IOTN was closer to the attractive end of the scale than the professionals (P< 0.001). The Dental health component of IOTN gave 66.3% no need, 19.6% moderate need and 14.1% great need for treatment in the school and 18.3%, 16.3% and 65.4% respectively in the referred population. The DAI gave need as 48.3% no treatment, 31.2% treatment elective, 11.7% treatment highly desirable and 8.8% treatment mandatory in the school, and 12.4%, 21.6%, 26.1% and 39.9%respectively for the referred population. CONCLUSIONS: The results of the study indicate that there is a difference of opinion on orthodontic treatment need between laypersons and professionals. The IOTN and DAI reliably record deviant occlusal traits and either of them can be used to prioritize treatment need.