Oral Health and Malocclusion in Taranaki 12-13-year olds

Objective: to describe malocclusion, dental caries and the uptake of orthodontic treatment among Taranaki 12-13-year olds.Methods: Ethical approval was granted by the Taranaki Ethics Committee for the dental examination of a random sample of 12-13-year-olds attending intermediate schools. Parents/caregivers completed a postal questionnaire. Children (N = 430; participation rate 74.1%) completed a questionnaire and were examined. Caries experience and malocclusion (Dental Aesthetic Index, or DAI; Cons et al, 1986) were recorded by a single calibrated examiner (LFP). Results: Caries prevalence and severity were 72.6% and 2.88 (sd = 4.25) respectively, with 20% having 4 or more DMFS. Caries prevalence and severity were greater in Maori and low-SES children. The mean DAI score was 28.3 (sd = 7.8). Females and nonMaori had greater mean DAI scores than males and Maori, respectively. A high proportion of the children needed orthodontic treatment (60.5% in the ‘definite’, ‘severe’ or ‘handicapping’ categories), and 17% had a ‘handicapping’ malocclusion. While over one-third of the children had been advised to seek an orthodontic consultation, a proportion (23.4 %) did not. Of those who did, a similar proportion did not proceed with care because of financial considerations. Low-SES children were disproportionately represented in these groups. Children with ‘severe’ or ‘handicapping’ malocclusions who did not proceed with treatment came predominantly from low-SES households and high-deprivation areas. Cost was a barrier to orthodontic treatment for low-SES, high-deprivation children and Maori. Conclusion:Social and ethnic inequalities exist in Taranaki in both caries and orthodontic treatment need. The allocation of orthodontic treatment was largely neither equitable nor rational; if it had been, there would have been no systematic differences by SES, deprivation or ethnicity. This study was supported by the New Zealand Dental Research Foundation.