Orthodontic treatment need in children aged 12-14 years in Mombasa, Kenya
A public orthodontic system generally is designed to prioritize patients so that those who have the greatest need receive treatment. The aim of this study was to compare the subjective perceptions of the occlusal appearance of 11 to 12 year-old schoolchildren of Nairobi with the modified Aesthetic Component (AC) scale of the Index of Orthodontic Treatment Need (IOTN). The objectives were to assess the children's perception of their occlusal appearance, categorise the occlusal appearance using the AC scale, by both the children and researcher; and to compare the children's' perception and the AC of the IOTN. Satisfaction with appearance of teeth and occlusion as well as peer comparison was investigated. The treatment need and demand was assessed using the modified AC photographs of the IOTN. Altogether, 488 school children (249 girls and 239 boys) assessed their perception of the anterior teeth using a Verbal Descriptor Scale (VDS) and a Visual Analog Scale (VAS) questionnaire. The researcher examined the anterior teeth of the participants and categorised them using the AC of the IOTN. The following results were reported: about two-thirds of the respondents were satisfied with the appearance of their teeth, with the gender difference being statistically significant. About 35% were dissatisfied or very dissatisfied, but reasons for it varied. More than half of the respondents rated their teeth as better than those of their peers and three-quarters were satisfied with their occlusion, the two responses elicited no gender difference. Treatment need was assessed by use of the AC indicated that there was a moderate agreement between researcher and respondents’ in treatment need assessment. The researcher found 36.3% needed treatment against self-perceived need of 30.9%. One-third of the respondents determined by the researcher to 'need treatment', felt 'no need'. There was no statistical gender difference in perceived need for treatment. The selection of ranked photographs of the AC by both researcher and respondents demonstrated skewed distributions towards the 'low ranked' or attractive end of the ranking order irrespective of the state of occlusion. Statistical comparison of the two methods used, namely the VDS and VAS, indicated that the responses were significantly different. Therefore it is suggested that any treatment priority assessment should take perceptions of occlusal appearance. into consideration.