The relationship between normative orthodontic treatment need and measures of consumer perception

Abstract

Aim: The first aim was to investigate whether there was an association between normative (clinician measured) orthodontic treatment need and the following consumer values, 1) child self-perceived aesthetic need, 2) child self-esteem, 3) oral aesthetic subjective impact score (OASIS). The secondary aim was to investigate whether there was an association between child self-esteem and 1) child self-perceived aesthetic need 2) OASIS.

Study type: Prospective, cross-sectional.

Sample: A random sample of 439, 11-12 year-old children was selected from schools in Greater Manchester.

Method: Normative and child self-perceived orthodontic treatment need were measured using the Index of Orthodontic Treatment Need (IOTN). The subjects completed questionnaires to measure their self-esteem (Piers Harris) and OASIS score.

Results: Children with higher normative IOTN scores had more negative psycho-social impact from their malocclusion (P<0.001). However, there was no association between clinician IOTN grades and child self-esteem. Clinician and child-rated IOTN aesthetic component (IOTN AC) grades were statistically significantly different (P<0.05). Higher child self-esteem scores were associated with lower child rated IOTN AC grades (P<0.05) and lower OASIS scores (P<0.001).

Conclusions: Only one of the consumer measures studies (OASIS) reflected normative/clinician IOTN grades. A high child self-esteem appears to be related to their self-perceived malocclusion and its psycho-social impact. It is still important to have additional information derived from consumer based measures rather than rely solely on normative measures of need. It remains to be seen whether these factors subsequently influence demand and uptake of orthodontic treatment.