Cent Eur J Public Health 2016, 24(2):123-127 | DOI: 10.21101/cejph.a4117

History of Orthodontic Treatment, Treatment Needs and Influencing Factors in Adolescents in Croatia

Stjepan Špalj1, Višnja Katić1, Renata Vidaković2, Martina Šlaj2, Mladen Šlaj2
1 Department of Orthodontics, School of Medicine, University of Rijeka, Rijeka, Croatia
2 Department of Orthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia

Aim: The aim of this study was to assess the orthodontic treatment needs of adolescents in Zagreb, Croatia, in relation to their orthodontic treatment history, caries experience and socio-demographic parameters.

Methods: The study sample comprised 1,289 adolescents from 12 randomly selected public schools in Zagreb, Croatia. The subjects were 15-18 years old (mean age 16.3±1.4), and 51% of them were girls. The Dental Aesthetic Index (DAI), the sum of the numbers of decayed, missing and filled teeth (DMFT index), and a questionnaire (covering socio-demographic issues, oral health-related attitudes and behaviours) were employed in this study. The data was analyzed by means of Chi-square test, analysis of variance, and multiple logistic regression models.

Results: The DMFT score was higher in adolescents with no orthodontic history (5.2±3.7) than in those who were under orthodontic treatment at the time of the research (4.5±3.2; p=0.043). More than 60% of the adolescents have never undergone any orthodontic treatment, around 24% previously undergone treatment and 15% were under treatment at the time of the research. Overall, 85% of the adolescents' orthodontic appliances were removable, and the girls were more often under orthodontic treatment. One fifth of the studied population had severe or very severe malocclusion. Adolescents with previous orthodontic treatment were more often interested in better teeth alignment, changes in their teeth positioning and continuing orthodontic treatment. Multiple logistic regression model demonstrated that previously treated adolescents, in comparison with their untreated peers, were on average older (p=0.002), were less satisfied with the appearance of their teeth (p=0.001), they had higher malocclusion severity (p=0.046), and fewer dental caries (p<0.001), changed toothbrushes more often (p=0.012), and their mothers attained higher education (p<0.001).

Conclusions: Although many adolescents received orthodontic treatment, the severity of their malocclusion was still somewhat high, and they were more often dissatisfied with their treatment outcome. Mothers' educational level was found to be the most important socio-demographic predictor for children's involvement in orthodontic treatment. The caries experience increased in comparison with the Croatian national survey data from 1999.

Keywords: malocclusion, caries, dental public health, orthodontic treatment need, orthodontic treatment history, socio-demographic characteristics

Received: September 24, 2014; Revised: July 9, 2015; Accepted: July 9, 2015; Published: June 1, 2016  Show citation

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Špalj S, Katić V, Vidaković R, Šlaj M, Šlaj M. History of Orthodontic Treatment, Treatment Needs and Influencing Factors in Adolescents in Croatia. Cent Eur J Public Health. 2016;24(2):123-127. doi: 10.21101/cejph.a4117. PubMed PMID: 27434243.
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References

  1. Tsakos G. Combining normative and psychosocial perceptions for assessing orthodontic treatment needs. J Dent Educ. 2008 Aug;72(8):876-85. Go to original source... Go to PubMed...
  2. Liu Z, McGrath C, Hägg U. The impact of malocclusion/orthodontic treatment need on the quality of life.Asystematic review.Angle Orthod. 2009 May;79(3):585-91. Go to original source... Go to PubMed...
  3. Manjith CM, Karnam SK, Manglam S, Praveen MN, Mathur A. Oral Health-Related Quality of Life (OHQoL) among adolescents seeking orthodontic treatment. J Contemp Dent Pract. 2012 May 1;13(3):294-8. Go to original source...
  4. Palomares NB, Celeste RK, Oliveira BH, Miguel JA. How does orthodontic treatment affect young adults' oral health-related quality of life? Am J Orthod Dentofacial Orthop. 2012 Jun;141(6):751-8. Go to original source... Go to PubMed...
  5. JohalA,Alyaqoobi I, Patel R, Cox S. The impact of orthodontic treatment on quality of life and self-esteem in adult patients. Eur J Orthod. 2015 Jun;37(3):233-7. Go to original source... Go to PubMed...
  6. Danyluk K, Lavelle C, Hassard T. Potential application of the dental aesthetic index to prioritize the orthodontic service needs in a publicly funded dental program.Am J Orthod Dentofacial Orthop. 1999 Sep;116(3):27986. Go to original source...
  7. Cons NC, Jenny J, Kohout FJ. DAI: the dental aesthetic index. Iowa City: University of Iowa; 1986.
  8. Jenny J, Cons NC, Kohout FJ, Jakobsen J. Predicting handicapping malocclusion using the Dental Aesthetic Index (DAI). Int Dent J. 1993 Apr;43(2):128-32.
  9. Shaw WC, Richmond S, O'Brien KD. The use of occlusal indices: a European perspective.Am J Orthod Dentofacial Orthop. 1995 Jan;107(1):1-10. Go to original source...
  10. Jenny J, Cons NC. Comparing and contrasting two orthodontic indices, the Index of Orthodontic Treatment need and the DentalAesthetic Index. Am J Orthod Dentofacial Orthop. 1996 Oct;110(4):410-6. Go to original source... Go to PubMed...
  11. Beglin FM, FirestoneAR, Vig KW, Beck FM, Kuthy RA, Wade D.Acomparison of the reliability and validity of 3 occlusal indexes of orthodontic treatment need.Am J Orthod Dentofacial Orthop. 2001 Sep;120(3):240-6. Go to original source... Go to PubMed...
  12. Shaw WC, Richmond S, O'Brien KD, Brook P, Stephens CD. Quality control in orthodontics: indices of treatment need and treatment standards. Br Dent J. 1991 Feb 9;170(3):107-12. Go to original source...
  13. SpencerAJ,Allister JH, Brennan DS. Utility of the dental aesthetic index as an orthodontic screening tool in Australia. Adelaide: University of Adelaide; 1992.
  14. Burden DJ, Holmes A. The need for orthodontic treatment in the child population of the United Kingdom. Eur J Orthod. 1994 Oct;16(5):395-9. Go to original source...
  15. Cardoso CF, DrummondAF, Lages EM, Pretti H, Ferreira EF,Abreu MH. The Dental Aesthetic Index and dental health component of the Index of Orthodontic Treatment Need as tools in epidemiological studies. Int J Environ Res Public Health. 2011 Aug;8(8):3277-86. Go to original source... Go to PubMed...
  16. Klein H, Palmer CE, Knutson JW. Studies on dental caries I. Dental status and dental needs of elementary school children. Public Health Rep. 1938;53(19):751-65. Go to original source...
  17. World Health Organization. Oral health surveys: basic methods. Geneva: WHO; 1997.
  18. Featherstone JD. Dental caries: a dynamic disease process. Aust Dent J. 2008 Sep;53(3):286-91. Go to original source... Go to PubMed...
  19. Borzabadi-Farahani A, Eslamipour F, Asgari I. Association between orthodontic treatment need and caries experience. Acta Odontol Scand. 2011 Jan;69(1):2-11. Go to original source... Go to PubMed...
  20. Piovesan C, Pádua MC,Ardenghi TM, Mendes FM, Bonini GC. Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study. BMC Med Res Methodol. 2011 Apr 2;11:37. doi: 10.1186/1471-2288-11-37. Go to original source... Go to PubMed...
  21. Mtaya M, Brudvik P, Astrøm AN. Prevalence of malocclusion and its relationship with socio-demographic factors, dental caries, and oral hygiene in 12- to 14-year-old Tanzanian schoolchildren. Eur J Orthod. 2009 Oct;31(5):467-76. Go to original source... Go to PubMed...
  22. Aggeryd T. Goals for oral health in the year 2000: cooperation between WHO, FDI and the national dental associations. Int Dent J. 1983 Mar;33(1):55-9. Go to PubMed...
  23. Pietilä I, Pietilä T, Svedström-OristoAL, Varrela J,Alanen P. Orthodontic treatment practices in Finnish municipal health centres with differing timing of treatment. Eur J Orthod. 2009 Jun;31(3):287-93. Go to original source... Go to PubMed...
  24. Josefsson E, Bjerklin K, Lindsten R. Self-perceived orthodontic treatment need and prevalence of malocclusion in 18- and 19-year-olds in Sweden with different geographic origin. Swed Dent J. 2010;34(2):95-106.
  25. Jurić H, Klarić T, Zagar M, Buković D Jr, Janković B, Spalj S. Incidence of caries in children of rural and subrural areas in Croatia. CollAntropol. 2008 Mar;32(1):131-6.
  26. Rajić Z, Radionov D, Rajić-Mestrović S. Trends in dental caries in 12year old children in Croatia. Coll Antropol. 2000 Jul;24 Suppl 1:21-4. Go to PubMed...
  27. Finlayson TL, Siefert K, Ismail AI, Sohn W. Maternal self-efficacy and 1-5-year-old children's brushing habits. Community Dent Oral Epidemiol. 2007 Aug;35(4):272-81. Go to original source... Go to PubMed...
  28. Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. Influence of mothers' oral health knowledge and attitudes on their children's dental health. Eur Arch Paediatr Dent. 2008 Jun;9(2):79-83. Go to original source... Go to PubMed...
  29. Walker KK, Steinfort EL, Keyler MJ. Cues to Action as Motivators for Children's Brushing. Health Commun. 2015;30(9):911-21. Go to original source... Go to PubMed...
  30. Angelopoulou MV, Oulis CJ, Kavvadia K. School-based oral healtheducation program using experiential learning or traditional lecturing in adolescents: a clinical trial. Int Dent J. 2014 Oct;64(5):278-84. Go to original source... Go to PubMed...
  31. Batoni G, Pardini M, Giannotti A, Ota F, Giuca MR, Gabriele M, et al. Effect of removable orthodontic appliances on oral colonisation by mutans streptococci in children. Eur J Oral Sci. 2001 Dec;109(6):388-92. Go to original source...
  32. Richter AE, Arruda AO, Peters MC, Sohn W. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop. 2011 May;139(5):657-64. Go to original source... Go to PubMed...
  33. Madléna M. The importance and possibilities of proper oral hygiene in orthodontic patients. In: Bourzgui F, editor. Orthodontics - basic aspects and clinical considerations. Rijeka: InTech; 2012. p. 69-110. Go to original source...
  34. Bjerklin K, Lindsten R, Tunge JS, Sjövall C. Orthodontic treatment need, outcome and residual treatment need in 15- and 20-year-olds. Swed Dent J. 2012;36(3):157-65.
  35. Miethke RR, Wronski C. What can be achieved with removable orthodontic appliances? J Orofac Orthop. 2009 May;70(3):185-99. Go to original source... Go to PubMed...
  36. Turbill EA, Richmond S, Wright JL. A closer look at General Dental Service orthodontics in England and Wales. I: Factors influencing effectiveness. Br Dent J. 1999 Aug 28;187(4):211-6. Go to original source...
  37. FirestoneAR, Häsler RU, Ingervall B. Treatment results in dental school orthodontic patients in 1983 and 1993.Angle Orthod. 1999 Feb;69(1):1926.
  38. Richmond S, Shaw WC, Stephens CD, Webb WG, Roberts CT,Andrews M. Orthodontics in the general dental service of England and Wales: a critical assessment of standards. Br Dent J. 1993 May 8;174(9):315-29. Go to original source... Go to PubMed...
  39. Lilja-Karlander E, Kurol J. Outcome of orthodontic care in 19-year-olds attending the Public Dental Service in Sweden: residual need and demand for treatment. Swed Dent J. 2003;27(2):91-7.
  40. Spalj S, Slaj M, Varga S, Strujic M, Slaj M. Perception of orthodontic treatment need in children and adolescents. Eur J Orthod. 2010 Aug;32(4):387-94. Go to original source... Go to PubMed...
  41. Cala L, Spalj S, Slaj M, Lapter MV, Slaj M. Facial profile preferences: differences in the perception of children with and without orthodontic history. Am J Orthod Dentofacial Orthop. 2010 Oct;138(4):442-50. Go to original source... Go to PubMed...
  42. Radica N. Demand of orthodontic treatment using index of orthodontic treatment need (IOTN) [dissertation]. Zagreb: University of Zagreb; 2005.