Assessment of the Relationship Between Perceptions of Dental Aesthetics and Demand for Orthodontic Treatment in 10-11 Year Old School Children in Birmingham, UK

Objective: To examine the relationship between perceptions of dental aesthetics and demand for orthodontic treatment, and to determine whether the former can be used to predict the latter.

Method: A prospective cross sectional epidemiological survey of a random and representative sample of comprehensive primary schools in South Birmingham, UK. Participants were 389 randomly selected school children aged 10-11 years from 7 primary schools in South Birmingham. Their perceptions of dental aesthetics were determined using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Demand for treatment was assessed by asking subjects if they wanted treatment with braces to correct their teeth.

Results: Only 2% of subjects assessed their dentition in the "definite need" for orthodontic treatment category. Demand for treatment was significantly greater in girls than boys (49% and 37% respectively, p < 0.05). Total demand (41%) was considerably greater than self assessed aesthetics in the "definite need" and "borderline need" categories combined (14%). Demand was accurately reflected in patients who perceived their dentition as having moderate to severe (AC 6-9) and very mild aesthetic impairment (AC 1).

Conclusions: Perceptions of dental aesthetics using the AC of IOTN were able to predict demand for orthodontic treatment in patients with malocclusions of moderate to severe (AC 6-9) aesthetic impairment.