ABSTRACT
Aim:
The current study’s objective was to find out the prevalence of malocclusion and the need for orthodontic treatment in 13- to 15-year-old school students in the Mehsana District of Gujarat using the IOTN.
Materials and Methods:
A descriptive cross-sectional epidemiological survey was planned among 13- to 15-year-old school-going children of Mehsana district. The sample comprised of 1290 school children. DHC-IOTN was applied to evaluate normative need for orthodontic treatment. Perceived orthodontic treatment was described by the Aesthetic component of the IOTN index.
Results:
Results showed that 33.7 percent of participants required little/no treatment need, 43.9 percent of participants required moderate orthodontic treatment need, and 22.4 percent of participants required severe orthodontic treatment need in the district.
Conclusion:
To prepare for public orthodontic and dental services, the current study provides baseline data on the need for orthodontic treatment among school-aged children.
KEYWORDS: Epidemiological study, malocclusion, orthodontic treatment need
INTRODUCTION
Orthodontics is one of the specialties of dentistry, which deals with facial and dental regions of the face with Prevention, Interception, and correction of malocclusion and other abnormalities.[1,2,3,4] Malocclusion can be defined as a teeth regularity disruption or in the dental arches relationship, which is not in the normal range.[5,6] Human beings have recognized the dentofacial problem and the need for its treatment centuries back in history.[7,8]
Epidemiological principles regarding health can be applied to medical and dental fields.[1] In the medical field and some of the dental-related problems like periodontitis, infection, and dental caries, each person classifies people as having or not having the problems.[9,10] The malocclusion cannot count as a disease and is very difficult to describe. Some Occlusal Indices can be used to measure occlusal problems.[11]
Usually, epidemiological principles can be used to carry out efficient and reliable research and evaluate the patients’ orthodontic results.[12] World Health Organization’s data shows that dental malocclusion is the third most common problem of oral health-related diseases.[13,14]
Some research regarding the prevalence of dental malocclusion in society gives guidance regarding treatment need, the availability of resources, skill, manpower, and the need for materials, and the speed at which they can be used.[15]
The present study assessed the malocclusion and its treatment requirement for public health In Mehsana District.
MATERIALS AND METHODS
This epidemiological survey was planned among school-going children of Mehsana district. It was carried out to evaluate the prevalence of dental malocclusion and the need for orthodontic treatment in 13- to 15-year-old school children In Mehsana District. Four talukas were randomly selected from 11 talukas from Mehsana district by lottery method. Schools were divided into two groups, that is, government schools and private schools. Randomly, six schools were selected from each taluka through Lottery Methods. An ethical clearance certificate was pursued by Narsinhbhai Patel Dental College and the Hospital’s Ethical Committee.
Inclusion criteria
Subjects with permanent dentition.
Subjects within the age group of 13-15 years.
Exclusion criteria
Subjects with missing permanent teeth or any deciduous teeth.
Subjects with any facial trauma.
Subjects with any history of orthodontic treatment.
Subjects with craniofacial anomalies and specific syndromes.
IOTN-DHC was assessed for normative orthodontic treatment needs, and IOTN-AC was considered for perceptive orthodontic treatment needs.
Statistical analysis
Data were entered in an Excel sheet by Microsoft Excel Software and shifted to SPSS version 21.2 IBM for Statistical Analysis. Different statistical tests were applied. (1) Descriptive analysis, (2) comparative table analysis, (3) Chi-square test, (4) kappa statistical analysis, and (5) Poisson regression analysis.
RESULTS
Descriptive statistics of the study participants are described. To check different malocclusion types, present in children of Mehsana district, we have checked malocclusion of children. We recorded that 568 students have class I malocclusion, which is the most common malocclusion in the Mehsana district. Three hundred eighty-nine students have class II division I malocclusion, and 242 students have class II division II malocclusion, respectively. When we compared different types of malocclusions in different talukas of Mehsana district, Participants from Mehsana Taluka has more Angle’s Class I Malocclusion (153) as compared with other talukas.
According to Table 1.1, the Ratio of Angle’s Class III malocclusion is less among all four talukas of Mehsana district. There is more occurrence of Angle’s Class I malocclusion with crowding among all four talukas. Mehsana district females had less occurrence of class III malocclusion.
Table 1.1.
Rate of various types of malocclusions in relation to different talukas and gender
| Taluka | Angle’ s class I Gender | Angle’ s class II div I Gender | Angle’ s class II div II Gender | Angle’ s class III Gender | Total Gender | Statistical inference | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
|
|
|
|
|||||||
| Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | ||
| Kadi | 74 (52.5%) (42.8%) | 67 (47.5%) (45%) | 51 (49.5%) (29.5%) | 52 (50.5%) (34.9%) | 40 (66.7%) (23.1%) | 20 (33.3%) (13.4%) | 8 (44.4%) (4.6%) | 10 (55.6%) (6.7%) | 173 (53.7%) (100%) | 149 (46.3%) (100%) | χ2=0.894, df=3, P=0.827 |
| Mehsana | 85 (55.6%) (49.1%) | 68 (44.4%) (45.6%) | 51 (58%) (29.5%) | 37 (42%) (24.8%) | 22 (37.9%) (12.7%) | 36 (62.1%) (24.2%) | 15 (65.2%) (8.7%) | 8 (34.8%) (5.4%) | 173 (53.7%) (100%) | 149 (46.3%) (100%) | χ2=4.855, df=3, P=0.183 |
| Visnagar | 70 (50.7%) (42.9%) | 68 (49.3%) (42.5%) | 58 (58.6%) (35.6%) | 41 (41.4%) (25.6%) | 25 (40.3%) (15.3%) | 37 (59.7%) (23.1%) | 10 (41.7%) (6.1%) | 14 (58.3%) (8.8%) | 163 (50.5%) (100%) | 160 (49.5%) (100%) | χ2=12.385, df=3, P=0.747 |
| Bahuchraji | 75 (55.1%) (46.6%) | 61 (44.9%) (37.7%) | 45 (45.5%) (28%) | 54 (54.5%) (33.3%) | 28 (45.2%) (17.4%) | 34 (54.8%) (21%) | 13 (50%) (8.1%) | 13 (50%) (8%) | 161 (49.8%) (100%) | 162 (50.2%) (100%) | χ2=3.009, df=3, P=0.390 |
| Total | 304 (53.5%) (45.4%) | 264 (46.5%) (42.6%) | 205 (52.7%) (30.6%) | 184 (47.3%) (29.7%) | 115 (47.5%) (17.2%) | 127 (52.5%) (20.5%) | 46 (50.5%) (6.9%) | 45 (49.5%) (7.3%) | 670 (51.9%) (100%) | 620 (48.1%) (100%) | χ2=1.673, df=3, P=0.643 |
DISCUSSION
Regarding oral health issues, malocclusion is considered as a major problem that affects people all over the world. It affects not only dental function and appearance but also economic, social, and psychological well-being. Malocclusion, or misalignment of teeth, is a common aesthetic issue that has been ranked as the third most important oral health concern. Malocclusion was added to the list of Handicapping Dentofacial Anomalies by the World Health Organization in 1987. Only a few indices and measures considered the examined person’s self-perception regarding the requirement of orthodontic treatment.
Malocclusion is prevalent In Mehsana district, and We chose Mehsana district and the age group of 13-15 years for our research. This is because the genes of people with malocclusion are hereditary, and it will not change, but external variables may influence the phenotypic. Climate, social habitat, agricultural divergence, and structure are used to group geographical regions within a country. As a result, participants must be drawn from similar geographical areas and compared across the same areas to conduct a true nationwide epidemiologic study.[16]
Angle’s Class I malocclusion, Angle’s Class II Division I, Angle’s Class II Division II, and Angle’s Class III malocclusion were found to be 44.03 percent, 30.15 percent, 18.75 percent, and 7.05 percent in the current study, respectively.[10] It is probable that ethnic differences explain why class I malocclusion is more common in other populations studied.[10]
The distribution of participants in government schools and private schools is shown in Table 1.1. After determining the type of malocclusion and the need for orthodontic treatment, which depends on school type even, we discovered that government schools’ children required more treatment than in private schools’ children. However, the outcome did not meet statistical significance.[12]
The situation has changed recently, maybe as a result of parents’ increased education levels. Malocclusion is equally prevalent in children attending public and private schools, with no statistically significant difference.[11,12]
CONCLUSION
There is more requirement of the orthodontic treatment in recent time. So, proper preparation regarding the orthodontic treatment of malocclusion in a large population is required to assess the requirement of facilities and manpower for providing this type of service. To design public orthodontic and dental services, the current study provides baseline data on the need and demand for orthodontic treatment among school-aged children.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.Draker HL. Handicapping labial lingual deviations: A proposed index for public health purposes. Am J Orthod Dentofacial Orthop. 1960;46:295–305. https://doi.org/10.1016/0002-9416(60) 90197-4. [Google Scholar]
- 2.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 school children. Eur J Orthod. 2009;31:467–76. doi: 10.1093/ejo/cjn125. doi: 10.1093/ejo/cjn125. [DOI] [PubMed] [Google Scholar]
- 3.Proffit WR, Fields HW, Larson BE, Sarver DM. 6th ed. Elsevier; Philadelphia: PA: 2019. Contemporary Orthodontics. [Google Scholar]
- 4.Mossey PA. The heritability of malocclusion: Part 2. The influence of genetics in malocclusion. Br J Orthod. 1999;26:195–203. doi: 10.1093/ortho/26.3.195. doi: 10.1093/ortho/26.3.195. [DOI] [PubMed] [Google Scholar]
- 5.Larsson E. The effect of dummy-sucking on the occlusion: A review. Eur J Orthod. 1986;8:127–30. doi: 10.1093/ejo/8.2.127. doi: 10.1093/ejo/8.2.127. [DOI] [PubMed] [Google Scholar]
- 6.Linder-Aronson S. Adenoids. Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the denition. A biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl. 1970;265:1–132. [PubMed] [Google Scholar]
- 7.Thilander B, Pena L, Infante C, Parada SS, de Mayorga C. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Eur J Orthod. 2001;23:153–67. doi: 10.1093/ejo/23.2.153. doi: 10.1093/ejo/23.2.153. [DOI] [PubMed] [Google Scholar]
- 8.Trehan M, Chugh VK, Sharma S. Prevalence of malocclusion in Jaipur, India. Int J Clin Pediatr Dent. 2009;2:23–5. doi: 10.5005/jp-journals-10005-1036. Mausner JS, Kramer S. Epidemiology—An introductory text. 2nd ed. Philadelphia: Saunders; 1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Marcos AVB, Andre WM. An overview of the prevalence of malocclusion in 6 to 10- year-old children in Brazil. Dental Press J Orthod. 2010;15:113–22. http://dx.doi.org/10.1590/S2176-94512010000600015. [Google Scholar]
- 10.Nashashibi I, Darwish SK, Khalifa El R. Prevalence of malocclusion and treatment needs in Riyadh (Saudi Arabia) Odontostomatol Trop. 1983;6:209–14. [PubMed] [Google Scholar]
- 11.Hassan R, Rahimah AK. Occlusion, malocclusion and method of measurements -An overview. Archives of Orofacial Sciences. 2007;2:3–9. [Google Scholar]
- 12.Lauc T. Orofacial analysis on the Adriatic islands: an epidemiological study of malocclusions on Hvar Island. Eur J Orthod. 2003;25:273–8. doi: 10.1093/ejo/25.3.273. [DOI] [PubMed] [Google Scholar]
- 13.Corrucini RS, Pacciani E. “Orthodontistry” and dental occlusion in Etruscans. Angle Orthod. 1989;59:61–4. doi: 10.1043/0003-3219(1989)059<0061:OADOIE>2.0.CO;2. [DOI] [PubMed] [Google Scholar]
- 14.Min-Ho Jung. Quality of Life and Self-Esteem of Female Orthognathic Surgery Patients. 2016;74:1240–7. doi: 10.1016/j.joms.2016.01.046. [DOI] [PubMed] [Google Scholar]
- 15.Tang ELK, Stephen HYW. Recording and measuring malocclusion. A review of the literature. Am J Orthod Dentofac Orthop. 1993;103:344–51. doi: 10.1016/0889-5406(93)70015-G. [DOI] [PubMed] [Google Scholar]
- 16.Ines Ghijselings, Veronique Brosens, Guy Williams, Steffen Fieuws, Maïté Clijmans, Jurgen Lemiere. Normative and self-perceived orthodontic treatment need in 11-to 16-year-old children. European Journal of Orthodontics. 2014;36:179–85. doi: 10.1093/ejo/cjt042. [DOI] [PubMed] [Google Scholar]
