Association between malocclusion and dissatisfaction with dental and gingival appearance: Study with Brazilian adolescents

Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Revista Brasileira de Epidemiologia 12/2010; 13(4):713-23. DOI: 10.1590/S1415-790X2010000400015
Source: PubMed


In spite of the high prevalence of malocclusion in adolescents reported worldwide, there are few studies that have investigated the association between normative malocclusion and self-rated dental and gingival appearance among adolescents. The aim of this study was to identify the association between normative malocclusion and dissatisfaction with dental and gingival appearance among Brazilian adolescents. A cross-sectional study was carried out with adolescents aged 15 to 19 years (n= 16,126) living in 250 towns of all five Brazilian regions. Dissatisfaction with dental and gingival appearance was the outcome. The main explanatory variable was malocclusion assessed by using the Dental Aesthetic Index - DAI. The other explanatory variables included were per capita family income, schooling delay, study conditions, sex, age, skin color, dental outcomes (untreated dental caries, missing teeth due dental caries, dental calculus, fluorosis, and dental pain) and use of dental services. Simple and multivariable Poisson regression analyses were performed. Dissatisfaction with dental appearance reached 11.4% (95%CI: 10.4-12.5) of the entire sample. All levels of malocclusion were associated with dissatisfaction with dental appearance. Adjusted multivariable analysis showed that dissatisfaction with dental appearance among individuals affected by severe or very severe malocclusion was respectively 40% and 80% higher than among those with normal occlusion. Malocclusion was associated with dissatisfaction with dental and gingival appearance. The results contribute to include self-rated dental appearance criteria in orthodontic treatment decision, mainly within the National Health System - SUS.

Download full-text


Available from: Karen Glazer Peres, Oct 07, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study estimated the prevalence of negative self-perception of smile because of occlusion abnormalities and investigated their association according to standard clinical criteria. The sample consisted of 1290 randomly selected Brazilian adolescent boys and girls aged 12-16 years. The outcome of interest was dissatisfaction with smile, and data were collected using a standardized questionnaire. Occlusion characteristics were assessed using the dental aesthetic index (DAI). The other study variables were gender, age, and use of dental services. A chi-square test and Poisson multiple regression were used for statistical analysis. Of the 1290 students interviewed and examined, 539 (41.8 per cent) were dissatisfied with their smile; of these, 373 (69.2 per cent) assigned their dissatisfaction to the presence of an occlusal abnormality, and 166 (30.8 per cent) reported reasons other than occlusal abnormalities for their negative self-perception of their smile. In multivariate analysis, the following variables were associated with the outcome of interest: maxillary anterior irregularity [prevalence ratio (PR) = 1.40; 95 per cent confidence interval (CI) = 1.29-1.80], incisal spacing (PR = 1.37; 95 per cent CI = 1.19-1.57), vertical open bite (PR = 1.34; 95 per cent CI = 1.15-1.55), mandibular anterior irregularity (PR = 1.29; 95 per cent CI = 1.14-1.46), permanent anterior teeth missing (PR = 1.21; 95 per cent CI = 1.05-1.39), and incisal diastema (PR = 1.14; 95 per cent CI = 1.01-1.31). The negative self-perception of smile was statistically associated with severity of occlusal disorders according to the DAI scores, which suggests that self-perception should be used together with standard clinical criteria when decisions about orthodontic treatments are made in public health care systems.
    Preview · Article · Apr 2012 · The European Journal of Orthodontics
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess the prevalence of malocclusion and treatment need in children and adolescents with sickle cell disease (SCD). Materials and methods: In this cross-sectional study, the sample size comprised 35 five-year-old children and 36 adolescents of both sexes, aged between 12 to 18 years, with SCD. Dental occlusion was assessed using two indexes: the Malocclusion Index (World Health Organization) and the Dental Aesthetic Index (DAI). Results: The prevalence of malocclusion in the preschool children was 62.9%. The main malocclusions observed in this age group were Class II (37.1%), increased overjet (28.6%), reduced overbite (28.6%), and open bite (17.1%). In the 12- to 18-year-old subjects, the prevalence of malocclusion was 100%, and the most prevalent types of malocclusion were maxillary overjet (63.9%) and maxillary misalignment (58.3%). It is noteworthy that the majority of adolescents (80.6%) had very severe or disabling malocclusions. Conclusion: The results revealed a high prevalence of malocclusion in children and adolescents with SCD. According to DAI score, the majority of the sample presented with very severe malocclusion and a compulsory treatment need.
    No preview · Article · Nov 2013 · The Angle Orthodontist
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: the objective was to assess the severity of malocclusion and orthodontic treatment needs in adolescents from Pasto, Colombia adolescents by using the Dental Aesthetic Index (DAI). Methods: a total of 387 adolescents were randomly selected from a population of 20175 students between 13 and 16 years of age. This cross-sectional study was carried out at Champagnat, San Francisco de Asís and San Juan Bosco high schools. Students wearing orthodontic appliances or reporting a history of orthodontic treatment were excluded from the study. Clinical examination was conducted with the DAI. Mann-Whitney and Kruskall-Wallis analyses were used to compare the DAI scores according to gender and socioeconomic status (SES), respectively. Results: the DAI mean was 34.37 ± 14.71. The 52.7% had between a severe and very severe malocclusion which implies an orthodontic treatment need. Statistically significant differences were found between the DAI scores according to SES (p < 0.001). Conclusions: half of the evaluated adolescents would need orthodontic treatment. In this study, SES was an important variable that is related to the Dental Aesthetic Index scores ANA CRISTINA MAFLA, DAVID ALEXANDER BARRERA, GINNA MABEL MUÑOZ
    Full-text · Dataset · Feb 2015