THE RELATIONSHIP BETWEEN ORTHODONTIC TREATMENT NEED AND ORAL HEALTH RELATED
QUALITY OF LIFE OF SCHOOL CHILDREN
Table 2 Characteristics and orthodontic treatment need of the subjects
Sample
Men
Women
Total
Number
343
341
684
Age(Mean± SD)
16 ±0.7
16 ±0.8
16 ±0.8
IOTN 1
65
93
158
IOTN 2
146
109
255
IOTN3
76
96
172
IOTN 4
25
16
41
IOTN 5
10
7
17
Previous Ortho
Treatment
21
20
41
need” (Table 1). The IOTN has problematic since
some patients who have no psychosocial need
for treatment would be perceived as requiring
treatment (12). The use of OHRQoL measures in
addition to professional indices offers a potentially
useful combination. Therefore, various studies
have evaluated IOTN and its impact on OHRQoL.
Masood et al (13) found that malocclusion
has a significant negative impact on OHRQoL
and its domains. Nevertheless, there was no
reported difference in impact between male and
females. Agou et al also found that the impact
of malocclusion on quality of life is substantial in
children with low self-esteem (14). Nevertheless,
some other authors did not find any relationship
between malocclusion or orthodontic treatment
need and OHRQoL (15-17). Therefore, the aim
of this study was to assess the effect of different
orthodontic treatment needs on the OHRQOL of
young adults.
Material and Methods
This study received approval from the Human
Research Ethics Committee of the IAU University of
medical sciences. Twelve schools were randomly
selected among all high schools in the east, west,
north, south, and center of Tehran (Iran) and a
random sample of 684 (343 boys and 341 girls)
aged 15–17 year-olds attending these schools
was selected (30 to 35 subjects were randomly
selected from each school). Parents of sampled
children were notified about the purposes of the
study.
Each patient was examined for orthodontic
treatment need with IOTN. The examinations were
conducted at school during the day, by one trained
and calibrated dentist with the help of a tongue
blade, mirror, probe and ruler; no radiographs
were taken. The treatment needs of the patients
were categorized as little or no treatment needed
(IOTN 1 and 2), borderline need (IOTN 3), and
definite need for treatment (IOTN 4 and 5). The
subjects with previous orthodontic treatment were
also categorized as a separate group. Examiner
error was determined by re-examining 30 subjects
after a period of at least two weeks. The error was
non-significant. The subjects were also asked to
complete questionnaires incorporating the Short
STOMA.EDUJ (2015) 2 (1)
Form Oral Health Impact Profile measure (OHIP-14,
a generic oral health–related QoL assessment) (18).
The OHIP is designed to determine the perception
of the social impact of oral disorders and has
well-documented psychometric properties (19)
.Responses to the 14 items of OHIP were recorded
in a 5-point Likert scale (0= never, 1= hardly ever,
2= occasionally, 3 = fairly often, 4 = very often).
The responses were dichotomized as “impact”
and “no impact”. The responses of “never” and
“hardly ever” were considered as “no impact” and
“occasionally”, “fairly often”, and “very often” were
considered as at least some oral health “impact”.
The Statistical Package for Social Sciences, Version
20 (SPSS Inc. Chicago, Illinois, USA) was used to
analyze the data. Chi-Square test was used to
analyze the data and p-value was set at P < 0.05.
Results
A total of 684 students (mean age16±0.8 years)
from 12 secondary schools were examined. Table 2
shows that the samples included 343 male and 341
female subjects. Table 2 also shows the detailed
distribution of subjects based on their IOTN
grades. As can be seen in table 3, daily activities
were associated with higher orthodontic treatment
needs in both male and female subjects. Almost
none of the subjects with no or little treatment
need and borderline treatment need had problem
pronouncing words; while 26 % of the male
students and 30% of the female students of the
definite need for treatment group had problem
pronouncing words. (P<0.001) About 70% of the
female subjects and 43% of the male subjects of
the definite need for treatment group felt tense
in their life; while, only 5% of the male subjects
and 4% of the female subjects of the no or little
treatment need group felt tense. Chi-square test
showed that all daily activities were significantly
affected by the treatment need.
Discussion
This study showed that malocclusion has both
physical and psychological impacts on male
and female subjects who are in definite need for
orthodontic treatment. The findings of this study
corresponds with the study conducted by Hassan
and Amin Hel (20). Their study results highlighted
39