title: Demand for orthodontic treatment among 9-18 year-olds seeking dental care in Dar-es-Salaam, Tanzania.
abstract: OBJECTIVE
  To investigate the demand for orthodontic treatment among 9-18 olds seeking dental care in Dar-es-Salaam, Tanzania.
  
  
  METHODS
  Case-control, interview and clinical study.
  
  
  METHODS
  Children seeking dental care.
  
  
  METHODS
  Demand for orthodontic treatment.
  
  
  RESULTS
  Most of the children (85%) in the case group attended the dental clinic because of crowding. Aesthetic impairment (AC grades 8-10) and severe malocclusions (DHC grades 4-5) were higher in cases than in controls being 47 and 5%; and 67 and 18%, respectively (p<0.0001). Absolute need (combined AC grade 8-10 and DHC 4-5) was found in 29% of the cases and 5% of the controls (p<0.0001). A relative probability for a child with absolute need to seek orthodontic treatment was 7.9 higher (95%) CI for OR = (5,13), compared to a child without an absolute need for orthodontic treatment. The most prevalent severe occlusal feature placing cases in the highest need category was crowding (74%). For the cases, it was mainly a mother (45%) who first recognized the problem in the family, and tooth extraction (62%) was the most common expected mode of treatment. Most parents (96%) were prepared to pay for their children's orthodontic treatment.
  
  
  CONCLUSIONS
  Most children in the case group had come to the clinic due to crowding. Ectopic canines were the driving factor for children and parents to seek orthodontic care. Further studies are recommended to map the demand for orthodontic treatment in the Tanzanian rural settings.
authors.affiliation: Department of Preventive and Community Dentistry, Faculty of Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
authors.forename: E A
authors.initials: EA
authors.lastname: Mugonzibwa
authors.forename: A M
authors.initials: AM
authors.lastname: Kuijpers-Jagtman
authors.forename: M A
authors.initials: MA
authors.lastname: van 't Hof
authors.forename: E N
authors.initials: EN
authors.lastname: Kikwilu
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003753:Dental Health Surveys; D004955:Esthetics, Dental; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000628:therapy*; D009970:Orthodontics; D012720:Severity of Illness Index; D013636:Tanzania