Objective, subjective, and self-assessment of preadolescent orthodontic treatment need--a function of age, gender, and ethnic/racial background?
Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment.


OBJECTIVE
To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES).


METHODS
Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need.


RESULTS
Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions.


CONCLUSIONS
Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES.
Christopherson
Elizabeth A
EA
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
Briskie
Dan
D
Inglehart
Marita Rohr
MR
D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000367:Age Factors; D002648:Child; D003752:Dental Health Services; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D009909:Oral Health; D009971:Orthodontics, Corrective / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D012647:Self-Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data