Malocclusion and Orthodontic treatment need among 12–15-year-old Tanzanian school children using the dental aesthetic index

Abstract

ABSTRACT Background: Prevalence of malocclusion in children and adolescents varies significantly in different geographical regions ranging from 39% to 93%, and its severity ranges from what is considered as a normal deviation to severe malocclusion or handicapping malocclusion. Normally, deciding if one should undergo orthodontic treatment or not, greatly depends on the severity of the malocclusion. Recently, dental appearance has been something of a great concern among members of the community. Perceived orthodontic treatment need differ correspondingly with social, cultural as well as geographical locations. It was therefore important to highlight the extent of malocclusion, the orthodontic treatment need and its related factors, in a Tanzanian community. Objective: To assess the prevalence of malocclusion and orthodontic treatment need among 12–15-year-old Tanzanian schoolchildren using the Dental Aesthetic Index (DAI). Material and Methods: This was a school-based cross-sectional analytical study which involved 12-15-year-old schoolchildren from Kinondoni District. Participants were obtained through a multistage random sampling method. Data collection was done by using a questionnaire, and a clinical examination was performed utilizing the Dental Aesthetic Index (DAI). Data was processed by using SPSS software, version 29.0. A comparison of proportions was done through a Chi-square test, whereas, the Modified Poisson Regression under Stata MP-17.0 was used to confirm the bivariate associations. The level of statistical significance was set at p<0.05, with 95% confidence interval. Results: A total of 483 12-15-year-old schoolchildren in Kinondoni Municipal-Dar es Salaam were enrolled, majority (43.3%) being 12-year-olds. The distribution of the participants by sex and residence, showed a slight predominance of girls and those from Northern wards of the Kinondoni Municipal (56.9% and 54.7%, respectively). The overall prevalence of malocclusion in schoolchildren was 55.9%. The most common malocclusion trait was crowding, and majority had normal molar relationship (39% and 85%) respectively. Also, a number of participants (52%) showed a subjective orthodontic treatment need. Schoolchildren who perceived to have malocclusion and those who had normative malocclusion, were more likely to demonstrate orthodontic treatment need than their counterparts (aOR 1.736, CI 1.509-1.998; p<0.001 and (aOR 1.252, CI 1.051-1.492; p=0.012, respectively). Furthermore, class seven pupils were less likely to express need for orthodontic treatment as compared to those in class six (aOR 0.712, CI 0.567-0.892; p =0.003). Conclusion: Majority of the schoolchildren (55.9%) had malocclusion with the severity ranging from definite to handicapping malocclusion, as per the DAI scores and orthodontic treatment needs ranged from elective to mandatory. The perceived orthodontic treatment needs were more likely to be influenced by the perceived malocclusion and presence of normative malocclusion. Also, most children belonging to a younger age group were found with subjective orthodontic treatment need, with majority of them belonging to class six.