Prevalence and factors related to malocclusion, normative and perceived orthodontic treatment need among children and adolescents in Bangladesh

ABSTRACT Objective: The purpose of the present study was to assess the prevalence of normative and perceived orthodontic treatment need in schoolchildren and adolescents, related risk factors, and children/parent’s aesthetic perception, compared to orthodontist’s opinion, in Dhaka city, Bangladesh. Methods: A random sample of 800 schoolchildren aging 11-15 years was selected from different schools in the city of Dhaka, Bangladesh. The Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) were assessed as normative treatment need. The Decayed, Missing, Filled Teeth (DMFT) index was used to record caries experience. Children were interviewed on the perception of orthodontic treatment need. Parents also completed a questionnaire on the perception of their child’s orthodontic treatment need, assessed by AC/ IOTN. Results: According to the DHC/IOTN, only 24.7% were in the category of definite need (grade 4-5) for orthodontic treatment. A significant difference was found between the clinician/children and clinician/parents perceived AC score of IOTN (p= 0.0001). Multiple logistic regression showed children with a higher DMFT were significantly more likely to need orthodontic treatment, according to the DHC of IOTN. Conclusion: A low proportion of schoolchildren needs normative orthodontic treatment in the city of Dhaka, Bangladesh. Children with a higher DMFT score were significantly more likely to need orthodontic treatment, according to the DHC of IOTN.

摘要
目的：本研究旨在评估孟加拉国达卡市学龄儿童及青少年的规范性正畸治疗需求与主观正畸治疗需求的患病率、相关危险因素，以及儿童/家长的审美认知与正畸医师评估结果的差异。
方法：本研究从孟加拉国达卡市各学校中随机抽取800名11~15岁的学龄儿童作为研究对象。采用正畸治疗需求指数（Index of Orthodontic Treatment Need, IOTN）的牙科健康组分（Dental Health Component, DHC）与美学组分（Aesthetic Component, AC）评估规范性正畸治疗需求；采用龋失补牙指数（Decayed, Missing, Filled Teeth, DMFT）记录龋病患病情况。对儿童进行访谈以了解其对正畸治疗需求的主观认知，同时让家长填写问卷，结合AC/IOTN标准评估其对子女正畸治疗需求的主观认知。
结果：根据DHC/IOTN的评估结果，仅24.7%的儿童被归为正畸治疗绝对需求组（等级4~5）。临床医师评估的AC评分与儿童、家长的主观AC评分之间均存在显著差异（p=0.0001）。多因素logistic回归分析显示，依据IOTN的DHC评估标准，龋失补牙指数较高的儿童正畸治疗需求显著更高。
结论：孟加拉国达卡市学龄儿童中需要规范性正畸治疗的比例较低。依据IOTN的DHC评估标准，龋失补牙指数较高的儿童显著更需要正畸治疗。