Agreement between normative and perceived orthodontic need amongst deprived multiethnic school children in London

The Index of Orthodontic Treatment Need (IOTN) has been used in dental epidemiology and to prioritize orthodontic treatment. The aim of this paper was to use the aesthetic component (AC) of the IOTN to measure agreement between normative and perceived orthodontic need amongst school children. Three hundred and seventy-eight children aged 11-14 years, enrolled in London UK state schools participated in this survey. The study focused on three ethnic groups: white, black and South Asian. Townsend deprivation scores suggested that the children were from areas of high socio-economic deprivation. Logistic regression analysis was carried out for agreement between normative and perceived need at each threshold value. Perceived need for braces, ethnic background, social class and hours of television viewing were significant variables. Black pupils were significantly less likely to concur on normative and perceived need scores, tending to perceive less need for treatment than did the dentist. Subjects from lower social classes were significantly more likely to concur on normative and perceived need scores. In conclusion, the study showed that using the IOTN AC at various points along the scale, different influences play a significant role in agreement/disagreement between normative and perceived needs, indicating that patient-clinician agreement regards orthodontic treatment is sensitive to several cultural factors.