A cultural comparison of treatment need

The aims of this study were two-fold. First to compare the perceptions of African dental aesthetics as determined by a panel of black African Senegalese and French Caucasian judges, and second to compare the sensitivity and specificity of both components of the Index of Orthodontic Treatment Need (IOTN) and the Index of Complexity, Outcome and Need (ICON) in relation to the opinions of African and Caucasian judges. Ninety-eight colour digital dental images of black adolescents and adults were scored for attractiveness on a 100 mm visual analogue scale (VAS) by 45 Caucasian and 41 black African judges. In addition the judges were asked to classify the level of treatment need. Both components of the IOTN and ICON were recorded for the 98 cases. The results indicated that Caucasian judges perceived the majority of images to be less attractive than African judges. African and Caucasian judges showed similar levels in the estimation of treatment need. The aesthetic component (AC) of the IOTN and ICON showed similar levels of sensitivity. Taking all factors into account, it would appear that the ICON is marginally better at identifying those individuals who are perceived to need orthodontic treatment.