Malocclusion and uptake of orthodontic treatment in Taranaki 12-13-year-olds

To describe the occurrence of malocclusion and the uptake of orthodontic treatment among 12-13-year-olds in the province of Taranaki, New Zealand.

Cross-sectional descriptive study using a random sample of 12-13-year-olds attending Intermediate schools.

Parents or caregivers completed a postal questionnaire. Children (N = 430; participation rate 74.1 percent) completed a questionnaire and were dentally examined.

Malocclusion, using the Dental Aesthetic Index, or DAI (Cons et al, 1986), recorded by a single calibrated examiner, and the use of orthodontic services as reported by parents or caregivers.

The mean DAI score was 28.3 (sd = 7.8). Females and non-Maori had greater mean DAI scores than males and Maori, respectively. A high proportion of the children needed orthodontic treatment (60.5 percent in the "definite", "severe" or "handicapping" categories), and 17 percent had a "handicapping" malocclusion. While over one-third of the children had been advised to seek an orthodontic consultation, a proportion (23.4 percent) did not. Of those who did, a similar proportion did not proceed with care because of financial considerations. Children of low socio-economic status (SES) were disproportionately represented in these groups. Children with "severe" or "handicapping" malocclusions who did not proceed with treatment came predominantly from low-SES households and high-deprivation areas.

Cost was a barrier to orthodontic treatment for low-SES, high-deprivation children and Maori. Social and ethnic inequalities exist in orthodontic treatment need in Taranaki. The utilisation of orthodontic treatment appeared to be largely neither equitable nor rational.