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Evaluation of orthodontic treatment need by patient-based methods compared with normative method
Imaneh Asgari1, Arezoo Ebn Ahmady2, Ghasem Yadegarfar3
1Dental Implant Research Center, Department of Oral Public Health, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran.
Assessing orthodontic need requires both clinical measures and patient input. While patient-based tools like the Aesthetic Component of Index of Orthodontic Treatment Need (AC-IOTN) and Child Oral Health Impact Profile (COHIP) show promise, they cannot replace professional dental assessments for determining treatment necessity.
Area of Science:
- Dental Public Health
- Orthodontics
- Health Services Research
Background:
- Comprehensive orthodontic need assessment integrates normative clinical measures with patient-based indicators.
- Patient perceptions and clinical evaluations of orthodontic need can differ.
- Existing tools require evaluation for their predictive capabilities in identifying treatment need.
Purpose of the Study:
- To evaluate the predictive value of the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) and the Child Oral Health Impact Profile (COHIP) in assessing orthodontic treatment need.
- To explore factors influencing patient and dentist judgments regarding orthodontic treatment necessity.
- To compare professional assessment with patient-based indicators.
Main Methods:
- Oral examinations were conducted on 597 Iranian students (aged 13-18) to determine the Dental Health Component (DHC) grade.
- Child Oral Health Impact Profile (COHIP) and AC-IOTN scores were recorded for each student.
- Diagnostic values of subjective measures were assessed using multiple logistic regressions to analyze influencing variables.
Main Results:
- Half of the students assessed did not require orthodontic treatment by either professional or self-assessment.
- 60% of patients with a definite need reported a significant impact on their quality of life.
- AC-IOTN demonstrated excellent specificity (0.99) but low sensitivity (0.08), while COHIP had better sensitivity (unspecified) but lower specificity (50%).
- Factors like caries experience, quality of life, parental education, and hygiene habits influenced agreement between patient and dentist judgments.
Conclusions:
- Current patient-based assessment tools (AC-IOTN, COHIP) do not fully meet the requirements for predicting orthodontic treatment need.
- Patient-based methods are insufficient to replace professional dental assessments.
- Identifying patients with higher quality of life impacts can aid in prioritizing orthodontic treatment.
