Evaluation of Unbiased Opinions Related to Orthodontic Treatment Decision-Making Using a Simplified Malocclusion Index: A Cross Sectional Study Within Two Tribal Populations With No Prior Treatment History

Abstract

Background An analysis of the factors influencing the decision-making process in accepting orthodontic treatment can be of profound importance in establishing trust and ensuring an overall positive outcome. This is all the more significant when dealing with a patient who has not had any prior interaction with an orthodontist. The Simplified Malocclusion Index for Layperson Evaluation (SMILE Index) allows an unbiased cross-evaluation between the perceived need for treatment and the factors of orthodontic awareness and self-perceived esthetics. Objectives Tribal adolescents belonging to 2 regions with no prior access to orthodontic treatment were chosen for the study. Most adolescents of this region were assumed to have orthodontic awareness by way of information from their schools and dental camps. During the orthodontic screening process, a verbally assigned questionnaire base index was used to elicit their willingness to undergo treatment and to understand influencing factors. Methods A total of 2,835 tribal adolescents between the ages of 13 and 19 years belonging to the Revenue divisions of Paderu (Visakhapatnam) and Parvathipuram (Vizianagaram) were screened in this study. Chosen candidates presented with normal growth and development, and had no nutritional deficiencies or metabolic disorders. Consent and permissions were obtained from the regional tribal authorities, institutional ethical clearance committee, the school authorities, and the parents or guardians of the adolescents. The orthodontic screening was performed under natural daylight with strict adherence to infection prevention protocol. Observed occlusions were categorized into either an ideal occlusion or Angle’s Class I, II, and III malocclusions. During the screening, the SMILE index was assigned in the vernacular Telugu. A percentage distribution analysis was made of the responses of those presenting with malocclusion. Results An analysis of the SMILE index results of the adolescents of Paderu Revenue division revealed higher SMILE index scores in categories III and V with a percentage distribution of 24.46% for males and 26.86% for females in SMILE Index Score Category III and 63.40% for the males and 52.13% for the females in Category V. Similarly, the results of Parvathipuram division had a higher score distribution in the categories of III and V with a percentage distribution of 16.07% for males and 15.84% for females in category III and 78.67% for males and 74.25% for females in category V. Conclusion Orthodontic treatment with proper counseling providing clarity of facts facilitates an easier decision-making process and enables both the patient and the orthodontist to understand one another and the treatment process better for a much more predictable overall treatment outcome.