History of Orthodontic Treatment, Treatment Needs and Influencing Factors in Adolescents in Croatia

Abstract

SUMMARYAim: The aim of this study was to assess the orthodontic treatment needs of adolescents in Zagreb, Croatia, in relation to their orthodontic treatment history, caries experience and socio-demographic parameters.Methods: The study sample comprised 1,289 adolescents from 12 randomly selected public schools in Zagreb, Croatia. The subjects were 15-18 years old (mean age 16.3 ± 1.4), and 51% of them were girls. The Dental Aesthetic Index (DAI), the sum of the numbers of decayed, missing and filled teeth (DMFT index), and a questionnaire (covering socio-demographic issues, oral health-related attitudes and behaviours) were employed in this study. The data was analyzed by means of Chi-square test, analysis of variance, and multiple logistic regression models.Results: The DMFT score was higher in adolescents with no orthodontic history (5.2 ± 3.7) than in those who were under orthodontic treatment at the time of the research (4.5 ± 3.2; p = 0.043). More than 60% of the adolescents have never undergone any orthodontic treatment, around 24% previously undergone treatment and 15% were under treatment at the time of the research. Overall, 85% of the adolescents' orthodontic appliances were removable, and the girls were more often under orthodontic treatment. One fifth of the studied population had severe or very severe malocclusion. Adolescents with previous orthodontic treatment were more often interested in better teeth alignment, changes in their teeth positioning and continuing orthodontic treatment. Multiple logistic regression model demonstrated that previously treated adolescents, in comparison with their untreated peers, were on average older (p = 0.002), were less satisfied with the appearance of their teeth (p = 0.001), they had higher malocclusion severity (p = 0.046), and fewer dental caries (p < 0.001), changed toothbrushes more often (p = 0.012), and their mothers attained higher education (p < 0.001).Conclusions: Although many adolescents received orthodontic treatment, the severity of their malocclusion was still somewhat high, and they were more often dissatisfied with their treatment outcome. Mothers' educational level was found to be the most important socio-demographic predictor for children's involvement in orthodontic treatment. The caries experience increased in comparison with the Croatian national survey data from 1999.

Pain and distress induced by elastomeric and spring separators in patients undergoing orthodontic treatment

“…Pain is generally a consequence of pressure, ischemia, inflammation, and edema developing in periodontal ligament ascribable to the applied orthodontic forces. [24] Pain may be associated with the interactions of inflammatory mediators, and control of these inflammatory mediators may be important to relieve the pain that accompanies tooth movement. [25]…”

Should my composite restorations last forever? Why are they failing?

“…The literature has shown that the increase in socioeconomic status elevates the search for treatments to improve dental aesthetics. 40 In this way, the demand for replacement or repair of anterior composite restorations tends to be higher in private dental offices. It is important to highlight that patients' opinion should be always taken in consideration in treatment planning.…”

Caries Experience in Patients Referred for an Orthodontic Consultation

“…One in 3.5 patients has active caries, as opposed to one in 5 in a previous similar study ( 11 ). According to these data, the severity of caries experience in Croatia is above the goals set by the World Health Organization (WHO) ( 5 ). In 2000, a goal for 12-year olds was the DMFT below three, and for year 2010 below one ( 1 ).…”

“…Oral health implies daily performance of procedures that prevent oral tissue diseases ( 3 , 4 ). Before any active orthodontic treatment, it is necessary that the patient has established satisfactory oral hygiene and cured all carious lesions, both on deciduous and permanent teeth ( 5 ). If teeth are not cured, orthodontic appliance cannot have controlled anchorage.…”