Malocclusion, psycho-social impacts and treatment need: A cross-sectional study of Tanzanian primary school-children

Abstract

Backgroundstudies on the relationship between children's malocclusion and its psycho-social impacts are so far largely unexplored in low-income countries. This study aimed to assess the prevalence of malocclusion, reported dental problems and dissatisfaction with dental appearance among primary school children in Tanzania. The relationship of dissatisfaction with socio-demographic characteristics, clinically defined malocclusion and psychosocial impacts of dental anomalies was investigated. Orthodontic treatment need was estimated using an integrated socio-dental approach.MethodOne thousand six hundred and one children (mean age 13 yr) attending primary schools in the districts of Kinondoni and Temeke completed face to face interviews and a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child Oral Impact on Daily Performance (Child-OIDP) frequency score, reported dental problems, dissatisfaction with dental appearance/function and socio-demographic characteristics.ResultsThe prevalence of malocclusion varied from 0.9% (deep bite) to 22.5% (midline shift) with a total of 63.8% having at least one type of anomaly. Moderate proportions of children admitted dental problems; ranging from 7% (space position) to 20% (pain). The odds ratio of having problems with teeth position, spaces, pain and swallowing if having any malocclusion were, respectively 6.7, 3.9, 1.4 and 6.8. A total of 23.3% children were dissatisfied with dental appearance/function. Children dissatisfied with their dental appearance were less likely to be Temeke residents (OR = 0.5) and having parents of higher education (OR = 0.6) and more likely to reporting problem with teeth position (OR = 4.3) and having oral impacts (OR = 2.7). The socio-dental treatment need of 12% was five times lower than the normative need assessment of 63.8%.ConclusionCompared to the high prevalence of malocclusion, psycho social impacts and dissatisfaction with appearance/function was not frequent among Tanzanian schoolchildren. Subjects with malocclusion reported problems most frequently and malocclusion together with other psycho-social impact scores determined children's satisfaction with teeth appearance- and function.

Relationships between dental appearance, self-esteem, socio-economic status, and oral health-related quality of life in UK schoolchildren: A 3-year cohort study

“…This concurs with Locker who found that there were disparities in OHQoL among a group of Canadian schoolchildren, with children from low income households having the poorest OHQoL (26). M M concerns about their dental appearance are influenced by the social and cultural context in which they live (29).…”

Associação entre presença de oclusopatias e insatisfação com a aparência dos dentes e gengivas: estudo com adolescentes brasileiros

“…A prevalência da insatisfação com a aparência dos dentes e gengivas nos adolescentes foi de 11,4% sendo menor quando comparada a países tão díspares como Tanzânia (23,3%) 19 , Nigéria (57,4%) 2 e Turquia (42,7%) 20 . No entanto, as comparações devem ser feitas com cautela devido às diferenças metodológicas existentes, como as diferentes faixas etárias estudadas, tipos de índices utilizados ou formas de categorização das variáveis 3 .…”

“…Um dos principais achados deste estudo foi o aumento da proporção de indivíduos insatisfeitos com a aparência dos dentes e gengivas conforme o aumento da gravidade das oclusopatias. Este achado reforça a relevância de considerar as medidas subjetivas quando se pretende identificar os problemas oclusais que provocam impacto negativo na vida dos adolescentes 19 . Considerando que o tratamento ortodôntico foi incluído no elenco de alternativas terapêuticas especializadas do Sistema Úni-co de Saúde, o diagnóstico das oclusopatias possui dois objetivos principais: avaliar a necessidade e a prioridade de tratamento dos indivíduos, e obter informações para alocar adequadamente os recursos necessários para a provisão do tratamento ortodôntico para a população 24 .…”

Malocclusion and oral health-related quality of life in Brazilian school children

“…8 However, the majority of the studies that investigated the impact of malocclusion on OHRQoL focused on adolescents with permanent dentition. [3][4][5][8][9][10][11][12][13][14][15][16][17][18] As children's feelings about their dental appearance begin early, at about 8 years of age, children have criteria similar to those of adults regarding the selfperception of body image. Occlusal changes may occur in the mixed dentition and affect self-image.…”