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Comparing a quality of life measure and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in assessing orthodontic treatment need and concern

University of Bristol, UK

Address for correspondence: N. W. T. Harradine Division of Child Dental Health, Department of Oral and Dental Sciences, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY, UK. Email:Nigel.Harradine{at}bristol.ac.uk

Objective: To compare the use of the Aesthetic Component (AC) of IOTN and the Child Perceptions Questionnaire (CPQ) in assessing orthodontic treatment need and concern.

Design: Cross-sectional observational study

Subjects and methods: The subjects were 204 children aged 10–12 years studying in 10 schools in Bristol, UK. They completed a questionnaire comprising the CPQ and questions regarding orthodontic concern. AC scores as rated by the child and by the calibrated examiner were recorded.

Main outcome measures: CPQ scores were calculated from the responses in the questionnaire. AC scores and responses to questions regarding orthodontic concern were recorded.

Results: The children gave themselves lower AC scores compared to the examiner (p<0.001).

The only section of the CPQ that correlated significantly with Examiner AC was the emotional impacts section (rho=0.151). CPQ scores had a slightly higher correlation with self-perceived AC than Examiner AC. However, the correlations were still very low. The emotional impacts section of CPQ (rho=0.332) and overall CPQ score (rho=0.282) were better than the examiner AC (rho=0.209) at reflecting how bothered the children were by the alignment of their teeth, and how upset they would be if they couldn’t receive orthodontic treatment (rho=0.464, 0.428 and 0.214, respectively). Children with a normative need for orthodontic treatment, based on examiner AC did not have a worse oral health-related quality of life.

Conclusion(s): The CPQ and IOTN AC measure different attributes. There should be a shift towards using quality of life measures to supplement the IOTN in assessing the perceived need for orthodontic treatment.

Key words: Aesthetic component, child perceptions questionnaire, IOTN, Quality of life

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