18 Perceived aesthetic impact of malocclusion and oral self-perception - 1999 European Orthodontic Society European Journal of Orthodontics 21(1999

18 Perceived aesthetic impact of malocclusion and oral self-perception

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Introduction This study was concerned with measurement of orthodontic aesthetic self-perception, and the perceived aesthetic impact of malocclusion and social variables that may influence this. Therefore, the literature will be reviewed in two main parts: (i) orthodontic perceptions and (ii) the measure- ment of oral aesthetic impact in dentistry. Orthodontic oral self-perceptions A number of authors (Shaw et al ., 1975, 1980; Lindsay and Hodgkins, 1983; Tulloch et al ., 1984; Roberts et al ., 1989) have suggested that teenage children have developed an oral perceptual awareness. For example, Shaw (1981) found that children with less perceptual awareness tended to be dissatisfied with their dental appearance and perceived a greater need for orthodontic treatment. In contrast to this, in a study compar- ing schoolchildren in Wales, UK, and Kentucky, USA, Tulloch et al . (1984) showed that per- ceptions of dental attractiveness and treatment need were similar. However, subtle differences were found, with the American children having a more realistic perception of treatment time, probably attributable to their greater exposure to peers undergoing orthodontic treatment. European Journal of Orthodontics 21 (1999) 175–183 ª 1999 European Orthodontic Society Perceived aesthetic impact of malocclusion and oral self-perceptions in 14–15-year-old Asian and Caucasian children in Greater Manchester N. A. Mandall, J. F. McCord, A. S. Blinkhorn, H. V. Worthington and K. D. O’Brien Department of Dental Medicine and Surgery, University of Manchester, UK SUMMARY The aims of this study were to evaluate (i) the effect of ethnicity, social depriva- tion, and normative orthodontic treatment need on orthodontic aesthetic self-perception, self-perceived need for orthodontic treatment, and oral aesthetic impact of malocclusion; (ii) the effect of ethnicity, social deprivation, and gender on perceived orthodontic treatment need and use of orthodontic services; (iii) the influence of perceived oral aesthetic impact of malocclusion on perceived need and wish for orthodontic treatment; and (iv) whether orthodontic treatment experience influences perceived oral aesthetic impact of malocclusion. A stratified, random sample of 434 14–15-year-old children from schools in Manchester, UK, was obtained. Information was collected on orthodontic aesthetic self-perception and orthodontic treatment experience using a questionnaire. The former data were combined to form an Oral Aesthetic Subjective Impact Scale (OASIS). Normative orthodontic treatment need was measured with the Index of Orthodontic Treatment Need (IOTN). Children with higher clinical need for orthodontic treatment perceived themselves as worse off than their peers with lower need. More socially deprived children or those with high IOTN aesthetic component (AC) scores had a higher (i.e. more negative) aesthetic impact (OASIS) score. Asians and females had higher IOTN dental health component (DHC) scores, but a better aesthetic appearance than Caucasians and males. More deprived children were less likely to have received orthodontic treatment. Despite this, OASIS scores were similar

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