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Orthodontic treatment need of adolescents in Haida Gwaii, Canada Karim, Asef Mohammed Iqbal


Introduction: The aims of the cross-sectional study were to determine the prevalence of malocclusion and orthodontic treatment need according to the Index of Complexity, Outcome, and Need (ICON) among schoolchildren of the Aboriginal Island Community of Haida Gwaii in Northwestern British Columbia, Canada. Methods: Out of 535 schoolchildren, 215 (90 boys and 125 girls) agreed to participate in the clinical examination. An examiner, trained in occlusal indices, assessed orthodontic treatment need in children employing the ICON score and the ICON complexity grade. In addition, a questionnaire was modified and used to measure the schoolchildren’s expectations of and self- perceived need for orthodontic treatment. Out of the 215 schoolchildren that were clinically examined, 192 were old enough to comprehend the questions in the questionnaire and were capable of completing the questionnaire without any assistance. Results: The mean age (N=215) was 12.9±2.8 years. Of the examined schoolchildren, 67% have Aboriginal ancestry (at least one parent is Aboriginal). The mean ICON score was 43.5±26.2. There were no statistically significant differences in ICON scores regarding gender (t-test, P=0.207), ethnicity (t-test, paternal ethnicity P=0.886 and maternal ethnicity, P=0.389), or school (ANOVA with Post Hoc Bonferroni Adjustment P=0.317). Overall, 43.7% of the schoolchildren needed orthodontic treatment (ICON > 43). Based on the ICON complexity, 31% of the schoolchildren had moderate to very difficult malocclusions to treat. Adolescents (N=192) with higher ICON complexity scores (more complicated malocclusions) felt a greater need for orthodontic treatment, for extractions, that treatment would give them confidence, and that they were willing to be treated either on island or off island (One way ANOVA with Post Hoc Bonferroni Adjustment, P<0.001, 0.014, 0.002, <0.001, 0.007 respectively) compared to those with lower ICON scores. Conclusions: There is need for orthodontic treatment among Haida Gwaii schoolchildren (43.7% of adolescents need orthodontic treatment according to their ICON scores). As 31% had moderate to very difficult malocclusions to treat, specialty orthodontic services are recommended. The adolescents’ self-perceived need for orthodontic treatment corresponded to their clinical need; i.e. schoolchildren with higher ICON complexity scores felt a greater need for orthodontic treatment than those with lower ICON complexity scores.

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