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 Table of Contents 
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 550-555  

Effect of orthodontic treatment needs on oral health related quality of life among the young population in Delhi NCR-region of North India

1 Department of Conservative Dentistry and Endodontics, Inderprastha Dental College & Hospital, Ghaziabad, Uttar Pradesh, India
2 Department of Public Health Dentistry, I.T.S Centre for Dental Studies & Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
3 Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
4 Department of Dentistry, Subdivisional Hospital, Ranchi, Jharkhand, India
5 Department of Dentistry, Saraswati Institute of Medical Sciences, Hapur, Uttar Pradesh, India
6 Department of Dental Surgery, Dr. RML Hospital, New Delhi, India
7 Department of Dentistry, ESIC Model Hospital, Indore, Madhya Pradesh, India

Date of Web Publication28-Feb-2019

Correspondence Address:
Dr. Garima Yadav
Department of Dentistry, Saraswati Institute of Medical Sciences, Hapur, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_431_18

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Aim: To assess the effect of orthodontic treatment needs on oral health-related quality of life among the young people of Delhi NCR. Methods: The study was conducted on 12–15 years of individuals attending dental clinic/hospital in Delhi NCR region. Data were collected using Index of Orthodontic Treatment Need -Dental Component and oral health impact profile 14 questionnaire. The Chi-square test was used to analyze the qualitative data. SPSS software version 20 was used for statistical analysis. Results: Orthodontic treatment needs had an almost similar impact on the daily activities of both males and females. The sense of taste was not significantly affected by the need for orthodontic treatment in either males or females. The proportions of orthodontic patients found to have the painful arch, embarrassment, tension, and self-conscious both in males and females. Conclusion: There is a significant correlation of orthodontic treatment needs among oral health-related quality of life.

Keywords: IOTN, malocclusion, oral health impact profile-14, oral health-related quality of life, orthodontic treatment needs

How to cite this article:
Singh TK, Bhagia P, Gupta U, Passi D, Goyal J, Yadav G, Gautam B, Jain S. Effect of orthodontic treatment needs on oral health related quality of life among the young population in Delhi NCR-region of North India. J Family Med Prim Care 2019;8:550-5

How to cite this URL:
Singh TK, Bhagia P, Gupta U, Passi D, Goyal J, Yadav G, Gautam B, Jain S. Effect of orthodontic treatment needs on oral health related quality of life among the young population in Delhi NCR-region of North India. J Family Med Prim Care [serial online] 2019 [cited 2021 May 8];8:550-5. Available from: https://www.jfmpc.com/text.asp?2019/8/2/550/253046

  Introduction Top

Dental malocclusions display the third most astounding commonness among oral pathologies, second just to tooth decay and periodontal problems, and in this way rank third among the world.[1] Malocclusion is neither a disease nor a perilous condition yet is for the most part, acknowledged to having physical, social, and mental outcomes that impact the nature of life.

The physical appearance of an individual might be the single variable component that has the best effect on confidence, standards of conduct, and individual communications. Singular observations, physical and psychosocial capacities, chances to have a typical existence and social communication – these components are basic for assessing the effect of medicinal services benefits on a person.[2] Young grown-ups are more worried about their conduct, appearance, and view of others about them.

Quality of life is a multidimensional idea that incorporates emotionally apparent physical, mental, and social capacity and also a feeling of abstract well-being.[3] The term health-related quality of life (HRQoL) has been used to describe an individual's assessment of how the following type of factors affect his or her well-being: experience of pain/discomfort, physical function, psychology (i.e., concerning the person's appearance and self-esteem), and social function, such as interactions with others. When center around orofacial regions, oral health-related quality of life (OHRQoL) is assessed.[4]

The impact of malocclusions and OHRQoL might be different in children than in adults as they not only deal differently with disease but also with psychological, social, and emotional factors. In addition, children and adult OHRQoL measures are different; thus, they should not be investigated simultaneously. When the focus lies on OHRQoL in children, a variety of instruments exist without one universally accepted. One of the first instruments used in adolescents is the oral health impact profile-14 (OHIP-14).[5]

Customarily, measures of orthodontic need and result have set generally little accentuation on the patient's view of need and all the more significantly, the distinction that orthodontic care makes to their everyday lives.[6] It is presently progressively acknowledged that estimation of the oral well-being related personal satisfaction has a critical part to play in clinical practice and should frame some portion of any protection and additionally restorative program proposed to enhance oral well-being.

The scarcity of information on malocclusion in the investigation territory guided to lead the present examination to evaluate the impact of orthodontic treatment needs on OHRQoL among the young people of Delhi NCR.

  Methods Top

A cross-sectional investigation was done from January 2012 to December 2017 in the Registered Hospitals/Clinics of urban area in Delhi National Capital Region. A total of 520 orthodontic patients of age 12–15 years visited the Dental Department of these hospitals were taken into contemplating.

Written consent was taken from the guardians whose wards were incorporated into the investigation. The adolescent whose guardians gave composed assent were incorporated into the investigation. The examination was guided on orthodontic patients to overview the association between orthodontic treatment needs assessed by the dental health component (DHC) of the index of orthodontic treatment need (IOTN) and OHQoL studied by the OHIP-14. Patients who had an apparent requirement for orthodontic treatment and who were about to undergo orthodontic therapy were included. The exclusion criteria were perpetual restorative conditions, past orthodontic treatment, and craniofacial oddities, for example, congenital diseases, cleft lip, palate, and untreated dental caries.

Individuals were clinically inspected for orthodontic treatment require utilizing the dental health component of the IOTN. The information gathered included socio-statistic information, history of orthodontic treatment, orthodontic treatment required, and the general oral well-being effects of malocclusion on day by day life to obtain accuracy in the use of the IOTN. With a specific end goal to acquire precision in the utilization of the IOTN, the researcher was trained and underwent a calibration exercise. Examiners were calibrated for its use (kappa, 8.9).

The individuals were interviewed with utilizing OHIP-14; clinical examinations were led to survey regularizing orthodontic treatment require utilizing the DHC of the IOTN. The treatment needs of the patients were categorized as:

Grade 1 (no treatment need),

Grade 2 (little treatment need),

Grade 3 (borderline need),

Grade 4 and 5 (high treatment need).

For this study, Grade 1 and Grade 2 were coupled in no or little treatment need; Grade 4 and 5 were coupled as definitive treatment need. The DHC utilizes missing teeth, overjet, cross bite, removals of contact focuses, and overbite to recognize the most serious occlusal characteristic for every patient. The last general score was given to the patient as per the most serious characteristic.[6]

The OHIP-14 is a 14-things survey intended to quantify self-detailed practical confinement, distress, and inability credited to oral conditions. Responses were made on a 5-point Likert-type scale (never, sometimes, once in a while, frequently, and all the time). The day by day exercises were had issues articulating words, felt that the feeling of taste intensified, had agonizing throbbing in the mouth, have been self-conscious, felt tense, had an unsatisfactory diet, had to interrupt meals, found it difficult to relax, have been somewhat humiliated, have been irritated with other individuals, experienced issues doing helpful employments, felt that life when all is said in done was less attractive, and have been absolutely unfit to work.[7]

Statistical analysis

Data presentation and statistical analysis were performed with the SPSS statistical package (version 20, SPSS, Chicago, ILL). The Chi-square test was used to analyze the qualitative data. The level of significance was 0.05.

  Results Top

A total of 520 individuals of 12–15 years participated in the study. [Table 1] displays the mean and standard deviation for each group in the study. The mean age of males was 13.25 years and female was 12.85 years [Table 1].
Table 1: Distribution of study population

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Among the 239, i.e., approximately, 46% comprising 111 males and 128 females have definitive treatment need. However, 106 males and 92 females, total 198 (38%) have borderline treatment needs. Approximately, 16% having 43 males and 40 females had no or little treatment needs [Table 2] and [Graph 1].
Table 2: Distribution of orthodontic treatment need with gender

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[Table 3] shows the impacts on daily activities in relation to gender and orthodontic treatment needs. The Chi-square test participates show that sense of taste and difficulty in doing useful jobs were not significantly affected by the need for orthodontic treatment in both males and females. Rest daily activities were some way affected by the need for orthodontic treatment.
Table 3: The impacts on daily activities in relation to gender and orthodontic treatment needs

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In the psychological domain, a majority of females i.e., 101 out of 128 felt self-conscious because of their teeth as compared to 91 of males requiring definitive treatment need [Graph 2]. Females with definitive treatment needs were found to be more tense because of their teeth as compared to males. Both males and females with “definitive treatment need” were found to be irritated with other people because of problems with their teeth. Trouble in pronunciations of words was also correlated to the orthodontic treatment needs.

The parameters of physical pain domain were found to be significantly affected by treatment needs.

According to [Table 4], embarrassment because of the problem with teeth was associated with both male and female with orthodontic treatment needs. There was no significant relation seen among dietary component with treatment needs.
Table 4: Correlation with Psychological disability and Physical disability

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[Table 5] shows a significant correlation among females with the feeling of less satisfaction and unable to function because of problems with teeth with orthodontic treatment needs. There was no significance seen with males.
Table 5: The impacts oh handicap OHIP domain in relation to gender and orthodontic treatment needs

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  Discussion Top

This examination assessed the impact of orthodontic treatment needs on oral health related personal satisfaction among the youngsters of Delhi NCR region. Because the subject's recognition is integral to the appraisal of by and large need and fulfillment with treatment, it is imperative to set up what the patients' discernments are.

The OHIP is a broadly used instrument for the appraisal of OHQoL. The first form of the scale incorporates 49 things partitioned into 7 areas. A short type of the OHIP containing just 14 things (OHIP-14) has been produced. The OHIP is intended to decide the impression of the social effect of the oral issue and has all around archived psychometric properties.[7]

The examination uncovers that female was more worried about their orthodontic treatment. Female was altogether felt incapacitate as they had the sentiment of less fulfillment and unfit to work because of an issue in teeth as the contrast with male partner. This may recommend that females are reacting to social desires for the significance of style instead of a dispassionately more prominent orthodontic treatment required in contrast with their male partners.[8]

However, parents might be more inclined to look for orthodontic treatment for their female youngsters than their male. It was normal that the effect of malocclusion on personal satisfaction would be fundamentally more noteworthy in the young female when contrasted with the young male.[9]

Young women were more likely to have had a higher dental impact than male youths, but the difference was not that much significant. Similar findings were reported by Oliveira and Sheiham in adolescents and other age groups by Birkeland et al.,[10] Hunt et al.,[11] and Bernabe et al.[12] However, Peres et al. found female's adolescents had greater dissatisfaction with their dental appearance.[13]

In both male and female patients, the need for orthodontic treatment significantly affected painful aching mouth, embarrassment, and feeling tensed. This finding is in agreement with Klages et al.[14] and Hassan AH.[15] Klages et al. discussed that young adults with more severe malocclusion acquired higher scores in self-consciousness domain, which means increased feeling of embarrassment and self-consciousness.[14]

Helm et al. reported that self-consciousness and embarrassment because of severe malocclusion were not limited to adolescents and were seen in adults as well.[16] However, studies by Lazaridou-Terzoudi et al.[17] and DiBiase[18] found no significant association between malocclusion and self-consciousness or embarrassment.

The present investigation additionally demonstrated that orthodontic treatment requires influence on the pronunciation of words. This finding was in comparison with that of different analysts.[19] These outcomes are not in accordance with the after effects of an investigation by Hassan AH.[15] The physical disability including diet unsatisfaction and interruption of diet were not influenced by orthodontic needs in both genders. This finding was rather than those of Owen S.[20] This outcome was likewise do not agree with the discoveries of cross-sectional investigations by English JD et al. and Magalhães IB et al. They expressed that malocclusion can influence the eating regimen and rumination of patients.[21],[22]

Embarrassment and the general feeling of irritation with other individuals were essentially connected with higher orthodontic treatment needs in both male and females in our investigation.[23] Further, orthodontic treatment needs did not altogether influence the capacity of the patients to carry out their employment and discovered hard to relax.[24] Therefore, our findings are also relevant for health education and policy decisions, especially in representing the patient's perspective. Finally, this study helps understanding the importance of OHIP as outcome measure in the orthodontic practice as well as health service research.

  Conclusion Top

Orthodontic treatment needs were related to OHRQoL among young people. Oral well-being related personal satisfaction measures epitomize more parts of people's recognition about their mouths and teeth. Surveying personal satisfaction as it identifies with patients' oral health when treatment makes it conceivable to altogether enhance the dental specialist unique relationship and, particularly, to accomplish more effective treatment results.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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Nagarjun S, Krishnappa P. The relationship of malocclusion as assessed by the Dental Aesthetic Index (DAI) with perceptions of aesthetics, function, speech and treatment needs among 14-15 year old school children of Bangalore, India. Oral Health Prev Dent 2010;8:221-8.  Back to cited text no. 2
Oliveira CM, Sheiham A. Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents. J Orthod 2004;31:20-7.  Back to cited text no. 3
Locker D, Gibson B. The concept of positive health: A review and commentary on its application in oral health research. Community Dent Oral Epidemiol 2006;34:161-73.  Back to cited text no. 4
Kragt L, Dhamo B, Wolvius EB, Ongkosuwito EM. The impact of malocclusions on oral health-related quality of life in children a systematic review and meta-analysis. Clin Oral Investig 2016;20:1881-94.  Back to cited text no. 5
Jarvinen S. Indexes for orthodontic treatment need. Am J Orthod Dentofacial Orthop 2001;120:237-9.  Back to cited text no. 6
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Kragt L, Wolvius EB, Jaddoe VW, Tiemeier H, Ongkosuwito EM. Influence of self-esteem on perceived orthodontic treatment need and oral health related quality of life in children: The Generation R Study. Eur J Orthod 2018;40:254-61.  Back to cited text no. 8
Kavaliauskienė A, Šidlauskas A, Zaborskis A. Relationship between orthodontic treatment need and oral health-related quality of life among 11-18-year-old adolescents in Lithuania. Int J Environ Res Public Health 2018;15:1012.  Back to cited text no. 9
Birkeland K, Boe OE, Wisth PJ. Subjective assessment of dental and psychosocial effects of orthodontic treatment. J Orofac Orthop 1997;58:44-61.  Back to cited text no. 10
Hunt O, Hepper P, Johnston C, Stevenson M, Burden D. The aesthetic component of the index of orthodontic treatment need validated against lay opinion. Eur J Orthod 2002;24:53-9.  Back to cited text no. 11
Bernabe E, Sheiham A, Tsakos G, Messias de Oliveira C. The impact oforthodontic treatment on the quality of life in adolescents: A case-control study. Eur J Orthod 2008;30:515-20.  Back to cited text no. 12
Peres KG, Barros AJ, Anselmi L, Peres MA, Barros FC. Does malocclusion influence the adolescent's satisfaction with appearance. A crosssectional study nested in a Brazilian birth cohort. Community Dent Oral Epidemiol 2008;36:137-43.  Back to cited text no. 13
Klages U, Bruckner A, Zentner A. Dental aesthetics, self awareness, and oral health-related quality of life in young adults. Eur J Orthod 2004;26:507-14.  Back to cited text no. 14
Ali HH, Hatem El-SA. Association of orthodontic treatment needs and oral health-related quality of life in young adults. Am J Orthod Dentofacial Orthop 2010;137:42-7.  Back to cited text no. 15
Helm S, Kreiborg S, Solow B. Psychosocial implications of malocclusion: A 15-year follow-up study in 30-year-old Danes. Am J Orthod 1985;87:110-8.  Back to cited text no. 16
Lazaridou-Terzoudi T, Kiyak HA, Moore R, Athanasiou AE, Melsen B. Long-term assessment of psychologic outcomes of orthognathic surgery. J Oral Maxillofac Surg 2003;61:545-52.  Back to cited text no. 17
DiBiase AT, Sandler PJ. Malocclusion, orthodontics and bullying. Dent Update 2001;28:464-6.  Back to cited text no. 18
George R, Samson RS, Soe HH, Donald PM, Hui WL, Ling PK, et al. Oral health-related quality of life and the index of orthodontic treatment need to evaluate the association of patients' self-perceived need and normative need toward orthodontic treatment. J Int Oral Health 2018;10:115-20.  Back to cited text no. 19
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English JD, Buschang P, Throckmorton G. Does malocclusion affect masticatory performance. Angle Orthod 2002;72:21-7.  Back to cited text no. 21
Magalhães IB, Pereira LJ, Marques LS, Gameiro GH. The influence of malocclusion on masticatory performance. A systematic review. Angle Orthod 2010;80:981-7.  Back to cited text no. 22
Montero J, Rosel E, Barrios R, López-Valverde A, Albaladejo A, Bravo M. Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain. Int J Paediatr Dent2016;26:220-30.  Back to cited text no. 23
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


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