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DEMOGRAPHIC PROFILE OF PERCEPTION OF PATIENTS ABOUT MALOCCLUSION AND TREATMENT NEED IN ABBOTTABAD.

Byline: NAVEED MAZHAR BHATTI and TABASSUM NAVEED

Abstract

Surveys have found that the aspect of appearance with which people are most dissatisfied is their teeth especially malocclusion of front teeth is considered much more influential in self-perceptions of dental attractiveness. Therefore, one of the main reasons for seeking orthodontic treatment is for improving aesthetics. The aim of the survey was to provide basic demographic profile of self-perception of patients about their malocclusion seeking the Orthodontic treatment in rural area of Abbottabad.

30 patients, 5 males and 25 females, with age range from 12-18 years at Rehmat Memorial Dental Hospital, Abbottabad seeking orthodontic treatment participated in study. Convenience sampling was used, and our study tool comprised a 10-item questionnaire. Data was analyzed using SPSS ver 21. 40% patients rated straight teeth to be important followed by face shape. 73% patients said attaining straight teeth is the main reason for treatment followed by 37% patients citing enhancing facial appearance as main reason. 50% mothers, 40% self and 15% recommendation by dentists were reasons for starting the treatment. Patients placed a lot of emphasis over their facial appearance and beauty. Parents, primarily the mothers, were responsible for seeking treatment for young and adolescent children. Patients placed high value on facial appearance to be normal in order to have high self-esteem and self-satisfaction and peer acceptance.

Key Words: Self-perception, Malocclusion, Orthodontics treatment.

INTRODUCTION

Teeth form an essential component for body image and for self-perception. Aesthetic preferences related to facial characteristics are formed early in life1 and self-esteem of a person appears to be related to perception of his appearance.2 Surveys have found that the aspect of appearance with which people are most dissatisfied is their teeth especially malocclusion of front teeth is considered much more influential in self-perceptions of dental attractiveness than those in the posterior.3 Therefore, one of the main reasons for seeking orthodontic treatment is for improving aesthetics.4 Studies have shown that malocclusion can lead to psychological problems such as low self-esteem and can lead to poor social acceptance from peers and society.5

The psychological response in the social situation is one indication for treatment.6 Assumably, the psycho-social stress caused by improper tooth arrangement varies between different cultures, and perhaps even between genders within the same culture. Numerous studies have been carried out internationally about the perception of patients about their teeth and seeking of treatment based on this perception. In Pakistan, very few studies have been carried out.7,8 The aim of this study was to provide a basic demographic profile of perception of patients with malocclusion reporting to Department of Orthodontics, Women Medical College, Abbottabad, which can serve as a mean of establishing data important for the diagnosis, treatment and counselling of patients/parents with malocclusion.

METHODOLOGY

The survey was undertaken at outpatient Orthodontic Department at Rehmat Hospital, Women Medical College, Abbottabad in 2015. The patients were selected according to convenience non-probability sampling technique. Total 30 patients (N=30) age 10-18 years were given questionnaire. 5 patients were males (mean age 12.4 years) and 25 were females (mean age 11.6 years). Inclusion criteria included patients who wanted orthodontic treatment and who have not received Orthodontic treatment before and willing to participate in the study. Patients below 10 years of age and above 18 years were excluded as well as those with removable and functional appliances were also excluded. All patients and their caretakers were briefed on the objectives of study. During their visit at the Orthodontic Clinic, verbal consent was obtained to participate in this study. Patients were given a modified 10-question questionnaire adapted from an earlier study by Bergman and Eliasi.

RESULTS

The statistical analysis was performed using SPSS ver. 21. Descriptive analysis for each gender was done and frequencies and percentages were calculated for each question. The demographics of patients are shown in Table 1 and age frequency is shown for male and female patients in Table 2 and Table 3 respectively. Table 4 shows frequency results from questionnaire. Table 5 shows descriptive statistics of age and gender from questionnaire.

DISCUSSION

This study was done with the purpose to explore the demographics of psychological perception of patients about their malocclusion in a Pakistani population in a relatively remote city of Abbottabad. Results showed that patients rated straight teeth to be most important feature followed by face shape. Patients' perception about irregular teeth was the main reason for treatment followed by need to enhance their facial appearance. This is in line with a previous study in Pakistan which found strong psychosocial impact of altered dental aesthetics on the emotional state of an individual.9 Onyeaso and Sanu10 also reported that adolescent children rate attractiveness (popularity) higher than young children who are more concerned with peer judgement of their appearance(acceptance). Findings like our results were also reported by Dann and Tulloch.11

40% patients in study rated teeth to be important followed by face shape. Uthman et al identified second important factor to be self-perception of dental appearance.12 In another study, it was reported that attractiveness of teeth, in many cases is more important to children than their health. Children with a normal dental appearance would be judged by peers and adults to be better looking, more desirable as friends and less likely to behave aggressively than children with dento-facial anomaly. Reason for treatment shows that 73% patients said attaining straight teeth is the main reason followed by 37% patients citing enhancing facial appearance as main reason. Miyawaki et al have shown that orthodontic patients showed a significantly higher awareness of teeth than the patients without treatment.13,14 In this survey, the first to notice crooked teeth were mothers 50%, self-noticed 40% and dentists 15%.

This is similar to a study in which parents realized the need for treatment based on perception of their children's teeth.15 33% patients were teased for teeth, 16% for color of skin and 13% for chin and facial appearance. In 47% of the participants, the initiative for treatment was taken by mothers, 24% by self and 20% of the time by the dentists. 60% thought that the Orthodontic treatment will have some positive change in lives and 33% were unsure. The awareness of malocclusion and dissatisfaction with dental appearance among participants agreed with their objectively determined and perceived orthodontic need. The findings in survey in general agrees with other studies16,17,18 but in contrast to the study.19

The study was limited due to inclusion of a range of age group of patients because self -perception change with age.20 Our culture, religion, family beliefs, attitude and friends do influence how we see ourselves. This self-perception also seems to influence the individual's judgement of orthodontic treatment need. Individuals with malocclusions are usually aware of it and their self-esteem is dependent on the relative value they assign to their self-image.

TABLE 1: DEMOGRAPHIC PROFILE OF ORTHODONTIC PATIENTS (GENDER)

Profile###N=30###%

Gender

Male###5###16.7

Female###25###83.3

TABLE 2A: AGE FREQUENCY TABLE FOR MALES

Age Value###Frequency###Frequency %

10###2###40%

12###1###20%

14###1###20%

16###1###20%

TABLE 2B: AGE FREQUENCY TABLE FOR FEMALES

Age Value###Frequency###Frequency%

10###6###24%

11###8###32%

12###5###20%

13###3###12%

14###2###8%

15###1###4%

TABLE 3: FREQUENCY FROM QUESTIONNAIRE

Q1 What is the###Hair 4%###Nose###6.7%###Jaws###Teeth###Face###Color

most import-###6.7%###40%###34%###10%

ant feature for

Facial Aesthet-

ic.

Q2. Which is###Improve###Enhance###Enhance###Improve###Improve###Attain

your reason for###chewing###Facial###self###dental###speech###straight

having treat-###3.4%###Appearance###confidence###health###0%###teeth

ment###36.7%###6.7%###3.4%###60%

Q3. Who was###Dentist###Relatives###Brother###Mother###Father###Your

the first to no-###10%###0%###0%###54%###10%###self

tice your crook-###26.7%

ed teeth

Q4. How much###A lot###Quite a lot###A little###Not at

did the crook-###13.4%###50%###33.34%###all

ed teeth bother###3.4%

you?

Q5. Have you###Teeth###Chin###Ears###Nose###Legs###Skin###Hair###Body

ever been###33.34%###13.3%###3.34%###6.66%###6.66%###16.7%###6.67%###Build

teased for?###13.3%

Q6. Who took###Myself###Mother###Father###Brother###Sister###Relative###Dentist

the initiative###33.4%###46.7%###6.7%###0%###0%###0%###13.34%

to start your

treatment?

Q7. In your###Not at All###Not so Imp###Quite imp###Very imp

opinion, how###3.34%###13.3%###23.3%###60%

important is

the treatment

for you?

Q8 Do you###Unsure###No###Yes

think that after###33.4%###6.6%###60%

your teeth are

straightened, it

will alter your

life?

Q9 Based on###Unsure###No###Yes

your own expe-###20%###6.6%###73.4%

riences, would

you recom-

mend others to

have braces?

Q10. Which of###Keeping###Embarrass-###Problems###Problem###Problem###Pain

the following###your ap-###ment###with Oral###in speak-###in eating###53.3%

parts has been###pointment###6.6%###hygiene###ing###26.6%

most difficult###3.3%###6.6%###3.3%

during your or-

thodontic

treatment?

TABLE 4: DESCRIPTIVE STATISTICS FOR AGE AND GENDER

N=30###Male N=5###Female N=25

Minimum###10###10

Maximum###16###15

Range###6###5

Count###5###25

Sum###62###290

Mean###12.4###11.6

Median###12###11

Mode###10###11

Standard Deviation###2.608###1.414

Variance###6.8###2

Mid-Range###13###12.5

Inter Quartile Range###4###2

Sum of Squares###27.2###48

Mean Absolute Devi-###2.08###1.152

ation

Root Mean Square###12.62###11.68

Std. Error of Mean###1.66###0.2828

Skewness###0.3248###0.7248

Kurtosis###1.302###2.625

Coefficient of Varia-###0.2103###0.1219

tion

CONCLUSION

This study aims to document the demographic data regarding the psychological perception of patients about malocclusion in population of Abbottabad. The conclusion in this study seems to be that patients place a lot of emphasis over their facial appearance and beauty. Not surprisingly, parents primarily the mothers21, were responsible for seeking treatment for young and adolescent children. Patients placed high value on facial appearance to be normal to have high self-esteem and self-satisfaction and peer acceptance. Further studies are required to validate the findings with larger sample size.

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Publication:Pakistan Oral and Dental Journal
Article Type:Report
Geographic Code:9PAKI
Date:Dec 31, 2017
Words:2686
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