|Year : 2015 | Volume
| Issue : 1 | Page : 79-82
Dental students perception of orthodontic treatment
Baswaraj1, K Jayasudha2, KM Kumarswamy3, MN Padmini3, B Chandralekha3, DP Shruthi1
1 Department of Orthodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
2 Department of Pedodontics, Rajarajeshwari Dental College, Bengaluru, Karnataka, India
3 Department of Orthodontics, Government Dental College and Research Centre, Bengaluru, Karnataka, India
|Date of Web Publication||19-Mar-2015|
Department of Orthodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: The relationship between physical appearance and perception of an esthetic deviation, and the impact of such deviation on self-esteem and body image are important issues in determining the benefits of orthodontic treatment. Aim: To assess dental students' perception of orthodontic treatment. Materials and Methods: A total of 230 undergraduate dental students of Government Dental College and Research Institute, Bangalore, Karnataka formed the study group. Each classroom of the participants was visited, and self-administered questionnaire was given. An analysis of variance was done between the groups to test for statistical difference. Categorical variables were evaluated using a Chi-square test with the level of significance of P < 0.001. Results: About 75% of the students were aware of their dental esthetics. About 75% of females were satisfied with the attractiveness of their teeth when compared to 69% in males. House surgeons had more positive attitude compared to the 1 st year students. Conclusion: The dental students had good knowledge about the orthodontic treatment and had a positive attitude toward it. Females had very good knowledge, satisfaction and positive attitude compared to the males regarding dental esthetics and treatment. House surgeons were much more aware, very much satisfied and had a more positive attitude than 1 st year students.
Keywords: Dental esthetics, dental students, satisfaction, self-evaluation
|How to cite this article:|
Baswaraj, Jayasudha K, Kumarswamy K M, Padmini M N, Chandralekha B, Shruthi D P. Dental students perception of orthodontic treatment. J Indian Assoc Public Health Dent 2015;13:79-82
|How to cite this URL:|
Baswaraj, Jayasudha K, Kumarswamy K M, Padmini M N, Chandralekha B, Shruthi D P. Dental students perception of orthodontic treatment. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2019 Dec 6];13:79-82. Available from: http://www.jiaphd.org/text.asp?2015/13/1/79/153600
| Introduction|| |
Measuring and recording the prevalence of mal-occlusion and treatment need in a population is useful for the planning of orthodontic services. Without a satisfactory estimate of the need and demand for treatment, it is difficult to develop and organize meaningful orthodontic services.  Orthodontic treatment is often carried out to improve the patient's dental appearance. The main factors influencing the decision for treatment are esthetic improvement and psychological aspect. In addition, knowledge about the attitude of patients to malocclusion is becoming increasingly important in orthodontics. ,
The orthodontist routinely evaluates his patients and prescribes treatment plans in order to satisfy the often stated goals of good dental function, stability of teeth and jaw position, and dental esthetics. While the first two considerations have been researched and are continually discussed in all the specialties of dentistry, the last aspect dental esthetics has escaped research attention.  The lack of research material in this area is not due to a lack of interest in the subject but to the difficulty of measuring exactly what "Dental esthetics" actually means. Esthetics is judgmental commodity, and the assumed variability in individual judgments (beauty is in the eye of the beholder) makes it difficult to make generalized statements. ,,
The aim of this study was to assess the self-evaluation and satisfaction of dental appearance among dental students. The objectives of this study were to assess the knowledge and attitude toward orthodontic treatment and comparing between different class groups and sexes.
| Materials and Methods|| |
The study participants were 230 dental students of Government Dental College and Research Institute, Bangalore, Karnataka. The study group comprised 93 males and 137 females of I, II, III, IV B.D.S. students and House surgeons, aged between 17 and 23 years [Table 1].
The data for this study were collected visiting to the class-rooms of subjects and were requested to complete a structured questionnaire. The questions were prepared as follows: Seven questions on awareness about their dentition, four questions on their self-satisfaction and six questions about their attitude toward orthodontic treatment. Each question had three possible answers, ranging from the positive response to a negative response, and these answers were given scores ranging 0-2, the highest score to the best and the lowest to the worst. The test items assessed the subject's ability to recognize the presence or absence of mal-occlusion, knowledge to perceive the impact of mal-occlusion and attitude about orthodontic treatment.
Statistical analysis of the data set was performed by grouping the answers to each of the questions into three categories: A negative response, an average response, and a positive or favorable response. Categorical variables were evaluated with a Chi-square test. Statistical significance was set at P < 0.05.
| Results|| |
Sixty-eight percent of the students were aware of their dental esthetics, 16% were not aware and 16% did not have knowledge about esthetics at all [Table 2]. About 97% of females had very good knowledge about dental esthetics compared to 93% of males. However, the differences are statistically not significant.
Self-satisfaction with the attractiveness of their teeth indicated a fairly objective evaluation of their own dental malocclusion situation. About 12% of the subjects were satisfied with the attractiveness of their teeth, 88% of the subjects reported negative feeling toward their teeth [Table 3].
Thirty-seven percent of subjects were very much satisfied with the attractiveness of their teeth, and 31% of these were not satisfied. This is highly statistically significant (P < 0.05) [Table 4].
Seventy-five percent of the females were satisfied with the attractiveness of their teeth and only 69% of males. But there was no statistical significance found. About 43% of the subjects were satisfied with the attractiveness of their teeth, 39% of the subjects reported negative feeling toward their teeth, 17% of the subjects showed a strong positive feeling toward their dentition.
Regarding the attitude toward orthodontic treatment, 31% had strong positive attitude, 53% were satisfied with their attractiveness and 16% were not aware of it [Table 4].
Satisfaction versus attitude
When asked about how many students were un-satisfied about their dental attractiveness and had a positive attitude toward orthodontic treatment-77% of subjects were un-satisfied of which 55% had a positive attitude toward orthodontic treatment. This is highly statistically significant (P < 0.01).
When compared among different class groups about the knowledge of dental esthetics, House surgeons were very much aware of it followed by final year students. However, there was no statistical significance found among the various classes. 1 st year students were not aware of dental esthetics very much.
When asked among different class groups about satisfaction of dental esthetics, House surgeons were very much satisfied about their teeth followed by final years. All the class groups were happy with their attractiveness almost equally. However, the House surgeons and 2 nd years were not happy with their dental esthetics. This was not statistically significant.
When the attitude toward orthodontic treatment was compared among different classes, House surgeons had more positive attitude with the least among the 1 st year students. Among satisfaction of dental attractiveness, 1 st year students and House surgeons were very much satisfied. 3 rd year students were least satisfied. No statistical significance was found.
Among Females there was almost even split between strongly positive (47%) and satisfactory (47%) attitude toward orthodontic treatment, there was no statistical significance found between males and females. The most influencing variable was found that, the teeth affect the way their face looks, and this was considered to be the most influencing factor among all the classes.
| Discussion|| |
The importance of patients' perceptions regarding orthodontic treatment cannot be underestimated as it is the patients who receive treatment and need to gain satisfaction from improved esthetics and function. 
It had been hypothesized that increased experience with and availability of orthodontic service should be translated into differences in esthetics rating and perception of treatment need.  Similar results have been obtained in our present study where 75% of the dental students who were having knowledge about orthodontic treatment were aware of dental esthetics.
The decision making process that a person undertakes when judging his/her own dental esthetic satisfaction may be broken down into several steps. First to know about the awareness about their own dentition, after this step, second their self-satisfaction, and finally their attitude toward orthodontic treatment. We may postulate that females had very good knowledge about dental esthetics compared to the males.
Regarding self-satisfaction about their teeth, the study indicates that the subjects did make fairly accurate self-evaluation of their own malocclusions (Crooked Teeth). The unsatisfied subjects with their dental esthetics had a positive attitude toward orthodontic treatment. The satisfied subjects with their dental esthetics were aware of the attractiveness of their teeth. This is also highly statistically significant.
The sex difference is probably due to the fact that the standards for acceptable facial form are more clearly delineated for females and thus deviations in dental form that adversely influence facial outline are more important to females than males. Similar results were obtained by Goel.  The subjects who had malocclusion and did not report to the orthodontic clinic seems to believe that teeth do not affect their esthetic value and this appeared to be more of an ignorance that teeth does significantly affect facial appearance and lack of knowledge was the main factor that kept away from treatment. 
Kerosuo et al. study concluded that access to free of cost orthodontic treatment was likely to affect the treatment rate, whereas it did not seem to influence the self-perceived need for treatment. 
Similar study conducted by Helm et al. suggested that certain malocclusions especially conspicuous occlusal and space anomalies may adversely affect body image and self-concept not only at adolescence but also in adulthood.  It is in the strongest association with study conducted by Birkeland et al. that both children and parents rate pleasant esthetics as an important factor for psycho-social well-being. 
In accordance to Bentele et al., Index of Orthodontic Treatment Need is an promising teaching aid for improving educational outcomes for orthodontic referral when sufficiently prepared to dental students to diagnose malocclusion and make appropriate referrals of potential orthodontic patients. 
The limitation of this study is that the dental students may not represent the general population of the society. Further cross-sectional studies are required to include more numbers of participants of different age groups.
| Summary and Conclusion|| |
A questionnaire study evaluated the awareness about teeth, level of self-satisfaction, attitude toward orthodontic treatment and the overall perception of dental appearance among a group of dental students.
From the study done it was found that the subjects had:
- Good knowledge about the orthodontic treatment and positive attitude toward orthodontic treatment
- The teeth affect the way their face looks, dental attractiveness the most influencing variable to perceive orthodontic treatment
- Females had very good knowledge, satisfaction and positive attitude compared to the males regarding dental esthetics and treatment
- House surgeons were much more aware, very much satisfied and had a more positive attitude than 1 st year students.
| References|| |
Espeland LV, Stenvik A. Perception of personal dental appearance in young adults: Relationship between occlusion, awareness, and satisfaction. Am J Orthod Dentofacial Orthop 1991;100:234-41.
Tang EL, So LL. Correlation of orthodontic treatment demand with treatment need assessed using two indices. Angle Orthod 1995;65:443-50.
Mandall NA, McCord JF, Blinkhorn AS, Worthington HV, O'Brien KD. Perceived aesthetic impact of malocclusion and oral self-perceptions in 14-15-year-old Asian and Caucasian children in greater Manchester. Eur J Orthod 2000;22:175-83.
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.
McGorray SP, Wheeler TT, Keeling SD, Yurkiewicz L, Taylor MG, King GJ. Evaluation of orthodontists' perception of treatment need and the peer assessment rating (PAR) index. Angle Orthod 1999;69:325-33.
Cochrane SM, Cunningham SJ, Hunt NP. Perceptions of facial appearance by orthodontists and the general public. J Clin Orthod 1997;31:164-8.
Shue-Te Yeh M, Koochek AR, Vlaskalic V, Boyd R, Richmond S. The relationship of 2 professional occlusal indexes with patients' perceptions of aesthetics, function, speech, and orthodontic treatment need. Am J Orthod Dentofacial Orthop 2000;118:421-8.
Tulloch JF, Shaw WC, Underhill C, Smith A, Jones G, Jones M. A comparison of attitudes toward orthodontic treatment in British and American communities. Am J Orthod 1984;85:253-9.
Goel S. Orthodontic treatment need-an orthodontist's and patient's perception. J Indian Orthod Soc 2002;35:28-35.
Kerosuo H, Abdulkarim E, Kerosuo E. Subjective need and orthodontic treatment experience in a Middle East country providing free orthodontic services: A questionnaire survey. Angle Orthod 2002;72:565-70.
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.
Birkeland K, Bøe OE, Wisth PJ. Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. Eur J Orthod 2000;22:509-18.
Bentele MJ, Vig KW, Shanker S, Beck FM. Efficacy of training dental students in the index of orthodontic treatment need. Am J Orthod Dentofacial Orthop 2002;122:456-62.
[Table 1], [Table 2], [Table 3], [Table 4]