Comparison of Normative Methods and the Sociodental Approach to Assessing Orthodontic Treatment Needs in 12-year-old Schoolchildren

Purpose: To compare normative methods of orthodontic treatment need with the sociodental approach in 12-year-old students and correlate the normative measures of malocclusion with the impact of oral health on daily activities. Materials and Methods: A cross-sectional study of 201 12-year-old students was conducted in the city of Manaus, Brazil. The normative orthodontic treatment need was determined by oral clinical examination using two occlusal indices, the Index of Orthodontic Treatment Need (IOTN), comprising the Dental Health Component (DHC) and Aesthetic Component (AC ), and the Dental Aesthetic Index (DAI). The sociodental approach combined normative measures (IOTN and DAI), the impact of malocclusion on daily activities (Child-Oral Impacts on Daily Performances index, Child-OIDP) and propensity- related orthodontic treatment assessment. The normative method and the sociodental approach of orthodontic treatment needs assessment were compared using the McNemar test. The association between the impact of malocclusion on daily activities and normative orthodontic need was tested using χ2 and Kruskal-Wallis tests. Results: The frequency of individuals with normative need according to IOTN/DHC (24.9%) and DAI (42.3%) was statistically higher when compared with the sociodental approach (= 4.5%) (P 0.001). The sociodental approach provided different results using IOTN/DHC (1.5%) and DAI (4.5%) (P 0.001). The magnitude of normative need was associated with the impact of malocclusion on children's daily activities. Conclusion: Substantial reductions in normative need estimates for orthodontic treatment were observed using the sociodental approach. The sociodental approach for orthodontic treatment needs can optimise the use of resources in oral health services. Keywords: health services needs and demand, malocclusion, needs assessment, orthodontics, quality of life