Comparative assessment of and self-perceived and normative orthodontic treatment need and its effect on the self-esteem of students of a prominent indian dental school – a cross sectional survey

Objective-To assess and compare the normative and self-perceived need for orthodontic treatment and its effect on self-esteem in a sample of undergraduate dental students. Methodology– This cross sectional study was conducted on a pool of 102 dental students after obtaining the required approval from the Institutional Ethics Committee. Students of either gender, between the ages of 18-22 yrs and with a similar socio-economic background were selected for the study.Those who were undergoing or had previously undergone orthodontic treatment were not considered. Self perceived need of orthodontic treatment was assessed by using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Needs(IOTN).The AC assesses the perception of an individual on the attractiveness of his/her dentition through a 10-point photographical scale showing different levels of dental attractiveness, with photo 1 representing the most attractive and photo 10 the least attractive. Clinical intraoral examination was done to assess the normative treatment need by using the modified Dental Health Component (m DHC) of the IOTN. Questionnaires were distributed to the participants to evaluate the psychological impact of the malocclusion. The Global Negative Self Evaluation Scale (GSE), which is an adaptation of the self-esteem scale of Rosenberg(1965), was used. Results: According to the AC scores only 3% of the study subjects felt a need to seek orthodontic treatment,whereas 58.8% of them fell into the “definite need for treatment” category as evaluated by the orthodontist using the mDHC.There was a negative correlation between perceived treatment need and self esteem.Female students had a higher self esteem than their male counterparts. Conclusion: There was a marked difference between the students’and investigator’s opinion in the need for orthodontic treatment.This stresses the importance of taking into account the patient’s need and expectations and avoiding the traditional paternal approach in treatment planning.