Perceptions of dental attractiveness and orthodontic treatment need among Tanzanian children

The aim of this study was to assess the opinions of Tanzanian children on dental attractiveness and their perceptions of orthodontic treatment need in relation to their own dental attractiveness as measured by the aesthetic component (AC) of the index of orthodontic treatment need (IOTN). In a random sample of 386 school children (48% boys, 52% girls), aged 9 to 18 years, the subjective need was assessed by using a prestructured questionnaire, and attractiveness was scored by using 18 intraoral frontal photographs. Orthodontic treatment need was measured with the IOTN, and 11% of the children definitely needed orthodontic treatment (grades 8-10 of the AC with 4-5 of the dental health component [DHC]). The AC indicated that 11% of the children needed orthodontic treatment, whereas the DHC indicated 22%. Although 38% of the children said they needed treatment, 33% and 31% were unhappy with the arrangement and the appearance of their teeth, respectively. Most children (85%) recognized well-aligned teeth as important for overall facial appearance. Photographs showing severe deviations including crowding were regarded as the most unattractive, with older children tending to dislike them the most (P < .0005). This suggests that, from the children's point of view, grades 8-10 of the AC and 4-5 of the DHC could be given the first priority when considering an orthodontic treatment policy in Tanzania.