Association of orthodontic treatment needs and oral health-related quality of life in Saudi children seeking orthodontic treatment

Figures & data

Table 1 IOTN and COHRQoL among study children

Items	IOTN		P¥
	No/little need (n=26)	Borderline/need treatment (n=94)
Teeth hurt now	5.6%	5.2%	0.963
Teeth hurt on eating something hot or cold	57.7%	53.2%	0.684
Teeth hurt on eating something sweet	30.8%	41.5%	0.322
A hurting tooth wakes child up at night	80.8%	77.7%	0.733
A hurting tooth stops child from playing	7.7%	7.4%	0.966
Is it hard for child to chew or bite	34.6%	60.6%	0.018*
Does the child like his/her teeth?	53.2%	26.2%	0.028*
Is the child happy with his teeth and smile?	51.1%	26.9%	0.029*
Kids make fun of child’s teeth	19.2%	40.4%	0.046*

Notes:

¥ Chi-square test.

* P<0.05 (significant). Cronbach’s alpha for total sample =0.64.

Abbreviations: IOTN, index of orthodontic treatment need; COHRQoL, children’s oral health-related quality of life; n, number of patients.

Table 2 IOTN and PGOHRQoL among study children

Items	IOTN	Never	Sometimes	Always	P¥
My child had difficulty chewing	No/little need	38.5	35.1	30.9	0.039*
	Borderline/need treatment	53.2	19.2	19.2
My child had difficulty biting hard	No/little need	61.5	24.5	22.3	0.040*
	Borderline/need treatment	34.0	50.0	11.5
My child’s teeth are sensitive to hot or cold	No/little need	65.4	30.8	3.8	0.010*
	Borderline/need treatment	39.4	28.7	31.9
My child’s teeth are sensitive to sweet	No/little need	42.3	26.9	30.8	0.431
	Borderline/need treatment	52.1	28.7	19.1
My child has a toothache now	No/little need	77.7	18.5	4.5	0.954
	Borderline/need treatment	76.5	19.3	3.2
My child’s toothache keeps him/her from sleeping at night	No/little need	30.8	46.2	23.1	0.461
	Borderline/need treatment	37.2	33.0	29.8
My child’s toothache keeps him/her from playing	No/little need	34.6	50.0	15.4	0.051
	Borderline/need treatment	45.7	25.5	28.7
My child’s toothache keeps him/her from learning at school	No/little need	50.0	30.8	19.2	0.016*M
	Borderline/need treatment	77.7	11.7	10.6
My child is happy with his/her teeth	No/little need	61.5	30.8	7.7	0.454
	Borderline/need treatment	61.7	22.3	16.0
My child complains about his/her teeth	No/little need	23.1	26.9	50.0	0.580
	Borderline/need treatment	16.0	23.4	60.6

Notes:

¥ Chi-square test.

* P<0.05 (significant). Cronbach’s alpha for total sample =0.739.

Abbreviations: IOTN, index of orthodontic treatment need; M, Monte Carlo P; PGOHRQoL, parent/guardian’s oral health-related quality of life.

Table 3 IOTN by socio-demographic characteristics of the study children

Characteristics		Children, n (%)	No/little need, n (%)	Borderline need, n (%)	Need treatment, n (%)	P¥	ICC (95% CI)
All samples		120 (100)	26 (21.7)	31 (25.8)	63 (52.5)		0.41*** (0.25–0.55)
Age (years)	<13	53 (44.2)	13 (24.5)	18 (34.0)	22 (41.5)	0.083	0.36** (0.10–0.57)
	≥13	67 (55.8)	13 (19.4)	13 (19.4)	41 (61.2)		0.48*** (0.27–0.64)
Sex	Male	36 (30.0)	8 (22.2)	8 (22.2)	20 (55.6)	0.836	0.47** (0.17–0.69)
	Female	84 (70.0)	18 (21.4)	23 (27.4)	43 (51.2)		0.40*** (0.21–0.57)
PG education	Less than high school	31 (25.8)	6 (19.4)	5 (16.1)	20 (64.5)	0.456	0.36* (0.01–0.63)
	High school	50 (41.7)	12 (24.0)	16 (32.0)	22 (44.0)		0.43** (0.18–0.63)
	University or higher	39 (32.5)	8 (20.5)	10 (25.6)	21 (53.8)		0.41*** (0.11–0.64)
Family income	Low income	23 (19.2)	2 (8.7)	7 (30.4)	14 (60.9)	0.442	0.36^NS (−0.05–0.67)
	Medium income	63 (52.5)	15 (23.8)	14 (22.2)	34 (54.0)		0.44*** (0.21–0.62)
	High income	34 (28.3)	9 (26.5)	10 (29.4)	15 (44.1)		0.38* (0.05–0.63)

Notes:

¥ Chi-square test.

* P<0.05,

** P<0.01,

*** P<0.001. ICC by IOTN = no/little need = 0.26NS (−0.13 to 0.59), borderline need = 0.37* (0.02–0.64), need treatment = 0.47*** (0.26–0.64).

Abbreviations: CI, confidence interval; ICC, intra-class correlation coefficient of children and parent/guardian oral health-related quality of life; IOTN, index of orthodontic treatment need; NS, nonsignificant; PG, parent/guardian; n, number of patients.

Figure 1 Correlation of oral health impact reported by children and parent/guardians according to the index of orthodontic treatment need.

Abbreviation: PG, parent/guardian.

Table 4 Multiple logistic regression analysis of factors associated with oral health impact as reported by children and PG

Factors		% with impact	Unadjusted OR (95% CI)	P	Adjusted OR (95% CI)	P
Children
Age (years)	<13	52.8	1.9 (0.9–3.9)	0.089	1.8 (0.8–4.1)	0.151
	≥13	37.3
Sex	Male	44.4	1.0 (0.5–2.2)	0.968	1.3 (0.5–3.1)	0.573
	Female	44.0
Education	Below high school	45.2	1.5 (0.5–4.3)	0.432	2.2 (0.7–6.4)	0.159
	High school	50.0	1.8 (0.7–4.6)	0.183	2.5 (0.9–6.5)	0.065
	University/higher^®	35.9
Income	Low^®	30.4
	Medium	46.0	2.0 (0.6–6.1)	0.194	3.1 (1.0–9.6)	0.053
	High	50.0	2.3 (0.7–8.1)	0.142	3.7* (1.0–13.0)	0.044
IOTN	No need^®	30.8
	Borderline need	61.3	3.6* (1.0–12.6)	0.022	4.6* (1.4–15.0)	0.012
	Need	41.3	1.6 (0.5–4.7)	0.354	2.3 (0.8–6.7)	0.122
PG
Age (years)	<13	58.5	3.6* (1.7–7.6)	0.001	3.8* (1.6–8.9)	0.003
	≥13	28.4
Sex	Male	55.6	2.3* (1.0–5.0)	0.043	0.6 (0.2–1.5)	0.277
	Female	35.7
Education	Below high school	41.9	2.1 (0.7–6.5)	0.149	2.2 (0.7–6.7)	0.189
	High school	54.0	3.4* (1.3–9.4)	0.007	4.0* (1.4–11.3)	0.008
	University/higher^®	25.6
Income	Low^®	43.5
	Medium	39.7	0.9 (0.3–2.5)	0.751	1.0 (0.3–3.1)	0.974
	High	44.1	1.0 (0.3–3.4)	0.962	1.3 (0.4–4.8)	0.657
IOTN	No need^®	34.6
	Borderline need	51.6	2.0 (0.6–6.8)	0.198	2.3 (0.7–7.8)	0.183
	Need	39.7	1.2 (0.4–3.6)	0.655	2.0 (0.6–6.0)	0.241

Notes: Oral health impact was classified into <median (=3 for children and 18 for PG) coded as 0 and ≥median coded as 1. ^®Reference category.

* P<0.05 (significant). Pseudo R² for children model =0.137 with 65.8% correctly classified. Pseudo R² for PG model =0.231 with 67.5% correctly classified.

Abbreviations: CI, confidence interval; IOTN, index of orthodontic treatment need; OR, odds ratio; PG, parent/guardian.