The socio-demographic and malocclusion characteristics of adolescents presenting for specialist orthodontic treatment in New Zealand practices


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Australasian Orthodontic Journal

Australian Society of Orthodontists

Subject: Dentistry, Orthodontics & Medicine


ISSN: 2207-7472
eISSN: 2207-7480





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VOLUME 31 , ISSUE 1 (May 2015) > List of articles

The socio-demographic and malocclusion characteristics of adolescents presenting for specialist orthodontic treatment in New Zealand practices

David L. Healey / Robin D. Gauld / W. Murray Thomson *

Citation Information : Australasian Orthodontic Journal. Volume 31, Issue 1, Pages 20-25, DOI:

License : (CC BY 4.0)

Published Online: 15-August-2021



Background: There are few reports of the socio-demographic and malocclusion characteristics of those undergoing clinical orthodontic treatment in private specialist practice.

Aim: To describe the pretreatment characteristics of individuals presenting for orthodontic treatment.

Methods: Individuals (N = 174) presenting for orthodontic treatment in 19 private specialist orthodontic practices in New Zealand were randomly selected and examined (at the beginning of a three-year prospective study) and their malocclusions compared using the Dental Aesthetic Index (DAI).

Results: The mean DAI score was 35.8 (SD 8.4). There were no statistically significant socio-demographic differences in DAI score other than by household-based socio-economic status (SES), whereby mean scores were considerably higher in those of low SES. The majority of patients attending for treatment had severe or very severe/handicapping malocclusions. Females had less severe malocclusions than males, on average, although the difference was not statistically significant.

Conclusions: The malocclusion severity threshold for seeking orthodontic treatment appears to be higher in those of lower SES. The study findings highlight the need to improve access to orthodontic treatment for this group.

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1. Chew MT, Sandham A. Effectiveness and duration of two-arch fixed appliance treatment. Aust Orthod J 2000;16:98-103.

2. Locker D. Deprivation and oral health: a review. Community Dent Oral Epidemiol 2000;28:161-9.

3. Thomson WM, Ayers KMS, Broughton JR. Child oral health inequalities in New Zealand. A background paper to the National Health Committee. Wellington: 2003.

4. Do LG, Spencer AJ, Slade GD, Ha DH, Roberts-Thomson KF, Liu P. Trend of income-related inequality of child oral health in Australia. J Dent Res 2010;89:959-64.

5. Thomson WM. Social inequality in oral health. Community Dent Oral Epidemiol 2012;40 Suppl 2:28-32.

6. Drugan CS, Hamilton S, Naqvi H, Boyles JR. Inequality in uptake of orthodontic services. Br Dent J 2007;202:E15; discussion 326-7.

7. Proffit WR, Fields HW Jr, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 1998;13:97-106.

8. Foster Page LA, Thomson WM. Malocclusion and uptake of orthodontic treatment in Taranaki 12-13-year-olds. NZ Dent J 2005;101:98-105.

9. Brown DF, Spencer AJ, Tolliday PD. Social and psychological factors associated with adolescents’ self-acceptance of occlusal condition. Community Dent Oral Epidemiol 1987;15:70-3.

10. Thomson WM. Orthodontic treatment outcomes in the long term: findings from a longitudinal study of New Zealanders. Angle Orthod 2002;72:449-55.

11. Harris EF, Glassell BE. Sex differences in the uptake of orthodontic services among adolescents in the United States. Am J Orthod Dentofacial Orthop 2011;140:543-9.

12. Chen M, Wang DW, Wu LP. Fixed orthodontic appliance therapy and its impact on oral health-related quality of life in Chinese patients. Angle Orthod 2010;80:49-53.

13. Badran SA, Al-Khateeb S. Factors influencing the uptake of orthodontic treatment. J Public Health Dent 2013;73:339-44.

14. Statistics New Zealand. New Zealand Census of Population and Dwellings 2006. Wellington: Statistics New Zealand, 2006.

15. Davis P, McLeod K, Ransom M, Ongley P, Pearce N, HowdenChapman P. The New Zealand Socioeconomic Index: developing and validating an occupationally-derived indicator of socio-economic status. Aust N Z J Public Health 1999;23:27-33.

16. Salmond C, Crampton P, King P, Waldegrave C. NZiDep: A New Zealand index of socioeconomic deprivation for individuals. Soc Sci Med 2006;62:1474-85.

17. Cons NC, Jenny J, Kohout FJ. DAI: The Dental Aesthetic Index. Iowa City: College of Dentistry, The University of Iowa, 1986.

18. Estioko LJ, Wright FA, Morgan MV. Orthodontic treatment need of secondary schoolchildren in Heidelberg, Victoria: an epidemiologic study using the Dental Aesthetic Index. Community Dent Health 1994;11:147-51.

19. Thilander B, Myrberg N. The prevalence of malocclusion in Swedish schoolchildren. Scand J Dent Res 1973;81:12-21.

20. O’Brien K, McComb JL, Fox N, Wright J. Factors influencing the uptake of orthodontic treatment. Br J Orthod 1996;23:331-4.

21. Thilander B, Pena L, Infante C, Parada SS, de Mayorga C. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Euro J Orthod 2001;23:153-67.

22. Locker D. Disparities in oral health-related quality of life in a population of Canadian children. Community Dent Oral Epidemiol 2007;35:348-56.

23. Agou S, Locker D, Streiner DL, Tompson B. Impact of self-esteem on the oral-health-related quality of life of children with malocclusion. Am J Orthod Dentofacial Orthop 2008;134:484-9.

24. Plunkett DJ. The provision of orthodontic treatment: some ethical considerations. N Z Dent J 1997;93:17-20.

25. Albino JE, Cunat JJ, Fox RN, Lewis EA, Slakter MJ, Tedesco LA. Variables discriminating individuals who seek orthodontic treatment. J Dent Res 1981;60:1661-7.

26. Moananui RT, Kieser JA, Herbison P, Liversidge HM. Advanced dental maturation in New Zealand Maori and Pacific Island children. Am J Hum Biol 2008;20:43-50.

27. Johnson M, Harkness M. Prevalence of malocclusion and orthodontic treatment need in 10-year-old New Zealand children. Aust Orthod J 2000;16:1-8.

28. Chi J, Johnson M, Harkness M. Age changes in orthodontic treatment need: a longitudinal study of 10- and 13-year-old children, using the Dental Aesthetic Index. Aust Orthod J 2000;16:150-6.

29. Thomson WM, Mackay TD. Child dental caries patterns described using a combination of area-based and household-based socioeconomic status measures. Community Dent Health 2004;21:285-90.

30. Thomson WM, Poulton R, Milne BJ, Caspi A, Broughton JR, Ayers KM. Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dent Oral Epidemiol 2004;32:345-53.

31. Germa A, Kaminski M, Nabet C. Impact of social and economic characteristics on orthodontic treatment among children and teenagers in France. Community Dent Oral Epidemiol 2010;38:171-9.

32. Burden DJ. The influence of social class, gender, and peers on the uptake of orthodontic treatment. Eur J Orthod 1995;17:199-203.

33. Breistein B, Burden DJ. Equity and orthodontic treatment: a study among adolescents in Northern Ireland. Am J Orthod Dentofacial Orthop 1998;113:408-13.

34. Scapini A, Feldens CA, Ardenghi TM, Kramer PF. Malocclusion impacts adolescents’ oral health-related quality of life. Angle Orthod 2013;83:512-8.

35. Foster Page LA, Thomson WM, Ukra A, Baker SR. Clinical status in adolescents: is its impact on oral health-related quality of life influenced by psychological characteristics? Eur J Oral Sci 2013;121:182-7.