Comparing a quality of life measure and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in assessing orthodontic treatment need and concern.

Objective: To compare the use of the Aesthetic Component (AC) of IOTN and the Child Perceptions Questionnaire (CPQ) in assessing orthodontic treatment need and concern.

Methods: Cross-sectional observational study. Methods: The subjects were 204 children aged 10-12 years studying in 10 schools in Bristol, UK. They completed a questionnaire comprising the CPQ and questions regarding orthodontic concern. AC scores as rated by the child and by the calibrated examiner were recorded. Methods: CPQ scores were calculated from the responses in the questionnaire. AC scores and responses to questions regarding orthodontic concern were recorded.

Results: The children gave themselves lower AC scores compared to the examiner (p<0.001). The only section of the CPQ that correlated significantly with Examiner AC was the emotional impacts section (rho=0.151). CPQ scores had a slightly higher correlation with self-perceived AC than Examiner AC. However, the correlations were still very low. The emotional impacts section of CPQ (rho=0.332) and overall CPQ score (rho=0.282) were better than the examiner AC (rho=0.209) at reflecting how bothered the children were by the alignment of their teeth, and how upset they would be if they couldn't receive orthodontic treatment (rho=0.464, 0.428 and 0.214, respectively). Children with a normative need for orthodontic treatment, based on examiner AC did not have a worse oral health-related quality of life.

Conclusions: The CPQ and IOTN AC measure different attributes. There should be a shift towards using quality of life measures to supplement the IOTN in assessing the perceived need for orthodontic treatment.