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Application of the dental aesthetic index in the prioritisation of orthodontic service needs.

OBJECTIVE
The provision of orthodontic treatment to patients in government funded training institutions is a major challenge due to constrained budget and resource allocation. The Dental Aesthetic Index (DAI) has been used to estimate orthodontic treatment need and as a screening tool to determine treatment priority. The DAI focuses on aesthetics and therefore omits other malocclusion traits that might require orthodontic treatment. The aim of the study was to compare the application of the DAI with the influence other malocclusion traits not included in the DAI might have on the determination of the prioritisation of orthodontic service need.


METHODS
Hundred-and-twenty pretreatment study models of orthodontic patients in the permanent dentition stage were selected from the archived records of the Department of Orthodontics, University of Limpopo, using a systematic sampling method. The study casts were assessed using the DAI. Other malocclusion traits not included in the DAI were also recorded. Descriptive statistics, the Pearson correlation coefficient, Chi-square values and t-tests were employed to analyse the data. P values less than or equal to 0,05 were considered statistically significant.


RESULTS
The mean DAI score was 35.2. Normal or minor malocclusion was found in 19.1% of the sample, whilst 17.5% had definitive malocclusion, 21.7% severe malocclusion, and 41.7% showed handicapping malocclusion. Other malocclusion traits not included in the DAI were identified and these traits accounted for 21.6% of all traits recorded in the study (DAI malocclusion traits accounted for 78.4%). Two thirds of other malocclusion traits were accounted for in categories which the DAI had already prioritised for treatment.


CONCLUSIONS
The study showed that the DAI can be used to prioritise orthodontic service needs and could be applied in government funded institutions.