Orthodontic Treatment Need Assessed Using the Index of Orthodontic Treatment Need (IOTN) in 1,155 Children Aged 3–7 Years
Keywords:
IOTN; orthodontic treatment need; early orthodontic assessmentAbstract
Background: Early identification of malocclusion can help prioritize orthodontic assessment and care. However, population-based evidence on orthodontic treatment need in young children remains limited.
Objective: To describe orthodontic treatment need, assessed using the dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN), in children aged 3–7 years and examine its distribution by age, sex, and dentition stage.
Methods: In this cross-sectional survey, 1,155 children aged 3–7 years were selected through two-stage random sampling and examined by an orthodontist. Treatment need was classified using the IOTN-DHC. Grade 1 was categorized as no treatment need, and grades 2–5 as increasing levels of need. Analyses included descriptive statistics, 95% confidence intervals (CIs), odds ratios (ORs), and chi-square tests.
Results: Overall, 837 children (72.5%) were classified as grade 1, while 318 (27.5%; 95% CI 25.0–30.2) were classified in grades 2–5. Grade 2 was the most frequent category (220; 19.0%), followed by grade 3 (55; 4.8%), grade 5 (28; 2.4%), and grade 4 (15; 1.3%). Treatment need was observed in 30.1% of children aged 3–5 years and 26.2% of those aged 6–7 years (OR 1.21; 95% CI 0.92–1.58; p = 0.17), and in 26.6% of girls and 28.4% of boys (OR 1.10; 95% CI 0.85–1.42; p = 0.48). Grades 3–5 were more frequent in children aged 3–5 years than in those aged 6–7 years (12.9% vs 6.3%; p < 0.001).
Conclusion: Approximately one in four children met the study definition of orthodontic treatment need, although grades 3–5 accounted for 8.5% of the sample. These findings support early assessment and appropriate referral, with treatment decisions individualized according to occlusal severity, function, and dental development.
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