How is orthodontic treatment need associated with perceived esthetic impact of malocclusion in adolescents?

The purpose of this research was to evaluate the esthetic impact of orthodontic treatment need in adolescents. This cross-sectional study was performed with 1172 adolescents aged 12 (n = 638) years and 15 (n = 534) years from Salvador, Bahia, Brazil. The esthetic impact was the following outcome variables: Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale. The normative orthodontic treatment need was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and by the Dental Aesthetic Index (DAI). Logistic regression models were adjusted, estimating crude odds ratio with the respective 95% confidence intervals. The variables with P ≤0.20 in the individual analyses were tested in multiple logistic regression models, remaining the variables with P ≤0.05. The results showed a statistically significant association for the esthetic impact (Aesthetic Component of the Index of Orthodontic Treatment Need and the Oral Aesthetic Subjective Impact Scale) when assessing the normative orthodontic treatment need by the DAI (P 0.05). DAI was more associated with the adolescents' esthetic concern than IOTN-DHC and should be the Index of Orthodontic Treatment Need to be selected to complement the patient's self-perception. •Normative orthodontic treatment need was assessed by the Dental Health Component of the Index of Orthodontic Treatment Need and by the Dental Aesthetic Index.•The subjects were adolescents (n = 1172), aged either 12 or 15 years.•Dental Aesthetic Index was better associated with adolescents' esthetic concerns than Dental Health Component of the Index of Orthodontic Treatment Need.