Evaluation of relationship between orthodontic treatment need according Dental Aesthetic Index (DAI) and student’s perception in 11-14 year old students in the city of Shiraz in 2012


  • Shahla Momeni Danaee Full Professor, Orthodontic Research Center, Dental College, Shiraz University of Medical Sciences, Shiraz
  • Soleiman Fijan Pediatric Dentistry Assistant, Dental College, Rafsanjan University of Medical Sciences, Rafsanjan
  • Najmeh Mohammadi Pediatric Dentistry Assistant, Dental College, Shiraz University of Medical Sciences, Shiraz
  • Rojin Soleiman Zadeh Pediatric Dentistry Assistant, Dental College, Sanandaj University of Medical Sciences, Sanandaj


Treatment need, Orthodontic, Dental aesthetic index (DAI)


Background: Although the demand for orthodontic treatment is affected by understanding the needs for treatment and costs, patients’ concerns do not always match with expert’s assessments. To gain a clearer understanding of children’s orthodontic needs, treatment recommendations and how an abnormality can affect a child’s quality of life is critical. Information on the relationship between assessment of need for treatment and an individual’s perception of need for orthodontic treatment is of great interest for orthodontic service providers. The present study aimed to assess the relationship between need for orthodontic treatment according to Dental Aesthetic Index (DAI) and individuals’ perception of need for treatment in 11-14 year old students.

Methods: In this study, 240 primary and middle school students from the four educational districts of Shiraz were selected through multi-stage random sampling and completed the study questionnaire. Then dental examination was done by the dentist according to DAI index to determine the student’s need for orthodontic treatment.

Results: According to the results, 73.8% of the students had DAI score of13-25 (little or no need for treatment), 15.2% had DAI score of 25-30 (specific malocclusion with elective need for treatment), 4.4% had DAI score of 30-35 (severe malocclusion with extreme need for treatment), and 6.7% had DAI score exceeding 35 indicating their serious need for orthodontic treatment. The total mean score of DAI was 23.57.

Conclusion: The results revealed a significant relationship between the students’ perception of need for treatment and professional assessment of need for orthodontic treatment based on DAI index (P = 0.002).



Sheiham A, Tsakos G. Oral health needs assessment. In: Pine CM, Harris R, eds. Community Oral Health. 2nd ed. London: Quintessence; 2007: 59-79.

Gherunpong S, Tsakos G, Sheiham A. A socio-dental approach to assessing children's orthodontic needs. Eur J Orthod. 2006;28(4):393-9.

Stenvik A, Espeland L, Mathisen A. A longitudinal study on subjective and objective orthodontic treatment need. Eur J Orthod. 1997;19:85-92.

Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment: effects on compliance and prediction of patients’ adaptation by personality variables. Eur J Orthod. 2000;22:307-15.

Doll GM, Zentner A, Klages U, Sergl HG. Relationship between patient discomfort, appliance acceptance and compliance in orthodontic therapy. J Orofac Orthop. 2000;61:398-413.

Shaw WC, O’Brien KD, Richmond S. Quality control in orthodontics: factors influencing the receipt of orthodontic treatment. Br Dent J. 1991;19:66-8.

Sheats RD, McGorray SP, Keeling SD, Wheeler TT, King GJ. Occlusal traits and perception of orthodontic need in eighth grade students. Angle Orthod. 1998;68:107-14.

Tuominen ML, Nystro¨m M, Tuominen RJ. Subjective and objective orthodontic treatment need among orthodontically treated and untreated Finnish adolescents. Community Dent Oral Epidemiol. 1995;23:286-90.

Searcy VL, Chisick MC. Perceived, desired, and normatively determined orthodontic treatment needs in male US Army recruits. Community Dent Oral Epidemiol. 1994;22:437-40.

A. Christopherson E. Preadolescent orthodontic treatment need: objective and subjective provider assessments and patient self-report. Am J Orthod Dentofacial Orthop. 2009;135:S80-6.

A. Christopherson E. Objective, subjective, and self-assessment of preadolescent orthodontic treatment need - a function of age, gender, and ethnic/racial background? J Public Health Dent. 2009:69(1):9-17.

Oshagh M, Salehi P, Pakshir H, Bazyar L, Rakhshan V. Associations between normative and self-perceived orthodontic treatment needs in young-adult dental patients. Korean J Orthod. 2011;41(6):440-6.

Otuyemi OD, Ogunyinka A, Dosuma O, Cons NC, Jenny J. Malocclusion and Orthodontic treatment need of secondary school students in Nigeria according to dental aesthetic (DAI). Int Dent J. 1999;49(3):203-10.

Rashida E, Abdul Razak I, Allister JH. Epidemiology of malocclusion and orthodontic treatment need of 12 and 13 years old Malaysian school children. J Community Dent Health. 2001;18(1):31-6.

Cons NC, Jenny J, Kohout FJ, Jakobsen J, Shi Y, Ying WH, et al. Comparing ethnic group-specific DAI equations with the standard DAI. Int Dent J. 1994;44(2):153-8.

M.Danaei S, Amir Rad F, Salehi P. Orthodontic treatment need of 12-15-year-old students in Shiraz, Islamic Repubic of Iran. East Mediterr Health J. 2007;13(2):326-34.

Khane Masjedi M, Basir L, Haghighi Zadeh MH. Evaluation of relationship between orthodontic treatment need according dental aesthetic index (DAI) and Student’s Perception in 11-14 year old students in the city of Ahwaz in 2005. J Mashhad Dent School Mashhad Univ Med Sci. 2007;31:37-46.

Omid Khoda M, Morteza O, Shahla MD, Ladan Z. Orthodontic treatment need in 18-14 year old students in Shiraz. Shiraz Univ Dent J. 2009;10(2):136-43.

Takahashi F, Abe A, Isobe Y, Aizawa Y, Hanada N. Assessment of malocclusion of Japanese Junior high school pupils aged 12-13 years in Iwate prefecture according to the dental aesthetic index (DAI). Asia Pac J Public Health. 1995;8(2):81-4.

Brook PH, Shaw WC. The development of an index for orthodontic treatment priority. Eur J Orthod. 1989;11(4):309-32.

Baca-Garcia A, Bravo M, Baca P, Baca A, Junco P. Malocclusions and orthodontic treatment needs in a group of Spanish adolescents using the dental aesthetic index. Int Dent J. 2004;54(3):138-42.

Van Wyk PJ, Drunnond RJ. Orthodontic Status and treatment need of 12 years old children in South Africa using the dental aesthetic index. SADJ 2005; 334-8.

Onyenso CO, Aderinokun GA. The relationship between dental aesthetic index (DAI) and perception of aesthetic, function and speech amongst secondary school children in Ibadan, Nigeria. Int J Paediatr Dent. 2003;13(5):336-41.

Proffit WR, Fields HW. Orthodontic treatment. In: Proffit WR, Fields HW, eds. Contemporary Orthodntics. 3th ed. St. Louis: The CV Mosby Co 2000: 15.

Shaw WC. The influence of children’s dentofacial appearance on their social attractiveness as judged by peers and lay adults. Am J Orthod. 1981;79(3):399-415.

Shaw WC, Ress G, Dawe M, Charles CR. The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod. 1985;87(1):21-6.

Marques LS, Barbosa CC, Ramos-Jorge ML. Malocclusion prevalence and orthodontic treatment need in 10-14-year-old schoolchildren in Belo Harizonte, Minas Gerais State. Cad Saude Publica. 2005;21(4):1096-9.

Asgari I, Ahmady AE, Yadegarfar G, Eslamipour F. Evaluation of the patient based indices for orthodontic need assessment in the 13 to 18 year-old adolescents in Isfahan. J Dent Med-Tehran Univ Med Sci. 2012;25(2):124-34.

Kerosuo H, Al Enezi S, Kerosuo E, Abdulkarim E. Association between normative and self-perceived orthodontic treatment need among Arab high school students. Am J Orthod Dentofacial Orthop. 2004;125(3):373-8.

Mtaya M, Astrom AN, Brudvik P. Malocclusion, Psychosocial impacts and treatment need: a cross-section study of Tanzanian primary school children. BMC Oral Health. 2008;8:14.

F. Dias P, Gleiser R. Orthodontic concerns of Brazilian children and their parents compared to the normative treatment need. J Oral Sci. 2010;25(1):101-7.




How to Cite

Danaee, S. M., Fijan, S., Mohammadi, N., & Zadeh, R. S. (2017). Evaluation of relationship between orthodontic treatment need according Dental Aesthetic Index (DAI) and student’s perception in 11-14 year old students in the city of Shiraz in 2012. International Journal of Research in Medical Sciences, 3(5), 1056–1060. Retrieved from https://msjonline.org/index.php/ijrms/article/view/1442



Original Research Articles