Sex Differences in the Uptake of Orthodontic Services Among Adolescents

Misaligned teeth negatively impact an individual's life as regards mastication, speech, and most importantly one's appearance that involves psychological issues and subjective concerns of self-esteem. However, not all people who would benefit from orthodontic treatment actually obtain treatment. Objective: The purpose of this study was to test whether girls are treated orthodontically for milder occlusal issues than boys, thus accounting for the greater uptake of treatment among females. Methods: The DAI (Dental Aesthetic Index) was used to score the severity of esthetic occlusal issues in 357 adolescent American whites. Half the cases were from private practices; the others were from a university specialty training program in the Midsouth United States. Results: Average DAI was statistically significantly lower (milder) in girls than boys in both venues, thereby confirming the assumption that the actual uptake of services is greater in girls because of their heightened concern for esthetic occlusal issues. Average DAI scores predictably were higher in the teaching setting because of selection for more complex cases, but the sex difference still is evident statistically. There was no association between DAI and age at start of treatment among these adolescents. Spacing and incisor irregularity exhibited the greatest sex differences from among the battery of DAI variables, possibly because girls are most attuned to these esthetic issues. Conclusion: These results complement those that have recorded adolescents' perceptions of treatment need. The actual uptake of orthodontic treatment is greater in girls because they seek treatment for milder occlusal issues. Supported by the University of Tennessee Alumni Endowment for Research.