Perceptions of dental aesthetics of Class III and anterior open bite malocclusions: a comparison between 10- to 11-year-old schoolchildren and orthodontists

Angle Orthod. 2012 Mar;82(2):202-8. doi: 10.2319/053111-359.1. Epub 2011 Aug 23.


Objective: To compare perceptions of dental aesthetics of Class III and anterior open bite (AOB) malocclusions between 10- to 11-year-old Birmingham schoolchildren and orthodontists.

Materials and methods: Thirty-one orthodontists practicing in Birmingham (UK) and 383 school children aged 10-11 years from a random and representative sample of seven primary schools in South Birmingham participated in the study. Participants were asked to assess five anterior photographs of the dentition representing varying degrees of aesthetic impairment of Class III and AOB malocclusions. Perceptions of dental aesthetics were determined using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN).

Results: Perceptions of dental aesthetics were similar among males and females (P > .05). Both groups allocated the highest median AC score to the photo representing severe Class III malocclusion and the lowest to the photo representing mild Class III and AOB malocclusion. Differences in perceived dental aesthetics were significant for photos representing severe Class III and moderate AOB malocclusions, with orthodontists perceiving greater aesthetic impairment for severe Class III and schoolchildren for moderate AOB, respectively (P < .05).

Conclusions: Schoolchildren and orthodontists perceived Class III malocclusions to have greater aesthetic impairment compared to AOB malocclusions. Surprisingly, none of the median AC scores allocated to the five photos were in the "Definite need" for treatment category. The IOTN may not be sensitive to these types of malocclusions. This finding merits further investigation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Attitude to Health*
  • Child
  • Esthetics, Dental*
  • Female
  • Humans
  • Index of Orthodontic Treatment Need
  • Male
  • Malocclusion, Angle Class III / psychology*
  • Open Bite / psychology*
  • Orthodontics*