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A qualitative study of the influence of poor dental aesthetics on the lives of young adults
Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
Högskolan i Halmstad.
2010 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 1, p. 19-26Article in journal (Refereed) Published
Abstract [en]

Objective: Although many countries offer some publicly funded orthodontic treatment for children, not all conditions receive treatment and some adolescents enter adulthood with persisting poor dental aesthetics or malocclusions. The aim of this study was to generate a theory highlighting the main concerns of young adults, either native-born or of immigrant background, with poor dental aesthetics and the measures they adopt to manage their condition in everyday life.

Material and methods: A qualitative method, classic grounded theory, was applied in order to generate a substantive theory highlighting the main concerns and managing mechanisms of 13 strategically selected 19- and 20-year-olds with poor dental aesthetics. Open interviews were conducted with each participant, the topics covering different aspects of social and dental conditions.

Results: A core category and three conceptual categories were generated. The core category was labelled "Being under the pressure of social norms" and was related to categories explaining three different ways in which these young adults handle their main concern: (1) avoiding showing their teeth; (2) minimizing the importance of appearance; and (3) seeking orthodontic treatment. The theory offers the potential for improved understanding of young adults who, despite poor dental aesthetics, are managing well with life, and also of those who have not adjusted well.

Conclusions: In early adolescence it may be problematic to make decisions about orthodontic treatment. Undisclosed dental fear can be an important barrier. Some of the young adults in the present study would probably benefit from treatment.

Place, publisher, year, edition, pages
2010. Vol. 68, no 1, p. 19-26
Keywords [en]
Dental aesthetics, Importance of appearance, Orthodontic therapy in adolescence, Social norms
National Category
Dentistry
Identifiers
URN: urn:nbn:se:hj:diva-11832DOI: 10.3109/00016350903281740ISI: 000274406500003PubMedID: 20001640OAI: oai:DiVA.org:hj-11832DiVA, id: diva2:305973
Available from: 2010-03-26 Created: 2010-03-26 Last updated: 2021-04-01Bibliographically approved
In thesis
1. Immigrant background and orthodontic treatment need: Quantitative and qualitative studies in Swedish adolescents
Open this publication in new window or tab >>Immigrant background and orthodontic treatment need: Quantitative and qualitative studies in Swedish adolescents
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During the last three decades there has been an increased influx of refugees and immigrants into Scandinavia. The overall aim of this thesis was primarily to improve our knowledge of malocclusion and orthodontic treatment need, both normative and self-perceived, in adolescents of varying geographic origin. A further aim was to determine whether any differences with respect to perception of general appearance and psychosocial well-being were related to geographic origin.

Papers I and II concerned self perceived and normative orthodontic treatment need. About 500 12-13 year-old subjects, stratified into different groups: A-Sweden, B-Eastern/Southeastern Europe, C-Asia and D-other countries, answered a questionnaire and underwent clinical examination by the author. In paper III the association between the two variables in papers I and II was investigated. Paper IV was a follow up study, at 18-19 years of age, of the relationship between geographic origin and prevalence of malocclusion, self-perceived treatment need, temporomandibular symptoms and psychosocial wellbeing. In Paper V a qualitative study of 19-20 year old subjects was conducted, to identify the strategies they had adopted to handle the issue of persisting poor dental aesthetics.

The main findings were that at 12-13 years of age, immigrant subjects had a lower perceived orthodontic treatment need than subjects of Swedish background. Girls of Swedish background had the highest self perceived treatment need, whilst girls of non-Swedish background were most concerned that fixed appliance therapy would be painful. In a few of the clinical variables measured at 12-13 years of age, the Swedish group exhibited the greatest space deficiency and irregularity in both the maxillary and mandibular anterior segments and greater overjet, compared to the Eastern/Southeastern European and Asian groups. The clinical implications were negligible. The orthodontic treatment need according to “Index of Orthodontic Treatment Need - Dental HealthComponent” (IOTN-DHC) grades 4 and 5, ranged from 30 to 40 percent, without any inter-group differences. There were strong associations between subjects perceiving a need for orthodontic treatment and 6IOTN-DHC grades 4 and 5, anterior crossbite and avoiding smiling because they were self-conscious about their teeth. At the age of 18-19 years, the frequency of malocclusion was similar in all groups. Subjects of Asian origin had a higher self-perceived orthodontic treatment need than their Swedish counterparts and a higher frequency of headache than those of Eastern/Southeastern European origin. Psychological wellbeing was reduced in nearly one quarter of the sample, more frequently in girls than boys. No association was found between self-perceived orthodontic treatment need and psychological wellbeing.

The theory “Being under the pressure of social norms” was generated in Paper V, and it can be applied to improve our understanding of young adults who have adjusted to living with poor dental aesthetics and also aid to identify those who are not as well-adjusted and would probably benefit from treatment. Undisclosed dental fear is an important barrier to acceptance of orthodontic treatment in early adolescence. Despite demographic changes due to immigration, no major change in the prevalence of malocclusion and normative orthodontic treatment need has been disclosed. This does not apply to adolescents and adults who immigrated at an older age.

Place, publisher, year, edition, pages
Jönköping: Hälsohögskolan, 2010. p. 83
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 10
Keywords
Orthodontic treatment need, adolescents, immigrant background, self-perceived need, malocclusion, poor dental aesthetics, social norms
National Category
Dentistry
Identifiers
urn:nbn:se:hj:diva-13141 (URN)978-91-85835-09-6 (ISBN)
Public defence
2010-09-10, Forum Humanum, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-08 Created: 2010-09-16 Last updated: 2013-04-08Bibliographically approved

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