Judith E. Albino

A dental-facial attractiveness scale

Since the decision to seek orthodontic treatment is frequently the result of concerns about appearance, assessment of need for treatment should include an impartial evaluation of dental-facial appearance. While some of the standardized techniques for assessing malocclusion have included a consideration of esthetic impairment, they tend to confound this with functional impairment. The purpose of this study was to develop a valid and reliable index that provides relatively objective judgments of dental-facial attractiveness. The subjects in this study were eighth- and ninth-grade children seeking orthodontic treatment and their siblings, and eighth- and ninth-grade children not seeking treatment and their siblings. Photographs of the children were rated for dental-facial attractiveness by lay and dental judges. Children were also assessed for severity of malocclusion by means of the Treatment Priority index. Children seeking treatment were perceived as significantly less attractive than children not seeking treatment. Dental judges rated children seeking treatment as more attractive than did nondental judges. Intraclass reliability coefficients were moderate to high.

Variables Discriminating Individuals who Seek Orthodontic Treatment

Characteristics differentiating two groups of adolescents were identified: those planning orthodontic treatment and a comparison group not planning treatment. Two separate analyses, for psychosocial and dental-related variables, were completed. Additional analyses were applied using salient variables for each group. Eighty-two percent of the subjects were correctly categorized using the resulting discriminant function.

A dental-facial attractiveness scale: Part II. Consistency of perception☆

A previous report describes the reliability and validity of a scale designed to assess perceptions of dental-facial attractiveness, independent of occlusal function. The purpose of the present study was to assess the consistency of judgments of dental-facial attractiveness (DFA) for sex and race differences in photographed children. Using a five-pont DFA scale, twelve college freshmen (three black females, three black males, three white females, three white males) rated ninety-six photographs of the mouths and jaws of 13- to 14-year-old children (twenty-four black females, twenty-four black males, twenty-four white females, twenty-four white males). No significant mean differences were found between the black and white photographed or between the female and male children photographed. However, means were significantly different for DFA judgments by race and sex of the raters. Black raters judged all photographs to be more attractive than did white raters, and female raters judged all photographs to be more attractive than did male raters. Correlational data are presented describing consistency of perception within rater groups and photographed groups of children.

Reliability and stability of the orthodontic Patient Cooperation Scale.

Patient cooperation is recognized as an important factor in the outcome of orthodontic treatment. In order to predict patient cooperation, there have been numerous studies which have examined its correlates in orthodontic treatment. However, few, if any, of these studies have considered the reliability or stability of their patient cooperation measures. Hence, the correlates found or not found are suspect. The present article reports on the internal consistency and stability of the Orthodontic Patient Cooperation Scale (OPCS). Using the responses of practicing orthodontists, a list was generated of ten patient behaviors frequently considered in evaluating a patients cooperation. Subjects were eighth- and ninth-grade students undergoing orthodontic treatment, who were rated by their own orthodontists after 2 months and 6 months of treatment. The internal consistency for the scale was estimated to be 0.71 (N = 44) at 2 months and 0.80 (N = 45) at 6 months. The correlation between scores at 2 months and at 6 months was 0.58 (N = 44), which may be considered to be a conservative estimate of the long-term stability of the scale. In summary, the OPCS has adequate internal consistency and reasonably stable scores over a 4-month period. As such, it should prove useful in studies looking for predictors of patient cooperation and in studies examining the relationship of patient cooperation and outcome of treatment.

Reliability and validity of clinical assessments of malocclusion

The purpose of this research was to determine the reliability and validity of selected clinical judgments of malocclusion, including general evaluations of occlusal status and more specific aspects of dentofacial malrelations. Study casts of twenty-one adolescents planning orthodontic treatment and twenty-nine not planning treatment were examined and rated. The examiners were five dentists in an orthodontic specialty-training program. They completed ratings on six dimensions: (1) need for treatment, (2) degree of malocclusion, (3) potential for tissue loss, (4) negative effect on occlusal stability, (5) negative effect on dental-facial attractiveness, and (6) negative effect on masticatory function. Six weeks later the same five rates scored the fifty casts, using the standardized Treatment Priority Index (TPI). Three weeks later, or 9 weeks after the initial ratings, the casts were again rated on the two general dimensions: need for treatment and degree of malocclusion. Correlations among all the measures were examined. Inter-rater reliability was highest for the ratings of impact on dental-facial attractiveness (r = 0.88). The two general assessments also yielded relatively high rater reliabilities, and the second rating yielded stability coefficients of 0.84 for both of these ratings. Correlations with total TPI scores were 0.70 for the dental-facial attractiveness measure and 0.65 and 0.64, respectively, for assessments of need for treatment and degree of malocclusion. The data indicate that clinical evaluations of the severity of malocclusions are comparable to objective measures in terms of inter-rater reliability. Clinical evaluations are also relatively stable over time. Correlations with the TPI scores also provide evidence of the concurrent validity of clinical judgments.

Examiner reliability for two methods of assessing malocclusion.

Abstract No Abstract Available. This research was supported in part by NIH-NIDR-NOI-DE-72499. An earlier version of the report was presented at the March 1978 meeting of the International Association for Dental Research.

Validity of an orthodontic treatment priority index to measure need for treatment.

In establishing the validity of an index for identifying individuals needing orthodontic treatment, we must concern ourselves with the construct validity of the measure. Since it is clear that the relevant theory concerning need for treatment must include esthetics and the accompanying social and psychological characteristics, the construct validation of an index to measure need for treatment must include tests of hypotheses with these dimensions. If we consider a childs self-perception of occlusion as a psychological variable and another persons perception of a childs occlusion as a social variable, theory relevant to an index of need for treatment would hypothesize that each should correlate positively with need for treatment. Subjects were eighth and ninth grade students from a metropolitan area in western New York State. Fifty-two of the children were planning to obtain orthodontic treatment, and 102 were not. Data were also obtained, whenever possible, from both parents and from a sibling (if any) nearest in age to the child. Data were collected in one session by a trained interviewer who used a structured interview and also photographed the childs teeth and jaws. In addition, the child was given an orthodontic Treatment Priority Index (TPI) examination by a dentist enrolled in a graduate program in orthodontics, who had previously been trained and standardized in the use of the TPI. In addition, to the TPI, scores obtained included three psychological measures and eight social measures. Each of the psychological and social variables correlated significantly with TPI at the 0.05 level, with values ranging from 0.21 to 0.54 and a median value of 0.42. On the basis of these correlations, evidence is presented for the construct validity of the TPI when measuring need for treatment.