Orthodontic treatment attitude versus orthodontic treatment need: differences by gender, age, socioeconomical status and geographical context

Objectives: To investigate the relationship between the attitude towards orthodontic treatment and the objective level of orthodontic need, and variables like gender, socioeconomic status and geographical context, among 6- to 16-year-old children. Methods: The attitude of 2284 Italian children towards orthodontics was assessed using the Child Orthodontic Attitude Survey (COAS) questionnaire, previously validated for Italian-speaking children. The level of orthodontic need was evaluated by using the Risk of Malocclusion Assessment (ROMA) Index while socioeconomic status (SES) was based on parental job activities. The univariate analysis was performed using chi-square tests to find differences between groups for categorical variables, while multivariate analyses were conducted using logistic regression models. Results: Individuals with a higher SES had a statistically significant lower need of orthodontic treatment (P = 0.003). Children with a very high SES were from northern (20.8%) and central Italy (65.9%), while only 13.3% lived in southern Italy (P < 0.001). Logistic regression showed that females, older children, in-treatment subjects and children from the region of Puglia were more likely to have orthodontics (OR = 2.09; 95% CI: 1.66-2.64, OR = 1.08; 95% CI: 1.01-1.15, OR = 1.48, 95% CI: 1.11-1.97, OR = 1.43; 95% CI: 1.05-1.95, respectively). Conclusions: The orthodontic treatment attitude largely depends on age, gender and geographical context but is not influenced by the real level of orthodontic therapy need.