Sex differences in esthetic treatment needs in American Black and White adolescent orthodontic patients

Abstract

Objective: To test whether the severity of malocclusions in adolescents who actually entered orthodontic treatment is different between the sexes, as this might explain the preponderance of girls in orthodontic practices. Materials and Methods: Severity was gauged with the 10-grade esthetic component of the Index of Orthodontic Treatment Need (IOTN) scored on the pretreatment intraoral photographs (n 5 562) in a university-based specialty program. The samples of American White (n 5 401) and American Black (n 5 161) adolescents were free of craniofacial defects. Nonparametric statistics were used for analysis. Results: There is a significant sex difference in the IOTN in White teenagers due to milder, more esthetic cases among the girls. No sex difference occurs in the sample of Blacks, with both sexes having IOTN scores on a par with White males. The severity of malocclusion is independent of the age at start of treatment (within range of 12 to 19 years). Conclusions: Greater subjective self-perceptions of occlusal issues seem to account for the preponderance of White girls in the patient pool, though why the sex difference is not evident in American Blacks is complex. We speculate that sex differences are larger in private practices, since there are fewer selection criteria for entering treatment. © 2011 by The EH Angle Education and Research Foundation, Inc.