Evaluation of the aesthetic component of the Index of Orthodontic Treatment Need by Swedish orthodontists

The aim of the present study was to evaluate if the majority of orthodontists in Sweden agree with the ranking of the photographs in the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN), and its treatment need classification. Ten separate colour photographs (originals from the AC) and two questionnaires were sent to 272 orthodontists in Sweden. Eighty-one per cent (219) returned one or both questionnaires. One hundred and ninety-four orthodontists answered the AC 'grading of dental attractiveness' and 217 the AC 'need for orthodontic treatment' (nine of the integrated questions had to be excluded because more than one alternative had been chosen). The aesthetic ranking by the orthodontists was compared with the original AC and the deviation was estimated. The results showed that the grading of photographs 2-9 varied greatly among the orthodontists, but the agreement was almost complete for photographs 1 and 10. The establishment of treatment need for each photograph had good agreement with the original index for photographs 1, 2, and 8-10, while the majority of the orthodontists considered that photographs 5 and 7 should be treated and that photograph 6 showed a borderline case. The participating Swedish orthodontists' aesthetic ranking of the photographs was: 1, 2, 3, 4, 6, 5, 7, 9, 8, and 10. Regarding treatment need, no need for treatment was set for photographs 1-4, borderline for photograph 6 and a need for treatment for photographs 5, 7-10. Further studies are needed to evaluate if laymen in Sweden make the same judgements as Swedish orthodontists.