>Magister Scientiae - MSc / Background In the Western-Cape province, orthodontic treatment provided to government patients is limited to tertiary hospitals such as the Tygerberg Oral Health Centre (TOHC). This results in growing waiting lists which place a huge strain on resources of the facility. Objectives To determine: 1. The prevalence of malocclusion among 7-to-10-year-old children examined at dental clinics within the Tygerberg sub-district. 2. The types of malocclusion they present with. 3. Which of these malocclusions can be treated with interceptive orthodontic treatment. Methods An analytical, descriptive, cross-sectional study was carried out and quantitative methods were used to achieve the aim and objectives. The study sample consisted of 100 children, 46 male and 54 female, from Bellville and Bishop Lavis dental clinics. Dental examinations were done by one examiner on children between the ages of 7 and 10 years. Dental problems were identified which, if left untreated, could result in the need for more complex orthodontic treatment at a later stage. All the necessary ethical clearance was obtained. Results The results showed that there is a very large interceptive orthodontic treatment need (79%) at these clinics. A large proportion (70%) presented with detrimental habits. Thumbsucking was more prevalent among girls than boys. Other problems like mouthbreathing, lip wedging, deep bite, asymmetrical mobility of primary teeth, rotated lateral incisors and crossbites were found. The biggest concern was that 71% of the children had early loss of primary teeth and only 5% of children received restorations, resulting in a high prevalence of unfavourable molar relationships. All of these should be addressed early, thereby preventing the development of complex orthodontic problems or skeletal discrepancies. iv Conclusion Interceptive and preventive orthodontic treatment should be regarded as a primary health centre service, as it may reduce the need for costly fixed orthodontic treatment. The study showed that urgent intervention is necessary from the Department of Health to address this issue.

Les anomalies de croissance maxillo-faciale résultent de variations du processus normal de croissance. Après les caries, elles représentent les problèmes bucco-dentaires les plus fréquents chez les jeunes et peuvent entraîner des troubles fonctionnels (mastication, phonation, respiration), esthétiques et parfois psychologiques. Le traitement orthodontique vise à corriger les anomalies de croissance maxillo-faciale. L’objectif de cette thèse est de rechercher des facteurs de risque précoces d’anomalies de croissance maxillo-faciale et d’étudier le rôle des facteurs socio-économiques, culturels et géographiques de l’accès au traitement orthodontique en France. Les enfants de la cohorte EPIPAGE, qui avait inclus toutes les naissances survenues entre 22 et 32 semaines d’aménorrhée dans neuf régions françaises en 1997, ont été examinés à 5 ans. Nous avons étudié les relations entre les caractéristiques néonatales et la déformation du palais à 5 ans chez 1711 enfants. Le sexe masculin, le petit âge gestationnel, le petit poids pour l’âge gestationnel et peut-être l’intubation de longue durée sont identifiés comme des facteurs de risque de déformation du palais à 5 ans chez les grands prématurés ; de plus, les enfants avec des déficiences neuro-motrices semblent particulièrement à risque. La cohorte mère-enfant EDEN, a inclus des femmes enceintes en 2002-2003 et leur enfant à la naissance. Nous avons recherché les facteurs de risque précoces de l’occlusion postérieure inversée et de la béance antérieure chez 422 enfants de 3 ans. En plus d’une tétine encore utilisée à 3 ans et de la respiration buccale qui sont des facteurs connus, un nouveau facteur de risque d’occlusion postérieure inversée en denture temporaire est mis en évidence : la prématurité. Enfin, l’étude chez les 5988 enfants et les adolescents de l’enquête sur la santé et la consommation de soins en France réalisée par l’Insee en 2002-2003, enquête transversale sur échantillon représentatif de la population vivant en France, montre que 23% des 12-15 ans ont un traitement orthodontique. En plus du facteur économique, le moindre recours au traitement orthodontique est aussi lié à l’environnement social et culturel moins favorisé de l’enfant, à l’absence de couverture complémentaire et à l’habitation en zone rurale.En conclusion, pour mieux comprendre les inégalités dans le traitement orthodontique, il faudrait en évaluer les besoins en amont. Nous avons étudié des facteurs liés à la présence d’anomalies de croissance maxillo-faciale à des âges très jeunes afin de pouvoir identifier tôt des enfants à risque de ces anomalies. Il est nécessaire de vérifier leur évolution pour savoir si elles sont de réels marqueurs précoces de besoin en traitement orthodontique. / Malocclusions are due to variations of normal process of growth. Besides caries, they are the most common oral problems encountered by children and teenagers. They may lead to oral dysfunction (in chewing, speaking and breathing), esthetic and sometimes psychological issues. Orthodontic treatment aims at correcting malocclusions.The purpose of this thesis is to investigate early risk factors for malocclusions and to analyze the role of socioeconomic, cultural and geographic factors in access to orthodontic treatment in France. In the EPIPAGE cohort study, which included all live births between 22 and 32 weeks of gestation in 9 French regions in 1997, 1711 children were examined at 5 years. We explored the relations between neonatal characteristics and alteration of palatal morphology at 5 years. Male sex, low gestational age, small for gestational age and maybe intubation of long duration were identified as risk factors for alteration of palatal morphology et 5 years in very preterm children; children with neuromotor deficiencies seem particularly at risk. The mother-child EDEN cohort included pregnant women in 2002-2003 and their child at birth. We investigated early risk factors for posterior crossbite and anterior open bite in 422 3-year-old children. In addition to ongoing pacifier sucking habit at 3 years and mouth breathing, which are well-known risk factors, prematurity appears to be a new risk factor for posterior crossbite in temporary dentition. Finally, the French survey on health and care consumption, carried out in 2002-2003 in a representative sample of 5988 children and teenagers, shows that 23% of the 12-15 years old have an orthodontic treatment. Besides the economic factor, the less orthodontic treatment uptake is related to a less privileged social environment, to the absence of supplementary insurance and to living in a rural area.In conclusion, to understand inequalities in orthodontic treatment better, orthodontic treatment need should be evaluated first. We investigated factors related to malocclusions at very young ages, which could help to early identify children at risk. The assessment of how these early malocclusions would evolve is therefore needed in order to control if those malocclusions are indeed early markers for orthodontic treatment need.

AIM: To evaluate the prevalence of orthodontic problems and quality of life in relation to orthodontic problems among adolescent children in the city of Chennai, India. OBJECTIVES: To analyze the differences in the need for orthodontic treatment among children in the public and private schools; to analyze the need for orthodontic treatment among the various socioeconomic groups; to evaluate the Quality of Life (QoL) among the children; to analyze the relationship between Quality of Life (QoL) and the need for orthodontic treatment. METHODS: 200 children participated in the study, out of which 100 were from the private school and 100 from the public school from the city of Chennai, India. Two sets of questionnaires were used for the study, one was filled by the children and the other was filled by the researchers and trained dental assistants after doing a thorough dental examination and asking questions from the participants. This was carried out according to the recommendations of WHO oral health assessment. Statistical data was collected, recorded and analyzed using the software SPSS 17.0 for Windows. RESULTS: The private school children had more orthodontic problems than the public school children (49% and 44% respectively). The need for Orthodontic Treatment was the highest in children under the rich category (56.4%), followed by the children under the poor category (45.3%) and is least among the children under the average category (44.4%). The Quality of Life was... [to full text] / TIKSLAS: Įvertinti ortodontinio problemas ir perspektyvas atsižvelgiant į ortodontinio problemas tarp paauglių vaikų mieste Chennai, Indija. TIKSLAI: Analizuoti skirtumus reikalingas Ortodontinis gydymas tarp vaikų, viešąsias ir privačias mokyklas; analizuoti kad ortodontinio gydymo tarp įvairių socialinių ir ekonominių grupių; vertinti gyvenimo kokybę (QoL) tarp vaikų; išanalizuoti ryšį tarp gyvenimo kokybę (QoL) ir ortodontinio gydymo poreikį. METODAI: 200 vaikai dalyvavo tyrime, iš kurių 100 buvo privati mokykla ir 100 iš viešųjų mokyklų iš miesto Chennai, Indija. Vienų, ir klausimynų buvo naudojami tyrimo, vienas buvo užpildyti vaikų ir kitų buvo užpildyti mokslininkų ir apmokyti dantų padėjėjai po daro dantų nuodugniai ir užduoti klausimus iš dalyvių. Tai buvo daroma pagal PSO burnos sveikatos vertinimo rekomendacijas. Statistiniai duomenys buvo renkami, įrašytos ir analizuoti naudojant SPSS 17,0 programinė įranga Windows. REZULTATAI: Privačios mokyklos vaikai turėjo daugiau ortodontinio problemų nei valstybinių mokyklų vaikai (atitinkamai 49 % ir 44 %). Ortodontinio gydymo poreikis buvo didžiausias vaikams pagal turtingas kategorija (56.4 %), po to vaikai iki prastos kategorija (45.3 %) ir kas tarp vaikų iki vidutinės kategorijos (44.4 %). Gyvenimo kokybė buvo nustatyta, kad geriau tarp vaikų, privačios mokyklos nei valstybinėse mokyklose (90,6 % ir 89.0 % atitinkamai). Vaikams, kurie neturėjo nei gera gyvenimo kokybė turėjo mažai arba visai nėra ortodontinio kai... [toliau žr. visą tekstą]