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Patterns of orthodontic treatment of children in Australia: a national population-based study Cover

Patterns of orthodontic treatment of children in Australia: a national population-based study

Open Access
|Aug 2024

Figures & Tables

Table I.

Sociodemographic characteristics of children in Australia by orthodontist visit 2012-14

Study sampleChildren who have visited an orthodontist
YesNo
ncol % (95%CI)nrow % (95%CI)col % (95%CI)nrow % (95%CI)col % (95%CI)
Age (Years)
    5-81059940.2 (38.4–42.0)4054.3 (3.7–4.9)10.0 (8.5–11.7)926895.7 (95.1–96.3)45.5 (43.7–47.4)
    9-11756129.6 (28.4–30.9)137018.5 (17.0–20.1)32.4 (29.2–35.7)566781.5 (79.9–83.0)29.1 (27.9–30.3)
    12-14650430.2 (27.6–32.9)202231.7 (29.6–33.9)57.7 (53.6–61.7)412568.3 (66.1–70.4)25.4 (23.0–27.9)
Sex
    Male1234851.2 (49.8–52.6)172214.6 (13.5–15.8)44.0 (40.8–47.3)972585.4 (84.2–86.5)52.6 (51.2–54.0)
    Female1231648.8 (47.4–50.2)207519.4 (17.7–21.2)56.0 (52.7–59.2)933580.6 (78.8–82.3)47.4 (46.0–48.8)
Indigenous Identity
    Non-indigenous2311395.1 (94.3–95.8)364117.2 (16.0–18.5)97.2 (96.2–98.0)1805482.8 (81.5–84.0)95.8 (95.1–96.4)
    Indigenous11024.9 (4.2–5.7)10911.9 (8.8–15.8)2.8 (2.0–3.8)73688.1 (84.2–91.2)4.2 (3.6–4.9)
Parents’ Country of Birth
    Australian Born1614664.6 (62.6–66.4)254317.8 (16.4–19.2)67.1 (64.6–69.6)1242882.2 (80.8–83.6)63.9 (51.8–65.9)
    Overseas Born791335.4 (33.6–37.4)118715.8 (14.3–17.3)32.9 (30.4–35.4)622784.2 (82.7–85.7)36.1 (34.1–38.2)
Parental Education
    School476728.9 (27.3–30.6)61113.5 (11.9–15.2)22.7 (20.4–25.2)398686.5 (84.8–88.1)29.8 (28.1–31.6)
    Vocational Training421322.5 (21.4–23.6)65317.1 (15.3–19.1)22.7 (20.3–25.3)345182.9 (80.9–84.7)22.5 (21.3–23.7)
    Tertiary Education1416048.6 (46.6–50.6)249019.0 (17.5–20.6)54.6 (51.4–57.7)1133881.0 (79.4–82.5)47.7 (45.6–49.8)
Household Income
    Low639031.9 (29.9–33.9)75412.0 (10.8–13.4)22.4 (20.1–24.9)543888.0 (86.6–89.2)33.5 (31.4–35.6)
    Medium955038.7 (37.3–40.1)152517.0 (15.6–18.5)39.1 (36.6–41.6)778983.0 (81.5–84.4)38.7 (37.2–40.3)
    High629029.4 (27.5–31.4)131022.0 (19.9–24.3)38.5 (35.4–41.7)485978.0 (75.7–80.1)27.8 (25.8–29.8)
Dental Aesthetic Index (DAI)*n=5112
    Normal/Mild Malocclusion257748.4 (45.9–50.9)76633.0 (29.7–36.6)48.9 (44.8–53.0)166167.0 (63.4–70.3)48.5 (45.6–51.4)
    Definite Malocclusion117023.3 (21.7–25.1)32026.3 (22.8–30.2)18.7 (16.2–21.5)77073.7 (69.8–77.2)25.7 (23.5–27.9)
    Severe Malocclusion70914.2 (12.9–15.6)23129.4 (24.5–34.9)12.4 (10.2–15.0)42870.6 (65.1–75.5)14.6 (12.9–16.4)
    Handicapping Malocclusion65614.0 (12.5–15.7)30946.6 (40.5–52.7)20.0 (17.0–23.4)30653.4 (47.3–59.5)11.2 (9.6–13.1)
Total24664100379716.9 (15.8–18.2)1001906083.1 (81.8–84.2)100

1* Includes only children aged ≥ 12, as the DAI is only used in the permanent dentition.

1 Col %, column percentage; CI, confidence interval; Row %, row percentage.

Table II.

Prevalence of orthodontic visit, type of orthodontic treatment received, and treatment provider, by age group, of children in Australia 2012-14

Age group (years)Study sample
5 to 1112 to 14
nrow % (95%CI)col% (95%CI)nrow % (95%CI)col% (95%CI)nrow % (95%CI)col% (95%CI)
Has visited an orthodontist
    Yes177542.3 (38.–46.4)10.4 (9.5–11.3)202257.7 (53.6–61.7)31.7 (29.6–33.9)379710016.9 (15.8–18.2)
    No1493574.6 (72.1–77.0)89.6 (88.7–90.5)412525.4 (23.0–27.9)68.3 (66.1–70.4)1906010083.1 (81.8–84.2)
Type of orthodontic treatment#
    Cons. Only93049.3 (44.4–54.2)4.7 (4.2–5.2)77050.7 (45.8–55.6)10.9 (9.8–12.2)17001006.6 (6.0–7.1)
    Rem. App.41037.8 (32.3–43.6)2.5 (2.1–3.0)58162.2 (56.4–67.7)9.5 (8.4–10.7)9911004.6 (4.1–5.2)
    Fix. App.24725.5 (21.0–30.6)1.8 (1.4–2.2)75174.5 (69.4–79.0)11.8 (10.6–13.2)9981004.8 (4.3–5.5)
    Exo32433.5 (28.4–39.1)1.8 (1.6–2.2)52766.5 (60.9–71.6)8.3 (7.3–9.4)8511003.8 (3.4–4.3)
    Rem. + Fix.7925.4 (18.9–33.3)0.6 (0.5–0.9)27074.6 (66.7–81.1)4.3 (3.6–5.1)3491001.7 (1.5–2.1)
    Rem. + Exo8225.5 (18.8–33.5)0.4 (0.3–0.6)17774.5 (66.5–81.2)2.9 (2.3–3.6)2591001.2 (1.0–1.4)
Fixed + Extraction6618.7 (13.6–25.0)0.4 (0.3–0.5)26281.3 (75.0–86.4)4.0 (3.3–4.8)3281001.5(1.3–1.8)
    Rem. + Fix. + Exo2614.4 (8.7–22.8)0.1 (0.1–0.2)11585.6 (77.2–91.3)1.8 (1.4–2.4)1411000.6 (0.5–0.8)
Type of orthodontic treatment*, #
    Cons. Only93049.3 (44.4–54.2)46.5 (42.7–50.4)77050.7 (45.8–55.6)35.0 (32.0–38.1)170010039.9 (37.4–42.4)
    Rem. App.41037.8 (32.3–43.6)25.1 (21.8–28.7)58162.2 (56.4–67.7)30.4 (27.4–33.6)99110028.2 (25.8–30.6)
    Fix. App.24725.5 (21.0–30.6)17.7 (15.0–20.9)75174.5 (69.4–79.0)38.0 (35.0–41.0)99810029.4 (27.1–31.8)
    Exo32433.5 (28.4–39.1)18.1 (15.6–20.9)52766.5 (60.9–71.6)26.8 (24.0–29.7)85110023.1 (21.2–25.1)
    Rem. + Fix.7925.4 (18.9–33.3)6.3 (4.7–8.6)27074.6 (66.7–81.1)13.6 (11.6–16.0)34910010.6 (9.1–12.1)
    Rem. + Exo8225.5 (18.8–33.5)4.2 (3.2–5.7)17774.5 (66.5–81.2)9.3 (7.5–11.4)2591007.1 (6.0–8.5)
    Fixed + Extraction6618.7 (13.6–25.0)4.0 (3.0–5.5)26281.3 (75.0–86.4)12.9 (11.0–15.0)3281009.1 (7.9–10.5)
    Rem. + Fix. + Exo2614.4 (8.7–22.8)1.3 (0.8–2.2)11585.6 (77.2–91.3)5.8 (4.5–7.5)1411003.9 (3.1–4.9)
Treatment provider*, #
    Public Clinic14446.7 (38.0–55.5)7.7 (5.9–9.9)11953.3 (44.5–62.0)6.7 (5.2–8.5)2631007.1 (5.9–8.5)
    Child and Youth Dental Clinic13860.4 (50.9–69.2)7.2 (5.5–9.3)8839.6 (30.8–49.1)3.4 (2.6–4.6)2261005.0 (4.1–6.2)
    Private General Dentist16638.1 (29.7–47.1)10.2 (7.9–13.1)23761.9 (52.9–70.3)12.3 (10.2–14.6)40310011.4 (9.8–13.2)
    Private Specialist137840.7 (36.5–44.9)75.2 (71.6–78.6)168359.3 (55.1–63.5)80.6 (77.6–83.3)306110078.3 (75.9–80.6)

1* The denominator includes children who have visited an orthodontist.

1# The categories are not mutually exclusive, as children can have multiple types of visits by different providers.

1 App., Appliance; Col %, column percentage; CI, confidence interval; Cons., Consultation; Exo, Extraction; Fix., Fixed, App; Row % = row percentage; Rem., Removable.

Figure 1.

Prevalence of malocclusion by sociodemographic characteristics.

Figure 2.

Prevalence of orthodontic visits by sociodemographic characteristics and malocclusion severity.

Appendix I

Type of orthodontic treatment, by treatment provider, among children in Australia 2012-14

Type of treatment
Consultation onlyRemovable applianceFixed applianceExtractions
Treatment provider*Nrow %(95%CI)col% (95%CI)Nrow % (95%CI)col% (95%CI)Nrow % (95%CI)col% (95%CI)Nrow % (95%CI)col% (95%CI)
All participants
    Public Clinic11438.2 (30.4–46.6)7.1 (5.4–9.1)7028.2 (20.6–37.2)7.4 (5.2–10.3)3517.2 (11.3–25.4)4.3 (2.8–6.7)9839.1 (31.0–47.9)12.5 (9.4–16.3)
    Child and Youth Dental Clinic11144.9 (36.5–53.5)5.7 (4.4–7.4)5122.6 (16.0–31.0)4.1 (2.8–5.9)3114.0 (9.5–20.1)2.4 (1.6–3.7)6934.5 (26.2–43.9)7.6 (5.4–10.5)
    Private General Dentist15233.9 (26.9–41.8)9.7 (7.6–12.4)13634.5 (27.9–41.8)14.0 (11.1–17.5)12230.8 (24.7–37.8)12.0 (9.2–15.5)15634.7 (27.8–42.3)17.1 (13.5–21.5)
    Private Specialist143742.1 (39.1–45.1)82.5 (79.2–85.3)85231.2 (28.5–33.9)86.4 (82.7–89.4)92334.3 (31.7–37.0)91.4 (88.1–93.9)69723.8 (21.6–26.2)80.5 (75.7–84.5)
5 to 11 years old
    Public Clinic6128.8 (20.4–39.0)5.0 (3.6–7.0)3631.0 (20.7–43.6)10.0 (6.4–15.4)1318.0 (9.4–31.8)8.3 (4.0–16.3)5239.7 (28.6–51.9)17.6 (12.3–24.5)
    Child and Youth Dental Clinic7749.2 (37.8–60.7)7.7 (5.6–10.5)2119.8 (11.6–31.6)5.7 (3.2–9.7)1210.9 (5.9–19.4)4.5 (2.3–8.4)3529.2 (18.7–42.5)11.5 (7.0–18.4)
    Private General Dentist7133.3 (22.8–45.7)7.4 (5.3–10.1)5334.5 (25.8–44.4)14.1 (9.4–20.6)2519.1 (10.9–31.2)11.1 (5.6–21.0)6235.5 (26.1–46.2)19.9 (13.7–28.0)
    Private Specialist78551.9 (47.3–56.5)83.8 (79.5–87.3)34027.9 (24.0–32.1)83.0 (77.0–87.8)22621.3 (17.8–25.2)90.2 (82.5–94.8)24817.5 (14.9–20.5)71.8 (62.2–79.7)
12 to 14 years old
    Public Clinic5346.3 (34.9–58.1)9.0 (6.3–12.6)3425.7 (16.4–38.0)5.8 (3.6–9.1)2216.5 (9.5–27.0)3.0 (1.7–5.1)4638.7 (27.9–50.7)9.9 (6.6–14.5)
    Child and Youth Dental Clinic3438.2 (25.9–52.3)3.8 (2.4–5.9)3026.9 (17.5–39.0)3.1 (2.0–4.7)1918.6 (10.9–29.9)1.7 (1.0–2.9)3442.7 (30.0–56.4)5.6 (3.7–8.3)
    Private General Dentist8134.4 (25.3–44.8)12.0 (8.6–16.6)8334.6 (25.3–45.2)14.0 (10.5–18.4)9738.0 (29.3–47.6)12.3 (9.3–16.1)9434.2 (24.8–44.9)15.7 (11.6–21.1)
    Private Specialist65235.4 (31.9–39.0)81.1 (76.0–85.3)51233.4 (30.2–36.9)88.4 (83.8–91.9)69743.3 (40.0–46.5)91.8 (87.9–94.6)44928.1 (25.0–31.5)84.8 (80.0–88.7)

1* The denominator includes children who have visited an orthodontist. The categories are not mutually exclusive, as children can receive multiple treatment types from different providers, Row %, row percentage; Col %, column percentage; CI, confidence interval.

Appendix II

Prevalence of planned extractions with appliances, by age, among children in Australia 2012-14

Age groupsTotal
Age 5-11 YearsAge 12-14 Years
Appliance usedAppliance usedAppliance used
Removable applianceFixed applianceTotalRemovable applianceFixed applianceTotalRemovable applianceFixed applianceTotal
Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)Ncol% (95%CI)
Planned extractions
Yes8217.1 (13.0-22.1)6622.6 (17.0-29.4)3241.8 (1.6-2.2)17730.4 (25.3-35.9)26233.8 (29.3-38.6)5278.3 (7.3-9.4)25925.3 (21.8-29.3)32831.0 (27.-34.9)8513.8 (3.4-4.3)
No32882.9 (77.9-87.0)18177.4 (70.6-83.0)1699298.2 (97.8-98.4)40469.6 (64.1-74.7)48966.2 (61.4-70.7)574091.7 (90.6-92.7)73274.7 (70.7-78.2)67069.0 (65.1-72.7)2273296.2 (95.7-96.6)
Total41010024710017316100581100751100626710099110099810023583100
Appendix III

Distribution of Household income by Malocclusion Severity

Appendix IV

Distribution of Parental Education by Malocclusion Severity

Appendix V

Distribution of Sex by Malocclusion Severity

Appendix VI

Distribution of indigenous Identity by Malocclusion Severity

Appendix VII

Distribution of Household by Malocclusion and Orthodontic Visit

Appendix VIII

Distribution of Parental Education by Malocclusion Severity and Orthodontic Visit

Appendix IX

Distribution of Sex by Malocclusion Severity and Orthodontic Visit

Appendix X

Distribution of indigenous Identity by Malocclusion Severity and Orthodontic Visit

DOI: https://doi.org/10.2478/aoj-2024-0019 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 22 - 39
Submitted on: May 1, 2024
Accepted on: Jul 1, 2024
Published on: Aug 9, 2024
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2024 Philip Phu-Tan Nguyen, Maurice J. Meade, Lisa M. Jamieson, Dandara G. Haag, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.