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VOLUME 16 , ISSUE 1 ( January-April, 2022 ) > List of Articles


Parental Knowledge and Practice Regarding their Children's Malocclusion and Orthodontic Care in Al-Madinah, Saudi Arabia: A Cross-sectional Study

Asim Almarhoumi, Mishari Alharbi, Samar Saib, Salihah Albalawi, Ahlam Alalawi, Shahad Albahith

Keywords : Children, Orthodontics, Parental knowledge, Practice, Saudi Arabia

Citation Information : Almarhoumi A, Alharbi M, Saib S, Albalawi S, Alalawi A, Albahith S. Parental Knowledge and Practice Regarding their Children's Malocclusion and Orthodontic Care in Al-Madinah, Saudi Arabia: A Cross-sectional Study. J Oral Health Comm Dent 2022; 16 (1):56-60.

DOI: 10.5005/jp-journals-10062-0135

License: CC BY-NC 4.0

Published Online: 27-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Objective: This article aims to measure parental knowledge and practice regarding their children's malocclusion and orthodontic treatment need. Materials and methods: A cross-sectional survey was distributed in the Al-Madinah region, Saudi Arabia. Parental demographic data, knowledge, and practice were collected. The maximum possible mean score was 1.0 for both knowledge and practice. Results: Three-hundred and fifteen participants completed the survey. The overall mean scores for parental knowledge and practice were 0.44 and 0.49, respectively. No statistically significant difference was detected between sexes, age, parental history of orthodontic treatment, education, and income levels. Females were more aware than males regarding the impact of malocclusion on their children's self-esteem (p = 0.004). Lower- and middle-income groups were less aware of increased risk of trauma with prominent incisors (p = 0.001) and various types of orthodontic appliances (p = 0.004). Although, 80% of parents stated that they were willing to convince their children toward orthodontic treatment based on professional advice. However, 40.5 and 34% of the lower- and middle-income groups would rather wait for public-funded services even if their child is in high need for treatment (p <0.000), compared to 18% of the higher-income group stating the same. Conclusion: Moderate to high parental knowledge and practice was demonstrated. Females and higher socioeconomic status parents were more aware and proactive than their counterparts. Public health services should consider parental socioeconomic status when allocating care for children's and adolescent's orthodontic treatment need.

  1. Angle HE. Classification of malocclusion. Dent Cosmos 1899;41: 350–375. Available from:
  2. Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31(Suppl 1):3–24. DOI: 10.1046/j.2003.com122.x.
  3. Haynes S. Orthodontic treatment needs in English children aged 11-12 years. Br J Orthod 1974;1(1):9–12. DOI: 10.1179/bjo.1.1.9.
  4. Hill PA. The prevalence and severity of malocclusion and the need for orthodontic treatment in 9-, 12-, and 15-year-old Glasgow schoolchildren. Br J Orthod 1992;19(2):87–96. DOI: 10.1179/bjo.19.2.87.
  5. Holmes A. The prevalence of orthodontic treatment need. Br J Orthod 1992;19(3):177–182. DOI: 10.1179/bjo.19.3.177.
  6. Proffit WR, Fields HW, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 1998;13(2):97–106. PMID: 9743642.
  7. Alogaibi Y, Murshid Z, Alsulimani F, et al. Prevalence of malocclusion and orthodontic treatment needs among young adults in Jeddah city. J Orthod Sci 2020;9(1):3. DOI: 10.4103/jos.JOS_44_19.
  8. Fatani NH, Hammam MB, Oraif H, et al. Prevalence of malocclusion among schoolchildren in Makkah, Saudi Arabia. Open Access Maced J Med Sci 2019;7(5):856–861. DOI: 10.3889/oamjms.2019.188.
  9. Kok YV, Mageson P, Harradine NWT, et al. Comparing a quality of life measure and the aesthetic component of the index of orthodontic treatment need (IOTN) in assessing orthodontic treatment need and concern. J Orthod 2004;31(4):312–318. DOI: 10.1179/146531204225020625.
  10. Martins-Júnior PA, Marques LS, Ramos-Jorge ML. Malocclusion: social, functional and emotional influence on children. J Clin Pediatr Dent 2012;37(1):103–108. DOI: 10.17796/jcpd.37.1.y75430328427210j.
  11. Lindsay SJE, Hodgkins JFW. Children's perceptions of their own malocclusions. Br J Orthod 1983;10(1):13–20. DOI: 10.1179/bjo.10.1.13.
  12. Paula DFDJ, Santos NCM, Silva ETD, et al. Psychosocial impact of dental esthetics on quality of life in adolescents. Angle Orthod 2009;79(6):1188–1193. DOI: 10.2319/082608-452R.1.
  13. Turbill EA, Richmond S, Wright JL. A closer look at General Dental Service orthodontics in England and Wales I: factors influencing effectiveness. Br Dent J 1999;187(4):211–216. DOI: 10.1038/sj.bdj.4800242.
  14. Tessarollo FR, Feldens CA, Closs LQ. The impact of malocclusion on adolescents’ dissatisfaction with dental appearance and oral functions. Angle Orthod 2012;82(3):403–409. DOI: 10.2319/031911-195.1.
  15. Abeleira MT, Pazos E, Ramos I, et al. Orthodontic treatment for disabled children: a survey of parents’ attitudes and overall satisfaction. BMC Oral Health 2014;14(1):98. DOI: 10.1186/1472-6831-14-98.
  16. Øland J, Jensen J, Elklit A, et al. Motives for surgical-orthodontic treatment and effect of treatment on psychosocial well-being and satisfaction: a prospective study of 118 patients. J Oral Maxillofac Surg 2011;69(1):104–113. DOI: 10.1016/j.joms.2010.06.203.
  17. Batista KBSL, Thiruvenkatachari B, Harrison JE, et al. Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents. Cochrane Database Syst Rev; 2018;3(3):CD003452. DOI: 10.1002/14651858.CD003452.pub4.
  18. Onyeaso CO. Demand and referral pattern for orthodontic care at University College Hospital, Ibadan, Nigeria. Int Dent J 2004;54(5):250–254. DOI: 10.1111/j.1875-595x.2004.tb00289.x.
  19. Birkeland K, Boe OE, Wisth PJ. Orthodontic concern among 11-year-old children and their parents compared with orthodontic treatment need assessed by index of orthodontic treatment need. Am J Orthod Dentofacial Orthop 1996;110(2):197–205. DOI: 10.1016/s0889-5406(96)70109-9.
  20. Jokovic A, Locker D, Guyatt G. How well do parents know their children? Implications for proxy reporting of child health-related quality of life. Qual Life Res 2004;13(7):1297–1307. DOI: 10.1023/B:QURE.0000037480.65972.eb.
  21. Jokovic A, Locker D, Stephens M, et al. Measuring parental perceptions of child oral health-related quality of life. J Public Health Dent 2007;63(2):67–72. DOI: 10.1111/j.1752-7325.2003.tb03477.x.
  22. Daniels AS, Seacat JD, Inglehart MR. Orthodontic treatment motivation and cooperation: a cross-sectional analysis of adolescent patients’ and parents’ responses. Am J Orthod Dentofac Orthop 2009;136(6):780–787. DOI: 10.1016/j.ajodo.2007.11.031.
  23. Geoghegan F, Birjandi AA, Xavier GM, et al. Motivation, expectations and understanding of patients and their parents seeking orthodontic treatment in specialist practice. J Orthod 2019;46(1):46–50. DOI: 10.1177/1465312518820330.
  24. Alshammary F, Aljohani FA, Alkhuwayr FS, et al. Measurement of parents’ knowledge toward oral health of their children: an observational study from Hail, Saudi Arabia. J Contemp Dent Pract 2019;20(7):801–805. PMID: 31597799.
  25. Zakirulla M, Mustafa MM, Ravi KS, et al. Knowledge of mothers about use of fissure sealant therapy and professional fluoride therapy among children in Saudi Arabia. Trop J Pharm Res 2019;18(10): 2189–2195. DOI: 10.4314/tjpr.v18i10.27.
  26. Alfahhad HM. Awareness of mothers about number of primary teeth and associated eruption disorders in hail. Pak Oral Dent J 2017;37(3):468–472.
  27. Moshkelgosha V, Kazemi M, Pakshir H, et al. Parental knowledge and attitude towards early orthodontic treatment for their primary school children. Iran J Orthod 2016;12(2). DOI: 10.5812/ijo.7377.
  28. Pietilä T, Pietilä I. Parents’ views on their own child's dentition compared with an orthodontist's assessment. Eur J Orthod 1994;16(4):309–316. DOI: 10.1093/ejo/16.4.309.
  29. Baccetti T, Franchi L, Toth LR, et al. Treatment timing for twin-block therapy. Am J Orthod Dentofac Orthop 2000;118(2):159–170. DOI: 10.1067/mod.2000.105571.
  30. DiBiase AT, Cobourne MT, Lee RT. The use of functional appliances in contemporary orthodontic practice. Br Dent J 2015;218(3):123–128. DOI: 10.1038/sj.bdj.2015.44.
  31. Mossey PA. The heritability of malocclusion: part 2. The influence of genetics in malocclusion. Br J Orthod 1999;26(3):195–203. DOI: 10.1093/ortho.26.3.195.
  32. Baldwin DC. Pattern of motivation in families seeking orthodontic treatment. Int Assoc Dent Res 1966;44:412.
  33. Dawoodbhoy I, Delgado-Angulo EK, Bernabé E. Impact of malocclusion on the quality of life of Saudi children. Angle Orthod 2013;83(6):1043–1048. DOI: 10.2319/012713-83.1.
  34. Taibah S, Al-Hummayani F. Effect of malocclusion on the self-esteem of adolescents. J Orthod Sci 2017;6(4):123. DOI: 10.4103/jos.JOS_16_17.
  35. Bindayel NA. Knowledge, demand, and the need of lay people for the orthodontic specialty in comparison to other dental disciplines. J Orthod Sci 2018;7(1):1–6. DOI: 10.4103/jos.JOS_5_18.
  36. Wȩdrychowska-Szulc B, Syryńska M. Patient and parent motivation for orthodontic treatment–a questionnaire study. Eur J Orthod 2010;32(4):447–452. DOI: 10.1093/ejo/cjp131.
  37. Hassan AH. Orthodontic treatment needs in the western region of Saudi Arabia: a research report. Head Face Med 2006;2:2. DOI: 10.1186/1746-160X-2-2.
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