Magister Scientiae Dentium - MSc(Dent) (Orthodontics)
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Item The Impact of Fixed Orthodontic Treatment on the Oral Health- Related Quality of Life in Adolescents(University of the Western Cape, 2023) Gordon, Carmen Tracey; Shaikh, AThis study aimed to determine whether fixed orthodontic treatment impacts on the oral healthrelated quality of life (OHRQoL) in adolescents aged 11-16 years. Oral health determinants, as well as demographic and psychosocial factors, may have an impact on oral health-related quality of life. This study explored whether sociodemographic and clinical factors impacted the emotional and social well-being of participants and whether these participants experienced any functional limitation at the start of treatment (T0) and 6-8 months later (T1). Materials and methodology: A prospective study design was applied, within the orthodontic clinics at Mitchell’s Plain and Tygerberg Oral Health Centre’s. A cohort of eighty-three adolescent participants receiving fixed orthodontic treatment was evaluated for oral health – related quality of life. All participants completed a set of validated questionnaires at baseline (T0), and then 6-8 months later (T1). Questionnaires included the Orthodontic Oral Health- Related Quality of Life Survey (OQoLAS₁₁₋₁₄) and a socioeconomic status (SES). The OQoLAS₁₁₋₁₄ measured the social, emotional and functional domains and the SES assessed the sociodemographic characteristics of participants’ and their caregiver; age, sex, educational level, employment status and combined household income. In addition, the clinical assessment was done using the Dental Aesthetics Index (DAI) score card, in order to assess the complexity of malocclusion and orthodontic treatment need.Item Dental maturation of the permanent mandibular teeth of South African children and the relation to chronological age(University of Western Cape, 2008) Phillips, Vincent; Nortjie, CJAge estimation of the skeletal remains of children can be accomplished by examination of the ossification centres and the fusion of the epiphyseal plates of long bones. Dental age estimation is done by examining the eruption of the deciduous and permanent teeth. Both these methods are inaccurate and are subject to the nutritional status of the individual. A more accurate method of age estimation is by the examination of radiographic images of the developmental stages of the tooth crown and root formation. Two methods of dental age estimation used are those of Moorrees, Fanning and Hunt (1963) (MFH) and that of Demirjian, Goldstein and Tanner (1973) (DGT). These methods were tested on a sample of 913 Tygerberg dental patients; a random mixture of Caucasoid and Khoisanoid children. The MFH method under-estimated the ages of the sample by an average of 0.91 years and the DGT method over-estimated the ages by an average of 0.89 years. Samples of Indian and Negroid children from Kwa-Zulu Natal were tested in a similar manner and the results showed similar under and over-estimation of the ages by these methods. The Negroid children were labelled the Zulu sample. Correction factors were derived for the MFH and DGT methods of dental age estimation when used on Tygerberg, Indian and Zulu children. These correction factors were tested on the samples and found to improve the accuracy of the age estimation methods of MFH and DGT significantly. A second sample group of Tygerberg, Indian and Zulu children were then tested firstly using the standard method of MFH and DGT and the using the correction factors. The results showed that the correction factors improved the age estimation on these samples except in the case of the DGT method on Zulu children. A sample of Xhosa speaking children were added to the two Zulu samples and made an Nguni sample. The Tygerberg samples were combined as were the Indian samples to form data bases for the construction of dental age related tables for Tygerberg, Indian and Nguni children. These tables show that there are distinct differences in the ages at which the teeth develop in the different sample groups and that dental age related tables are necessary for children of different population origins. Statistical analysis of the age related tables from this study (Phillips Tables) show these tables are more accurate in the age estimation of South African children.Item Retrospective evaluation of transverse arch dimensional changes in non-extraction and premolar extraction cases using a passive self-ligating bracket system(University of the Western Cape, 2022) Coetsee, Marthinus Johannes; Harris, AngelaThe effect of extraction and non-extraction treatment protocols on the dental arch width has comprehensively been researched. The effect of non-extraction protocols using passive selfligating systems has also been adequately investigated. Although the literature comes to contrasting conclusions and further research is always encouraged, the impact on the dental arch width using an extraction protocol in combination with a passive self-ligating system has not been defined thoroughly. Aim: this study investigated the effect of 2 treatment protocols on transverse arch width, before and after treatment, using a passive self-ligating system. The null hypothesis to be tested was that treatment with a second premolar extraction protocol would result in no difference in transverse arch width changes compared to treatment with a non-extraction protocol.Item Professional burnout among dentists in Saudi Arabia: A cross sectional survey(University of the Western Cape, 2022) Alkhzam, Hamza; Naidoo, SudeshniDentists are confronted with considerable professional stressors and are highly prone to depression and professional burnout. The present study investigated the prevalence levels of burnout among dentists working in direct clinical contact with patients in Saudi Arabia and identified its relationship with the basic work-setting conditions in Saudi Arabia. The study design was cross-sectional and conducted in the central, western and eastern regions of Saudi Arabia in both public and private sectors. A self-administered questionnaire, containing the19-item Copenhagen Burnout Inventory (CBI) included the Personal Burnout (PB), Work-Related Burnout (WRB), and Client-Related Burnout (CRB) scales and socio-demographic data, was used to determine the prevalence of burnout among dentists. To achieve this, factors such as age, gender, marital status, nationality, years of experience, professional rank, specialty and sector of work, working days per week, working hours per day and number of patients were compared regarding participant burnout levelsItem Demarcated hypomineralization lesions: Prevalence, defect characteristics and OHRQoL among a subpopulation of Saudi children attending King Khalid University outpatient dental clinics(University of the Western Cape, 2022) Salih, Malaz Mohamed Elrafie Mustafa; Mohamed, NadiaDemarcated hypomineralization lesions of enamel (DHL) are qualitative developmental abnormalities of dental enamel, described morphologically as well-defined areas of hypomineralization. Two distinct entities of DHL have been demonstrated: Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM). To date, very few prevalence studies of DHL exist in the Arab and Saudi regions.Item The Physical and Mechanical Aspects of Orthodontic Appliances(University of the Western Cape, 1978) Bibby, R.E; Bibby, R.EThese laws were first published in Latin,in 1687.The first law may be literally translated thus, Every body continues in its state of reat or of uniform motion in a straight line ,unless it is compelled to change that state by impressed force. This meano that if a body is at rest it will remain so unless some force acts on it,if in motion ,the velocity of motion must continue uniform unless some force acts to increase it or diminish it. Also the direction of motioA mast continue unchanged and therefom rectilinear unless some force causes it to be diverted. This law therefore supplies us with a definition of force; Force is that which produces or tends to produce, motion 0.' change of motion. Newton's second law of motion may be translated as follows:- Newton's second law of motion may be translated as follows:- The change of motion (produced)is proportional to the impressed force producing it,and pursues the direction in which that force is impressed. This law leads to a method of measuring forces. If we change the velocity with which a mass is moving,we also change its momentum. Change in momentum will serve to measure force.lt seems obvious that whatever change in momentum is produced by a force, twice the force will produce twice the change ,etc.i.e. the change is directly proportional to the force. For a given mass,m,change of momentum ,mv,means change of velocity;the change of velocity per unit time is aceeleration,a;the change in momentum per unit time is therefore malf we employ absolute units (poundals or dynes)this can be shown as; Newton's third law of motion states that 'to every action there is an equaI and opposite reaction'.This law recognises the dual aspect of forces It a tooth is pushed by a finger spring ,the spring is also pushed by the tooth,and an eqpal counter force acts towards the spring unti1 the biology of the system intervenes. This dual stress is called pressure. Retracting incisors against posterior segments it is apparent that the reaction of the posterior segments must be equal and opposite to the incisors.In this case the two forces act away trom each other,and tG this dual stress we give the name tension.Item A comparison of lay and professional opinion on treatment need and treatment outcome(A comparison of lay and professional opinion on treatment need and treatment outcome, 1997) Vally, Ismail M.; Jones, M.L.The psychological, social, and cultural aspects of facial and dental attractiveness is an integral part of health care. Lay persons perceptions of facial and dental attractiveness are influenced by many factors including age, gender, geographic location (nationally or international), ethnic status, employment status, cultural differences and social class will effect the social impact of the anomalies. In addition, the public response to dental anomalies will vary according to experience of good health or ill health of the individual, relatives and friends. The perception of malocclusion is often seen differently between orthodontists, patients and lay public. The differing perceptions of patients and dental practitioners may influence the delivery of orthodontic care. It has been reported that 70% of orthodontic treatment is dentist induced and that orthodontic treatment may be undertaken without the patient or parents perceiving a problem with the teeth. (DHSS, Schanscheiff Report, 1986). The thresholds of entry and exit for orthodontic care may be different as perceived by orthodontists and lay persons. Orthodontists may pursue full alignment and perfect occlusion whereas lay persons may accept varying degrees of deviation from normal. This current study has assessed and recorded the differences in opinions of professional orthodontists and lay persons on dento-facial aesthetics, orthodontic treatment need and orthodontic treatment outcome. The study was carried out at the Orthodontic Department, University of Wales, College of Medicine, School of Dentistry. The opinions of 56 lay persons (dental technicians, dental nurses and lay persons not involved in the clinical process) and 97 orthodontists was collected by recording judgements using various patient records as stimuli. For each set of records examined, each member of the panel indicated their opinion using Likert scales. Judgements were made by assessments of 68 study casts in respect of:- * the need for orthodontic treatment on dental health grounds. the need for orthodontic treatment on dental aesthetic grounds. deviation from normal occlusion. the decision whether to treat. ** * In addition, judgements were made on a sample of 50 pairs of outline facial profiles before and after treatment in respect of: * * deviation from normal facial aesthetics comparison of aesthetics pre-treatment and post-treatment. Furthermore, assessments on 50 pairs of pre-treatment and post-treatment study casts in respect of: * * degree of improvement as a result of treatment. acceptability of result. Orthodontists subjective judgements are more reliable than lay persons in their assessments of dental aesthetics, dental health and deviation from normal. The level of agreement for the decision to recommend treatment is similar between orthodontists and lay groups ie. lay persons are as reliable as orthodontists in the decision to recommend treatment. Orthodontists tend to recommend 10 - 12 % more treatment than lay persons. The orthodontist group were more reliable than the lay group in assessing degree of improvement and assessment of outcome. Orthodontists reject approximately 25% of cases deemed acceptable by the lay group. Dental aesthetics appeared to be the most important feature in the assessment of treatment outcome by both orthodontists and lay groups.Item Chemical aspects of human plaque and enamel(University of the Western Cape, 1982) Grobler, Sias Renier; van Wyk, C.WThe ideal conditions for the use of hydrazinium sulphate as a reducing agent to determine phosphorus in dental plaque were investigated. When this method was compared to the tin (II) chloride (Kuttner and Cohen, 1927) and ascorbic acid method (Chen, loribara and Warner, 1956),which is generally in use for the measurement of phosphorus in plaque, it was found to have certain advantages. Different ashing techniques were compared, as well as the influence of different acids on wet ashing. The hydrazinium sulphate method could determine as little as 1,8 ~g phosphorus per 50 ml and is recommended for the routine analysis of phosphorus in dental plaque samples with wet ashing. Today phosphorus can be determined, among other methods gravimetrically, titrimetically and spectroscopically (Williams, 1979). Through spectroscopic methods phosphate might be analysed spectrophotometrically by 3 main methods, as molybdophosphoric acid, its reducing product molybdenum blue and the yellow vanadomolybdophosphoric complex (Stuart and Duff, 1980). In addition indirect methods derived from molybdophosphoric acid might also be used (Williams, 1979). When phosphorus is spectrophotometrically determined during the reduction of a phosphomolybdate complex by means of different reducing agents (Kuttner and Cohen, 1927; Chen et aI, 1956; Fiske and Subbarow, 1925 and 1929, Taylor and Miller, 1914; Martin and Doty, 1949; Eibl and Lands, 1969; Vogel, 1961; Boltz and Mellong, 1947; Lazarus and Chou, 1972; Laws and Webley, 1959; Burton and Riley, 1955; Dickman and Bray, 1940), it is necessary to establish the optimum conditions under which the reducing agent, hydrazinium sulphate, can be used. In spite of this, many details about exact experimental procedures are not known (Taylor and Miller, 1914; Vogel, 1961; Boltz and Mellon, 1947). The present investigation is an attempt to establish the ideal conditions for the use of hydrazinium sulphate as a reducing agent during the formation of molybdenum blue (Schirmer et al, 1942) and the effectiveness of the method for the determination of phosphorus in dental plaque by different ashing techniques. The hydrazine method is also compared to that of Chen et al (1956) which is generally in use for plaque phosphate determinations by many authors (Ashley, 1975; Ashley and Wilson, 1976; Kleinberg et al, 1971; Zuniga et al, 1973), as well as to the sometimes used (Dawes and Jenkins, 1962) tin (II) chloride method of Kuttner and Cohen (1927). For the review of many other accepted methods, see Lindberg and Ernster (1956), and Williams (1979). The results are compared to the modified ascorbic acid method (Chen et al, 1956) as well as to the tin (II) chloride method (Kuttner and Cohen, 1927).Item Research related to clinical dentistry (1967 - 1983)(University of Stellenbosch, 1984) Retief, Daniel Hugo; Prins, F. X.Four spectrophotometric procedures for the analysis of phosphorus were evaluated (1F1). The phosphorus concentrations in saliva and dentine were determined. All four analytical procedures were accurate but the one method was the most sensitive. An acid etch enamel biopsy procedure which was originally developed in Switzerland was modified in our laboratory (#2). It was subsequently shown by other investigators that the modified technique was much more accurate for the determination of the fluoride concentration in enamel than the original procedure.Item The accuracy of non-radiographic mixed dentition predictive methods used for the diagnosis of space discrepancies in orthodontic patients in the mixed dentition phase in Africa: A systematic review of diagnostic test accuracy(University of Western Cape, 2021) Brijlall, Sarika; Harris, AngelaOrthodontic space analysis is a critical component into informing diagnosis and leading to targeted interceptive treatment planning in the mixed dentition stage of tooth development. Accurate and reliable space analysis methods - radiographic and non-radiographic - are beneficial for the early detection of imbalances between the mesiodistal diameter of unerupted permanent teeth and its alveolar bone support, which can contribute significantly in preventing severe malocclusions. Due to the ease and simplicity in its application, the non-radiographic mixed dentition space analysis methods; Moyers, and Tanaka and Johnston; were widely recommended. However, due to these space analysis methods derived from data of a Caucasian European population in the early 1970s, the external validation question, with dubious applicability of these methods in other populations, has been questioned. This has prompted researchers to seek newer, more context-specified prediction tables and equations for specific sample population groups.Item A comparison of three types of orthodontic study models(University of the Western Cape, 2020) Madhoo, Amika; Johannes, Keith C.The aim of this present study was to compare the accuracy of digital and printed study models with plaster study models, that are considered the gold standard. The objectives were to compare the accuracy of measurements obtained from digital and printed study models with those of plaster study models, to establish which type of study model yielded the most accurate measurements in comparison to plaster study models and to identify possible disadvantages and errors that can be made using any of the three types of study models.Item Using a mathematical model to determine dental arch- perimeter in class ii patients presenting at UWC orthodontic clinics(University of the Western Cape, 2021) Raan, F.J. du; Harris, A.M.P.Determining arch perimeter is of importance in both a clinical setting, where it is used to determine space requirements, as well as in an epidemiological setting where it is used to describe large populations. Physical measurement of arch perimeter is time consuming and may be prone to operator errors when done on study casts and even more so in a clinical situation. The use of a simple mathematical model to predict arch perimeter, using a few measurements that can be done easily and reliably, would be of great use to the practitioner.Item Is conventional sugar-free chewing gum effective in the management of orthodontic pain associated with fixed appliances? A randomised clinical trial comparing the pain-reducing effects of sugar-free chewing gum versus a placebo medicament(University of the Western Cape, 2020) Govender, Yolin; Harris, AngelaBackground and aim: Managing orthodontic pain traditionally involves the prescription of non-steroidal anti-inflammatory drugs combined with other analgesic medication. Sugar-free chewing gum has been advocated in the control of orthodontic pain due to its mechanical and physiological effects on periodontal tissue; however, the literature is scant. The ‘placebo effect’ that conventional sugar-free chewing gum may have in the relief of orthodontic pain has not been documented. The aim of this study was to compare the effectiveness of conventional sugar-free chewing gum in reducing orthodontic pain associated with fixed appliances with a placebo (sugar-free sweets) medicament. Objectives: The objectives of the study were to determine if there were differences in pain reporting between the sugar-free chewing gum and the placebo, to ascertain whether gender influenced pain scores and to observe any differences in pain reporting between different orthodontic techniques.Item Effects of premolar extraction on airway dimensions: A retrospective cephalometric appraisal(University of the Western Cape, 2020) Van Zyl, Luzaan; Hudson, AtholAim: The aim of this study was to assess the effect of retraction of anterior teeth on pharyngeal airway dimensions, after orthodontic treatment of bimaxillary protrusion cases by means of the extraction of four premolars. Method: A total of 88 lateral cephalometric radiograph pairs, consisting of a pre-treatment and post-treatment radiograph taken for orthodontic treatment of bimaxillary protrusion by means of extraction of four premolars, was used. The pharyngeal airway space, measured across three different levels, as well as the length of the maxilla and mandible were assessed for changes from pre-treatment to post-treatment. Pearson’s correlation coefficient was used to determine the degree to which the change in pharyngeal airway space was associated with the change in maxilla or mandible length. Results: The pre-treatment average pharyngeal airway space measurements were recorded as 15.23mm for the Superior Pharyngeal Airway Space, 11.63mm for the Middle Pharyngeal Airway Space and 13.56mm for the Inferior Pharyngeal Airway Space. The average reduction in the pharyngeal airway space was noted as 1.21mm, 1.64mm and 2.23mm respectively. All with statistically significant P values of <0.001.Item Factors influencing the implementation of interceptive Orthodontic treatment at the level of the general dentist: 24 case studies from the Metropolitan area of Tshwane, South Africa(University of Western Cape, 2019) Joubert, Leorika; Harris, AMPGeneral dentists in practice (both public and private) are often reluctant to perform interceptive orthodontic procedures on patients that present to their practices. As interceptive orthodontic treatment (IOT) can be of great benefit to some patients, it validates the need to assess the factors that influence the implementation of such treatment.Item Accuracy of Orthodontic bracket adaptation(University of the Western Cape, 2019) Noordien, Naeemah; Hudson, AtholBackground: A close marginal adaptation between the tooth and the bracket base is important since it provides the space for the adhesive. In order to withstand and resist the orthodontic forces exerted as well as everyday forces like mastication and oral hygiene practices, the adhesive material to the bracket must have sufficient sheer bond strength. This means that no deformations, cracks, or fractures should occur within the bracket material and adhesive (Keizer et al., 1976). Aim: The aim of this study was to determine the accuracy of the marginal adaptation of the bracket bases of seven different brands of orthodontic brackets to the tooth surface of a right upper first premolar (ie. Abzil, Forestadent, GAC, Gemini, IMD, Ormco and Victory LP). Method: This research was an in vitro, descriptive comparison study. Fifteen caries and crack free intact human first premolars were used. The teeth were obtained from patients requiring extractions for orthodontic purposes and collected from Tygerberg Oral Health Centre. A convenience sample method was used, where whenever an upper caries free premolar was extracted, the parent was asked if the tooth could be used for this study and consent was obtained. The crowns of the 15 teeth were cleaned and polished with pumice and rubber cups for 10 seconds (as the clinician would do prior to bracket cementation). The same 15 teeth were used with the seven different brands of brackets in order to establish a comparison of the adaptability of the brackets. The brackets were placed at a set orthodontic prescription of 4mm (measured from the slot area of the bracket to the tip of the buccal cusp of the tooth) on the upper first premolars. After bracket placement, the dontrix gauge was applied to the bracket to engage the slot area. The brackets were held in place with a constant force of 0.70 Newton (N) by the dontrix gauge. This allowed for reproducibility for the seven brackets with all fifteen teeth. In order to assess the space between the brackets and the teeth no adhesive was used. The space between the margins of the bracket and tooth interface was viewed under the Stereomicroscope (Carl Zeiss microscope, Zeiss Stemi508) at 50 times magnification. A two way mixed measures ANOVA was run to determine whether there were differences between the seven brackets placed at six points on the tooth surface. Results: GAC had the smallest overall mean measurement between bracket base and tooth surface followed by Ormco and Gemini respectively. Abzil had the largest overall mean measurement for the six points around the bracketItem The orthodontic treatment needs in children aged 12-15 years in a school in Khomas region, Namibia(University of the Western Cape, 2018) Serebe, Catherine; Harris, Angela; Kimmie-Dhansay, FaheemaIn modern day dentistry, aesthetics forms an integral part of our social perception almost as much as functionality. Malocclusion has been brought to the forefront of developmental anomalies as it can affect mastication, speech as well as the appearance of the face. Furthermore, pre-pubertal and pubertal changes have compounded existing malocclusions in this growth period thus spiraling the need for orthodontic treatment. Therefore, it is essential to determine the normative and selfperceived need for orthodontic treatment in a population. The epidemiological data collected can be used to facilitate policy changes to manage malocclusion in Khomas, Namibia. Aim: The aim of this study was to determine the orthodontic treatment needs of a population of 12-15 year-old children attending a school in Khomas and to express it as percentages of those with subjective and objective orthodontic treatment need over the whole sample population. The objectives were to find associations between treatment needs and some demographic and socioeconomic factors.Item Soft tissue profile changes in patients treated with non-extraction versus second premolar extraction protocols - using the Damon system(University of the Western Cape, 2018) Julyan, Johan Christian; Harris, AngelaOrthodontic treatment has the ability to improve the aesthetics and the function of patients. In order to create space, orthodontic treatment often requires removal of teeth. The most common teeth removed for orthodontic treatment are the premolars. It has become popular to remove second premolars in certain cases where the soft tissue profile should not be altered. The Damon self-ligating orthodontic system is renowned for not requiring dental extractions in the majority of cases. The effect of extractions on the soft tissue profile of patients, in conjunction with using the Damon system, has therefore not been researched. It is important to understand the effect that orthodontic treatment and extractions can have on the soft tissue profile of patients. This effect can accurately be determined by making use of the soft tissue cephalometric analysis, developed by Dr Reed A. Holdaway in 1983.Item Orthodontic treatment need and demand in the Upington area of the Northern Cape Province(University of the Western Cape, 2018) Booysen, Jeannette; Harris, AngelaWhen considering a person's self-esteem, behavioural patterns and personal interactions, the one feature having the most impact is their physical appearance. In an ideal world, every person should have a fair opportunity to reach their full potential in life. Orthodontics can improve a person's quality of life by creating confident smiles and a functional occlusion (Sheiham, 1993). Uncorrected malocclusions can adversely affect one's speech, general health and self-esteem. Improving the general physiological implications malocclusions has on person, may make them more employable and more successful in relationships, creating an overall happier, healthier and more successful community. The more people are offered affordable orthodontic treatment, the more acceptable orthodontic treatment may become. Thus, the perceived benefits of Orthodontic treatment in a population group are Improvement of Oral Health and enhancement of psychosocial welfare. Accurate data on the prevalence, distribution and severity of malocclusion is needed by provincial oral health management. They also need accurate data of the orthodontic treatment need of the children in that specific area. This data is vital for the effective planning of the education, training and deployment of dental workers, as well as the resources and distribution thereof in specific, designated areas (Holtshousen, 1997; So & Tang, 1993). This study's focus was to estimate the prevalence of malocclusion amongst adolescents in Upington area in the Northern Cape, and to determine the need for orthodontic treatment in the area using the Index for Orthodontic Treatment Need (IOTN).Item Orthodontic treatment need in children aged 12-14 years in Mombasa, Kenya(University of the Western Cape, 2016) Mwang'ombe, Fiona Githua; Shaikh, A.; Elkhadem, A.A public orthodontic system generally is designed to prioritize patients so that those who have the greatest need receive treatment. The aim of this study was to compare the subjective perceptions of the occlusal appearance of 11 to 12 year-old schoolchildren of Nairobi with the modified Aesthetic Component (AC) scale of the Index of Orthodontic Treatment Need (IOTN). The objectives were to assess the children's perception of their occlusal appearance, categorise the occlusal appearance using the AC scale, by both the children and researcher; and to compare the children's' perception and the AC of the IOTN. Satisfaction with appearance of teeth and occlusion as well as peer comparison was investigated. The treatment need and demand was assessed using the modified AC photographs of the IOTN. Altogether, 488 school children (249 girls and 239 boys) assessed their perception of the anterior teeth using a Verbal Descriptor Scale (VDS) and a Visual Analog Scale (VAS) questionnaire. The researcher examined the anterior teeth of the participants and categorised them using the AC of the IOTN. The following results were reported: about two-thirds of the respondents were satisfied with the appearance of their teeth, with the gender difference being statistically significant. About 35% were dissatisfied or very dissatisfied, but reasons for it varied. More than half of the respondents rated their teeth as better than those of their peers and three-quarters were satisfied with their occlusion, the two responses elicited no gender difference. Treatment need was assessed by use of the AC indicated that there was a moderate agreement between researcher and respondents’ in treatment need assessment. The researcher found 36.3% needed treatment against self-perceived need of 30.9%. One-third of the respondents determined by the researcher to 'need treatment', felt 'no need'. There was no statistical gender difference in perceived need for treatment. The selection of ranked photographs of the AC by both researcher and respondents demonstrated skewed distributions towards the 'low ranked' or attractive end of the ranking order irrespective of the state of occlusion. Statistical comparison of the two methods used, namely the VDS and VAS, indicated that the responses were significantly different. Therefore it is suggested that any treatment priority assessment should take perceptions of occlusal appearance. into consideration.