Oral health problems still remain in many communities around the world, particularly among underprivileged groups in developed and developing countries. The significant role of socio-behavioural and environmental factors in oral disease and health is demonstrated in a large number of epidemiological surveys. The global burden of oral conditions increased from 1990 to 2010, collectively affecting 3.9 billion people [1]. Dental caries are still a major oral health problem in most industrialized countries, affecting 60 ± 90 % of schoolchildren and the vast majority of adults [2].
Treatment need indices have been used to plan for the provision of orthodontic treatment in countries in which dental health services are subsidized by the government as part of the national health service or national health insurance system, as is the case in Denmark, Finland, Great Britain, Netherlands, Norway, and Sweden. Because of this connection with public health programs, the use of indices has been limited in countries where publicly funded dental health services are not generally available. However, treatment need indices are also important tools for recording the prevalence and severity of malocclusions in epidemiological studies.
IOTN is used to determine the need or priority for orthodontic treatment in epidemiological surveys. In more recent studies, the IOTN index in relation to different ages has been described in many countries: Spain [3], Brazil [4], United States [5], Iran [6], Malaysia [7] and Albania [8, 9].
The DMFT Index measures the lifetime experience of dental caries in permanent dentition. In many developing countries, access to oral health services is limited and teeth are often left untreated or are extracted because of pain or discomfort. Throughout the world, the loss of teeth is still seen by many people as a natural consequence of aging but it is very important to recognize and lower this index among young people [2].
World Health Organization (WHO) CPI codes are also recorded as an assessment of periodontitis. CPI codes of 0–4 were given: healthy cases and absence of gingival bleeding (score 0), gingival bleeding (score 1), presence of supra or subgingival calculus (score 2), probing pocket depth of 4–5 mm (score 3) or probing pocket ≥6 mm (score 4), respectively. In this WHO classification of periodontitis, it has been determined that the highest CPI code should be selectively applied for each patient by determining all codes in six individual blocks in each periodontal patient [2].
The OHI by Greene [10] is composed of the combined Debris Index and Calculus index, each of these indices is in turn based on 12 numerical determinations representing the amount of debris or calculus found on the buccal and lingual surfaces of each of three segments of each dental arch: the segment distal to the right cuspid, the segment distal to the left cuspid, the segment mesial to the right and left first bicuspids.
The PI system by Sillness defined four levels of quantity and quality of soft deposits: score 0 no plaque, score 1 a film of plaque adhering to the free gingival margin and adjacent areas of the tooth, score 2 moderate accumulation of soft deposits within the gingival pocket or on the tooth and gingival margin which can be seen with the naked eye, score 3 abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin.
Very few epidemiological studies are found which describe oral health conditions and the need of orthodontic treatment in Albania [8, 9, 11]. Laganà found a DMTF value of 2.3 in 7 to 15 year-old students; Hysi found a value of 3.8 in a younger group (12 years old) [12].
The aim of the present study was to determine the orthodontic treatment need using IOTN (Index of Orthodontic Treatment Need) and oral conditions using Decayed Missing Filled Teeth (DMFT), Community Periodontal Index (CPI), Oral Hygiene Index (OHI), Plaque Index (PI), in an adolescent population of Tirana.