Prevalence of malocclusion and orthodontic treatment needs among Saudi primary school male children aged 6-12 years: A cross-sectional study

Aim: To evaluate the prevalence of malocclusion and the need for early orthodontic treatment (EOT) using dental health component (DHC) of the index of orthodontic treatment need (IOTN). Materials and Methods: In this cross-sectional study, clinical examination was performed on 357 male children, aged 6-12 years who were randomly selected from five public schools and one public pediatric dental clinic, in Al-Kharj province, Saudi Arabia. The examination assessed various occlusal parameters using IOTN, across the total sample and further between two subgroups (early and late mixed dentitions). Results: For the total sample 58.8% had Angle's Class I malocclusion, 26.7% had Angle's Class II, 9.8% had Angle's Class III, while crowding was present in 44.5%. Over 1/4 of the younger group and 42.8% of the older group exhibited at least one feature indicating EOT: anterior crossbite, posterior crossbite, open bite, impinging overbite, ≥7 mm overjet, and Class III malocclusion. However, no statistical differences were found between the two groups (P > 0.05). According to DHC score, 77 participants (21.6%) were in definite OTN. The DHC score demonstrates its validity in identifying evidence-based malocclusion features as significant indicators for EOT. Compared to DHC, the esthetic component significantly overestimated lack of OTN and significantly underestimated definite OTN (P 0.05). Conclusion: The prevalence of malocclusion and EOT need is generally similar among younger and older children, but the distribution is higher among older children. Orthodontic screening at early mixed dentition stage is essential.