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 Table of Contents  
Year : 2016  |  Volume : 3  |  Issue : 3  |  Page : 99-102

Prevalence of malocclusion and its common traits in Saudi males of Aseer region

1 Department of Pediatric Dentistry and Orthodontic Sciences, Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
2 Department of Maxillofacial Surgery and Diagnostic Sciences, Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
3 Department of Orthodontics, Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
4 Department of Oral and Maxillofacial Surgery, Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
5 Department of Community Dentistry, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia

Date of Web Publication28-Nov-2016

Correspondence Address:
Zakirulla Meer
Department of Pediatric Dentistry and Orthodontic Sciences, Dentistry, College of Dentistry, King Khalid University, Abha
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2348-2915.194834

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Background: To evaluate the prevalence of malocclusion and its common characteristics in young male population of Aseer province. Methods: One thousand eight hundred and twenty Saudi male students between the age of 15 and 17 years were chosen from 3408 pupils studying in different middle schools of Abha region. Oral examination was performed to check the prevalence of malocclusion according to Angles classification and the individual traits including crowding, spacing, deep bite, anterior open bite, and anterior cross bite. Results: The prevalence of Class I, II, and III malocclusions was 62.3%, 28.4%, and 9.3%, respectively. Crowding was the most common individual trait (43.8%) while anterior open bite was the least prevalent (7.2%). Conclusion: There was high prevalence of malocclusion observed in the study population. Nearly half of them were suffering from crowding of teeth.

Keywords: Crossbite, crowding, malocclusion, occlusal traits, prevalence, spacing

How to cite this article:
Meer Z, Sadatullah S, Wahab MA, Mustafa AB, Odusanya SA, Razak PA. Prevalence of malocclusion and its common traits in Saudi males of Aseer region. J Dent Res Rev 2016;3:99-102

How to cite this URL:
Meer Z, Sadatullah S, Wahab MA, Mustafa AB, Odusanya SA, Razak PA. Prevalence of malocclusion and its common traits in Saudi males of Aseer region. J Dent Res Rev [serial online] 2016 [cited 2023 Jan 30];3:99-102. Available from: https://www.jdrr.org/text.asp?2016/3/3/99/194834

  Introduction Top

Occlusal malrelationship is not a disease, but a morphologic variation commonly occurring without a pathologic condition. [1] Such a manifestation is commonly known as malocclusion. Dental malocclusions are the third highest prevalent oral pathologies, next to tooth decay, and periodontal disease. They are categorized as the third most severe problems affecting oral health. [2] The high occurrence of malocclusion is related to a number of genetic and environmental factors. Premature tooth loss, missing teeth, discrepancy in jaw, and tooth size are a few to name. [3] Finger or thumb sucking habit and excessive mouth breathing also lead to improper occlusion relationship. The reported incidence in different populations varies from 39% to 93% making it clear that a high percentage of individuals have less than ideal occlusion. [4],[5],[6] Untreated malocclusions lead to increase in the prevalence of dental caries and temporomandibular disorders. [7] It affects the appearance, mastication, and speech of an individual while having an impact on the social, physical, and emotional wellbeing.

The demand for orthodontic treatment has been rapidly increasing and is influenced by socioeconomic factors, cultural background, the sufferer's perceived need for treatment, and anticipated improvement of self-image. [8],[9] The studies have reported that people who are satisfied with their facial appearance seem to be more self-confident and have higher self-esteem than those who are dissatisfied with their facial appearance. [10],[11] The early recognition of malocclusion is indispensable for positive prognosis of its treatment. [12] Therefore, collection of epidemiological data on the prevalence is essential in assessing the resources needed to plan and implement preventive and therapeutic measures. It also provides valuable information regarding the etiology of malocclusion and its preference to specific ethnic groups. [13]

The prevalence of malocclusion is not alike various ethnic groups and countries worldwide. A number of investigators have reported the prevalence and need for orthodontic treatment in the Saudi Arabian population. [14],[15],[16] Most of these studies were done in big cities on patients reporting to clinics for dental treatment. No study, to the best of our knowledge, was done across a huge geographically and ethnically identical Saudi population. A vacuum for this information prompted to initiate the current study in the Southern region of Saudi Arabia. The purpose of this investigation was to determine the prevalence of malocclusions and its common traits in Saudi male population of Aseer region.

  Methods Top

This cross-sectional epidemiological study comprised 1820 Saudi Middle School male students randomly selected from 3408 pupils. The screening was performed in twenty boys schools over a period of 3 months. It was part of "Oral Health Screening Program" approved by Scientific Research Committee of King Khalid University, College of Dentistry (KKU/COD) Abha. Permission was obtained from the school authorities before carrying out oral health awareness demonstrations and oral examination during school hours. The oral examination was carried out in school premises under sufficient lighting conditions using examination gloves, sterile disposable tongue depressors (to retract cheek), mouth masks, and torch light. Criteria to include students in the study population were as follows.

  • Age range of 15-17 years
  • No previous orthodontic treatment performed
  • Presence and complete eruption of all permanent teeth excluding third molars
  • Absence of large fillings, fractured, or malformed teeth
  • No previous history of permanent teeth extraction
  • No apparently evident craniofacial deformities or syndrome
  • Saudi Arabian national.

The observed data were recorded in a prepared form by seven experienced examiners from KKU/COD. All the examiners involved in the study were calibrated, and interexaminer reliability was calculated using kappa statistics (κ =0.94). All interarch parameters were scored with the teeth in maximum intercuspal relation. The different characteristics of malocclusion that were noted included Angles classification, crowding, spacing, deep bite, anterior open bite, and anterior cross bite. The details of criteria employed to score the malocclusion are given in [Table 1]. The recorded malocclusions were calculated as frequency and percentage values.
Table 1: Description for different types of malocclusions

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  Results Top

High incidence of caries, filled and extracted teeth meant that more than 40% of the screened boys were left out of the study. One thousand eight hundred and twenty boys meeting the selection criteria were shortlisted from the main data pool of 3408 students for analysis. The prevalence of Angles Class I, II, and III malocclusion was 62.3%, 28.4%, and 9.3% respectively [Figure 1]. The distribution of other malocclusions trait recorded is given in [Figure 2]. Crowding was the most common malocclusion (43.8%) followed by deep bite (21%) and spacing (16.7%). Anterior cross bite (12.6%) and anterior open bite (7.2%) were the least prevalent traits. Due to time restrain and to avoid intraobserver bias in the huge study population, the degree of malocclusion was not recorded. Students needing immediate dental treatment were referred to KKU/COD Dental Clinics.
Figure 1: Prevalence of malocclusion

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Figure 2: Prevalence of different types of malocclusion trait

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  Discussion Top

Numerous studies have been published describing the prevalence of malocclusion and its different types. [17],[18],[19] The reported prevalence varies from group to group. The number of patients seeking orthodontic treatment in Saudi Arabia has increased markedly during recent years. [20] As a result, health-care planners are compelled to have relevant epidemiological data on different types of malocclusions to estimate and plan for treatment. Although Angle's classification has less versatility, it is universally accepted as a reliable system that can be used in large study populations avoiding intraobserver bias. [14],[21] Class I molar relationship is the most prevalent form of occlusion in any population. The frequency distribution of Angle's classes of malocclusion in Aseer region was in close agreement with other studies done on Saudi population. [14],[15],[16],[22],[23] Majority of these studies may not completely represent the occurrence of malocclusion solely because of the insufficient sample size. [24] The prevalence of Class I malocclusion observed in this study was less than Latino [21] and Lithuanian populations. [25] Similarly, Class III malocclusion was less prevalent in Saudi population compared to Turkish [26] population. Conversely, the Americans [27] and Columbians [6] had less cases of Class III reported than the current study. This is consistent with the fact that youngsters are highly concerned about their appearance even though the malocclusion may or may not affect their functional ability. In Saudi Arabia, governmental sectors provide free orthodontic treatment for Saudi citizens, and they have good exposure to resources available.

The type of malocclusion is a key factor that drives a patient to seek orthodontic treatment. [28] If this is any indication, crowding should keep the orthodontist of this region very busy. It is the most common malocclusion trait found in the present study 43.8% and numerous previous studies. [22],[27],[28],[29] Jones, however, reported a higher incidence of crowding (67.4%) in population of Central region of Riyadh. [24] Similarly, 81.4% of female population in the Western region had some degree of incisor crowding. This is substantially higher than the findings of our study in females. The high prevalence of crowding seems to be associated with high incidence of caries. This has been explained by the cascading effect of caries in deciduous molars followed by extraction, and the migration of the first permanent molars, resulting in inclination and rotation of teeth in the anterior sextant. [6]

Consistent with the observations of Corruccini and Whitley, spacing occurred less frequently (16.7%) when compared to crowding. [30] Higher incidence of spacing was reported in Columbian children (25.9%). [6] Similarly, in the present study anterior open bite (7.2%) was found less common than deep bite (21%). Al-Hummayani reported an identical pattern of anterior open bite and deep bite prevalence. [31] However, this observation differs from the findings of Nashashibi et al. [32] and Al-Emran et al., [22] wherein the prevalence of open bite cases outnumbered deep bite. Elsewhere, other studies have reported a higher prevalence of anterior open bite (10.2%) and lower prevalence (3%) than the present study. [6],[33]

In the present study, 12.6% of the study subjects displayed anterior cross bite. Higher prevalence than this was reported by Burden et al., Hill, Behbehani et al., and Oshagh et al. [34],[35],[36],[37] Higher prevalence for cross bite can be attributed to variation in growth and disproportion in the dentoalveolar width and genetic factors. An early interception of cross bites should be aimed at to prevent asymmetric growth abnormalities of the mandible and maxilla. [38]

  Conclusion Top

Saudi Arabia is one of the most populated countries in the Middle East. Its big cities in the Western, Central, and the Eastern region are inhabited with ethnically mixed cosmopolitan population. The influx of urbanization, to a large extent, has still evaded the Southern region resulting in a racially preserved society. The advantage of this study over similar studies on Saudi population is that it involved a huge cross section of ethnically alike individuals of the Southern region. However, this study could not include females from the same population. Nevertheless, a high prevalence of malocclusion was recorded with crowding being the most common malocclusion trait. Epidemiological data on the prevalence of malocclusion are an important determinant in planning appropriate levels of orthodontic services. Further large-scale studies are required in different regions of Saudi Arabia to provide accurate estimates of the orthodontic treatment need in the Saudi population.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Diagne F, Ba I, Ba-Diop K, Yam AA, Ba-Tamba A. Prevalence of malocclusion in Senegal. Community Dent Oral Epidemiol 1993;21:325-6.  Back to cited text no. 1
World Health Organization. Standardization of Reporting of Dental Diseases and Conditions. The Assessment of Handicapping Dental Facial Anomalies. Geneva: World Health Organization; 1962.  Back to cited text no. 2
Corruccini RS. An epidemiologic transition in dental occlusion in world populations. Am J Orthod 1984;86:419-26.  Back to cited text no. 3
Jacobson S, Lennartsson B. Prevalence of malocclusion and awareness of dental appearance in young adults. Swed Dent J 1996;20:113-20.  Back to cited text no. 4
Al-Ibrahim HM, Telfah HD, Hyasat AN. Frequency of malocclusion in an orthodontically referred Jordanian population. JRMS 2010;17:19-23.  Back to cited text no. 5
Thilander B, Pena L, Infante C, Parada SS, de Mayorga C. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Eur J Orthod 2001;23:153-67.  Back to cited text no. 6
Zakirulla M. Malocclusion in deciduous dentition of Saudi children: A cross-sectional study. Bangladesh J Med Sci 2012;11:343-6.  Back to cited text no. 7
Burden DJ, Holmes A. The need for orthodontic treatment in the child population of the United Kingdom. Eur J Orthod 1994;16:395-9.  Back to cited text no. 8
de Oliveira CM, Sheiham A. Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents. J Orthod 2004;31:20-7.  Back to cited text no. 9
Bos A, Hoogstraten J, Prahl-Andersen B. Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients. Am J Orthod Dentofacial Orthop 2003;123:127-32.  Back to cited text no. 10
Williams DM, Bentley R, Cobourne MT, Gibilaro A, Good S, Huppa C, et al. The impact of idealised facial images on satisfaction with facial appearance: Comparing "ideal" and "average" faces. J Dent 2008;36:711-7.  Back to cited text no. 11
Adib K, Joseph BS, Nayla BN. Orthodontic patients: An epidemiologic and analytic study, an observational retrospective study. IAJD 2010;1:36-43.  Back to cited text no. 12
Rudan I, Campbell H, Rudan P. Genetic epidemiological studies of Eastern Adriatic Island isolates, Croatia: Objective and strategies. Coll Antropol 1999;23:531-46.  Back to cited text no. 13
AlQarni MA, Banihuwaiz AH, Alshehri FD, Alqarni AS, Alasmari DS. Evaluate the malocclusion in subjects reporting for orthodontic treatment among Saudi population in Asser Region. J Int Oral Health 2014;6:42-6.  Back to cited text no. 14
Ajayi EO. Prevalence of malocclusion among school going children in Benin City, Nigeria: A peer-review. J Biomed Sci 2008;7:5-11.  Back to cited text no. 15
Al-Hummayani FM. Prevalence of incisors crowding in Saudi Arabian female students. Med Sci J 2004;20:3.  Back to cited text no. 16
Baume LJ. Uniform methods for the epidemiologic assessment of malocclusion. Results obtained with the World Health Organization standard methods (1962 and 1971) in South Pacific populations. Am J Orthod 1974;66:251-72.  Back to cited text no. 17
Bezroukov V, Freer TJ, Helm S, Kalamkarov H, Sardo Infirri J, Solow B. Basic method for recording occlusal traits. Bull World Health Organ 1979;57:955-61.  Back to cited text no. 18
Tang EL, Wei SH. Recording and measuring malocclusion: A review of the literature. Am J Orthod Dentofacial Orthop 1993;103:344-51.  Back to cited text no. 19
Anita G, Asiya B. Adult orthodontics. IJDA 2010;2:96-9.  Back to cited text no. 20
Silva RG, Kang DS. Prevalence of malocclusion among Latino adolescents. Am J Orthod Dentofacial Orthop 2001;119:313-5.  Back to cited text no. 21
al-Emran S, Wisth PJ, Böe OE. Prevalence of malocclusion and need for orthodontic treatment in Saudi Arabia. Community Dent Oral Epidemiol 1990;18:253-5.  Back to cited text no. 22
Al-Balkhi KM, Zahrani AA. The pattern of malocclusions in Saudi Arabian patients attending for orthodontic treatment at the College of Dentistry, King Saud University, Riyadh. Saudi Dent J 1994;6:138-44.  Back to cited text no. 23
Jones WB. Malocclusion and facial types in a group of Saudi Arabian patients referred for orthodontic treatment: A preliminary study. Br J Orthod 1987;14:143-6.  Back to cited text no. 24
Sidlauskas A, Lopatiene K. The prevalence of malocclusion among 7-15-year-old Lithuanian schoolchildren. Medicina (Kaunas) 2009;45:147-52.  Back to cited text no. 25
Celikoglu M, Akpinar S, Yavuz I. The pattern of malocclusion in a sample of orthodontic patients from Turkey. Med Oral Patol Oral Cir Bucal 2010;15:e791-6.  Back to cited text no. 26
Proffit WR, Fields HW Jr., 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;13:97-106.  Back to cited text no. 27
Sayin MO, Türkkahraman H. Malocclusion and crowding in an orthodontically referred Turkish population. Angle Orthod 2004;74:635-9.  Back to cited text no. 28
Abu Alhaija ES, Al-Khateeb SN, Al-Nimri KS. Prevalence of malocclusion in 13-15 year-old North Jordanian school children. Community Dent Health 2005;22:266-71.  Back to cited text no. 29
Corruccini RS, Whitley LD. Occlusal variation in a rural Kentucky community. Am J Orthod 1981;79:250-62.  Back to cited text no. 30
Al-Hummayani FM. Incisor overbite in Saudi Arabia. Egypt Dent J 2005;51:1-5.  Back to cited text no. 31
Nashashibi I, Darwish SK, Khalifa El R. Prevalence of malocclusion and treatment needs in Riyadh (Saudi Arabia). Odontostomatol Trop 1983;6:209-14.  Back to cited text no. 32
Otuyemi OD, Ogunyinka A, Dosumu O, Cons NC, Jenny J. Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the dental aesthetic index (DAI). Int Dent J 1999;49:203-10.  Back to cited text no. 33
Burden DJ, Pine CM, Burnside G. Modified IOTN: An orthodontic treatment need index for use in oral health surveys. Community Dent Oral Epidemiol 2001;29:220-5.  Back to cited text no. 34
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;19:87-96.  Back to cited text no. 35
Behbehani F, Artun J, Al-Jame B, Kerosuo H. Prevalence and severity of malocclusion in adolescent Kuwaitis. Med Princ Pract 2005;14:390-5.  Back to cited text no. 36
Oshagh M, Ghaderi F, Pakshir HR, Baghmollai AM. Prevalence of malocclusions in school-age children attending the orthodontics department of Shiraz University of Medical Sciences. East Mediterr Health J 2012;16:1245-50.  Back to cited text no. 37
Tausche E, Luck O, Harzer W. Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need. Eur J Orthod 2004;26:237-44.  Back to cited text no. 38


  [Figure 1], [Figure 2]

  [Table 1]

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