Differences in Need for Orthodontic Treatment Between Native Americans and the General Population Based on DAI Scores

Clinical impressions by Indian Health Service (IHS) dentists of a greater frequency of severe dental malrelations among Native Americans than in the general US population have never been objectively confirmed. This study uses the DAI as the standard to determine whether there is a greater prevalence of severe malocclusions among Native Americans. Four hundred eighty-five Native American students in grades 7-12 from two remote sites–Pine Ridge, SD, and Many Farms, AZ– and one nonremote site–Lapwai, ID–were scored for the DAI. The mean scores from each reservation, as well as the mean score from the three reservations combined, were significantly higher, indicating poorer aesthetics, than the mean DAI score from a large sample of the general US population. These data confirm the clinical impressions of IHS dentists that Native Americans residing on reservations have significantly poorer dental aesthetics than the aesthetics found in the general US population; therefore, Native Americans have greater needs for orthodontic treatment.