Disease and Health: Conceptual Issues in Orthodontic Assessment in Nigeria

Abstract

The purpose of this review was to examine the appropriateness of currently used orthodontic assessment indices. We examined the appropriateness of the indices from three perspectives: the validity of the indices to assess malocclusion, the relative contribution of malocclusion to the overall burden of diseases in Nigeria, and the amount of resources available to manage the burden of health problems in Nigeria. Estimates of the contribution of various diseases to the burden of diseases in Nigeria and the amount of money spent on health was obtained from open source data available from the Institute for Health Metrics and Evaluation, the World Bank group, and the World Health Organization. It was observed that the norms used to establish malocclusion were based on morphological and aesthetic norms (standards of beauty) that do not apply to the Nigerian population. In general, oral conditions contribute less than 0.5% of the disability life adjusted years (DALYs) and less than 1.5% of years lost due to disability (YLDs). Meanwhile, the highest total per capita health expenditure between 1995 and 2014 was $117.52, 6.7% of which was from external resources. It was concluded that measures to assess malocclusion in Nigeria must be valid as well as address the contribution of varying degrees of malocclusion to the ability of individuals to live an economically and socially productive life.