Orthodontic treatment need of adolescents in the island community of Haida Gwaii, Canada

  • Asef Karim
  • Jolanta Aleksejuniene DDS, MSc, PhD, Assistant Professor, Chair, Preventive and Community Dentistry, Faculty of Dentistry, University of British Columbia.
  • Edwin H. K. Yen
  • Mario Brondani DDS, MSc, PhD, Assistant Professor, Dental Public Health, Faculty of Dentistry, University of British Columbia.
  • Arminée Kazanjian
Keywords: Aboriginal, Haida Gwaii, malocclusion, orthodontics, adolescent, Skidegate, Masset, ICON


The aim of this study was to determine the prevalence of malocclusion and orthodontic treatment need according to the Index of Complexity, Outcome, and Need (ICON) among schoolchildren of the island community of Haida Gwaii in northwestern British Columbia, Canada. Two elementary and two high schools in Haida Gwaii were approached for census sampling. Out of 535 schoolchildren, 215 (90 boys and 125 girls) agreed to participate (40.2% response) in this cross-sectional epidemiological study. A trained examiner assessed orthodontic treatment need in children employing the ICON score and the ICON complexity grade. The mean age (N = 215) was 12.9 ± 2.8 years. Of the examined schoolchildren, 67% had Aboriginal ancestry (at least one Aboriginal parent). The mean ICON score (N = 215) was 43.5 ± 26.2. There were no statistically significant differences in ICON scores for gender (t test, p = 0.207), ethnicity (t tests: paternal ethnicity, p = 0.886 and maternal ethnicity, p = 0.389), or school (ANOVA with post hoc Bonferroni adjustment, p = 0.317). Overall, 43.7% of the surveyed Haida Gwaii adolescents needed orthodontic treatment (ICON > 43). Based on the ICON complexity grade, 31% of the schoolchildren had moderate to very difficult malocclusions; therefore, specialty orthodontic services are recommended in this remote community.

Research Papers