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Assessment of early orthodontic treatment needs in children aged 4–6 using the baby-risk of malocclusion assessment (Baby-ROMA) index
1Department of Pedodontics, Faculty of Dentistry, Sakarya University, 54100 Sakarya, Türkiye
2Department of Periodontology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
3Department of Orthodontics, Faculty of Dentistry, Ankara Medipol University, 06570 Ankara, Türkiye
4Private Practice, 54050 Sakarya, Türkiye
5Department of Pedodontics, Faculty of Dentistry, Yıldırım Beyazıt University, 06110 Ankara, Türkiye
DOI: 10.22514/jocpd.2025.141 Vol.49,Issue 6,November 2025 pp.189-197
Submitted: 25 February 2025 Accepted: 30 April 2025
Published: 03 November 2025
*Corresponding Author(s): Neslihan Yilmaz E-mail: neslihanyilmaz@sakarya.edu.tr
Background: This study aimed to assess the prevalence of malocclusion and orthodontic treatment needs using the Baby-ROMA index in a group of Turkish children aged 4–6 years, and to examine the association between Baby-ROMA index scores and demographic and dental characteristics. Methods: A total of 203 children aged 4–6 years with primary dentition and no previous orthodontic treatment were included. Demographic data and parental perceptions of orthodontic treatment need were collected via interviews. Clinical examinations were performed using the Baby-ROMA index, and dental caries status was assessed using the decayed, missing and filled teeth (dmft) index. The presence of primate spaces, molar relationships, and canine relationships were also recorded. Results: The most prevalent risk factors for malocclusion were parafunctional habits (27.6%), poor oral hygiene (27.1%), and dental caries or early loss of primary teeth (25.1%). The results indicated statistically significant differences in Baby-ROMA index scores based on age groups (p = 0.004), right molar relationship (p = 0.019) and dmft scores (p < 0.001). Despite these findings, 76.2% of parents did not perceive any orthodontic treatment need for their children. Conclusions: Our findings demonstrate a high prevalence of malocclusion risk and orthodontic treatment needs among Turkish children aged 4–6 years. The results highlight the importance of early intervention and preventive strategies to address key risk factors, such as parafunctional habits, dental caries and poor oral hygiene.
Malocclusion; Primary teeth; Treatment need; Baby-ROMA
Neslihan Yilmaz,Elif Gökçe Erkan Acar,Elif Gül Aydin,Esra Ceren Tuğutlu. Assessment of early orthodontic treatment needs in children aged 4–6 using the baby-risk of malocclusion assessment (Baby-ROMA) index. Journal of Clinical Pediatric Dentistry. 2025. 49(6);189-197.
[1] Bekes K, Kuhr K, Ohm C, Frenzel Baudisch N, Jordan AR. Does orthodontic treatment need have an impact on oral health-related quality of life? Journal of Orofacial Orthopedics. 2023; 84: 19–25.
[2] Leck R, Paul N, Rolland S, Birnie D. The consequences of living with a severe malocclusion: a review of the literature. Journal of Orthodontics. 2022; 49: 228–239.
[3] Carli E, Fambrini E, Lardani L, Derchi G, Defabianis P. Early orthodontic treatment need in paediatric age: a prospective observational study in Italian school-children. European Journal of Paediatric Dentistry. 2023; 24: 94–98.
[4] Grippaudo C, Paolantonio EG, Pantanali F, Antonini G, Deli R. Early orthodontic treatment: a new index to assess the risk of malocclusion in primary dentition. European Journal of Paediatric Dentistry. 2014; 15: 401–406.
[5] Madiraju GS, Almugla YM, Mohan R, Alnasser BM. An epidemiological study on early orthodontic treatment need among eastern Saudi Arabian children in the mixed dentition stage. Scientific Reports. 2024; 14: 4084.
[6] Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. European Journal of Orthodontics. 1989; 11: 309–320.
[7] Vedovello SAS, Carvalho ALMD, Carneiro DPA, Meneghim MC. A 4-year follow-up of the need for orthodontic treatment using the Dental Aesthetic Index-DAI: an exploratory analysis. Brazilian Oral Research. 2025; 39: e007.
[8] Summers CJ. The occlusal index: a system for identifying and scoring occlusal disorders. American Journal of Orthodontics. 1971; 59: 552–567.
[9] Tang EL, Wei SH. Assessing treatment effectiveness of removable and fixed orthodontic appliances with the occlusal index. American Journal of Orthodontics and Dentofacial Orthopedics. 1990; 98: 550–556.
[10] Chen H, Lin L, Chen J, Huang F. Prevalence of malocclusion traits in primary dentition, 2010–2024: a systematic review. Healthcare. 2024; 12: 1321.
[11] Peres KG, Peres MA, Thomson WM, Broadbent J, Hallal PC, Menezes AB. Deciduous-dentition malocclusion predicts orthodontic treatment needs later: findings from a population-based birth cohort study. American Journal of Orthodontics and Dentofacial Orthopedics. 2015; 147: 492–498.
[12] Grippaudo C, Paolantonio EG, Deli R, La Torre G. Orthodontic treatment need in the Italian child population. European Journal of Paediatric Dentistry. 2008; 9: 71–75.
[13] Grippaudo C, Quinzi V, Manai A, Paolantonio EG, Valente F, Torre G La, et al. Orthodontic treatment need and timing: assessment of evolutive malocclusion conditions and associated risk factors. European Journal of Paediatric Dentistry. 2020; 21: 203–208.
[14] Jahanimoghadam F, Nikzad S, Ahmadipour H, Sadeghi S, Aftabi R. Baby‑risk of malocclusion assessment index: an assessment tool for preventive orthodontic treatment needs in a selected population of children in southeast of Iran. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 2021; 37: 29–35.
[15] Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009; 41: 1149–1160.
[16] Machado E, Dal-Fabbro C, Cunali PA, Kaizer OB. Prevalence of sleep bruxism in children: a systematic review. Dental Press Journal of Orthodontics. 2014; 19: 54–61.
[17] Almeida AB, Rodrigues RS, Simão C, de Araújo RP, Figueiredo J. Prevalence of sleep bruxism reported by parents/caregivers in a portuguese pediatric dentistry service: a retrospective study. International Journal of Environmental Research and Public Health. 2022; 19: 7823.
[18] Singh A, Rathore M, Govil S, Umale V, Kulshrestha R, Kolhe T. Prevalence of malocclusion and orthodontic treatment needs in primary and mixed dentition using baby Roma index and index of orthodontic treatment needs. International Journal of Clinical Pediatric Dentistry. 2021; 14: S22–S28.
[19] Orhan AI, Alkan A, Orhan K, Tezel A, Karaoglanoglu S, Oztas D. Dental caries and associated factors among Turkish children and adults: findings from the 3rd National Oral Health Survey. Community Dentistry Oral Epidemiology. 2024; 52: 499–508.
[20] Shakti P, Singh A, Purohit BM, Purohit A, Taneja S. Effect of premature loss of primary teeth on prevalence of malocclusion in permanent dentition: a systematic review and meta-analysis. International Orthodontics. 2023; 21: 100816.
[21] Gomide RT, Frencken JE, Leal SC, Kuijpers-Jagtman AM, Faber J. Impact of proximal cavities and primary molar absence on space in the dental arches. PeerJ. 2020; 8: e8924.
[22] Gandhi J, Gurunathan D. Short-and long-term dental arch spatial changes following premature loss of primary molars: a systematic review. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 2022; 40: 239–245.
[23] Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngologica Italica. 2016; 36: 386–394.
[24] Lin L, Zhao T, Qin D, Hua F, He H. The impact of mouth breathing on dentofacial development: a concise review. Frontiers in Public Health. 2022; 10: 929165.
[25] Kirzioglu Z, Simsek S, Yilmaz Y. Longitudinal occlusal changes during the primary dentition and during the passage from primary dentition to mixed dentition among a group of Turkish children. European Archives of Paediatric Dentistry. 2013; 14: 97–103.
[26] Bishara SE, Hoppens BJ, Jakobsen JR, Kohout FJ. Changes in the molar relationship between the deciduous and permanent dentitions: a longitudinal study. American Journal of Orthodontics and Dentofacial Orthopedics. 1988; 93: 19–28.
[27] Zhou C, Duan P, He H, Song J, Hu M, Liu Y, et al. Expert consensus on pediatric orthodontic therapies of malocclusions in children. International Journal of Oral Science. 2024; 16: 32.
[28] Dos Santos CCO, da Rosa Moreira Bastos RT, Bellini-Pereira SA, Garib D, Normando D. Spontaneous changes in mandibular incisor crowding from mixed to permanent dentition: a systematic review. Progress in Orthodontics 2023; 24: 15.
[29] Jahanbin A, Haghifar M, Shahamfar M. Effect of various educational methods on increasing parents’ awareness of their children’s preventive orthodontic treatments. Brazilian Journal of Oral Sciences. 2024; 23: e240396.
[30] Mohammed Alwusaybie M, AlBaqshi FS, Alshaks MA, Zaki Alabdullah M, Abdulaziz Alwosaibei M, AlBahrani HJ, et al. Parental knowledge and awareness regarding early orthodontic consultation in children: a cross-sectional study. Cureus. 2024; 16: e73842.
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