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| Knowledge, attitude, and perception regarding myofunctional appliance: A cross-sectional survey of parents' view |
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Bhuvaneswari Mani1, I Bevin shaga2, Agasthiya Ayyapillai3, Gayathri Gangadharan3, Jejo Mathew4, Revathi Somasundaram3
1 Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Karpaga Vinayaga Institute of Dental Sciences, Kancheepuram, Tamil Nadu, India
2 Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
3 Consultant Orthodontist, Madurai, Tamil Nadu, India
4 Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
Click here for correspondence address and email
| Date of Submission | 13-Nov-2020 |
| Date of Acceptance | 22-Nov-2020 |
| Date of Web Publication | 21-Jan-2021 |
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Aim: The current survey is conducted to assess the knowledge, attitude, and perception regarding myofunctional appliance from parents' point of view.
Materials and Methods: This was a cross-sectional web-based questionnaire survey conducted among parents in Tamil Nadu. The pilot study was conducted to estimate the sample size, and the final sample size arrived was 260 participants. The predesigned and validated, self-administered, structured ten questions are related to awareness of myofunctional appliance. The statistical analysis was done using the Statistical Package for the Social Sciences SPSS (V 22.0), and the frequency distribution was computed.
Results: The survey revealed that 74% of the respondents had awareness about skeletal problems. Thirty-four percent of the population answered that forwardly placed upper and lower jaw bases are facial skeletal jaw base problems. Sixty-four percent of the parents are willing to counsel their child to take up this treatment and 84% had awareness about the importance of myofunctional appliance.
Conclusion: Every orthodontist should be aware of discomfort depending on the appliance type and to inform the patients beforehand during clinical evaluation and appliance selection. The current study showed that the vast majority of the parents were aware about functional appliance and they had knowledge about how to distinguish skeletal problem. More awareness regarding functional appliance is mandatory and has to be created in order to treat skeletal problems during appropriate early age group of an individual.
Keywords: Myofunctional appliance, parents' survey, skeletal malocclusion
How to cite this URL:
Mani B, shaga I B, Ayyapillai A, Gangadharan G, Mathew J, Somasundaram R. Knowledge, attitude, and perception regarding myofunctional appliance: A cross-sectional survey of parents' view. Int J Prev Clin Dent Res [Epub ahead of print] [cited 2023 Mar 28]. Available from: https://www.ijpcdr.org/preprintarticle.asp?id=307609 |
| Introduction | |  |
In the current situation, parents are more focused on oral problems such as malocclusion and dental caries, and dental problem has an unfavorable impact on the physical and emotional well-being of children.[1],[2] Recent times, children are developing an unusual type of malocclusions which are meant to be treated during their developmental stage in its place of treating more invasive in their later stage. Myofunctional appliances are designed to set up muscular balance and eradicate oral dysfunction and thus direct in proper growth of the maxilla and mandible. Pain, discomfort, functional impairment, and esthetic impairment are the prime reasons for poor cooperation and treatment discontinuation in early stage of treatment. Myofunctional therapy encourage greater mandibular skeletal effects than therapy at a prepubertal stage.[3],[4] Cohen recommended that treatment should begin before the patient achieves peak growth rate in order to take the improvement of periods of fast growth, which both lead and follow the peak growth rate itself.[5]
Facial appearance and smile have a constructive impact on psychosocial health as it boosts personal confidence and self-esteem.[6] Children who are ragged about their teeth expressed dissatisfaction with their dental appearance and had a desire for early orthodontic treatment.[7] Therefore, parents' awareness about early orthodontic treatment has a positive influence on successful orthodontic treatment. The current survey is conducted to assess the knowledge, attitude, and perception regarding myofunctional appliance from parents' point of view.
| Materials and Methods | | |
A cross-sectional descriptive questionnaire survey was conducted among parents in the age group from 7 to 13 years using an online questionnaire form. A web-based questionnaire form was developed with the help of Google Forms from Google Sites. A pilot study was conducted to determine the sample size. After conducting the pilot study, the final sample size arrived was 260 subjects. A pretesting and pilot study sample was not included in the main sample size. A structured questionnaire was framed which contained ten questions related to knowledge, awareness, and attitude on the importance of undergoing myofunctional appliance therapy among parents who were recorded. A convenient sampling technique was used. All participants completed questionnaires with a duration of 8 months from March to October 2020. After a brief introduction on the purpose and intent of the study, an informed consent form was obtained from every participant involved in the survey. Confidentiality of the information provided was assured, and participation was purely voluntary.
The data collected were entered into Microsoft Office Excel and analyzed using the Statistical Package for the Social Sciences SPSS (V 22.0) (SPSS Inc., Chicago, Illinois, USA). The frequency distribution was computed.
| Results | | |
Among 260 study subjects, the survey revealed that 74% of the respondents had awareness about skeletal problems. A question regarding the knowledge about facial skeletal jaw base problems was raised, and 34% answered that forwardly placed upper and lower jaw bases are facial skeletal jaw base problems [Graph 1]. The arena of distinguishing facial skeletal jaw base problems was explored, in which 42% of the people said yes, and they are readily distinguishable. A question regarding proper age to start with braces treatment or correction of facial skeletal problems was raised, where 24% of the people responded as 4–6 years, 14% of the people said as 6–7 years, 32% of the people declared as 8–11 years, and 30% of the people reported as 13 years and above [Table 1]. About 98% were informed by the dentist about myofunctional appliance therapy. In order to correct skeletal problem, about 64% of the parents are willing to counsel their child to take up this treatment and 84% had awareness about the importance of myofunctional appliance.
 | Table 1: Knowledge regarding right age to start orthodontic treatment for correction of facial skeletal problem
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About 92% of the people need alternative treatment, and they were anxious about functional appliance. Sixty percent of the people felt that their children will be uncomfortable in wearing functional appliance in public. Fifty-four percent of the people said yes, and they will refer their patient to orthodontist for myofunctional appliance.
| Discussion | | |
The survey was conducted to assess the knowledge, attitude, and perception regarding myofunctional appliance from parents' point of view. Class II skeletal malocclusion is commonly seen in orthodontic practice, and it occurs as a result of prognathic maxilla, retrognathic mandible, or a combination of both.[8] The treatment for skeletal Class 2 malocclusion due to mandibular retrognathism is to enhance mandibular growth in the sagittal direction during maximum growth period. Different types of functional appliance are at present in use for the correction of Class II, Division 1 malocclusions, but the results are changeable and unpredictable. Broadbent and Golden also declared that skeletal maturity influences the treatment outcome of the functional appliance.[9] Early treatment to modify growth might allow the treatment of skeletal problems and to correct the alignment and occlusion of permanent teeth. Drawbacks regarding functional appliance are soft-tissue irritation, limited mandibular movement, and oral hygiene problems.[10] Knowledge regarding skeletal problems and functional appliances for parents is mandatory. The current survey reported that 74% of the respondents had awareness about skeletal problems and 84% had awareness about the importance of myofunctional appliance. Tanner et al.[11] found that functional appliance is more effective during peak height velocity on an average: around 12 years in girls and 14 years in boys. Petrovic et al. exposed that the therapeutic effectiveness of the activator, Fränkel appliance, and Bionator is most encouraging when these appliances are used during the ascending portion of the individual pubertal growth spurt.[12] In our survey, 60% of the people felt that their children will be uncomfortable in wearing functional appliance in public. On supporting these above findings, Sergl and Zentner reported that speech difficulties can also be present among patients and the appearance of the appliances may be unlikable when facing outside environment.[13]
| Conclusion | | |
The current study showed that the vast majority of the parents were aware about functional appliance and they had knowledge about how to distinguish skeletal problem. Most of the study sample felt discomfort and anxious in wearing functional appliance. Orthodontists should be aware of discomforts depending on the appliance type and to inform the patients beforehand during clinical evaluation and appliance selection. More awareness regarding functional appliance is mandatory and has to be created in order to treat skeletal problems during appropriate early age group of an individual.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Martins-Júnior PA, Oliveira M, Marques LS, Ramos-Jorge ML. Untreated dental caries: Impact on quality of life of children of low socioeconomic status. Pediatr Dent 2012;34:49-52.  |
| 2. | Ukra A, Foster Page LA, Thomson WM, Farella M, Tawse Smith A, Beck V. Impact of malocclusion on quality of life among New Zealand adolescents. N Z Dent J 2013;109:18-23. |
| 3. | Pancherz H, Hägg U. Dentofacial orthopedics in relation to somatic maturation. An analysis of 70 consecutive cases treated with the Herbst appliance. Am J Orthod 1985;88:273-87. |
| 4. | Malmgren O, Omblus J, Hägg U, Pancherz H. Treatment with an orthopedic appliance system in relation to treatment intensity and growth periods. A study of initial effects. Am J Orthod Dentofacial Orthop 1987;91:143-51. |
| 5. | Cohen AM. The timing of orthodontic treatment in relation to growth. Br J Orthod 1980;7:69-74. |
| 6. | Lukez A, Pavlic A, Trinajstic Zrinski M, Spalj S. The unique contribution of elements of smile aesthetics to psychosocial well-being. J Oral Rehabil 2015;42:275-81. |
| 7. | Shaw WC. Factors influencing the desire for orthodontic treatment. Eur J Orthod 1981;3:151-62. |
| 8. | McNamara JA Jr. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981;51:177-202. |
| 9. | Broadbent BH Jr., Golden WH. The value of an assessment of skeletal maturity in orthodontic diagnosis. Am J Phys Anthropol 1971;35:409-10. |
| 10. | O'Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S, et al. Effectiveness of treatment for Class II malocclusion with the Herbst or twin-block appliances: A randomized, controlled trial. Am J Orthod Dentofacial Orthop 2003;124:128-37. |
| 11. | Tanner JM, Whitehouse RH, Marubini E, Resele LF. The adolescent growth spurt of boys and girls of the Harpenden growth study. Ann Hum Biol 1976;3:109-26. |
| 12. | Petrovic A, Stutzmann J, Lavergne J, Shaye R. Is it possible to modulate the growth of the human mandible with a functional appliance? Int J Orthod 1991;29:3-8. |
| 13. | Sergl HG, Zentner A. A comparative assessment of acceptance of different types of functional appliances. Eur J Orthod 1998;20:517-24. |
Correspondence Address:
Bhuvaneswari Mani,
Department of Orthodontics and Dentofacial Orthopedics, Karpaga Vinayaga Institute of Dental Sciences, Kancheepuram - 603 308, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijpcdr.ijpcdr_47_20
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