This study was designed to adapt the original English-language COAS (Children's Orthodontic Attitude Survey) for third-
grade schoolchildren to the Italian cultural environment and to investigate its properties in typical populations, as well as to evaluate
children self-perception of their dental appearance. STUDY DESIGN: The COAS questionnaire for third-grade schoolchildren was
translated and culturally adapted for Italian-speaking children. The Italian version of the questionnaire was tested on 169 (73 females,
96 males) children. Test-retest reliability was assessed on 34 children one week after the first administration. We also analysed
correlations between social status and questionnaire findings.
All children filled in the questionnaire and then they were
clinically examined by three residents. The clinical parameters were correlated with the questionnaire findings to evaluate children's
satisfaction with their dental appearance.
Ninety-five per cent of children thought it was important to have straight teeth and
87 per cent considered that crooked teeth were ugly. Comparison with clinical parameters showed a statistically significant correlation
between crowding and overjet and some answers. Urban children have a better opinion on braces: they would like to have braces and
they think they need braces statistically more than rural subjects.
The Italian version of the modified-COAS
questionnaire had a very good reliability. Social status and geographical context play a very important role in children's satisfaction with
dental appearance. Children with different social context demonstrate they have very different approaches towards their dental aspect
Vol.9 – n.1/2008
Harvard: R. Deli, L. A. Macr, M. De Luca, F. Torsello, C. Grippaudo (2008) "Satisfaction with dental appearance in 8-9 years-old children. Validation of COAS questionnaire for Italian-speaking children and evaluation of social and geographical context", European Journal of Paediatric Dentistry, 9(1), pp7-12. doi:
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