This study investigates the relationship between dental aesthetics and orthodontic treatment complexity and need in a group of patients with sickle-cell anemia (SCA) in Nigeria. The study sample consisted of 176 individuals - 77 (43.8%) male and 99 (56.3%) female subjects with SCA (aged 10 to 35 years) who were coming for routine medical care to two outpatient clinics. Dental aesthetics were assessed using the Standardized Continuum of Aesthetic Need component of the Index of Orthodontic Treatment Need. Treatment complexity and need were assessed according to the Index of Complexity, Outcome and Need and Dental Aesthetic Index. Both parametric and nonparametric statistics were employed in the data analysis. Significant positive relationships were found between dental aesthetics and orthodontic treatment complexity as well as treatment need according to both indices (p= .000). The correlations of the scores for dental aesthetics and the objectively derived treatment complexity and need were significant (p= .01). About 50% of the subjects had poor dental aesthetics and this correlated with their high orthodontic treatment complexity and need.
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