Korean J Orthod.  2016 Jan;46(1):20-26. 10.4041/kjod.2016.46.1.20.

Patients' and parents' concerns and decisions about orthodontic treatment

• Kazanci F
• Aydogan C
• Alkan O

• KMID: 2152894
• DOI: http://doi.org/10.4041/kjod.2016.46.1.20

Abstract

OBJECTIVE
Patients' and parents' expectations are important in orthodontic treatment decision making. The literature generally demonstrates the perceived benefits of orthodontic treatment, but patients' and their parents' concerns about orthodontic treatment have not been investigated comprehensively. The aim of this study was to identify patients' and parents' concerns about orthodontic treatment and compare them according to sex, age, and treatment demand level.
METHODS
One hundred and eighty-nine children and their parents were interviewed about concerns related to orthodontic treatment. Patients and parents were asked about orthodontic treatment decisions. Answers were recorded as "yes," "no," or "don't know." Chi-squared and Fisher's exact tests were used to compare concerns between age groups, sexes, and treatment demand levels. Kappa statistics were used to assess agreement between patients and their parents.
RESULTS
Concerns about orthodontic treatment were gathered under 10 items as follows: "feeling pain," "the appearance of braces," "being teased," "avoiding smiling," "speech problems," "dietary changes," "problems with transportation," "economic problems," "long treatment duration," and "missing school." There was no statistically significant difference in concerns between the sexes or age groups. Some concern items and treatment demand were inversely related in patients.
CONCLUSIONS
The results of this study demonstrate patients' and parents' concerns about orthodontic treatment. Differences between the concerns of patients with different treatment demands imply that children might reject orthodontic treatment because of their concerns. Appropriate consultation of patients addressing their concerns may help reduce anxiety and improve the acceptance of treatment.

Keyword

Psychology; Pain; Perception; Socioeconomic factors

MeSH Terms

Anxiety
Child
Decision Making
Humans
Parents
Psychology
Socioeconomic Factors

Reference

1. Shaw WC, O'Brien KD, Richmond S, Brook P. Quality control in orthodontics: risk/benefit considerations. Br Dent J. 1991; 170:33–37.

2. Sari Z, Uysal T, Karaman AI, Sargin N, Ure O. Does orthodontic treatment affect patient's and parent's anxiety levels? Eur J Orthod. 2005; 27:155–159.

3. MacLeod AK, Williams JM, Bekerian DA. Worry is reasonable: the role of explanations in pessimism about future personal events. J Abnorm Psychol. 1991; 100:478–486.

4. Borkovec TD, Robinson E, Pruzinsky T, DePree JA. Preliminary exploration of worry: some characteristics and processes. Behav Res Ther. 1983; 21:9–16.

5. Hamdan AM. The relationship between patient, parent and clinician perceived need and normative orthodontic treatment need. Eur J Orthod. 2004; 26:265–271.

6. Zhang M, McGrath C, Hägg U. Who knows more about the impact of malocclusion on children's quality of life, mothers or fathers? Eur J Orthod. 2007; 29:180–185.

7. Bos A, Hoogs t, Prahl-Andersen B. Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients. Am J Orthod Dentofacial Orthop. 2003; 123:127–132.

8. Bennett ME, Michaels C, O'Brien K, Weyant R, Phillips C, Dryland K. Measuring beliefs about orthodontic treatment: a questionnaire approach. J Public Health Dent. 1997; 57:215–223.

9. Sayers MS, Newton JT. Patients' expectations of orthodontic treatment: part 2--findings from a questionnaire survey. J Orthod. 2007; 34:25–35.

10. Mays N, Pope C. Rigour and qualitative research. BMJ. 1995; 311:109–112.

11. Sayers MS, Newton JT. Patients' expectations of orthodontic treatment: part 1 - development of a questionnaire. J Orthod. 2006; 33:258–269.

12. Harmsen IA, Mollema L, Ruiter RA, Paulussen TG, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013; 13:1183.

13. Burden DJ. The influence of social class, gender, and peers on the uptake of orthodontic treatment. Eur J Orthod. 1995; 17:199–203.

14. Erdinç AM, Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod. 2004; 26:79–85.

15. Krishnan V. Orthodontic pain: from causes to management--a review. Eur J Orthod. 2007; 29:170–179.

16. Tecco S, D'Attilio M, Tetè S, Festa F. Prevalence and type of pain during conventional and self-ligating orthodontic treatment. Eur J Orthod. 2009; 31:380–384.

17. Wu AK, McGrath C, Wong RW, Wiechmann D, Rabie AB. A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances. Eur J Orthod. 2010; 32:403–407.

18. Firestone AR, Scheurer PA, Bürgin WB. Patients' anticipation of pain and pain-related side effects, and their perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod. 1999; 21:387–396.

19. Lewis HG, Brown WA. The attitude of patients to the wearing of a removable orthodontic appliance. Br Dent J. 1973; 134:87–90.

20. Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients' adaptation by personality variables. Eur J Orthod. 2000; 22:307–315.

21. Abed Al, Cunningham SJ, Croft N, Johal A. A qualitative study of the early effects of fixed orthodontic treatment on dietary intake and behaviour in adolescent patients. Eur J Orthod. 2012; 34:432–436.