Orthodontically treated young adults: awareness of their own dental arrangement

Orthodontic treatment goals are generally based upon professional ideals of function, aesthetics, and stability. In order to evaluate whether the professional treatment goals are meaningful to the patients, awareness of their own occlusion was studied in 80 orthodontically treated individuals (mean age 18.3 years). By comparing the treated patients to a control group of 50 untreated individuals (mean age 17.8 years) the effect of the treatment experience on the level of awareness was also examined. Awareness was assessed by comparing the subjects' answers to six questions about their own dental arrangement, to recordings on study casts according to two sets of criteria. These criteria defined malocclusion and minor deviations in tooth position. The validity of the method was tested by asking the subjects to identify their own teeth among 18 dental photographs. Almost two-thirds of the treated subjects described their teeth without making mistakes according to the malocclusion criteria. When the minor deviation criteria were applied, one third answered all the six questions correctly and two-thirds made not more than one mistake. Compared to the control group no significant differences existed as most untreated individuals also gave accurate descriptions. Eighty-two per cent of the tested subjects identified their own photo on the first attempt. Professional treatment goals seem to be justified by the high level of dental awareness in young adults, and the findings indicate that the treatment per se does not affect perceptual accuracy.

Subjective appraisal of orthodontic practices. An investigation into perceived practice characteristics associated with patient and parent treatment satisfaction

Based on a comprehensive in-practice questionnaire survey among 254 school-age patients and their parents, the subjective perception and evaluation of orthodontic care was investigated. By means of refined statistical analysis, three types of practice showing significantly distinct image profiles were identified. Likewise, the set of discriminating variables was reduced and assigned to the fundamental concepts of 'interpersonal satisfaction' and 'perceived efficacy' which appeared to play a crucial part in the crystallization of both patients' and parents' contentedness with the treatment received. To take account of the interdependence of instrumental and social factors, a model of perceived practice similarity is suggested; its significance regarding treatment decisions and future research efforts is pointed out.

Cooperation of adolescents in orthodontic treatment

Cooperation of 39 adolescents with orthodontic treatment was examined 8-10 months into treatment and again at completion. Early in treatment, parental attitudes served as the best predictors of cooperation. By the end of active treatment, however, the adolescent patients' own cognitions were the most salient predictors of cooperation. Prior to beginning orthodontic treatment, subjects and their parents completed a battery of psychosocial and orthodontic-specific measures. Results of stepwise multiple regression analyses showed that only the Parent Positive Attitude Toward Braces measure significantly predicted orthodontic cooperation early in treatment, while External-Powerful Others (Professionals) attributions of control, External-Chance attributions of control, and the initial assessment of cooperation significantly predicted cooperation over longer periods of time.

[Adaptation level to social rules as a predictive index for degree of cooperation in orthodontic treatment of adolescent and preadolescent patients]

Aim of this work was to study psychological aspects of orthodontic patients cooperation. The Authors used "lie-scale" of Busnelli, Dall'Aglio and Faina's questionnaire that measures social desirability. In fact more social desirability results in "cooperative" than in "no cooperative" patients.

[Psychological study of questionnaire relating to dentition and orthodontic treatment]

Concern of patients for dentition and receptivity of orthodontic treatment was studied by a general population questionnaire. Subjects (general population) consisted of elder elementary school boys and girls (157), junior high school (274) and high school students (90) and adults (45) in Tokushima, Kagawa and Kouchi prefectures. Twenty-three questions, previously selected from forty-seven using the Quantification III for orthodontic patients. Furthermore, ten questions were selected from these twenty-three using the same method and categorized into two groups. Each category was given a meaning. Five answers in each category were given marks: a positive answer was 'point one' and a negative one was 'point zero'. Mean points in each category were compared with eight groups according to age and sex. AIC (Akaike Information Criterion) was used for statistical analysis. The following results were obtained. 1. Two categories were independently identified. One had meaning in relation to concern for dentition and other had meaning in relation to receptivity of orthodontic treatment. 2. Orthodontic patients showed significantly higher points than general population for concern and receptivity. 3. Females in each group showed higher points for concern of dentition in general population, but males showed higher points for receptivity of orthodontic treatment. 4. Junior high school and high school students showed significantly lower points in two categories, in addition, males in this group showed lower points in these categories. 5. There were no significant differences between subjects in three prefectures. It is possible for general population to evaluate instructions or education methods for promoting interest in dentition by this study. Orthodontic patients will also be encouraged by the present study to receive orthodontic treatment.

[Recognition of orthodontic patients and their parents about the orthodontic treatment and results--a questionnaire method]

This study was undertaken to investigate the desire and consciousness of orthodontic patients and their parents on the content and effect of orthodontic treatment. The subjects were 362 post-treatment patients and 353 of their parents, who answered the questionnaires. The following conclusions were obtained: 1. 49% of the patients and 16% of the parents of the patients thought of giving up the treatment while the patients were under the orthodontic treatment. The main reasons were the discomfort of orthodontic appliances, long treatment period, and the absence from school. 2. 55% of the patients felt uneasy about a change of the occlusion for the worse after removal of the orthodontic appliances, and 60-70% of the patients and parents had forgotten the necessity of the retainer after active orthodontic treatment. 3. Both patients and parents hoped to finish the orthodontic treatment by the end of junior high school. 4. About 50% of the parents preferred the university hospital and about 45% preferred a private dental office which was convenient for attending as an outpatient. 5. About 70% of the patients and parents were satisfied with occlusion after orthodontic treatment, and 33% of the patients and 61% of the parents were satisfied with the orofacial appearance after treatment. 6. About 9% of the patients hoped to keep secret their history of orthodontic treatment. 7. About 35% of the patients and 60% of the parents would recommend people with malocclusions to receive orthodontic treatment. About 80% of the patients would make their own children receive the orthodontic treatment if needed. 8. About 90-95% of the patients and parents were pleased with orthodontic treatment.

[Dental awareness among young adults]

Awareness of own dental appearance was studied in 150 18-year old individuals by assessing their ability to identify a photograph of own teeth among 17 alternative photographs. More than two thirds of the subjects identified their picture on first trial, which reflects a high level of dental awareness in the group. Consciousness about dental arrangement was high as 56% reported deviating tooth position as a primary cause for recognition. Other features, such as tooth morphology, discolouration and fractures were stated as reasons for identification by 26% of the individuals. The findings indicate that young adults are able to recognize a good orthodontic treatment result. Therefore, a high standard of the treatment delivered seems to be justified by the level of dental awareness in young adults.

[The motivation and assessment of the success of adult patients undergoing orthodontic treatment--the interpretation of a questionnaire]

In order to analyze orthodontic treatment of adults concerning information, motives and retrospective evaluation 225 patients with fixed appliances were questioned. The dentist had a key position as a mediator of information. The decision to an orthodontic treatment was led by esthetic and functional motives. The extent of the respective motives depended from age, personal status, education and cooperation. Interest and understanding in functional improvements as they could be found above all by people with a higher education level were decisive for a durable regard of the treatment.

Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear

Factors related to compliance with the wearing of headgear and intraoral elastics were explored in a sample of 100 university clinic orthodontic patients. Data were gathered by means of a questionnaire that comprised items presumed to be associated with orthodontic compliance. These items were not patient characteristics, but variables of beliefs, attitudes, perceptions, and reasons thought to be associated with compliance. The 58 questions were reduced through alpha factor analysis and the imposition of a coefficient alpha restriction to 12 factors. These 12 factors were named according to the questions they comprised. To assess whether these factors were indeed related to compliance, correlation coefficients were calculated between the factor scores (independent variables) and the criterion of compliance with headgear and elastics (dependent variable). Compliance was rated on a three-point scale. Four factors were found to be weakly, though significantly, correlated with compliance. These factors were combinations of personality type, negative motives (pain, inconvenience, and dysfunction), and positive motives (general health awareness, specific dental knowledge, and personal oral embarrassment). The findings were compared with existing theories of patient behavior.

[Psychological aspects of the orthodontic treatment of middle-aged and elderly patients]

The authors emphasize the knowledge of the psychologic characteristics of an old man to make good contacts with him. They give recommendations on the physician's behavioral patterns with elderly patients at all stages of orthodontic treatment and point out the relationship between the personality features of the physician and his ability to psychologically influence the patients.

[Some reflections on orthodontic treatment of adult patients from social point of view]

Starting from a statistical inquiry of 141 adult patients with anomalous set of teeth author comments on problems of late dental treatment. The therapeutical responsibility of orthodontists in cases of late treatment is emphasized. In taking decisions on therapy social points of view are to be taken into consideration.

Time course of the discomfort in young patients undergoing orthodontic treatment

Discomfort may accompany orthodontic movement of teeth. The purpose of this study was to determine the time envelope of discomfort induced in young patients (10-16 years) following placement of orthodontic separators and arch wires. Secondly, psychosocial factors concerning feelings of "self" were investigated. Forty-five experimental and 14 control patients seeking orthodontic treatment were included. A data sheet consisting of several visual analogue scales measuring patient perceptions of dental discomfort and psychosocial factors was used. The results indicated that the experimental group experienced significant discomfort with both separators and arch wires at 4 and 24 hr compared to controls; however, the discomfort dissipated by 7 days. The appearance of the teeth and face were significant factors predicting the patient's perspective of "self." The results have significant clinical implications and these are discussed.

[Oral hygiene motivation in orthodontic patients]

The task of the present study has been to verify experimentally if prolonged motivation may produce better oral hygienic conditions in orthodontic patients. Applying oral hygienic index modified, gingival index and saliva lactobacilli's concentration count, the A.A. obtained encouraging data evaluating the motivated subjects situation versus control group.

An evaluation of the psychological and social effects of malocclusion: some implications for dental policy making

Initial findings are reported from a longitudinal study investigating the effects of malocclusion on dental health and psychological well-being and the effectiveness of orthodontic treatment. Implicit in the orthodontic intervention decision process is the view that there are discernible social and psychological benefits of good occlusion. This view has not been adequately validated. The primary psychological question addressed by this study concerns the relationship between adolescents' orthodontic status and their psychological status and well-being. Empirical evidence allowed an examination of the major hypothesis that children with poor occlusion are likely to be socially and psychologically disadvantaged. Ratings of dental status and physical attractiveness, and measures of psychosocial well-being were obtained for sample of 1018, 11-12-year-old children and the associations between these variables were examined. The results provide little support for the major hypothesis that children 'suffer' psychologically from having poor dentition. Several points of caution are made with regard to this conclusion and some implications for dental policy making are considered.

[Psychological aspects of orthodontic treatment]

Psychical factors are often contributory determinants of success or failure of treatment. The orthodontist should therefore dispose of basic psychological knowledge to give his patients help in an entire sense. The psychosocial impact of malocclosion should represent a major factor in the decision to obtain treatment, because what is most important in terms of psychosocial response to malocclusion is not the absolute degree of disfigurement that results from malocclusion, but rather how the individual perceives and evaluates the esthetic effects of these dentofacial problems and their orthodontic correction.