An investigation into some of the factors influencing the desire for orthodontic treatment

A sample of 207 patients and their respective parents were surveyed to assess the influence various occlusal anomalies and other factors had had in stimulating a desire for orthodontic treatment. From the results obtained it is thought that more attention should be given to the particular occlusal and aesthetic deviations which are causing concern to the patient: assumptions based purely upon the presenting occlusal condition should be avoided. It was shown that for the majority of patients the provision of orthodontic care was dictated largely by aesthetics but that the general dental practitioner exerted an appreciable influence on patient acceptance of treatment.

Attitudes to orthodontic treatment

A survey of the attitudes of patients and parents to active orthodontic treatment was undertaken at two centres. Questionnaires were distributed which enquired about pre-treatment appearance, reactions to the proposed treatment, experiences during treatment, perceived benefits of treatment, and values placed upon treatment. The results indicated that both patients and parents were satisfied with the treatment received, and pain from the appliance and its appearance were the main discouraging features.

The emotional impact of orthognathic surgery and conventional orthodontics

Previous research by the authors has pointed to depressive reactions among orthognathic surgery patients during the fixation-removal stage and up to 9 months later. However, less is known about emotional shifts among persons who choose to undergo conventional orthodontic treatment after considering surgical orthodontics. In the current study, a standard measure of mood states was applied to 90 surgical patients and 66 who had considered surgery but decided against it. Of these, 33 were undergoing orthodontic treatment and 33 were having no treatment. The mood scale and measures of personality were first applied before surgery and then during orthodontic treatment, just after surgery, at fixation removal, and 6 months after surgery. Nonsurgical respondents completed questionnaires at the same time as their matched surgical respondents. Scores on tension and fatigue increased significantly among surgical patients from before surgery to immediately after surgery and dropped to presurgical levels when fixation was removed. Anger-hostility increased at fixation removal but declined within 5 months. Postsurgical discomfort, pain, and paresthesia, and interpersonal and oral function problems were correlated with postsurgery emotional state. On the later questionnaires, which corresponded to the later periods of orthodontic treatment, patients who had opted for conventional orthodontic treatment reported that they experienced greater depression, anger, and tension. These patients may be particularly vulnerable to emotional problems because their orthodontic treatment may be more complex and of longer duration than that of the typical orthodontic patient. These results point to the importance of continued psychological support for both orthodontic and surgical patients throughout their course of treatment.

Development and validation of a measure of attitudes toward malocclusion

The Orthodontic Attitude Survey was designed to assess children's and their parents' attitudes toward malocclusion and orthodontic treatment. Five consistent clusters of attitudes had discriminant validity, and were significantly related to plans for orthodontic treatment and to objective and subjective indicators of the child's occlusal status and appearance.