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Fahd CG, Castro GG, Costa ACS, Costa CPS, Carvalho CN, Pinzan-Vercelino CRM, Ferreira MC. Oral Health-Related Quality of Life among Adolescents in the First 6 Months of Fixed Orthodontic Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7110. [PMID: 38063540 PMCID: PMC10706226 DOI: 10.3390/ijerph20237110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023]
Abstract
Clarification on disabilities that may arise during orthodontic treatment allows patients to have more realistic expectations. This prospective study assessed the impact of fixed orthodontic therapy on adolescents' quality of life over 6 months. A total of 78 adolescents aged 11-17 years were included. Quality of life was measured using the Child Perceptions Questionnaire (CPQ11-14, short form) at five moments: before treatment (T0), one week (T1), one month (T2), three months (T3), and six months (T4) after treatment initiation. Multiple and pairwise comparisons were conducted for CPQ11-14 scores (Friedman and Wilcoxon test; effect size). Changes in the quality of life were assessed as mean differences (T0-T1 and T0-T4) in total and domain scores (Kruskal-Wallis and Mann-Whitney test) (α = 5%). Significant differences were observed between T0 and T4 in the oral symptoms' domain (p < 0.001), and between T0 and T1, T2, T3, and T4 for emotional well-being (p < 0.001 for all). Significant differences in impact were also found between T0 and T2, T3, and T4 with regard to social well-being (p = 0.004, =0.049, and <0.001, respectively). Orthodontic therapy positively impacted the emotional and social aspects of adolescents' quality of life. Negative effects were primarily related to pain, mouth sores, and difficulty biting or chewing. Understanding the symptoms and feelings of orthodontic patients aids professionals in decision-making.
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Affiliation(s)
- Cláudia Gonçalves Fahd
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Gustavo Garcia Castro
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Ana Carla Souza Costa
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Cyrene Piazera Silva Costa
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | - Ceci Nunes Carvalho
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
| | | | - Meire Coelho Ferreira
- Post-Graduation Program in Dentistry, Ceuma University, São Luís 65075-120, Brazil; (C.G.F.); (A.C.S.C.); (C.P.S.C.); (C.N.C.)
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Kwon O, Joury E, Colonio-Salazar F, Moussa-Pacha M, Johal A. A comparison of children's experiences with fixed and removable functional appliances: A qualitative study. Am J Orthod Dentofacial Orthop 2023; 164:423-430. [PMID: 37041097 DOI: 10.1016/j.ajodo.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/13/2023]
Abstract
INTRODUCTION The objective of this study was to compare children's experiences and perceptions of treatment with Hanks-Herbst (HH) and modified Twin-block (MTB) functional appliances. METHODS A pragmatic nested qualitative study was undertaken in a single hospital setting. Participants from a randomized controlled trial (International Standard Randomised Controlled Trial Number 11717011) wearing HH and/or MTB appliances were interviewed using a topic guide in a one-to-one, semistructured format. Interviews were recorded and transcribed verbatim for framework methodology analysis until data saturation was reached. RESULTS Eighteen participants (HH, 7: MTB, 4; switched group, 7) were interviewed. Thirteen codes were constructed and grouped into 3 themes: (1) functional impairment and symptoms, (2) psychosocial factors and impacts, and (3) feedback on appliances and patient care. Both appliances had a negative impact on quality of life, with disruption to children's daily routines and psychological well-being. Speaking was more problematic for MTB participants, whereas HH participants encountered mastication and breakage issues. HH was preferred by most participants, as its nonremovable feature meant less managing and self-discipline was required. MTB was considered a suitable option for children with good self-discipline and who preferred a versatile lifestyle. Feedback included wishes for the availability of multiple appliance options and a degree of autonomy in decision-making processes. CONCLUSIONS HH and MTB can negatively affect children's quality of life. Participants preferred HH over MTB because of its nonremovable feature, and children requested to be empowered during decision-making processes.
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Affiliation(s)
- Ohsun Kwon
- Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Easter Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Moaiyad Moussa-Pacha
- Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ama Johal
- Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom.
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Santiwong P, Dutsadeeviroj K, Potchanarungvakul K, Leartchotikul T, Jiwsiritrakul T, Sipiyaruk K. Significance of Non-Statistically Significant Results in the Prediction of Oral Health-Related Quality of Life in Orthodontic Patients: A Survey Using Two Linking Questionnaires. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085446. [PMID: 37107728 PMCID: PMC10138500 DOI: 10.3390/ijerph20085446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 05/11/2023]
Abstract
Patients with a fixed orthodontic appliance may have difficulties in maintaining good oral health-related quality of life (OHRQoL), and evaluating self-perceived OHRQoL in orthodontic patients could be challenging for their orthodontists. Therefore, this research was conducted to investigate whether orthodontic postgraduates would accurately evaluate the OHRQoL of their patients. Two self-administered questionnaires were designed for patients to rate their OHRQoL and for their orthodontic postgraduates to evaluate them on OHRQoL. All pairs of patients and their orthodontic postgraduates were requested to independently complete the questionnaires. Pearson's correlation and multiple linear regression were performed to determine the relationships of the variables and to identify significant predictors on OHRQoL, respectively. There were 132 pairs of orthodontic patients and their residents who completed the questionnaires. There were no significant correlations between OHRQoL perceived by patients and evaluated by their orthodontic postgraduates in all aspects of treatment needs and dietary difficulties (p > 0.05). In addition, the regression model demonstrated no significant predictors for the self-perceived treatment needs and dietary difficulties of orthodontic patients. There seemed to be challenges for orthodontic postgraduates to evaluate their patients' oral health-related quality of life. Therefore, the OHRQoL measures should be increasingly implemented in orthodontic education and practice in order to enhance the concept of patient-centered care.
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Affiliation(s)
- Peerapong Santiwong
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Kantrakorn Dutsadeeviroj
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | | | - Thanpat Leartchotikul
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Thanachot Jiwsiritrakul
- Doctor of Dental Surgery Program, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Kawin Sipiyaruk
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
- Correspondence:
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Muacevic A, Adler JR. The Impact of Orthodontic Treatment on Masticatory Performance: A Literature Review. Cureus 2022; 14:e30453. [PMID: 36415350 PMCID: PMC9674042 DOI: 10.7759/cureus.30453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this narrative review was to evaluate the possible association between orthodontic therapy and improved masticatory function. A search strategy was conducted using the PubMed database for up to January 2020 using the keywords "mastication" and "orthodontics". Only human studies investigating mastication in orthodontics settings were selected. The search strategy resulted in 1,011 articles, out of which 57 were included in the final analysis. Investigations have generally agreed that masticatory and chewing functions improved post-orthodontic and orthognathic treatments. Studies also showed improvement in the quality of life of patients' post-orthodontic treatment. The articles examined reinforced that besides esthetic reasons, orthodontic therapy does improve the masticatory and chewing functions of individuals, ultimately enhancing their health-related quality of life.
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Babaee Hemmati Y, Mirmoayed A, Ghaffari ME, Falahchai M. Eating‐ and oral health‐related quality of life in patients under fixed orthodontic treatment. Clin Exp Dent Res 2022; 8:1192-1201. [PMID: 35809225 PMCID: PMC9562793 DOI: 10.1002/cre2.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The eating problems and changes in the diet and dietary intake of patients under orthodontic treatment are of great importance, and the available studies on this topic are mostly qualitative. Thus, this study aimed to assess the oral health‐related quality of life (OHRQoL) and the eating‐related quality of life (ERQoL) of patients under fixed orthodontic treatment. Materials and Methods This prospective study evaluated 105 patients (65 males, 40 females) with a mean age of 26 ± 1.1 years, who required fixed orthodontic treatment. All participants filled out the Oral Health Impact Profile‐14 (OHIP‐14) questionnaire before treatment (T0), and at 1 (T1), 3 (T2), and 6 (T3) months after treatment, and the ERQoL questionnaire at 1 (T1), 3 (T2), and 6 (T3) months after treatment. Data were analyzed using repeated measures analysis of variance with Greenhouse–Geisser and Huynh‐Feldt corrections and Bonferroni test for pairwise comparisons (α = .05). Results The OHIP‐14 total score increased at T1 and decreased at T2 and T3, with significant differences between all four time points (p < .001). The ERQoL total score decreased over time, and significant differences were noted between all three time points (p < .001). No significant difference existed in OHRQoL or ERQoL with regard to gender at any time point (p > .05). Conclusion The reduction in OHRQoL due to fixed orthodontic treatment was temporary and improved over time. The eating problems also decreased with time.
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Affiliation(s)
- Yasamin Babaee Hemmati
- Department of Orthodontics, School of Dentistry, Dental Sciences Research Center Guilan University of Medical Sciences Rasht Iran
| | - Arastoo Mirmoayed
- School of Dentistry, Dental Sciences Research Center Guilan University of Medical Sciences Rasht Iran
| | - Mohammad Ebrahim Ghaffari
- School of Dentistry, Dental Sciences Research Center Guilan University of Medical Sciences Rasht Iran
| | - Mehran Falahchai
- Department of Prosthodontics, School of Dentistry, Dental Sciences Research Center Guilan University of Medical Sciences Rasht Iran
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Frawley T, Parkin N, Kettle J, Longstaff S, Benson P. Young people's experiences of orthodontic retainers: A qualitative study. J Orthod 2022; 49:394-402. [PMID: 35611854 DOI: 10.1177/14653125221099962] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate young people's experiences of retainers, the associated impact of retainers on their lives and their perceptions of what influences their own co-operation. DESIGN Qualitative, cross-sectional study. SETTING An orthodontic department in a UK dental hospital. PARTICIPANTS Purposive sampling was used to recruit young people, aged 11-17 years, wearing a range of different types of retainers. METHODS Semi-structured interviews were conducted and transcribed. The resultant data were analysed using codebook thematic analysis. RESULTS Ten patients were recruited before thematic saturation was achieved. Four themes were identified: impact and experiences of wearing retainers; facilitators and barriers to retainer adherence; finding out about retainers; and, finally, involvement in decisions about retainers. Although some initial negative impacts were described, participants generally adapted quickly to retainers. Several factors were perceived to influence co-operation with removable retainers, including concerns about relapse and the associated waste of personal effort and wider resources. There were perceived deficiencies in the information provided by clinicians, which led participants to seek advice from other sources, including social media. Some young people wanted to be more involved in decisions about their retainers. CONCLUSION While patients perceived retainers to be easier to wear than active appliances, some transient negative impacts occurred, largely related to initial periods of full-time wear. There were a range of factors which patients perceived to influence their adherence with removable retainers.
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Affiliation(s)
- Tom Frawley
- Department of Orthodontics, University of Sheffield, Sheffield, UK
| | - Nicola Parkin
- Department of Orthodontics, University of Sheffield, Sheffield, UK
| | - Jen Kettle
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sarah Longstaff
- University Hospitals of Derby and Burton NHS Foundation Trust, Burton on Trent, UK
| | - Philip Benson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Duarte L, Bezerra AP, Flores-Mir C, De Luca Canto G, Pereira LJ, Vega Gonçalves TMS. Activation and installation of orthodontic appliances temporarily impairs mastication. Angle Orthod 2022; 92:275-286. [PMID: 34878525 PMCID: PMC8887415 DOI: 10.2319/061221-469.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners). MATERIALS AND METHODS Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed. RESULTS Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: -4.867 to -0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found. CONCLUSIONS Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.
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Koukou M, Javed F, Michelogiannakis D. Is There an Association Between Fixed Orthodontic Treatment and Initiation of Eating Disorders? A Review of Currently Available Evidence. FRONTIERS IN ORAL HEALTH 2022; 2:707040. [PMID: 35048042 PMCID: PMC8757685 DOI: 10.3389/froh.2021.707040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 06/14/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: The aim was to review the available literature regarding the potential association between fixed orthodontic treatment (OT) and the onset of eating disorders (EDs). Method and Materials: Six indexed databases were searched until November 2020. The inclusion criteria were as follows: (a) patients undergoing fixed OT and (b) EDs in relation to fixed OT. Commentaries, letters to the Editor, reviews, and studies in patients with EDs not undergoing fixed OT were excluded. The pattern of the present review was customized to summarize the pertinent information. Results: Four out of 10,076 initially-identified studies were included, and all of them were case reports. All patients were females, and the EDs reported were either anorexia nervosa (AN) or bulimia nervosa (BN). In three case reports, patients developed EDs after the initiation of OT. Fixed OT was performed in all the studies, and a variety of oral complications such as sore mouth, gingivitis, tooth surface demineralization, and others were reported. Conclusion: Based upon the limited available evidence, the association between OT and the onset of EDs remains unclear. Further well-designed observational clinical studies are needed in this regard.
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Affiliation(s)
- Melina Koukou
- Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, NY, United States
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, NY, United States
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Sharma R, Drummond R, Wiltshire W, Schroth R, Lekic M, Bertone M, Tate R. Quality of life in an adolescent orthodontic population: Invisalign versus fixed appliances. Angle Orthod 2021; 91:718-724. [PMID: 34260709 DOI: 10.2319/062820-592.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate adolescent orthodontic patient experiences and quality of life with fixed appliances compared to Invisalign. MATERIALS AND METHODS Adolescent patients in active treatment with Invisalign or fixed appliances for a minimum of 6 months were provided with the Child Oral Health Impact Profile-Short Form 19 questionnaire, along with additional items of interest that were assessed separately. Pearson's χ2 test was used to compare responses (P < .05), and unpaired t-tests (P < .05) were used to test for differences in mean satisfaction, quality of life, and domain scores. RESULTS In total, 74 patients (37 in each treatment group) participated. Overall, no significant differences were noted in the mean quality of life, satisfaction, or domain scores between the two groups. A significant difference was noted in the time taken to adjust to appliances, with the Invisalign group demonstrating faster adaptation. Additionally, the fixed appliance group was 3.8 times more likely to report missing school because of their appliance (95% confidence interval [CI]: 1.2, 12.5) and 2.7 times more likely to report having difficulty eating certain foods (95% CI: 1.1, 7.1). When the sample of females between the ages of 14 and 18 was analyzed, the Invisalign group reported feeling attractive more often than the fixed appliance group. CONCLUSIONS Both treatment groups were generally very satisfied with their treatment modality. The overall quality of life of adolescent orthodontic patients undergoing treatment with fixed appliances and Invisalign for a minimum of 6 months was similar.
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Albaqami G, Abreu LG, Bernabé E. Is wearing orthodontic appliances associated with eating difficulties and sugar intake among British adolescents? A cross-sectional study. Eur J Orthod 2021; 43:193-199. [PMID: 33184645 DOI: 10.1093/ejo/cjaa071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. METHODS This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children's Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. RESULTS 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0-20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: -0.27, 0.66) and -0.30 (95% CI: -0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. CONCLUSION Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents.
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Affiliation(s)
- Ghaliah Albaqami
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Lucas Guimarães Abreu
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK.,Department of Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
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Yassir YA, Kadhum AS, Saloom HF, McIntyre GT, Bearn DR. Development of patient information leaflets for fixed, removable, and functional appliances for Arabic-speaking orthodontic patients. Saudi Dent J 2021; 33:143-149. [PMID: 33679107 PMCID: PMC7910650 DOI: 10.1016/j.sdentj.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/22/2019] [Accepted: 12/01/2019] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To develop Orthodontic Patient Information Leaflets (PILs) in Arabic. MATERIAL & METHOD This study included five phases starting with Arabic translation of existing British Orthodontic Society leaflets; initial face validation with three orthodontists; content validation with ten orthodontists; final face validation with ten orthodontists, five postgraduate students, and ten patients; and re-translation to English prior to comparing the new documents with the original PILs to verify that all the necessary information were included. The content validity index (CVI) assessed item level (I-CVI) and scale level (S-CVI). RESULTS The three Arabic PILs were face validated with inclusion of mini-screws, rapid maxillary expansion, and interproximal reduction. Content validity was perfect with no item I-CVI < 0.80. The S-CVI/Ave for PIL Fixed Appliances = 0.98, PIL Removable Appliances = 0.98 and PIL Functional Appliances = 0.97. In the final face validation, the three leaflets received 100% agreement from all observers for consistency of leaflet format and style, clarity, readability and use of adequate phrases. Finally, the leaflets were re-translated and the information was checked by native English speakers to ensure the completeness of information. There were no discrepancies and face validity was excellent. CONCLUSION Valid PILs for Arabic-speaking patients undergoing orthodontic treatment with fixed, removable, and functional appliances have been developed.
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Affiliation(s)
- Yassir A. Yassir
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
- School of Dentistry, University of Dundee, UK
| | - Ammar S. Kadhum
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Hayder F. Saloom
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
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Ozdemir M, Ilhan A, Gorucu-Coskuner H, Taner T, Bilgic P. Assessment of food consumption changes in adolescents during orthodontic treatment. Am J Orthod Dentofacial Orthop 2021; 159:604-612. [PMID: 33583694 DOI: 10.1016/j.ajodo.2019.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/01/2019] [Accepted: 11/01/2019] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study aimed to evaluate the changes in food consumption in adolescents during orthodontic treatment. METHODS Twenty-five adolescents aged between 12 and 18 years participated in the study. Before the treatment, the participants were interviewed, and their food consumption frequency and 24-hour retrospective food consumption records were taken. Participants were followed up for 3 months, that is, in the first, fourth, and 12th week of the treatment. In the interviews, questions about food consumption changes and posttreatment pain were asked to the participants, and 24-hour retrospective food consumption records were obtained. RESULTS When the food consumption records of the adolescents before the orthodontic treatment and at the first week, first month, and third month of the active orthodontic treatment were compared, there was no significant difference between total energy, protein, and carbohydrate intake. However, total fat intake decreased in the first week of treatment and increased significantly during the treatment period (P = 0.05). There was a significant decrease in the amount of fiber (P = 0.039), vitamin E (P = 0.043), and vitamin C (P = 0.048) intake of patients during the orthodontic treatment. CONCLUSIONS Nutrition and feeding habits are important for growth and development in adolescence. In adolescents having orthodontic treatment, vitamin C, vitamin E, and fiber intake decreased significantly, especially in the first weeks of treatment. The intake of these nutrients did not return to their initial levels by the 12th week of the orthodontic treatment. It is thought that cooperation with dietitians and orthodontists might minimize the undesired nutritional effects of the orthodontic treatment.
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Affiliation(s)
- Merve Ozdemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Azad Ilhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Hande Gorucu-Coskuner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tülin Taner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Pelin Bilgic
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
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Perry J, Popat H, Johnson I, Farnell D, Morgan MZ. Professional consensus on orthodontic risks: What orthodontists should tell their patients. Am J Orthod Dentofacial Orthop 2020; 159:41-52. [PMID: 33221095 DOI: 10.1016/j.ajodo.2019.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Effective communication of risk is a requisite for valid consent, shared decision-making, and the provision of person-centered care. No agreed standard for the content of discussions with patients about the risks of orthodontic treatment exists. This study aimed to produce a professional consensus recommendation about the risks that should be discussed with patients as part of consent for orthodontic treatment. METHODS A serial cross-sectional survey design using a modified electronic Delphi technique was used. Two survey rounds were conducted nationally in the United Kingdom using a custom-made online system. The risks used as the prespecified items scored in the Delphi exercise were identified through a structured literature review. Orthodontists scored treatment risks on a 1-9 scale (1 = not important, 9 = critical to discuss with patients). The consensus that a risk should be discussed as part of consent was predefined as ≥70% orthodontists scoring risk as 7-9 and <15% scoring 1-3. RESULTS The electronic Delphi was completed by 237 orthodontists who reached a professional consensus that 10 risks should be discussed as part of consent for orthodontic treatment; demineralization, relapse, resorption, pain, gingivitis, ulceration, appliances breaking, failed tooth movements, treatment duration, and consequences of no treatment. CONCLUSIONS A professional orthodontic consensus has been reached that 10 key risks should be discussed with patients as part of consent for orthodontic treatment. The information in this evidence base should be tailored to patients' individual needs and delivered as part of a continuing risk communication process.
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Affiliation(s)
- John Perry
- Cardiff University School of Dentistry, Cardiff University, Cardiff, United Kingdom.
| | - Hashmat Popat
- Cardiff University School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Ilona Johnson
- Cardiff University School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Damian Farnell
- Cardiff University School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Maria Z Morgan
- Cardiff University School of Dentistry, Cardiff University, Cardiff, United Kingdom
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Pacha MM, Fleming PS, Johal A. Complications, impacts, and success rates of different approaches to treatment of Class II malocclusion in adolescents: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2020; 158:477-494.e7. [DOI: 10.1016/j.ajodo.2020.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 10/23/2022]
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15
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Zhang B, Huang X, Huo S, Zhang C, Zhao S, Cen X, Zhao Z. Effect of clear aligners on oral health‐related quality of life: A systematic review. Orthod Craniofac Res 2020; 23:363-370. [PMID: 32340082 DOI: 10.1111/ocr.12382] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Bo Zhang
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu China
| | - Sibei Huo
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Pediatric Dentistry West China Hospital of Stomatology Sichuan University Chengdu China
| | - Chenghao Zhang
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu China
| | - Sen Zhao
- Department of Orthodontics School of Dentistry Chonbuk National University Jeonju South Korea
| | - Xiao Cen
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Temporomandibular Joint West China Hospital of Stomatology Sichuan University Chengdu China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases National Clinical Research Center for Oral Diseases West China Hospital of Stomatology Sichuan University Chengdu China
- Department of Orthodontics West China Hospital of Stomatology Sichuan University Chengdu China
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Guo J, Yan X, Li S, Van der Walt J, Guan G, Mei L. Quantitative and qualitative analyses of orthodontic-related videos on YouTube. Angle Orthod 2020; 90:411-418. [PMID: 33378439 PMCID: PMC8032311 DOI: 10.2319/082019-542.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/01/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To investigate content of orthodontic-related videos on YouTube to improve the understanding of orthodontic patients' perceptions and treatment experiences. MATERIALS AND METHODS A systematic search was conducted on YouTube on March 20, 2018, and updated on August 4, 2019, to identify all relevant videos using search terms "orthodontic," "orthodontics," "braces," and "orthodontic braces." The data set was captured from YouTube Data API (Application Programming Interface) and stored in an Excel database using a query function written in Python. All videos captured were viewed and categorized by three independent dental investigators using thematic analysis. The top 100 videos (by view count) related to patients' treatment experience were further analyzed using discourse analysis. RESULTS A total of 600 orthodontic videos were screened, and 546 were included in the study. Six main themes were identified: (1) individual review of orthodontic treatment (45.8%, n = 250), (2) entertainment (19.8%, n = 108), (3) education (18.3%, n = 100), (4) advertisements (6.6%, n = 36), (5) time lapse of orthodontic treatment (5.3%, n = 29), and (6) do-it-yourself orthodontics (4.2%, n = 23). Of the top 100 videos related to patient's individual review of treatment, patients' main focuses were on pain (24%), problems with chewing and swallowing (12%), and adhesive removal (10%). CONCLUSIONS Orthodontic-related YouTube videos are diverse in nature. The most common video category was video providing an individual review of orthodontic treatment experience. Other popular video categories included entertainment, education, and advertisements. A range of do-it-yourself YouTube videos were also identified. YouTube may provide an opportunity for orthodontic professionals to disseminate health information.
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Kettle JE, Hyde AC, Frawley T, Granger C, Longstaff SJ, Benson PE. Managing orthodontic appliances in everyday life: A qualitative study of young people's experiences with removable functional appliances, fixed appliances and retainers. J Orthod 2020; 47:47-54. [PMID: 32009494 DOI: 10.1177/1465312519899671] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare young people's experiences of wearing a range of orthodontic appliances. DESIGN A cross-sectional, qualitative study with purposive sampling. SETTING UK dental teaching hospital. PARTICIPANTS Twenty-six orthodontic patients aged 11-17 years. METHODS Patients participated in in-depth semi-structured interviews. All interviews were transcribed verbatim and analysed thematically. RESULTS Young people reported physical, practical and emotional impacts from their appliances. Despite these reported impacts, participants described 'getting used' to and, therefore, not being bothered by their appliance. Framework analysis of the data identified a multi-dimensional social process of managing everyday life with an appliance. This involves addressing the 'dys-appearance' of the body through physically adapting to an appliance. This process also includes psychological approaches, drawing on social networks, developing strategies and situating experiences in a longer-term context. Engaging in this process allowed young people to address the physical, practical and emotional impacts of their appliances. CONCLUSION This qualitative research has identified how young people manage everyday life with an appliance. Understanding this process will help orthodontists to support their patients.
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Affiliation(s)
- Jennifer E Kettle
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Amy C Hyde
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Tom Frawley
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Clare Granger
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Sarah J Longstaff
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Philip E Benson
- School of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, UK
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Diddige R, Negi G, Kiran KVS, Chitra P. Comparison of pain levels in patients treated with 3 different orthodontic appliances - a randomized trial. Med Pharm Rep 2020; 93:81-88. [PMID: 32133451 PMCID: PMC7051823 DOI: 10.15386/mpr-1311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/28/2019] [Accepted: 06/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aims To compare pain levels experienced during initial alignment with three different orthodontic appliance types and to correlate pain with male and female differences, if any. Methods A prospective, randomized 3-arm parallel trial allocated 36 adult orthodontic patients into three appliance groups: MBT 0.022" slot (Mini Twin, Ormco, Glendora, USA), self ligating 0.022" slot Damon 3MX (Ormco, Glendora, USA) and clear aligners (Smile align, Mumbai, India). The level of discomfort was assessed through a questionnaire based on the visual analogue scale at four hours, twenty four hours, third and seventh day after appliance placement. Results Patients treated with clear aligners reported less pain than patients treated with conventional and self ligating fixed appliances. Patients treated with MBT conventional appliances showed greater pain levels than Damon appliances. A significantly higher visual analogue scale score was observed at 24 hours and the least visual analogue scale scores on the seventh day post appliance placement. Conclusion During the first week of orthodontic treatment, patients treated with clear aligners reported lower pain than those treated with conventional and self-ligating appliances.
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Affiliation(s)
- Rajasri Diddige
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
| | - Gunjan Negi
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
| | | | - Prasad Chitra
- Department of Orthodontics and Dentofacial Orthopedics, Army College of Dental Sciences, Secunderabad, Telangana, India
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Al-Moghrabi D, Colonio Salazar FB, Johal A, Fleming PS. Factors influencing adherence to vacuum-formed retainer wear: A qualitative study. J Orthod 2019; 46:212-219. [DOI: 10.1177/1465312519851196] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years. Design: A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers. Setting: Institute of Dentistry, Queen Mary University of London. Participants: Fifteen participants wearing vacuum-formed retainers for at least four years. Methods: One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology. Results: High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear. Conclusions: Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.
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Affiliation(s)
- Dalya Al-Moghrabi
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fiorella Beatriz Colonio Salazar
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Dental Institute, King’s College London, London, UK
| | - Ama Johal
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Padhraig S Fleming
- Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Meade MJ, Weston A, Dreyer CW. Valid consent and orthodontic treatment. AUSTRALASIAN ORTHODONTIC JOURNAL 2019. [DOI: 10.21307/aoj-2020-031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Valid patient consent is a legal and ethical principle that is fundamental to healthcare provision. Oral health practitioners (OHPs) must understand the principles that need to be addressed to ensure that the consent given by a patient is valid. Failure to obtain consent may result in a negligence claim or a complaint of professional misconduct against the OHP. Orthodontic treatment is mostly elective but is not without risk to the patient. Obtaining and maintaining valid consent for orthodontic treatment presents additional challenges in comparison with other dental procedures as the treatment lasts over a longer time and is most commonly performed in adolescents. In addition, prospective patients need to be informed regarding ‘lifelong’ management in the retention phase to minimise the risk of relapse. The present paper outlines the principles of valid consent with particular regard to orthodontic treatment in the adolescent patient. OHPs must ensure that they are satisfied that the competent patient has the capacity to voluntarily consent. Clinicians must also recognise that valid consent is not a one-off ‘tick the box’ procedural exercise but an ongoing process of effective information sharing in light of changing laws and an ever-changing scientific evidence base within a patient-centred model of healthcare.
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Affiliation(s)
- Maurice J. Meade
- * Orthodontic Unit , School of Dentistry , The University of Adelaide , Adelaide South Australia , Australia
| | | | - Craig W. Dreyer
- * Orthodontic Unit , School of Dentistry , The University of Adelaide , Adelaide South Australia , Australia
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Ohkubo M, Ueda T, Sugito H, Watanabe A, Seshima F, Morioka T, Yajima Y. Two-year Survey of Trends at Food Introduction Booth at Suidobashi Hospital of Tokyo Dental College. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 59:213-221. [PMID: 30224616 DOI: 10.2209/tdcpublication.2017-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A working group established at Tokyo Dental College Suidobashi Hospital considered how to manage patients experiencing difficulties with food intake during the process of dental treatment. This resulted in the opening of an in-hospital booth dedicated to providing advice on such problems. A survey was performed to determine the number of patients utilizing this facility and the department which they were attending with the aim of investigating factors involved in eating-related problems. The results revealed that patients were being referred to the booth from the departments of dental prosthetics, conservative dentistry, oral and maxillofacial surgery (by both dentists and dietitians), oral implantation, and orthodontics. Patients were provided with information on the booth by their dentist or dietician, either by means of introductory materials or verbally. These patients were requested to complete a questionnaire, with informed consent, over a 2-year period. The participants were classified according to age and original dental problem on attending this hospital and the results analyzed. The inability to eat hard foodstuffs, difficulty in chewing, inability to open the mouth, insufficient nutrition, unbalanced nutrition, intraoral pain, and difficulty in swallowing were all identified as problems related to eating. A total of 1,948, 413 visitors had received introductory materials, while 156 had learned of the facility verbally. Looking at department as a factor, the inability to eat hard foodstuffs and difficulty chewing occupied a large percentage of the reported problems for all departments. Taken together, these results revealed that many patients experienced difficulties in eating during the process of treatment. This indicates that it is necessary to give the appropriate eating instructions to each patient according to their specific needs and stage of dental treatment.
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Affiliation(s)
- Mai Ohkubo
- Suidobashi Hospital, Tokyo Dental College.,Department of Oral Health and Clinical Science, Division of Dysphagia Rehabilitation, Tokyo Dental College
| | - Takayuki Ueda
- Suidobashi Hospital, Tokyo Dental College.,Department of Removable Prosthodontics and Gerontology, Tokyo Dental College
| | - Hiroki Sugito
- Suidobashi Hospital, Tokyo Dental College.,Department of Operative Dentistry, Cariology and Pulp Biology, Tokyo Dental College.,Department of Dental Hygiene, Tokyo Dental Junior College
| | - Akira Watanabe
- Suidobashi Hospital, Tokyo Dental College.,Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Fumi Seshima
- Suidobashi Hospital, Tokyo Dental College.,Department of Periodontology, Tokyo Dental College
| | - Toshiyuki Morioka
- Suidobashi Hospital, Tokyo Dental College.,Department of Removable Partial Prosthodontics, Tokyo Dental College
| | - Yasutomo Yajima
- Suidobashi Hospital, Tokyo Dental College.,Department of Oral Implantology, Tokyo Dental College
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Adolescent perceptions of orthodontic treatment risks and risk information: A qualitative study. J Dent 2018; 74:61-70. [PMID: 29702151 DOI: 10.1016/j.jdent.2018.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/08/2018] [Accepted: 04/13/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION For effective risk communication, clinicians must understand patients' values and beliefs in relation to the risks of treatment. This qualitative study aimed to explore adolescent perceptions of orthodontic treatment risks and risk information. METHODS Five focus groups were carried out with 32 school/college pupils aged 12-18 in Wales, UK. Participants were purposively selected and had all experienced orthodontic treatment. A thematic approach was used for analysis and data collection was completed at the point of data saturation. RESULTS Four themes emerged from the data; (a) day-to-day risks of orthodontic treatment, (b) important orthodontic risk information, (c) engaging with orthodontic risk information and (d) managing the risks of orthodontic treatment. Day-to-day risks of orthodontic treatment that were affecting participants "here and now" were of most concern. Information about preventing the risks of treatment was deemed to be important. Participants did not actively seek risk information but engaged passively with information from convenient sources. Perceptions of risk susceptibility influenced participants' management of the risks of orthodontic treatment. CONCLUSIONS This study demonstrates that adolescent patients can understand information about the nature and severity of orthodontic treatment risks. However, adolescent patients can have false perceptions if the risks are unfamiliar, perceived only to have a future impact or if seen as easy to control. Adolescent patients must be provided with timely and easily accessible risk information and with practical solutions to prevent the risks of treatment. CLINICAL SIGNIFICANCE The views and experiences gathered in this study can assist clinicians to better understand their young patients' beliefs about treatment risks, facilitate effective risk communication and contribute to improved patient-centred care.
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