Advertisement

Adolescents’ perception of malocclusion, their motivations, and expectations concerning the orthodontic treatment. Is it all about attractiveness? A qualitative study

Published:January 12, 2022DOI:https://doi.org/10.1016/j.ajodo.2021.10.014

      Highlights

      • Attractiveness is exceptionally relevant among adolescent orthodontic patients.
      • Adolescents expect upsetting dentofacial traits to be corrected by orthodontics.
      • Esthetic self-oriented motivations are influential for adolescents seeking treatment.
      • Parents, professionals, and peers also influence adolescents’ perception.
      • Normal dentofacial status is attached to adolescents’ social and individual aspirations.

      Introduction

      In addition to essential clinical parameters, orthodontic treatment outcomes should also consider patients’ opinions and perceptions, which could be comprehensively clarified with a qualitative scientific approach. Considering that the information on younger patients’ views is scarce, the objective of this study was to investigate how adolescent orthodontic patients perceive malocclusion, and their motivations and expectations concerning orthodontic corrective treatment.

      Methods

      In this descriptive qualitative study, 12 adolescents aged 12 to 14 years and of both genders, covering a heterogeneous collection of malocclusions, were recruited from the waiting list of an Orthodontics Graduate Course. They were individually interviewed before the appliance insertion by an experienced researcher using an interview guide and photographic records to stimulate patients’ self-perception of their oral condition. The interviews proceeded simultaneously with transcription analyses until saturation. After the transcription evaluation, the framework analysis technique was performed.

      Results

      Data derived from the transcription analyses were grouped into 3 major themes: perceptions concerning the concepts of normality and abnormality regarding oral health; self-perceptions regarding malocclusion and other discrepancies; and motivations for seeking orthodontic treatment and expectations related to the results.

      Conclusions

      Attractiveness was exceptionally relevant among adolescent patients. Most interviewees seemed to focus their attention on esthetically upsetting dentofacial traits, which they expected to be corrected by orthodontic treatment. In addition to self-oriented appearance-driven motivations, parents, other health professionals, friends, and peers also influenced adolescents’ perception of their need for treatment. The achievement of a normal dentofacial status seems to be closely attached to social and individual aspirations.
      To read this article in full you will need to make a payment

      References

        • Phillips C.
        Patient-centered outcomes in surgical and orthodontic treatment.
        Semin Orthod. 1999; 5: 223-230
        • Travess H.C.
        • Newton J.T.
        • Sandy J.R.
        • Williams A.C.
        The development of a patient-centered measure of the process and outcome of combined orthodontic and orthognathic treatment.
        J Orthod. 2004; 31 (discussion 201-2): 220-234
        • Fleming P.S.
        • Koletsi D.
        • O’Brien K.
        • Tsichlaki A.
        • Pandis N.
        Are dental researchers asking patient-important questions? A scoping review.
        J Dent. 2016; 49: 9-13
        • Taylor K.R.
        • Kiyak A.
        • Huang G.J.
        • Greenlee G.M.
        • Jolley C.J.
        • King G.J.
        Effects of malocclusion and its treatment on the quality of life of adolescents.
        Am J Orthod Dentofacial Orthop. 2009; 136: 382-392
        • Masood Y.
        • Masood M.
        • Zainul N.N.
        • Araby N.B.
        • Hussain S.F.
        • Newton T.
        Impact of malocclusion on oral health related quality of life in young people.
        Health Qual Life Outcomes. 2013; 11: 25
        • Zhou Y.
        • Wang Y.
        • Wang X.
        • Volière G.
        • Hu R.
        The impact of orthodontic treatment on the quality of life a systematic review.
        BMC Oral Health. 2014; 14: 66
        • Andiappan M.
        • Gao W.
        • Bernabé E.
        • Kandala N.B.
        • Donaldson A.N.
        Malocclusion, orthodontic treatment, and the Oral Health Impact Profile (OHIP-14): systematic review and meta-analysis.
        Angle Orthod. 2015; 85: 493-500
        • Liu Z.
        • McGrath C.
        • Hägg U.
        The impact of malocclusion/orthodontic treatment need on the quality of life. A systematic review.
        Angle Orthod. 2009; 79: 585-591
        • Gussy M.
        • Dickson-Swift V.
        • Adams J.
        A scoping review of qualitative research in peer-reviewed dental publications.
        Int J Dent Hyg. 2013; 11: 174-179
        • Stanford N.D.
        • Ip T.B.
        • Durham J.
        Adult orthodontic patients’ views regarding dentofacial normality: a qualitative study.
        Am J Orthod Dentofacial Orthop. 2014; 145: 287-295
        • Pabari S.
        • Moles D.R.
        • Cunningham S.J.
        Assessment of motivation and psychological characteristics of adult orthodontic patients.
        Am J Orthod Dentofacial Orthop. 2011; 140: e263-e272
        • Wong L.
        • Ryan F.S.
        • Christensen L.R.
        • Cunningham S.J.
        Factors influencing satisfaction with the process of orthodontic treatment in adult patients.
        Am J Orthod Dentofacial Orthop. 2018; 153: 362-370
        • Gray M.M.
        • Bradnock G.
        • Gray H.L.
        An analysis of the qualitative factors which influence young people’s acceptance of orthodontic care.
        Prim Dent Care. 2000; 7: 157-161
        • Al Jawad F.A.
        • Cunningham S.J.
        • 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
        • Čirgić E.
        • Kjellberg H.
        • Hansen K.
        • Lepp M.
        Adolescents’ experiences of using removable functional appliances.
        Orthod Craniofac Res. 2015; 18: 165-174
        • Perry J.
        • Johnson I.
        • Popat H.
        • Morgan M.Z.
        • Gill P.
        Adolescent perceptions of orthodontic treatment risks and risk information: a qualitative study.
        J Dent. 2018; 74: 61-70
        • Twigge E.
        • Roberts R.M.
        • Jamieson L.
        • Dreyer C.W.
        • Sampson W.J.
        Qualitative evaluation of pretreatment patient concerns in orthodontics.
        Am J Orthod Dentofacial Orthop. 2016; 150: 49-57
        • Vazquez Fde L.
        • Cortellazzi K.L.
        • Gonçalo Cda S.
        • Bulgareli J.V.
        • Guerra L.M.
        • Tagliaferro E.S.
        • et al.
        Qualitative study on adolescents’ reasons to non-adherence to dental treatment.
        Cien Saúde Colet. 2015; 20: 2147-2156
        • Kazancı F.
        • Aydoğan C.
        • Alkan Ö.
        Patients’ and parents’ concerns and decisions about orthodontic treatment.
        Korean J Orthod. 2016; 46: 20-26
        • Hardwick L.J.
        • Sayers M.S.
        • Newton J.T.
        Patient’s expectations of lingual orthodontic treatment: a qualitative study.
        J Orthod. 2017; 44: 21-27
        • Guest G.
        • Namey E.
        • Chen M.
        A simple method to assess and report thematic saturation in qualitative research.
        PLoS One. 2020; 15e0232076
        • Saunders B.
        • Sim J.
        • Kingstone T.
        • Baker S.
        • Waterfield J.
        • Bartlam B.
        • et al.
        Saturation in qualitative research: exploring its conceptualization and operationalization.
        Qual Quant. 2018; 52: 1893-1907
        • Ward D.J.
        • Furber C.
        • Tierney S.
        • Swallow V.
        Using Framework Analysis in nursing research: a worked example.
        J Adv Nurs. 2013; 69: 2423-2431
        • Setia M.S.
        Methodology series module 10: qualitative health research.
        Indian J Dermatol. 2017; 62: 367-370
        • Daniels A.S.
        • Seacat J.D.
        • Inglehart M.R.
        Orthodontic treatment motivation and cooperation: a cross-sectional analysis of adolescent patients’ and parents’ responses.
        Am J Orthod Dentofacial Orthop. 2009; 136: 780-787
        • Al-Moghrabi D.
        • Salazar F.C.
        • Pandis N.
        • Fleming P.S.
        Compliance with removable orthodontic appliances and adjuncts: a systematic review and meta-analysis.
        Am J Orthod Dentofacial Orthop. 2017; 152: 17-32
        • Stewart K.
        • Gill P.
        • Chadwick B.
        • Treasure E.
        Qualitative research in dentistry.
        Br Dent J. 2008; 204: 235-239
        • Calderon S.J.
        • Mallory C.
        Look at my pearly white teeth: exploring adolescents’ oral health behavior.
        Public Health Nurs. 2019; 36: 62-69
        • Samsonyanová L.
        • Broukal Z.
        A systematic review of individual motivational factors in orthodontic treatment: facial attractiveness as the main motivational factor in orthodontic treatment.
        Int J Dent. 2014; 2014938274
        • Tuncer C.
        • Canigur Bavbek N.
        • Balos Tuncer B.
        • Ayhan Bani A.
        • Çelik B.
        How do patients and parents decide for orthodontic treatment-effects of malocclusion, personal expectations, education and media.
        J Clin Pediatr Dent. 2015; 39: 392-399
        • Maisel A.
        • Waldman A.
        • Furlan K.
        • Weil A.
        • Sacotte K.
        • Lazaroff J.M.
        • et al.
        Self-reported patient motivations for seeking cosmetic procedures.
        JAMA Dermatol. 2018; 154: 1167-1174
        • Silva D.F.O.
        • Sena-Evangelista K.C.M.
        • Lyra C.O.
        • Pedrosa L.F.C.
        • Arrais R.F.
        • Lima S.C.V.C.
        Motivations for weight loss in adolescents with overweight and obesity: a systematic review.
        BMC Pediatr. 2018; 18: 364
        • Jones E.S.
        • Gibson J.A.G.
        • Dobbs T.D.
        • Whitaker I.S.
        The psychological, social and educational impact of prominent ears: a systematic review.
        J Plast Reconstr Aesthet Surg. 2020; 73: 2111-2120
        • Marques L.S.
        • Filogônio C.A.
        • Filogônio C.B.
        • Pereira L.J.
        • Pordeus I.A.
        • Paiva S.M.
        • et al.
        Aesthetic impact of malocclusion in the daily living of Brazilian adolescents.
        J Orthod. 2009; 36: 152-159
        • Wedrychowska-Szulc B.
        • Syryńska M.
        Patient and parent motivation for orthodontic treatment--a questionnaire study.
        Eur J Orthod. 2010; 32: 447-452
        • Ernest M.A.
        • daCosta O.O.
        • Adegbite K.
        • Yemitan T.
        • Adeniran A.
        Orthodontic treatment motivation and cooperation: a cross-sectional analysis of adolescent patients’ and parents’ responses.
        J Orthod Sci. 2019; 8: 12
        • Brumini M.
        • Slaj M.
        • Katic V.
        • Pavlic A.
        • Trinajstic Zrinski M.
        • Spalj S.
        Parental influence is the most important predictor of child’s orthodontic treatment demand in a preadolescent age.
        Odontology. 2020; 108: 109-116
        • El Tantawi M.E.
        • Bakhurji E.
        • Al-Ansari A.
        • Al-Khalifa K.S.
        • AlSubaie A.
        Influences of parents, close friends and classmates on four co-existing oral health practices in Saudi male teenagers.
        Acta Odontol Scand. 2017; 75: 137-143
        • Montgomery S.C.
        • Donnelly M.
        • Bhatnagar P.
        • Carlin A.
        • Kee F.
        • Hunter R.F.
        Peer social network processes and adolescent health behaviors: a systematic review.
        Prev Med. 2020; 130105900
        • Deng X.
        • Wang Y.J.
        • Deng F.
        • Liu P.L.
        • Wu Y.
        Psychological well-being, dental esthetics, and psychosocial impacts in adolescent orthodontic patients: a prospective longitudinal study.
        Am J Orthod Dentofacial Orthop. 2018; 153: 87-96.e2
        • Martins L.P.
        • Bittencourt J.M.
        • Bendo C.B.
        • Vale M.P.
        • Paiva S.M.
        Malocclusion and social vulnerability: a representative study with adolescents from Belo Horizonte, Brazil.
        Cien Saúde Colet. 2019; 24: 393-400
        • Al Quraini N.
        • Shah R.
        • Cunningham S.J.
        Perceptions of outcomes of orthodontic treatment in adolescent patients: a qualitative study.
        Eur J Orthod. 2019; 24: 294-300