Expectations of orthodontic treatment among 7–12 year-old children – a cross sectional study

Authors

  • Anne-Maria Aulu Wellbeing Services County of Vantaa and Kerava, Vantaa, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
  • Tuija Pikkusaari Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
  • David Rice Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
  • Heidi Arponen Wellbeing Services County of Vantaa and Kerava, Vantaa, Finland; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Head and Neck Center, Helsinki University Hospital, Helsinki, Finland

DOI:

https://doi.org/10.2340/aos.v84.43910

Keywords:

orthodontics, treatment expectations, children, treatment need, patient reported outcomes

Abstract

Objective: The primary aim of this study was to investigate participants’ orthodontic treatment expectations and to assess participants’ perceptions of their own orthodontic treatment need. A secondary aim was to compare participants’ self-perceived treatment need to an orthodontist’s opinion.

Material and methods: In this cross-sectional study, a total of 98 participants, aged 7–12 years, completed a modified Sayers questionnaire before an orthodontic screening in a public health center in Finland. After completing the questionnaire, the participants underwent a clinical examination of the occlusion by an orthodontist specialist. A Spearman’s rank correlation was conducted to evaluate the relationship between the questionnaire answers. The chi square statistic was applied to assess association between categorical variables.

Results: From the initial orthodontic screening, a sample of 98, 94 participants were included in further analysis. Of them, 89% expressed a self-perceived need for orthodontic treatment. Orthodontic treatment need was determined by an orthodontist for 66% of the participants based on a severe malocclusion. Gender, age, or family history of orthodontic treatment were not associated with subjective treatment need. The main expectations for orthodontic treatment result were to straighten the teeth, to get a better smile, and to avoid problems in the future.

Conclusions: The study found that patients’ expectations of treatment did not fully align with reality. More information for patients and their guardians is needed in advance to avoid unrealistic expectations before the orthodontic treatment.

Downloads

Download data is not yet available.

References

Pietilä I, Pietilä T, Svedström-Oristo A-L, Varrela J, Alanen P. Orthodontic treatment practices in Finnish municipal health centres with differing timing of treatment. Eur J Orthod. 2009;3:287–93. https://doi.org/10.1093/ejo/cjn109 DOI: https://doi.org/10.1093/ejo/cjn109

Heikinheimo K. Need of orthodontic treatment and prevalence of craniomandibular dysfunction in Finnish children [thesis]. Turku: University of Turku; 1989.

Grainger RM. Orthodontic treatment priority index. Washington National Centre for Health Statistics; 1967.

Finnish Ministry of Social Affairs and Health. Helsinki. Finland.

12-year-old children receiving orthodontic care, % of all 12-year-olds receiving dental care (ind. 5025) Sotkanet.fi, accessed 14/11/2024. Statistics and Indicator Bank © The Finnish Institute for Health and Welfare 2005–2024, Finland.

Arpalahti A, Saarnio-Syrjäläinen A, Laaksonen S, Arponen H. Early orthodontic treatment in a Finnish public health centre: a retrospective cross-sectional study. Acta Odontol Scand. 2022;81:396–401. https://doi.org/10.1080/00016357.2022.2161623 DOI: https://doi.org/10.1080/00016357.2022.2161623

Tavares de Sousa E, Feitosa da Silva B, Barros Marinho Maia F, Delano Soares Forte F, Correia Sampaio F. Perception of children and mothers regarding dental aesthetics and orthodontic treatment need: a cross-sectional study. Prog Orthod. 2016;17:37. https://doi.org/10.1186/s40510-016-0149-6 DOI: https://doi.org/10.1186/s40510-016-0149-6

Livas C, Delli K. Subjective and objective perception of orthodontic treatment need: a systematic review. Eur J Orthod. 2013;35:347–53. https://doi.org/10.1093/ejo/cjr142 DOI: https://doi.org/10.1093/ejo/cjr142

Kerosuo H, Al Enezi S, Kerosuo E, Abdulkarim E. Association between normative and self- perceived orthodontic treatment need among Arab high school students. Am J Orthod Dentof Orthoped. 2004;125:373–8. https://doi.org/10.1016/S088954060​300917X DOI: https://doi.org/10.1016/j.ajodo.2003.04.009

Sheats R, McGorray S, Keeling S, Wheeler T, King G. Occlusal traits and perception of orthodontic need in eight grade students. Angle Orthod. 1998;68:107–14. https://doi.org/10.1043/0003-3219(1998)068<0107:OTAPOO>2.3.CO;2

Tuominen M, Nyström M, Tuominen R. Subjective and objective orthodontic treatment need among orthodontically treated and untreated Finnish adolescents. Community Dent Oral Epidemiol. 1995;23:286–90.https://doi.org/10.1111/j.1600-0528.​1995.tb00250.x DOI: https://doi.org/10.1111/j.1600-0528.1995.tb00250.x

Salih F, Lindsten R, Bågesund M. Perception of orthodontic treatment need among Swedish children, adolescents and young adults. Acta Odontol Scand. 2017;75:407–12. https://doi.org/10.1080/00016357.2017.1326062 DOI: https://doi.org/10.1080/00016357.2017.1326062

Theodoridou MZ, Herclides A, Lamnisos D. Need for orthodontic treatment and oral health-related quality of life in children and adolescents – a systematic review. Community Dent Health. 2024;41:​5–13. https://doi.org/10.1922/CDH_00125Theodoridou09

Michelogiannakis D, Gajendra S, Pathagunti S, Sayers M, Newton J, Zhou Z, et al. Patients’ and parents’ expectations of orthodontic treatment in university settings. Am J Orthod Dentof Orthoped. 2021;159:443–52. https://doi.org/10.1179/14653120723247 DOI: https://doi.org/10.1016/j.ajodo.2020.02.009

Obilade O, Da Costa O, Sanu O. Patient/parent expectations of orthodontic treatment. Int Orthod. 2017;15:82–102. https://doi.org/10.1016/j.ortho.2016.12.005 DOI: https://doi.org/10.1016/j.ortho.2016.12.005

Sayers M, Cunningham S, Newton J. How do you identify the patient with ‘high expectations’ of orthodontic treatment: an empirical approach. J Orthod. 2020;47:289–93. https://doi.org/10.1177/1465​312520939970 DOI: https://doi.org/10.1177/1465312520939970

Twigge E, Roberts RM, Jamieson L, Dreyer CW, Sampson WJ. The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients. Eur J Orthod. 2016;38:593–601. https://doi.org/10.1093/ejo/cjv093 DOI: https://doi.org/10.1093/ejo/cjv093

Bos A, Hoogstraten J, Prahl-Andersen B. Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients. Am J Orthod Dentof Orthoped. 2003;123:127–32. https://doi.org/10.1067/mod.2003.84 DOI: https://doi.org/10.1067/mod.2003.84

Yao J, Li D, Yang Y, McGrath CPJ, Mattheos N. What are patients’ expectations of orthodontic treatment: a systematic review. BMC Oral Health. 2016;16:19. https://doi.org/10.1186/s12903- 016-0182-3 DOI: https://doi.org/10.1186/s12903-016-0182-3

Liu C, Seehra J, Cobourne MT. Longitudinal bibliometric investigation of published orthodontic research 2013–23: are we investigating patient-reported outcomes? Eur J Orthod. 2024;46:cjae042. https://doi.org/10.1093/ejo/cjae042 DOI: https://doi.org/10.1093/ejo/cjae042

O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89:1245–51. https://doi.org/10.1097/ACM.000000​0000000388 DOI: https://doi.org/10.1097/ACM.0000000000000388

Sayers M, Newton J. Patients’ expectations of orthodontic treatment: part 1 – development of a questionnaire. J Orthod. 2006;33:258–69. https://doi.org/10.1179/146531205225021753 DOI: https://doi.org/10.1179/146531205225021753

Hiemstra R, Bos A, Hoogstraten J. Patients’ and parents’ expectations of orthodontic treatment. J Orthod. 2009;36:219–28. https://doi.org/10.1179/14653120723247 DOI: https://doi.org/10.1179/14653120723247

Sadek S, Newton T, Sayers M. How patient and carer expectations of orthodontic treatment vary with ethnicity. J Orthod. 2015;42:​208–13. https://doi.org/10.1179/1465313314Y.0000000127 DOI: https://doi.org/10.1179/1465313314Y.0000000127

Third edition of the Finnish version of the International Statistical Classification of Diseases and Related Health Problems. 3rd ed. Finnish Institute for Health and Welfare and World Health Organization. Finland.

Deli R, Macrì LA, Radico P, Pantanali F, Grieco DL, Gualano MR, et al. Orthodontic treatment attitude versus orthodontic treatment need: differences by gender, age, socioeconomical status and geographical context. Community Dent Oral Epidemiol. 2012;40:71–6. https://doi.org/10.1111/j.1600-0528.2011.00669.x DOI: https://doi.org/10.1111/j.1600-0528.2011.00669.x

Bauss O, Vassis S. Prevalence of bullying in orthodontic patients and it’s impact on the desire for orthodontic therapy, treatment motivation and expectations of treatment. J Orofac Orthoped. 2023;84:​69–78. https://doi.org/10.1007/s00056-021-00343-w DOI: https://doi.org/10.1007/s00056-021-00343-w

Nanda RS, Kierl MJ. Prediction of cooperation in orthodontic treatment. Am J Orthod Dentofac Orthoped. 1992;102:15–21. https://doi.org/10.1016/0889-5406(92)70010-8 DOI: https://doi.org/10.1016/0889-5406(92)70010-8

Grewal H, Sapawat P, Modi P, Aggarwal S. Psychological impact of orthodontic treatment on quality of life – a longitudinal study. Int Orthod. 2019;17:269–76. https://doi.org/10.1016/j.ortho.2019.​03.009 DOI: https://doi.org/10.1016/j.ortho.2019.03.009

Additional Files

Published

2025-06-18