OHRQoL and Treatment Expectations in Adults and Children Undergoing Orthodontics

Objectives: To compare long-term expectations and oral health-related quality of life (OHRQoL) scores in children and adults prior to orthodontic intervention with their perceptions during and after treatment.

Methods: A non-random, consecutive sample of 105 children (ages 10-17) and 93 adults (>18 yo) was recruited at the NYU orthodontic clinic. Participants were evaluated at three separate time periods: T1- before the start of treatment; T2- after 6-8 months of active orthodontic treatment; and T3- after 20-22 months of active orthodontic treatment. At each time interval, participants were asked to complete questionnaires to provide information about long-term expectations of care using the Kiyak/Phillips scale and OHRQoL using the Child Oral Health Impact Profile (COHIP) for children and Oral Health Impact Profile (OHIP) for adults. Of the initial sample, 53 children and 35 adults participated in the third phase (T3) of this study, 30 of whom were in retention. Data from the expectations and OHRQoL questionnaires were analyzed using F tests and post-hoc T-tests.

Results: The sample was comprised of 40% males; 46% Latino, 21% black, 16% white and 17% Other. Expectations were highest for self-image. No differences among children or adults were found in expectations over time. Among children, Functional well-being and School Environment decreased from T1 to T3, while self-image and social/emotional well-being increased (improved OHRQoL) from T1 to T3 on the COHIP. Among adults, Functional limitation and physical pain significantly increased from T1 to T3; while psychological disability and handicap score decreased (improved OHRQoL) from T1 to T3. Among those in retention, overall OHRQoL improved (p<0.05); most notably in the psychological well- being subscales (p<0.01).

Conclusions: The long-term expectations of orthodontic treatment among children and adults prior to treatment were not statistically different from their perceptions following orthodontic treatment. OHRQoL improved in both children and adults following orthodontic treatment.