Pretreatment Expectations and Post Treatment Perceptions of Adolescent Orthodontic Patients

Objectives: Adolescents may have unrealistic expectations about difficulties or discomfort associated with future orthodontic appliances. The purpose of this study was to investigate adolescent expectations of future orthodontic treatment compared to perception of the actual experience once orthodontic appliances were placed. Methods: In a graduate orthodontic clinic, 32 female and 30 male patients (12 – 17 years; mean -13.4 years) completed two questionnaires, the first at the initial records appointment and the second at least 3 months after the placement of complete orthodontic appliances. The questionnaires included questions about dental experience, dental anxiety, treatment expectations and treatment perceptions. The initial questionnaire was completed before any pretreatment information about future orthodontic treatment was provided. The Cochran-Mantel-Haenszel general association statistic for repeated measures was used to compare the results of the two questionnaires. Results: The placement of separators (p<0.001) and appliances (p<0.0001) were less painful than expected. The appearance of orthodontic appliances (p=0.001) and appearance on smiling (p<0.001) were less attractive than initially expected. Speech (p=0.01) was more negatively affected that expected. Irritation of the tongue (p=0.01) and cheeks (p=0.02) were more significant than expected. Oral hygiene (p=0.05) was also more difficult than initially expected. No differences between expectation and perception of experience in food choices, biting ability and chewing ability were found. Conclusions: Adolescent orthodontic patients underestimated the effects of future orthodontic treatment on appearance, speech, soft tissue irritation and oral hygiene, and over estimated the pain experienced during the placement of the appliances. Supported by NIH grant DE005215.