Can Socioeconomic and Psychosocial Factors Predict Orthodontic Treatment Success?

Objectives: to test whether socioeconomic and psychosocial factors are associated with orthodontic treatment outcome.

Methods: this hospital-based prospective longitudinal study included 145 consecutively selected patients aged 12-16 years, who underwent treatment for anterior upper crowding/spacing, increased/reversed overjet and/or anterior crossbite in Barts and The London Hospital. Baseline data were collected by a validated self-completed questionnaire before the placement of fixed appliances. Thereafter, patients were followed up on a monthly basis to collect information relating to their “daily hassles” and treatment adherence. Orthodontic treatment outcome was measured by the amount of improvement in occlusion achieved in one year. Data analysis was carried out using simple and multiple logistic regression. The level of significance was set at 5%.

Results: the response rate was 98.6% and the drop out was 5.6%. Household social class and maternal support showed an important impact on orthodontic treatment outcome. Adolescents from low household social class were less likely to achieve improvement in occlusion than those from high household social class (OR = 0.2; 95%CI = 0.07-0.79; P = 0.019). Adolescents with high levels of maternal support were more likely to achieve improvement in occlusion than those with low levels of maternal support (OR = 3; 95% CI = 1.53-6.27; P = 0.002). Daily hassles, paternal support and parents' control were not significantly related to treatment outcome (P>0.05). The significance of household social class and maternal support persists after adjusting the model for the effect of ethnicity, malocclusion severity, type of malocclusion, clinician skills and patient adherence (adjusted OR = 0.1, 4.6; 95% CI = 0.02-0.68, 1.41-14.79; P = 0.017, 0.011; respectively).

Conclusion: Socioeconomic and family environment factors seem to play an important role in orthodontic treatment outcome.