|Year : 2018 | Volume
| Issue : 2 | Page : 55-59
Evaluation of different motivational factors for seeking orthodontic treatment: The patients' and parents' response
Department of Orthodontics and Dentofacial Orthopedics, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India
|Date of Web Publication||1-Nov-2018|
Dr. Monika Mahajan
Department of Orthodontics and Dentofacial Orthopedics, Himachal Pradesh Government Dental College and Hospital, Shimla - 171 001, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
Aim: Orthodontic treatment helps to improve not only facial esthetics but also functional occlusion of an individual. The aim of this study is to find out different factors which motivate patients and their parents to seek orthodontic treatment. This study also aims at determining any differences according to gender in perception of different motivational factors. Materials and Methods: The sample consisted of 35 male patients and 70 female female in the age group of 12–23 years. They along with their parents were given a questionnaire to answer before the start of the treatment to find out the reason for seeking orthodontic treatment. Results: There were a high percentage of patients (88.6%) who wanted the orthodontic treatment to improve their facial esthetics. Nearly 98.1% of parents sought this treatment to make their child look pretty. Conclusion: There are many factors which motivate the patients and their parents to seek orthodontic treatment like improvement in dentofacial esthetics leading to enhancement of self-esteem and providing better career opportunities.
Keywords: Fixed orthodontic treatment, motivational factors, parents
|How to cite this article:|
Mahajan M. Evaluation of different motivational factors for seeking orthodontic treatment: The patients' and parents' response. J Dent Allied Sci 2018;7:55-9
|How to cite this URL:|
Mahajan M. Evaluation of different motivational factors for seeking orthodontic treatment: The patients' and parents' response. J Dent Allied Sci [serial online] 2018 [cited 2020 Sep 23];7:55-9. Available from: http://www.jdas.in/text.asp?2018/7/2/55/244754
| Introduction|| |
Facial esthetics seem to be a significant determinant of self and social perceptions. Orthodontic treatment is a method of aligning the teeth or correcting other irregularities which can improve health, oral function, appearance, and social well-being of an individual., Malocclusion seems to affect satisfaction with one's dental appearance, facial appearance, and perceived attractiveness.,,, Optimal facial appearance is not only seen as being more attractive but also more socially accepted by peers, teachers, employers, and others.,,
Irregularities in the position of the teeth and jaws have a significant impact on the attractiveness and esthetics of the smile and quality of life of an individual. Attractive people are regarded as friendly, intelligent, interesting, more social, and with much more positive personalities. While orthodontic treatment is an effective manner to treat different types of malocclusions, which can lead to an improvement in quality of life,,, but the desire to undergo treatment has been explored little in scientific literature. It is important to identify the factors which directly motivate the patient and parents to bring their child in for the orthodontic treatment. Motivation stems from several sources and can be defined as a concept that describes the conscious or unconscious stimulus for action toward a desired goal. Both positive and negative motivations are correlated with adherence to the treatment. The motivation to seek treatment that is positive motivation is referred to as motivation generally. When motivation is lost, there is danger that the patient's compliance will suffer leading to premature termination of treatment or a compromised result.,
Most orthodontic patients are children and adolescents., The motivation of patients and their parents regarding orthodontic treatment seems to contribute to cooperation during the treatment, the prognosis of case, and posttreatment satisfaction.,, There are various reasons and factors which influence patients in seeking orthodontic treatment., By understanding these factors, the orthodontists are allowed better planning of resources and better assessment of the requirements and priorities of treatment.
The aim of this study is to explore different factors which motivate patients and their parents to seek orthodontic treatment. By assessing motivational factors, we can use them in counseling before treatment and may improve patient adherence thereby reducing the risk of patient dissatisfaction with the outcomes of the treatment. This study also aims at studying any difference in perception of different motivational factors according to gender.
| Materials and Methods|| |
The sample consisted of 105 patients aged between 12 and 23 years who had come to the Department of Orthodontics and Dentofacial Orthopedics, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India for orthodontic treatment. The male patients were 35 and females were 70. Patients with cleft lip and palate and craniofacial syndromes were excluded because they are not representative of typical orthodontic population. The questionnaire consisted of three subgroups [Table 1]. Subgroups 1 and 2 consisted of 7 and 10 questions, respectively, which were answered by the patient themselves and related to patient's dental awareness, any dental irregularities; effects of dental anomalies, any teasing episode as well as their expectation from the treatment, etc., respectively. Subgroup 3 consisted of nine questions and was addressed to the patient's parents and had questions related to the reasons for them to seek orthodontic treatment for their children.
|Table 1: Questionnaire to evaluate treatment motivation and expectations|
Click here to view
Individuals were given questionnaire at the start of the treatment. Each question was answered as yes or no. The data were analyzed using SPSS for Windows(version 16.0; SPSS Inc., Chicago, IL, USA) and statistical analysis was done.
| Results|| |
The study sample was of 105 patients with the age range of 12–23 years making the mean age of 17.5 years. Most of the study patients were female (66.6%) whereas males made only 33.3% of the whole sample. The male:female ratio was 1:2.
The percentage of patients agreeing or disagreeing to each question was calculated, and one-way test was done to show the percent score of individual subgroup. It shows that patient motivation score was 90% as compared to 45% score each of patient expectation and parent motivation subgroups [Table 2].
Post hoc test was done to compare percent score of each subgroup to other two subgroups and it was found that patient motivation percent score was statistically significant when compared to patient expectation and parent motivation subgroups each, whereas there was no significant difference when patient expectation and parent motivation subgroups were compared to each other [Table 3].
|Table 3: Post hoc test showing comparison of each subgroup to other two subgroups|
Click here to view
The difference in male and female motivations was also calculated with group statistics showing mean of percent score of male and female sample separately in each subgroup as shown in [Table 4]. T-test was done to find out any significant difference according to gender and it was found out there was statistically significant difference between male and female percent score in patient motivation subgroup but not in other two subgroups [Table 5].
|Table 4: T-test to compare differences in motivations according to gender|
Click here to view
|Table 5: Results of t-test showing differences in patient motivation according to gender|
Click here to view
| Discussion|| |
Most of the motivational factors relate broadly to esthetic, functional, and societal concerns. As the questionnaire was divided into three subgroups, results are being discussed in same categories.
Pabari et al. found that a desire to improve their smile was a prime motivating factor for the patient. The satisfaction of adolescents with their dental and facial appearance has been reported to be associated with the desire for orthodontic treatment in different populations., Prof Langlois et al. showed that even children pay greater attention to people with a more attractive face than people of less attractive appearance. Oral health professionals generally agree that esthetics' issues are very important to an individual.,, The major motive behind young adults seeking orthodontic treatment is the displeasure and frustration with the dental and facial esthetics. Better dental and facial esthetics play an essential role in finding better jobs and social contacts. Many studies suggest that dental and facial esthetics as the chief reason for seeking orthodontic treatment which is also shown in our study with 88.6% of patients feeling concerned about their dental appearance and 91.4% wanting to correct it.
There are many expectations which a patient has from orthodontic treatment which motivates them to undergo the treatment.
The patient's decision in relation to starting orthodontic treatment was based on the recommendation of either the dentist or their parents. However, their influence decreased with increasing age of the patient as shown by different authors. Most of our patients (87.6%) have self-reported to the orthodontist in contrast to other studies., In our study, only 12.4% were referred by dentist. This may point to a weakness in dental school curriculum in the ability to recognize a malocclusion by the dentist. Shauv, in his study, found that irregular routine dental attendance pattern was associated with more dissatisfaction of the patient with dental appearance which leads to higher demand for orthodontic treatment.
The manners and opinions of friends have a great impact on the study patients. Certain malocclusions such as crowding in the frontal area of the teeth, gap between the teeth, and deep bite are easily recognizable by children and can become the reason for teasing as shown in the studies by Shaw and Fawzan., Irregularities in the position of the teeth and jaws are a cause of teasing and harassment among children and that they relate to decreased social attractiveness., Previous research shows importance of physical appearance to self-esteem. Low self-esteem may result from the pressure to look good in today's society and patient's history of being teased about their appearance. Badran et al. concluded that patients who needed orthodontic treatment demonstrated low self-esteem. In our study, only 28.6% of the patients were teased about their dental and facial appearance.
Some authors have reported that some patients with problems in biting and chewing, temporomandibular disorders and headache seek orthodontists advice. Nurmenen et al. and Trullson et al. also concluded that functional reasons were found in 47%–68% of their patients undergoing orthognathic surgery., In the present study, only 12.4% of patients reported with health problems. And hence did not appear to be an important motivating factor which is also in agreement with fi ndings of Fazwan's study. Malocclusion influences masticatory efficiency due to which esthetics and function of teeth become two crucial motivations in patients attending for orthodontic treatment.
In our study, there was no response of school authorities and employers toward malocclusion. Only 1% of them showed awareness toward the malocclusion, and hence as a motivating factor, it was found to be nonsignificant.
The relationship of the child with his parent plays an important role in any type of treatment. Hence, it is important to examine the factors which influence the parental attitude and behavior toward the treatment. Some patients are influenced by the recommendations of the parents. Tung and Kiyak reported in their study that 75% of the parents were dissatisfied with their children's teeth and 54% of the parents wanted their children to look pretty. Similarly, in our study, 95% of the parents showed concern about irregular teeth of their children and 98.1% of the parents wanted their children to look pretty showing that dentofacial appearance plays important part in establishing one's overall attractiveness of an individual. Most of the patients are adolescents who may not visualize long-term benefi ts of orthodontic treatment in improving their social life and self confid ence in later stages of life. However 93% of parents of chidren in our study show concern about orthodontic treatment affecting their child's career opportunity. affecting their child's career opportunity. The parents are the ones to make final decision which may depend on different motivational factors on different priority levels. They give more importance to the treatment than their children as also reported by Birkland et al.
The females in our study demonstrated more concern for appearance (66.6%) than males (33.3%). Ali Rafighi et al. stated that girls, in general, undergo orthodontic treatment more frequently than boys as they are more sensitive to dentofacial attractiveness. The fact that female adolescents have a greater desire for orthodontic treatment has been reported in previous studies. Nonetheless, there is no consensus in the literature on this gender issue as some studies have found no such association. It is generally recognized that women seek treatment more and are self-critical regarding their appearance, which is evident in our study also with the male:female ratio of 1:2.
| Conclusion|| |
The motivations of adolescents and their parents are complex. Understanding of these motivational factors allows for better planning of resources and better assessment of the requirements and priorities of treatment.
This study concluded that:
- The main motive for seeking orthodontic treatment is dissatisfaction with one's dental and facial esthetics
- Other factors like improvement in self-esteem and better career opportunities also play some role in motivating the patients for treatment
- Most of the parents thought that orthodontic treatment was needed for the improvement of facial appearance of their children hence making it the most important motivating factor
- Gender of the patient also influences differences in motivation toward orthodontic treatment.
This study may help in future research on specific type of patient motivation that may help the clinicians to improve patient adherence. Perceived needs of the patients should be taken into consideration before starting orthodontic treatment to increase chances of satisfying both the orthodontist and the patients.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bos A, Hoogstraten J, Prahl-Andersen B. Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients. Am J Orthod Dentofacial Orthop 2003;123:127-32.
Liu Z, McGrath C, Hägg U. The impact of malocclusion/orthodontic treatment need on the quality of life. A systematic review. Angle Orthod 2009;79:585-91.
Zhang M, McGrath C, Hägg U. The impact of malocclusion and its treatment on quality of life: A literature review. Int J Paediatr Dent 2006;16:381-7.
Bernabé E, Tsakos G, Messias de Oliveira C, Sheiham A. Impacts on daily performances attributed to malocclusions using the condition-specific feature of the Oral Impacts on Daily Performances Index. Angle Orthod 2008;78:241-7.
Miguel JA, Sales HX, Quintão CC, Oliveira BH, Feu D. Factors associated with orthodontic treatment seeking by 12-15-year-old children at a state university-funded clinic. J Orthod 2010;37:100-6.
Tessarollo FR, Feldens CA, Closs LQ. The impact of malocclusion on adolescents' dissatisfaction with dental appearance and oral functions. Angle Orthod 2012;82:403-9.
Naini FB, Donaldson AN, McDonald F, Cobourne MT. Assessing the influence of lower facial profile convexity on perceived attractiveness in the orthognathic patient, clinician, and layperson. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:303-11.
Phillips C, Bennett ME, Broder HL. Dentofacial disharmony: Psychological status of patients seeking treatment consultation. Angle Orthod 1998;68:547-56.
Tung AW, Kiyak HA. Psychological influences on the timing of orthodontic treatment. Am J Orthod Dentofacial Orthop 1998;113:29-39.
Trulsson U, Strandmark M, Mohlin B, Berggren U. A qualitative study of teenagers' decisions to undergo orthodontic treatment with fixed appliance. J Orthod 2002;29:197-204.
Janson G, Sathler R, Fernandes TM, Branco NC, Freitas MR. Correction of Class II malocclusion with Class II elastics: A systematic review. Am J Orthod Dentofacial Orthop 2013;143:383-92.
Feu D, Miguel JA, Celeste RK, Oliveira BH. Effect of orthodontic treatment on oral health-related quality of life. Angle Orthod 2013;83:892-8.
Palomares NB, Celeste RK, Oliveira BH, Miguel JA. How does orthodontic treatment affect young adults' oral health-related quality of life? Am J Orthod Dentofacial Orthop 2012;141:751-8.
de Oliveira CM, Sheiham A. Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents. J Orthod 2004;31:20-7.
Soanes C, Stevenson A. Concise Oxford English Dictionary. Oxford, UK: Oxford University Press; 2008.
Egolf RJ, BeGole EA, Upshaw HS. Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear. Am J Orthod Dentofacial Orthop 1990;97:336-48.
Prabakaran R, Seymour S, Moles DR, Cunningham SJ. Motivation for orthodontic treatment investigated with Q-methodology: Patients' and parents' perspectives. Am J Orthod Dentofacial Orthop 2012;142:213-20.
Otuyami OD, Kolawole KA. Pereception of orthodontic treatment need: Opinion comparisons of patients, parents and orthodontists. Afr J Oral Health 2005;2:42-51.
Pratelli P, Gelbier S, Gibbons DE. Parental perceptions and attitudes on orthodontic care. Br J Orthod 1998;25:41-6.
Pabari S, Moles DR, Cunningham SJ. Assessment of motivation and psychological characteristics of adult orthodontic patients. Am J Orthod Dentofacial Orthop 2011;140:e263-72.
Anderson LE, Arruda A. Adolescents motivation and satisfaction with orthodontic treatment. Angle Orthod 2009;79:821-7.
Daniels AS, Seacat JD, Inglehart MR. Orthodontic treatment motivation and cooperation: A cross-sectional analysis of adolescent patients' and parents' responses. Am J Orthod Dentofacial Orthop 2009;136:780-7.
Langlois JH, Roggman LA, Musselman L. What is average and what is not average about attractive faces. Psychol Sci 1994;5:214-20.
Shaw WC. Factors influencing the desire for orthodontic treatment. Eur J Orthod 1981;3:151-62.
Wedrychowska-Szulc B, Syrynska M. Patient and parent motivation for orthodontic treatment – A questionnaire study. Eur J Orthod 2010;32:447-52.
Feldmann I. Satisfaction with orthodontic treatment outcome. Angle Orthod 2014;84:581-7.
Birkeland K, Katle A, Løvgreen S, Bøe OE, Wisth PJ. [Article in English, German] Factors influencing the decision about orthodontic treatment. A longitudinal study among 11- and 15-year-olds and their parents. J Orofac Orthop 1999;60:292-307.
Gosney MB. An investigation into some of the factors influencing the desire for orthodontic treatment. Br J Orthod 1986;13:87-94.
Bennett ME, Tulloch JF. Understanding orthodontic treatment satisfaction from the patients' perspective: A qualitative approach. Clin Orthod Res 1999;2:53-61.
Oshagh M, Danaei SM, Ghahremani Y, Pajuhi N, Boushehri SG. Impact of an educational leaflet on parents' knowledge and awareness of children's orthodontic problems in Shiraz. East Mediterr Health J 2011;17:121-5.
Fawzan AA. Reasons for seeking orthodontic treatment in Qassim region: A pilot study. Int Dent J Stud Res 2013;1:58-62.
Sousa Dias N, Tsingene F. SAEF – Smile's Aesthetic Evaluation form: A useful tool to improve communications between clinicians and patients during multidisciplinary treatment. Eur J Esthet Dent 2011;6:160-76.
Badran SA. The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents. Eur J Orthod 2010;32:638-44.
Nurminen L, Pietilä T, Vinkka-Puhakka H. Motivation for and satisfaction with orthodontic-surgical treatment: A retrospective study of 28 patients. Eur J Orthod 1999;21:79-87.
Ali Rafighi, et al
. Awareness of orthodontic treatment among school teachers of two cities in Iran. Journal of Dental Research, Dental Clinics, dental Prospects 2012;6:25-28.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]