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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 19-21

Factors contributing to not seeking orthodontic treatment in male adolescents - A questionnaire study


Department Public Health Dentistry, Sathyabama University Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission06-Oct-2021
Date of Acceptance06-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Prof. Anu
Department of Public Health Dentistry, Sathyabama University Dental College and Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_14_21

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  Abstract 


Introduction: Motivation is an impetus for patients to seek orthodontic treatment; it also affects adherence, treatment outcomes, and satisfaction towards orthodontic treatment. The aim of this study was to assess the lack of motivation of adult male patients or the other reasons responsible for not seeking orthodontic treatment, and classify the patients according to their reasons. Prejudiced notions about treatment and various fears have created a resistance or hesitation towards orthodontic treatment in men. The aim of this study is to assess the mind set and overall attitude of male adolescent patients toward not seeking orthodontic correction for malocclusion. Materials and Methods: A questionnaire based study was conducted at the department of Orthodontics, Private Dental College, a total of 50 male subjects with malocclusions requiring orthodontic interventions were selected for the study. Data was collected using a structured, self-administered questionnaire which was designed after reviewing recent articles, developments and also similar questionnaires that are based on the objectives of the study. Results: Sixty-nine percent of subjects were aware that they had a malocclusion whereas the remaining 31% were not aware. On asking as to why they were not correcting the malocclusion, 18% stated that it was embarrassing to wear braces, 4% stated that the treatment was too expensive, 19% stated that the treatment was that of a long duration, 7% felt they were too old for seeking orthodontic treatment, 6% had no interest to do the treatment, 9% stated it would painful, another 16% had concerns that food would get stuck to the braces, 21% were scared to undergo treatment. Conclusion: The unwillingness of male adolescent patients for seeking orthodontic treatment is studied and the reasons are discussed. This will help in educating them on the long term effects of malocclusion and to convince them for opting to go ahead with orthodontic treatment.

Keywords: Braces, malocclusion, orthodontic intervention


How to cite this article:
Manoharan P, Anu. Factors contributing to not seeking orthodontic treatment in male adolescents - A questionnaire study. Int J Soc Rehabil 2021;6:19-21

How to cite this URL:
Manoharan P, Anu. Factors contributing to not seeking orthodontic treatment in male adolescents - A questionnaire study. Int J Soc Rehabil [serial online] 2021 [cited 2022 Dec 9];6:19-21. Available from: https://www.ijsocialrehab.com/text.asp?2021/6/1/19/331474




  Introduction Top


Orthodontic treatment is the process of aligning the teeth or correcting other irregularities, which thus improves health, function, appearance, and social well-being.[1],[2] Males are generally more concerned about the comfort rendered during treatment of their teeth. Understanding the factors that decide the requirement for orthodontic treatment will enable a more systematic planning and also better assessment of treatment needs and patient's priorities.[3]

There is a lack of research on the motivation of adults seeking orthodontic treatment, especially in men.[4] Both positive and negative motivations are correlated with adherence to treatment.[5] In orthodontic clinical practice, as well as in other dental specialties, treatment success does not depend solely on factors such as proper diagnosis, biocompatibility, and skill of the dentist but also depends on the patient's cooperation.[6] If the patient is not cooperative and does not follow the instructions given by the dentist, it may lead to unsatisfactory outcomes of the treatment; adolescence is a period when important physical, social, and emotional changes appear.[7],[8]

The cooperation of the adolescent patients can be altered based on extrinsic factors (social stereotypes, gender, educational level, family) and the intrinsic factors (personality, temperament). The unwillingness of male adolescent patients with malocclusions for orthodontic treatment is studied so as to be able to educate them on the long-term effects of malocclusion. Hence, we can convince them for opting to go ahead with orthodontic treatment. Self-perception of orthodontic treatment plays a major role in bringing the patient to the orthodontist for treatment, and the perception varies according to psychological status, basic knowledge of malocclusions, and also perception changes according to the comments an individual receives from the surrounding people.[9]

Social psychologists have described various theories on patient compliance. Many components of “health belief model” are applicable to orthodontic treatment situation. Variables such as treatment-seeking behavior, personality type, and barriers to action comply well with the compliance of the patient.[10],[11] A compliant orthodontic patient may be described as a patient who practices good oral hygiene, follows appropriate diet, maintains appliance without breaking, keeps regular appointments, and follows instructions of the doctor. The purpose of the present study is to evaluate the current perspective of Indian orthodontic patients toward not seeking orthodontic treatment.


  Materials and Methods Top


A questionnaire-based study was conducted at the Department of Orthodontics, Private Dental College; a total of 50 male subjects with malocclusions requiring orthodontic interventions were selected for the study. Data were collected using a structured, self-administered questionnaire which was designed after reviewing recent articles, developments and also similar questionnaires that are based on the objectives of the study.

The questionnaire was divided into three parts. The first part included questions based on awareness of malocclusion, the second part consisted of questions related to their knowledge on sequelae of malocclusions, and the final part consisted of an open question asking them to state out their reason for not undergoing orthodontic treatment. All questionnaires were anonymously collected and the data were kept confidential and not used for anything apart from the study purpose.

Questionnaire

This questionnaire was modified from the questionnaire of Ingervall et al. and Ng'ang'a et al.[12],[13]

The following questions were included in the study:

  1. Do you find that your teeth are irregular (not straight)?
  2. If your teeth are irregular, does this affect your
  3. If you think you need orthodontic treatment, why have not you done so yet?



  Results Top


[Figure 1] indicates that 69% of them were aware that they had a malocclusion whereas the remaining 31% were not aware. When asked about the sequelae of malocclusion, 48% of adolescent males pointed out the difficulty in mastication during orthodontic treatment while 24% said that food accumulation is a problem, 9% stated that compromised esthetics was their concern, and 19% were concerned of dental caries that could occur during treatment [Figure 2]. On asking as to why they were not correcting the malocclusion, 18% stated that it was embarrassing to wear braces, 4% stated that the treatment was too expensive, 19% stated that the treatment was that of a long duration, 7% felt that they were too old for seeking orthodontic treatment, 6% had no interest to do the treatment, 9% stated that it would painful, another 16% had concerns that food would get stuck to the braces, 21% were scared to undergo treatment [Figure 3].
Figure 1: Pie chart depicting self-awareness of irregular teeth

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Figure 2: Bar chart of sequelae of malocclusion

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Figure 3: Pie chart of reasons for not correcting irregular teeth

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  Discussion Top


This survey conveyed that patients had satisfactory knowledge of whether they possess malocclusions or not as well as the sequelae of the same. When looking at the factors contributing to the negative attitude of patients in not seeking orthodontic treatment, fear, no interest, and time constraints were the main concerns. Closely following were the concerns of difficulty in maintenance and embarrassment.

In our study sample, we conclude that for male patients, esthetics was not a major reason for seeking orthodontic treatment; hence, they lacked the motivation to seek orthodontic treatment and that can be a main reason for lack of interest toward orthodontic treatment.

In the study done by Al Zubair NM, the most common reason for not seeking orthodontic treatment in children was:

  1. Lack of awareness about orthodontic treatment
  2. Fear of pain and of tooth removal.[14] The predominance of fear of pain is similar to that of Batayine,[15] Al-Huwaizi,[16] and Gatchel.[17]


Various studies identified female orthodontic patients as more cooperative than males.[4],[5],[6],[7] The present study showed similar findings that male adolescents were concerned more about pain and time duration of orthodontic therapy.

Egolf et al.[5] studied history factors associated with compliance. These factors were considered as a combination of personality type, negative motives, and positive motives. This study assessed the reason for patients not going forward with orthodontic treatment. The assessment on attitude of the patient was related to perception on treatment service, cost, and also personal factors such as embarrassment.

The factors contributing to the above-mentioned study vary from the present study due to variations in sample size and geographical variations.


  Conclusion Top


The unwillingness of male adolescent patients for seeking orthodontic treatment is studied and the reasons are discussed. This will help in educating them on the long-term effects of malocclusion and to convince them for opting to go ahead with orthodontic treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
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.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
Jayachandar D, Saravana Dinesh SP. Factors affecting patient's desire for seeking orthodontic treatment. Int J Orthod Rehabil 2016;7:89-91.  Back to cited text no. 3
  [Full text]  
4.
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.  Back to cited text no. 4
    
5.
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.  Back to cited text no. 5
    
6.
Arnrup K, Broberg AG, Berggren U, Bodin L. Treatment outcome in subgroups of uncooperative child dental patients: An exploratory study. Int J Paediatr Dent 2003;13:304-19.  Back to cited text no. 6
    
7.
Cucalon A 3rd, Smith RJ. Relationship between compliance by adolescent orthodontic patients and performance on psychological tests. Angle Orthod 1990;60:253-89.  Back to cited text no. 7
    
8.
Slakter MJ, Albino JE, Fox RN, Lewis EA. Reliability and stability of the orthodontic patient cooperation scale. Am J Orthod 1980;78:559-63.  Back to cited text no. 8
    
9.
Shilpa R. Self perceived orthodontic treatment need in dental students. Int J Pharm Sci Rev Res 2017;46:39-44.  Back to cited text no. 9
    
10.
Haynes RB, Taylor DW, Sackett DL. Compliance in Health Care. Vol. 12. Baltimore: Johns Hopkins University Press; 1979. p. 93-102.  Back to cited text no. 10
    
11.
Tulloch JF, Shaw WC, Underhill C, Smith A, Jones G, Jones M. A comparison of attitudes toward orthodontic treatment in British and American communities. Am J Orthod 1984;85:253-9.  Back to cited text no. 11
    
12.
Ingervall B, Mohlin B, Thilander B. Prevalence and awareness of malocclusion in Swedish men. Community Dent Oral Epidemiol 1978;6:308-14.  Back to cited text no. 12
    
13.
Ng'ang'a PM, Stenvik A, Ohito F, Ogaard B. The need and demand for orthodontic treatment in 13- to 15-year-olds in Nairobi, Kenya. Acta Odontol Scand 1997;55:325-8.  Back to cited text no. 13
    
14.
Al-Zubair NM. Perception of occlusion and reasons for not seeking orthodontic treatment among Yemeni children. J Orthod Res 2014;2:68-73.  Back to cited text no. 14
  [Full text]  
15.
Batayine FA. Occlusal features and perception of occlusion of Jordanian adolescents: A comparative study with an Iraqi sample. In: Master Thesis. Iraq: College of Dentistry, University of Baghdad; 1997.  Back to cited text no. 15
    
16.
Al-Huwaizi AF. Occlusal features, perception of occlusion, orthodontic treatment need and demand among 13-year-old Iraqi school children. In: Doctoratethesis. Iraq: College of Dentistry, University of Baghdad; 2002.  Back to cited text no. 16
    
17.
Gatchel RJ. The prevalence of dental fear and avoidance: Expanded adult and recent adolescent surveys. J Am Dent Assoc 1989;118:591-3.  Back to cited text no. 17
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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