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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 71-77

Estimation of Self-perception for Orthodontic Treatment among Dental Professionals – A Questionnaire Survey


Department of Orthodontics and Dentofacial Orthopaedics, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India

Date of Submission25-Oct-2019
Date of Decision28-Apr-2020
Date of Acceptance08-Jun-2020
Date of Web Publication06-Aug-2020

Correspondence Address:
Dr. Romilkumar Shah
Department of Orthodontics and Dentofacial Orthopaedics, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIHS.JIHS_43_19

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  Abstract 


Objectives: To evaluate the percentage of interest in receiving orthodontic treatment and factors of positive perception in order of importance for thinking of receiving orthodontic treatment and negative barriers in order of importance for thinking of not receiving orthodontic treatment yet, amongst dental professionals according to age and sex. Methodology: participants included 425 dental professionals divided into five groups i.e. 21-30....61-70. After taking necessary permissions and informed concert, participant information sheet and questionnaire wereprovided to them through Google forms. All the filled questionnaires were then statistically analysed to conclude results. Results: Rate of positive perception towards orthodontic treatment was 57.9% amongst dental professionals. Malaligned teeth and Unesthetic were the first chief complaint of the partakers in their second, third and fourth decade; spacing was highly prevalent among fifth and sixth decade of their chronologic age , time and treatment fees were the reasons why patients not received orthodontic treatment yet in their 20s, 30s and 40s while periodontal complications and difficulties in chewing were the barriers in their 50s and 60s. Conclusion: Middle and old aged patients require precise understanding regarding the possibilities, advances and limitations of different orthodontic treatment modalities.

Keywords: Dental professionals, orthodontic treatment, perception


How to cite this article:
Shah R. Estimation of Self-perception for Orthodontic Treatment among Dental Professionals – A Questionnaire Survey. J Integr Health Sci 2020;8:71-7

How to cite this URL:
Shah R. Estimation of Self-perception for Orthodontic Treatment among Dental Professionals – A Questionnaire Survey. J Integr Health Sci [serial online] 2020 [cited 2021 Sep 28];8:71-7. Available from: https://www.jihs.in/text.asp?2020/8/2/71/291508




  Introduction Top


In recent years, due to the increase in overall patient awareness, technological advancement, and the available treatment choices, the demand for orthodontic treatment in adult patients has evidently increased.[1] Earlier adult orthodontic treatment included patients in their 20s and early 30s, but this concept has been gradually broadened and the age does not seem to be a concern for orthodontic treatment.[2] The reported rate of adults seeking orthodontic treatment was 20%–25% and it is continuously increasing owing to improvement in overall lifestyle, awareness, technology, treatment capability of an orthodontist, life expectancy, and financial stability.[3]

It has been observed that adults are more prone to periodontal problems because they differ from adolescents in terms of bone turnover rates and psychological profiles. Nowadays, multidisciplinary treatment approach has allowed better management of complicated treatment, thereby greatly improving the quality of care and treatment prognosis.[4] Aging of dentition leading to signs of periodontal problems, long-standing manifold dental restorations, and other underlying medical conditions and increased awareness to esthetics and functional endurance arise the different subjective needs for orthodontic treatment among adults in comparison to adolescents.[5] The self-perception of the treatment needs among older adults makes the objective of treatment to be different in comparison to solo orthodontic approach, as determined by the orthodontist. Hence, the need for orthodontic treatment significantly changes with growing age.

Thus, there is a necessity for accurate estimation of the adult patient's perceptions toward orthodontic treatment as the vast majority of studies have been conducted only on children and adolescents.[6],[7],[8] The incidence and complexity of malocclusion, age, sex, socioeconomic status, and educational level determine the rates of starting an orthodontic treatment.[9],[10],[11],[12]

Thus, it is required to examine the self-perception among dental professionals for looking for orthodontic treatment by evaluating the percentage and factors of positive perception in order of importance for thinking of receiving orthodontic treatment and negative barriers in order of importance for thinking of not receiving orthodontic treatment yet.

Need of the study

After appraising the literature, very few studies were found investigating the self-perception among adults seeking orthodontic treatment in the Indian population Therefore, there is a need to assess the overall percentage and factors of positive self-perception in order of importance toward orthodontic treatment between adults characterized according to age and sex and to recognize negative barricades in order of importance averting them yet for not receiving orthodontic treatment.

Aim

The aim of the study was to evaluate the percentage of interest in receiving orthodontic treatment and factors of positive perception in order of importance for thinking of receiving orthodontic treatment and negative barriers in order of importance for thinking of not receiving orthodontic treatment yet among dental professionals according to age and sex.


  Materials and Methods Top


Place of the study

The study was conducted at the Department of Orthodontics and Dentofacial Orthopedics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth.

Source of sample

The source of the sample was dental professionals from Gujarat state.

Related approvals

  • Study approval letter from SVIEC/ON/Dent/RP/18015 for conducting the present research [Annexure 1]
  • Permission was obtained from Indian Dental Association president, Gujarat State for the use of contact details (E-mail Id and contact number) of dental professionals [Annexure 2]
  • The author of the base article Kim was informed regarding the use of his questionnaire for this study through e-mail [Annexure 3]
  • Questionnaire of this study [Annexure 4].



Sample description

Based on the previous study done by Kim,[5] a total sample of 424.68 were obtained using the following formula for calculating the sample size at an alpha error of 5% power of 80%.



Where,

p1 = 0.426

p2 = 0.522

P = 0.474

Alpha error = 5%

Z (1-α/2) = 1.959964

Power (1-β) = 80.00%

Z (1-β) = 0.841621

p1-p2 = 0.096

The sample size included in the study was estimated to be 425 participants.

Selection criteria

Inclusion criteria

Dental professionals of Gujarat state were included in the study.

Exclusion criteria

Participants who had undergone or undergoing any kind of orthodontic treatment were excluded from the study.

Methodology

Dental professionals of Gujarat state willing to take part in this study were recruited for the study according to the inclusion and exclusion criteria. The participants were divided into five groups according to age.[5] Participants having a chronologic age range of 21–30, 31–40, 41–50, 51–60, and 61–70 were categorized in Groups A, B, C, D, and E, respectively.

An e-mail was sent to the corresponding author of the reference study with regard to obtain consent to use the questionnaire. The informed consent form was obtained from all the participants and participant information sheet was provided to all the participants. The questionnaire was sent to all the participants through Google Forms. All the participants were asked to reply within 1 month. After 1 month, if the participants did not reply, one reminder mail was sent to them after which a wait was observed for 15 more days. All the filled questionnaires received were collected by the principal investigator for the statistical analysis.


  Observation and Results Top


[Table 1] and [Chart 1] show age- and gender-wise sample distribution. Of 425 participants, 21–30 years age group had highest (125) participants and 61–70 years age group had lowest, i.e., 43, participants. Of the 425 participants, 54% were male and 46% were female.
Table 1: Age- and gender-wise sample distribution

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[Table 2] and [Chart 2] reveal the distribution of the frequency of participants interested to take orthodontic treatment. A total of 246 participants of 425 gave a statistically significant positive response. Recorded positive response regarding interest in Orthodontic treatment was differ between given age groups. For age groups 21-30 years (62.4%), 31-40 years (69.7%), 51-60 years (42.6%) and 61-70 years (44.2%) respectively. P < 0.05
Table 2: Distribution of participants opting for orthodontic treatment among different age groups

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[Table 3] and [Chart 3] display the percentage of interest in orthodontic treatment in context with gender. In females, 37.4% gave a negative response and 62.6% gave a positive response. Likewise in males, 46.3% gave a negative response and 53.7% gave a positive response. No statistically significant difference was observed in relation to gender for all the given age groups, P > 0.05.
Table 3: Gender Comparison of participants interested in Orthodontic treatment

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[Table 4] and [Chart 4] show age-wise distribution of the reasons for thinking of receiving orthodontic treatment in order of importance. The age group of 21–30 years showed choice 3 (malaligned tooth) as the first priority, choice 8 (friends/family receiving treatment) as the second priority, and choice 6 (dentist's recommendation) as the third priority. The age group of 31–40 years showed choice 4 (unesthetic) as the first priority, choice 6 (dentist's recommendation) as the second priority, and choice 3 (malaligned tooth) as the third priority. The age group of 41–50 years showed choice 4 (unesthetic) as the first priority, choice 2 (tooth tipping after extraction) as the second priority, and choice 13 (spacing between the teeth) as the third priority. The age group of 51–60 years showed choice 13 (spacing between teeth) as the first priority, choice 9 (more crowding than when younger) as the second priority, and choice 12 (hard to chew) as the third priority. The age group of 61–70 years showed choice 13 (spacing between teeth) as the first priority, choice 12 (hard to chew) as the second priority, and choice 11 (tooth longer than when younger) as the third priority. Here, the order of priority of chief complaint showed obvious difference according to the age.
Table 4: Order of priority of chief complaints according to the age

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[Table 5] and [Chart 5] show age-wise distribution of the reasons for thinking of not receiving orthodontic treatment yet in order of importance. The age group of 21–30 years showed choice 3 (pain) as the first priority, choice 4 (draws attention) as the second priority, and choice 1 (treatment fees) as the third priority. The age group of 31–40 years showed choice 2 (time) as the first priority, choice 1 (treatment fees) as the second priority, and choice 5 (appliance too conspicuous) as the third priority. The age group of 41–50 years showed choice 4 (draws attention) as the first priority, choice 2 (time) as the second priority, and choice 1 (treatment fees) as the third priority. The age group of 51–60 years showed choice 7 (age-too old) as the first priority, choice 8 (periodontal complications) as the second priority, and choice 6 (underlying medical history) as the third priority. The age group of 61–70 years showed choice 7 (age-too old) as the first priority, choice 6 (underlying medical history) as the second priority, and choice 8 (periodontal complications) as the third priority. Here, the order of priority of reasons for not receiving orthodontic treatment showed a definite difference according to age.
Table 5: Prioritized causes for not seeking orthodontic treatment

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  Discussion Top


Due to a significant increase in the number of middle- and old-aged patients, it is needed to understand their priorities of chief complaint and barriers which are not allowing them to take orthodontic treatment. In addition, as an orthodontist, we should also update ourself for recent advances in materials and techniques required for the treatment of adult orthodontics.

The older patients have a different state of dentition called “mature dentition.” It involves multiple restorations, missing teeth, compromised periodontium, and other medical problems. Hence, as an orthodontist, it is our duty to educate the patient about their present dental condition and different possibilities of orthodontic treatments as well as feasible corrections.

In majority of orthodontic clinics, patients who crossed the fourth decade of chronologic age were observed to be around 10% as advocated by Lim.[13] When we compared the percentage of interest in orthodontic treatment in different age groups, 21–30 years had 62.4%, 31–40 years had 69.7%, 41–50 years had 53.2%, 51–60 years had 42.6%, and 61–70 years had 44.2%. It shows that there was a lower percentage of interest in the orthodontic treatment within middle and older age groups, P < 0.05.

It was observed that gender did not influence the interest of the participant in undergoing orthodontic treatment. This observation was in contrast to the observation made by Kerousuo et al.[14] This change in the trend of interest could be attributed to enhanced esthetic awareness of individuals to orthodontic treatment.

The chief complaint is a patient's self-reported principal motive for seeking orthodontic treatment. The need for standardization of chief complaints in orthodontics is the demand of an hour. The priorities of the chief complaint also change as the age advances. In the present study, the younger participants in their 20s and 30s had crowding, esthetics, family/friend's recommendations, and lip protrusion as higher priorities, while older participants had spacing, secondary crowding, and difficulty in chewing as higher priorities. These results were similar to that of the study done by Kim.[5]

The possible barriers for not receiving orthodontic treatment also vary in different age groups. In the present study, participants in their 20s and 30s had pain, draw attention, fees, and time as higher priority barriers, while the participants in their 50s and 60s had old age, underling medical history, and periodontal complications as higher priority barriers. In the present study, the participants were dental professionals, so more than treatment fees, time, pain, and appearance were more important. As the age advances, they were also worried about their periodontium, chewing efficiency, and underlying medical condition.

In the present study, we had taken a common background, i.e., dental professionals to match socioeconomic standards between participants. However, despite of dental professionals, there is a need to update their knowledge regarding recent advances in orthodontic treatment modalities and probable treatment limitations. We as an orthodontist should understand the demands of patients according to their age and we have to clear the misunderstanding regarding the orthodontic treatment. Moreover, we should remain updated regarding our subject and we have to increase the use of multidisciplinary treatment approach.

Further multicentric survey with a larger sample size is required to understand the demand of middle-aged and older individuals and their misunderstanding regarding orthodontic treatment. Furthermore, there should be an improved format for recording chief complaint as well as negative barriers as per individual's priority.


  Conclusion Top


As the age increased, the rate of positive response toward orthodontic treatment decreased significantly. The gender of the participants did not influence the response for undergoing orthodontic treatment. The priority of treatment objective was distinct among older age adults. Alignment and esthetics were of major concern for participants in the second, third, and fourth decades of chronologic age. However, spacing was of major concern among older adults of the fifth and sixth decades. Pain, time, and treatment fees were the reasons why patients not received orthodontic treatment yet in their second, third, and fourth decades, while among older adults of the fifth and sixth decades of chronologic age, periodontal complications and difficulties in chewing were the barriers to undergo orthodontic treatment. The observation of this study indicates the need for emphasis on providing more awareness on the scope of possibilities and limitations of orthodontic treatment among middle and old age adults.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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Kim Y. Study on the perception of orthodontic treatment according to age: A questionnaire survey. Korean J Orthod 2017;47:215-21.  Back to cited text no. 5
    
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Livas C, Delli K. Subjective and objective perception of orthodontic treatment need: A systematic review. Eur J Orthod 2013;35:347-53.  Back to cited text no. 6
    
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Reichmuth M, Greene KA, Orsini MG, Cisneros GJ, King GJ, Kiyak HA. Occlusal perceptions of children seeking orthodontic treatment: Impact of ethnicity and socioeconomic status. Am J Orthod Dentofacial Orthop 2005;128:575-82.  Back to cited text no. 7
    
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Josefsson E, Bjerklin K, Lindsten R. Factors determining perceived orthodontic treatment need in adolescents of Swedish and immigrant background. Eur J Orthod 2009;31:95-102.  Back to cited text no. 8
    
9.
Mandall NA, Wright J, Conboy F, Kay E, Harvey L, O'Brien KD. Index of orthodontic treatment need as a predictor of orthodontic treatment uptake. Am J Orthod Dentofacial Orthop 2005;128:703-7.  Back to cited text no. 9
    
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Hassan AH, Amin Hel-S. Association of orthodontic treatment needs and oral health-related quality of life in young adults. Am J Orthod Dentofacial Orthop 2010;137:42-7.  Back to cited text no. 10
    
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Ravindranath S, En JT, Heng AP. Orthodontic treatment need and self-perceived psychosocial impact of dental esthetics in a university adult population in Malaysia. J Indian Orthod Soc 2017;51:69-74.  Back to cited text no. 11
  [Full text]  
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Mahajan M. Are adults enough motivated for orthodontic treatment: A questionnaire study. Indian J Multidiscip Dent 2017;7:87-93.  Back to cited text no. 12
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13.
Lim SH. Practive survey in 2010 by KAO (Part II). Clin J Korean Assoc Orthod 2012;11:24-9.  Back to cited text no. 13
    
14.
Kerousuo H, Kerouso E, Niemi M, Simola H. The need for treatment and satisfaction with dental appearance among young Finnish adults with and without a history of orthodontic treatment J Orofac Orthop 2010;61:330-40.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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