An investigation into the rationale and treatment impact of removable and fixed appliances in adults: A qualitative studyAn investigation into the rationale and treatment impact of removable and fixed appliances in adults: A qualitative study

Abstract

Introduction: There is limited evidence available that focuses on the experiences of adult patients during orthodontic treatment. A better understanding of the adult patient's rationale and preferences will allow orthodontists to provide more relevant information to patients and likely to facilitate the development of a patient-centred approach to providing better care. The aim of the current study was to understand why adult patients, undergo orthodontic treatment, in particular their reasoning and overall experience with their choice of appliance. Materials: A qualitative study was conducted on adult participants recruited from four different London-based orthodontic private practises. Participants wearing fixed ceramic labial appliances (FC), removable aligner appliances (RA), and fixed lingual appliances (FL) were invited to take part in one-to-one, semi-structured interviews. Qualitative data were collected using a topic guide, until saturation was reached. Interviews were audio-recorded and transcribed verbatim and analysed using framework methodology. Results: In total, 22 participants (13 females; FC = 8, RA = 8 and FL=6), were interviewed. The data was presented under three objectives, with 2 themes for each objective and 15 overall sub-themes developed. Objective one, the reasons that lead adults to seek orthodontic treatment: theme A: psychosocial influence; theme B: health related issues. Objective two, the rationale for selecting specific treatment options: theme C: social influence and theme D: appliance 5 features and finally, objective three, the impact of different orthodontic appliances on the quality of life of participants: theme E: functional impairment and F: psychosocial impact. Conclusions: The present research identified a number of factors influence adults in their decision-making process and treatment experiences. It is important for both orthodontists and patients to understand these findings. It is particularly important to facilitate the development of a patient-centred approach to providing better care.