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Abstract
Abstract Objective To describe patient and treatment characteristics in West Australian private orthodontic practices. Methods A quantitative retrospective cross-sectional study of patient records from private practices in Western Australia was conducted. Permission was sought to access clinical records of 100 most recently-treated patients at each participating practice. A sample of 3,200 patients (response rate 84%) was collected, representing approximately one-third of practices in Western Australia, and simple descriptive statistics were applied to assess patient and treatment characteristics. Results The majority of patients were female (58.5%), adolescent and had private health insurance (75.6%). The most common patient complaint was crowding (37.6%) and aesthetics (21.3%). Data analysis indicated that 31% of patients were self-referred and a similar proportion did not have a specific complaint. Adult females had a higher interest in aesthetic options. Over half of the patients (56%) received first phase treatment, and non-extraction orthodontics accounted for 61.6% of cases. Full fixed appliances were the most commonly prescribed device (94%). The acceptance rate of orthognathic surgery, when offered, was approximately 30%. Conclusion Clinical data relating to actual patient presentations provide an invaluable insight into the realities of private practice. The eventual course of treatment is often determined by the patient’s tolerances and expectations as much as a clinical recommendation.
Highlights
Numerous studies have reported variability in the worldwide prevalence of malocclusions and suggested figures ranging widely between 39 and 93%.1-3 The differences are attributed to a complex interplay of factors including genetics,[4,5,6] ethnicity,[1,7,8] environment,[9,10,11,12] nutrition,[13,14] self-perception[15,16] and the registration methods employed by researchers
This may be related to recommendations made by the treating clinician to seek orthodontic care either as part of general dentistry or when it was considered that orthodontic consultation/intervention may be Private health Insurance Ethnicity
By exploring clinical data relating to patient and treatment characteristics in West Australian private orthodontic practices, it was observed that the majority of patients were Caucasian, female, had private health insurance and were adolescent
Summary
Numerous studies have reported variability in the worldwide prevalence of malocclusions and suggested figures ranging widely between 39 and 93%.1-3 The differences are attributed to a complex interplay of factors including genetics,[4,5,6] ethnicity,[1,7,8] environment,[9,10,11,12] nutrition,[13,14] self-perception[15,16] and the registration methods employed by researchers. Socioeconomic status (SES) is often considered in population-based research in which a number of studies associate lower SES with diminished utilisation of orthodontic care.[26,27,28,29] this finding was not universally reported, with several studies, including an Australian-based investigation, concluding that SES did not account for any substantial variability in those seeking treatment.[30,31] In other aspects, differences in the prevalence and self-perception of a malocclusion have not been consistently identified between ethnic groups.[15,32,33] Most studies report a gender bias favouring females, who are reported to seek treatment for milder occlusal issues.[34,35,36] In Australia, the results are mixed and highlighted by a study that focussed on 13-year-old adolescent children and reported that males were more likely to seek treatment.[30] research by Spencer et al indicated that females were more likely to receive treatment in a cohort of similar age.[37] Specific studies related to the jurisdiction in question are needed, as the applicability of research to the local profession is questionable
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