Orthodontists' and parents’ perception of finished occlusion and willingness to extend treatment time

Abstract

Patients and parents want shorter treatment times, but it is unclear whether they would compromise outcome quality to shorten treatment. The purpose of this study was to compare orthodontists' and parents' perceptions of finished occlusion and their willingness to extend treatment time to achieve improved outcomes. The effects of elapsed treatment time and patient compliance were also investigated. Parallel surveys for orthodontists (n=1000) and parents (n=750) displayed simulated treatment outcomes of well-aligned teeth with occlusions in 1mm increments from 3mm Class III to 3mm Class II. Participants rated their preferences on a visual analogue scale (VAS; 0-100) and specified whether they would extend treatment, and for how long, to improve the occlusion. Two hundred thirty-three orthodontists (23%) and 243 parents (32%) responded. Despite differences between the scores given (P<0.0001), both groups rated Class I occlusion most acceptable (mean VAS=93.9 and 80.7, respectively) and 3mm Class III malocclusion least acceptable (mean VAS=25.9 and 40.9, respectively). Parents were willing to extend treatment more often and for a greater time than orthodontists to improve results (P<0.0001). In addition, parents were less willing to terminate treatment early (P<0.05). Both groups perceived existing outcomes as more acceptable if the patient was noncompliant (P<0.05), but elapsed time in treatment had no significant effect on ratings. For outcomes with well-aligned teeth, orthodontists and parents agreed on what the most and least acceptable occlusal relationships were. To achieve better outcomes, parents were willing to extend treatment duration more often and for a greater time than were orthodontists. In addition, parents were less willing than orthodontists to terminate treatment early.