The long‐term influence of orthodontic treatment on adults’ psychosocial outcomes: An Australian cohort study

Abstract

Objectives To assess the influence of orthodontic treatment on psychosocial outcomes in 30‐year‐olds. The research hypothesis tested was that participants previously treated orthodontically would have better psychosocial outcomes. Setting and Sample Population A prospective longitudinal cohort design was used to follow‐up a sample of 1859 30‐year‐olds from Adelaide, South Australia, who had previously participated in an oral epidemiology study. Materials and methods Clinical examination in 1988‐1989 recorded participants’ malocclusion severity. In 2005‐2006, participants were invited to complete a questionnaire collecting data on socio‐demographic characteristics, dental health behaviours, receipt of orthodontic treatment and psychosocial factors. Data were analysed descriptively and by linear regression models. Results Data for 448 participants were available; 56% of participants were female. Over a third of participants had received orthodontic treatment. Higher income earners had the best psychosocial outcomes while participants with a basic level of secondary education had the lowest. Regardless of initial malocclusion severity, orthodontic treatment was not associated with better psychosocial outcomes. Instead, a pattern of better psychosocial outcome was observed amongst untreated participants, regardless of malocclusion severity, this being significant for optimism. Adjusted models controlling for socio‐demographic, dental health behaviour and malocclusion severity showed no association between orthodontic treatment and self‐efficacy, health competence or social support. There was, however, a strong association with optimism. Conclusion There was no difference in long‐term psychosocial outcomes based on orthodontic treatment. Our study does not support the contention that orthodontic treatment produces better psychosocial functioning later in life.

Association between pulp and periapical conditions and dental emergency visits involving pain relief: epidemiological profile and risk indicators in private practice in Australia

“…Furthermore, questionnaires and dental logbooks have been used in endodontic research (Chew et al 2019). This approach is favoured to one relying solely on a participant or patients self‐reported recollection of treatment completed in the past, which can be influenced by recall bias or Hawthorne effect (Doğramaci & Brennan 2019a, 2019b). It should be noted that data regarding the treatment modalities were not collected.…”

The long‐term influence of orthodontic treatment on adults' psychosocial outcomes: Reflections and critique on a recent commentary

“…The work published in the research article was derived from a long-term study titled 'Oral Health of Adults Entering their Fourth Decade', which was described in the published work as being a population oral health study focused on oral epidemiology. 1 Longitudinal prospective, observational studies such as this are scant, largely owing to the immense financial and human resources required to: establish them, seek ethical approval, attract funding, recruit and train investigators, recruit participants, administer the study, collect and transcribe the raw data, clean the data, analyse all data and write up the results for publication. This undoubtedly takes time.…”

“…2 The published study made clear that 'The research hypothesis tested was that participants who were previously treated orthodontically would have better psychosocial outcomes'. 1 It was further outlined that with the exception of baseline DAI, all outcome and explanatory variables were derived from the questionnaire in the long-term study. Therefore, there is no methodological error in assessing psychosocial outcome measures against receipt of orthodontic treatment, or otherwise, while controlling for baseline DAI, particularly in a longitudinal prospective and observational study such as this research.…”

“…Therefore, there is no methodological error in assessing psychosocial outcome measures against receipt of orthodontic treatment, or otherwise, while controlling for baseline DAI, particularly in a longitudinal prospective and observational study such as this research. 1 The EBD commentary stated 'A major concern in the study is to the research as it is specifically focussed on orthognathic surgery patients, as explained by Ostler and Kiyak in 1991 as having been designed for assessing the motives of orthognathic surgery patients for undergoing surgical treatment, their surgical expectations/ experiences and their post-surgery satisfaction with the results of their treatment. Therefore, it would have been highly inappropriate to adopt it for this study.…”

“…Therefore, it would have been highly inappropriate to adopt it for this study. All scales used and reported in the research article 1 have been widely adopted in the literature, have well established psychometric properties and cover a broad range of psychosocial dimensions; therefore, there should not be any concern as to their choice.…”