Advances in Clinical and Experimental Medicine
2019, vol. 28, nr 12, December, p. 1633–1638
Publication type: original article
Self-perception of smile attractiveness as a reliable predictor of increased patient compliance with an orthodontist
1 Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Poland
2 Department of Orthodontics, Kyungpook National University, Daegu, South Korea
Background. Predicting the cooperation of orthodontic patients seems to be of the utmost importance for successful results in treatment with removable appliances, especially if their cost is to be covered from public funding. Therefore, the issue of unbiased pre-treatment assessment of cooperation still calls for an investigation.
Objectives. The objective of this study was to check whether smile attractiveness and its importance, subjectively evaluated by the patients/their caregivers, are reliable predictors of a patient’s compliance during treatment with removable appliances.
Material and Methods. The study group comprised 97 patients aged 9–12 years, treated with active plates or twin-blocks, equipped with the TheraMon® system. Before treatment, the caregivers and the patients filled out the questionnaires ranking both of the investigated variables. After 9 months of treatment, we analyzed the correlations of the daily wear time (DWT) and other variables.
Results. The analysis revealed the following: no relevance of the DWT to the type of removable appliances; negative correlation between the DWT and smile attractiveness assessed by the children and their caregivers; evidently elongated DWT (up to 9.68 h in children), who, together with the caregivers, evaluated their smile attractiveness as poor; coherence of children’s and their caregivers’ responses evaluating smile attractiveness and its importance, as well as the lack of consistency when comparing responses provided separately by the children and their caregivers.
Conclusion. Application of the TheraMon® sensors objectively proved that the patient’s smile attractiveness ranked subjectively as low predicts the orthodontic patient’s irreproachable cooperation. Therefore, our easy-to-use questionnaire calls for changing the protocol regarding the wearing time of removable appliances during treatment and introducing an evidence-based policy of reimbursement for such therapy from public funds. Further investigation of the effectiveness of removable appliances worn shorter than previously presumed and of the motivation to continue treatment, once smile attractiveness has been improved, is necessary.
self-perception of smile attractiveness, orthodontic appliances, cooperative behavior
- Tausche E, Luck O, Harzer W. Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need. Eur J Orthod. 2004;26(3):237–244.
- Proffit WR, Fields HW Jr, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: Estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg. 1998;13(2):97–106.
- Witanowska J, Zadurska M. System solutions for orthodontic care across Europe, including world trends. Forum Ortod. 2012;8:207–214.
- Żyła T, Kawala B, Antoszewska-Smith J, Kawala M. Black stain and dental caries: A review of the literature. Biomed Res Int. 2015;2015:469392.
- Nimri K, Richardson A. Applicability of interceptive orthodontics in the community. British J Orthod. 1997;24(3):223–228.
- Schott TC, Göz G. Wearing times of orthodontic devices as measured by the TheraMon® microsensor. J Orofac Orthop. 2011;72(2):103–110.
- Stocker B, Jan H, Willmann JH, Wilmes B, Vasudavan S, Drescher D. Wear-time recording during early Class III facemask treatment using TheraMon chip technology. Am J Orthod Dentofacial Orthop. 2016;150(3):533–540.
- Kawala B, Antoszewska J, Sarul M, Kozanecka A. Application of microsensors to measure real wear time of removable orthodontic appliances. Czas Stomatol. 2013;66(3):321–330.
- Schott TC, Ludwig B. Microelectronic wear-time documentation of removable orthodontic devices detects heterogeneous wear behavior and individualizes treatment planning. Am J Orthod Dentofacial Orthop. 2014;146(2):155–160.
- Sergl H, Zentner A. Predicting patient compliance in orthodontic treatment. Semin Orthod. 2000;6(4):231–236.
- Albino JE, Lawrence SD, Lopes CE, Nash LB, Tedesco LA. Cooperation of adolescents in orthodontic treatment. J Behav Med. 1991;14(1):53–70.
- Woolass KF, Shaw WC, Viader PH, Lewis AS. The prediction of patient co-operation in orthodontic treatment. Eur J Orthod. 1988;10(3):235–243.
- Sarul M, Kawala B, Kozanecka A, Łyczek J, Antoszewska-Smith J. Objectively measured cooperation during early orthodontic treatment: Do the treatment needs have an impact? Adv Clin Exp Med. 2017;26(1):83–87.
- Amado J, Sierra AM, Gallon A, Alvarez C, Baccetti T. Relationship between personality traits and cooperation of adolescent orthodontic patients. Angle Orthod. 2008;78(4):688–691.
- Shaw WC, Rees G, Dawe M, Charles CR. The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod. 1985;87(1):21–26.
- de Almeida AB, Leite ICG, Melgaço CA, Marques LS. Dissatisfaction with dentofacial appearance and the normative need for orthodontic treatment: Determinant factors. Dental Press J Orthod. 2014;19(3):120–126.
- Giraldo LMC, Rendón ACP, Londoño AG, Vásquez JMC. Perception of adolescent patients on cooperation during orthodontic treatment: A qualitative study. Int J Odontostomat. 2014;8(2):225–228.
- Samsonyanová L, Broukal Z. A Systematic review of individual motivational factors in orthodontic treatment: Facial attractiveness as the main motivational factor in orthodontic treatment. Int J Dent. 2014;2014:938274.
- Pauls A, Nienkemper M, Panayotidis A, Wilmes B, Drescher D. Effects of wear time recording on the patient’s compliance. Angle Orthod. 2013;83(6):1002–1008.
- Koronacki J, Mielniczuk J. Statystyka dla kierunków technicznych i przyrodniczych. Warszawa, Poland: WNT; 2001.
- Colwell DJ, Gillett JR. Spearman versus Kendall. The Mathematical Gazette. 1982;66:307–309.
- Zar JH. Biostatistical Analysis. 5th ed. DeKalb, IL: Northern Illinois University, Pearson Education Limited; 2010.
- Schott TC, Meyer-Gutknecht H, Mayer N, Weber J, Weimer K. A comparison between indirect and objective wear-time assessment of removable orthodontic appliances. Europ J Orthod. 2017;39(2):170–175.
- Kirshenblatt S, Chen H, Dieltjens M, Pliska B, Almeida FR. Accuracy of thermosensitive microsensors intended to monitor patient use of removable oral appliances. J Can Dent Assoc. 2018;84:i2.
- Sarul M, Lewandowska B, Kawala B, Kozanecka A, Antoszewska-Smith J. Objectively measured patient cooperation during early orthodontic treatment: Does psychology have an impact? Adv Clin Exp Med. 2017;26(8):1245–1251.
- Sergl HG, Zentner A. A comparative assessment of acceptance of different types of functional appliances. Eur J Orthod. 1998;20(5):517–524.
- Schäfer K, Ludwig B, Meyer-Gutknecht H, Schott TC. Quantifying patient adherence during active orthodontic treatment with removable appliances using microelectronic wear-time documentation. Eur J Orthod. 2015;37(1):73–80.
- Allan TK, Hodgson EW. The use of personality measures as a determinant of patient cooperation in an orthodontic practice. Am J Orthod. 1968;54(6):433–440.
- Lin FO, Sun H, Ni ZY, Zheng ML, Yao LJ. A feasible method to improve adherence of Hawley retainer in adolescent orthodontic patients: A randomized controlled trial. Patient Prefer Adherence. 2015;9:1525–1530.
- Jie Y, Dan-Dan L, Yan-Qi Y, Colman P, McGrath J, Nikos M. What are patients’ expectations of orthodontic treatment: A systematic review. BMC Oral Health. 2016;16:19.
- Dion KK, Berscheid E. Physical attractiveness and peer perception among children. Sociometry. 1974;37(1):1–12.
- Albino JEN. Factors influencing adolescent cooperation in orthodontic treatment. Semin Orthod. 2000;6(4):214–223.
- Chen JY, Will LA, Niederman R. Analysis of efficacy of functional appliances on mandibular growth. Am J Orthod Dentofacial Orthop. 2002;122(5):470–476.
- Folger J. Relationships of children’s compliance to mothers’ health beliefs and behavior. J Clin Orthod. 1988;22(7):424–426.
- Gross AM, Samson G, Dierkes M. Patient cooperation in treatment with removable appliances: A model of patient noncompliance with treatment implications. Am J Orthod. 1985;87(5):392–397.
- Shaw WC. The influence of children’s dentofacial appearance on their social attractiveness judged by peers and lay adults. Am J Orthod. 1981;79(4):399–415.
- Cross JF, Cross J. Age, sex, race, and the perception of facial beauty. Develop Psych. 1971;5(3):433–439.
- Kleck R, Richardson S, Ronald L. Physical appearance cues and interpersonal attraction in children. Child Develop. 1974;45(2):305–310.
- Lansdown R, Polak L. A study of the psychological effects of facial deformity in children. Child Care Health Dev. 1975;1(2):85–91.
- Kjäldman I-O. Self-Concept and School Achievement of Pupils with Cleft Lip, Cleft Palate or Both. A Longitudinal Study [doctoral dissertation]. University of Helsinki, Finland; 2006.
- Henson ST, Lindauer SJ, Gardner WG, Shroff B, Tufekci E, Best AM. Influence of dental esthetics on social perceptions of adolescents judged by peers. Am J Orthod Dentofacial Orthop. 2011;140(3):389–395.
- Birkeland K, Bøe OE, Wisth PJ. Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. Europ J Orthod. 2000;22(5):509–518.
- Planinšec J, Fošnarič S. Relationship of perceived physical self-concept and physical activity level and sex among young children. Percept Mot Skills. 2005;100(2):349–353.
- Cavero MAB. Harter’s Self-Perception Profile for Children: An adaptation and validation of the Spanish version. Psych Rep. 2014;115(2):444–466.
- Salih FN, Lindsten, Bågesund M. Perception of orthodontic treatment need among Swedish children, adolescents and young adults. Acta Odontologica Scandinavica. 2017;75(6):407–412.
- Boeira GF, Salas MMS, Araújo DC, Masotti AS, Correa MB, Demarco FF. Factors influencing dental appearance satisfaction in adolescents: A cross-sectional study conducted in southern Brazil. Braz J Oral Sci. 2016;15(1):8–15.