Adolescent perceptions of orthodontic treatment risks and risk information: A qualitative study

Abstract

Introduction: For effective risk communication, clinicians must understand patients' values and beliefs in relation to the risks of treatment. This qualitative study aimed to explore adolescent perceptions of orthodontic treatment risks and risk information. Methods: Five focus groups were carried out with 32 school/college pupils aged 12-18 in Wales, UK. Participants were purposively selected and had all experienced orthodontic treatment. A thematic approach was used for analysis and data collection was completed at the point of data saturation. Results: Four themes emerged from the data; (a) day-to-day risks of orthodontic treatment, (b) important orthodontic risk information, (c) engaging with orthodontic risk information and (d) managing the risks of orthodontic treatment. Day-to-day risks of orthodontic treatment that were affecting participants "here and now" were of most concern. Information about preventing the risks of treatment was deemed to be important. Participants did not actively seek risk information but engaged passively with information from convenient sources. Perceptions of risk susceptibility influenced participants' management of the risks of orthodontic treatment. Conclusions: This study demonstrates that adolescent patients can understand information about the nature and severity of orthodontic treatment risks. However, adolescent patients can have false perceptions if the risks are unfamiliar, perceived only to have a future impact or if seen as easy to control. Adolescent patients must be provided with timely and easily accessible risk information and with practical solutions to prevent the risks of treatment. Clinical significance: The views and experiences gathered in this study can assist clinicians to better understand their young patients' beliefs about treatment risks, facilitate effective risk communication and contribute to improved patient-centred care.

<p>Adherence to Dietary Advice and Oral Hygiene Practices Among Orthodontic Patients</p>

“…38 The latter are less likely to consider their orthodontist's advice and change their dietary habits. 39,40 Patients may also find it difficult to follow their orthodontist's advice completely and change their dietary habits as they find the advice unrealistic. 40,41 The findings of this and previous studies highlight the importance of dealing with patients' expectations as well as reinforcing dietary advice through informed consent and constant reminders during follow-up visits.…”

Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers

“…One study that included fixed and functional/removable appliances, and retainers, found that young people reported restricted food choice and impacts on the eating process (Carter et al, 2015). Studies that investigated the lived experience of braces and retainers found some negative impacts including pain, difficulty eating and problems due to breakages (McNair et al, 2006; Perry et al, 2018). These authors argued that young people tolerate negative aspects because they are motivated by the benefits of undergoing treatment.…”

Valid consent and orthodontic treatment

“…It may also be prudent to revisit the consent process at particular time-points during the course of treatment to maintain the 'validity' of the consent. 28 This is particularly important as patients may progress from a 'pre-Gillick' state of competence to become Gillick competent in the 'eyes of the law', during the course of treatment.…”

“…1 Optimal patient-centred methods of assessing and describing risks are being explored. 28,44 Focus groups encourage communication between participants in order to explore people's knowledge, experiences and concerns. 13 The use of such groups has been shown to be an effective way of determining what information patients want regarding their health and available treatment options.…”

“…13 The use of such groups has been shown to be an effective way of determining what information patients want regarding their health and available treatment options. 28 Their use in orthodontics may improve the information provided to patients and produce a more patient-led consent process.…”