An orthodontic information package designed to increase patient awareness.

BACKGROUND: Most patients and their parents experience difficulty in fully appreciating the implications and demands of orthodontic treatment. This is largely because of inadequate understanding of the process of treatment or the commitment required. OBJECTIVES: To determine if a specifically developed video information package could significantly increase patient awareness of the implications of a full course of orthodontic treatment. Changes in attitude to orthodontic treatment after viewing the package were also measured. METHODS: Year 7 (12 year-old) students in two primary schools in the City of Gold Coast, Australia were randomly allocated to either a study group or a control group. Knowledge of and attitude to orthodontic treatment were measured with self-administered questionnaires before and after viewing the information package. RESULTS: The intervention group showed a 15 per cent gain in knowledge (p < 0.001). There was no gain in knowledge for the 45 students in the control group. There was no measured change in perception of need for orthodontic treatment in the study group. There was, however, an increase in potential compliance and positive attitude to the appearance of orthodontic appliances. There was a small increase in willingness to undertake treatment, but this was not statistically significant. CONCLUSIONS: The information package developed for this study increased awareness of the implications and practical difficulties which may be encountered during a course of orthodontic treatment, and produced some changes in attitude to treatment.

Patients' attitudes towards compliance with retainer wear.

OBJECTIVES: The objectives of this survey were to determine patients' attitudes towards retainers and their compliance in wearing retainers. METHODS: Three hundred dental school patients were selected at random and survey questionnaires were distributed. Twelve private orthodontists were willing to participate in the survey and each was given 20 questionnaires for distribution to their patients. The questionnaire was designed to gather information regarding compliance in wearing removable retainers, perception of the comfort level of retainers and acceptance of the appearance of removable and fixed retainers. RESULTS: The results revealed that compliance in wearing an upper retainer was related to its comfort level and acceptance. Discomfort was the main reason given by dental school patients and forgetfulness was the major reason given by private patients for not wearing retainers. Higher proportions of patients found fixed retainers more comfortable to wear and were more willing to accept the appearance of fixed retainers. A higher proportion of private patients accepted the appearance of retainers compared with dental school patients, while a higher proportion of dental school patients found retainers less comfortable to wear than private patients. CONCLUSIONS: There was a strong relationship between compliance and comfort level in wearing upper removable retainers. Patients found fixed retainers more acceptable than removable types because of appearance and comfort.

Visual application of the American Board of Orthodontics Grading System.

BACKGROUND: Assessment of treatment outcomes has traditionally been accomplished using the subjective opinion of experienced clinicians. Reduced subjectivity in the assessment of orthodontic treatment can be achieved with the use of an occlusal index. To implement an index for quality assurance purposes is time-consuming and subject to the inherent error of the index. Quality assessment of orthodontic treatment on a routine basis has been difficult to implement in private practice. OBJECTIVES: To investigate whether a clinician can accurately apply the American Board of Orthodontics Objective Grading System by direct visual inspection instead of measuring individual traits. METHODS: A random sample of 30 cases was selected, including pretreatment and post-treatment upper and lower study casts and panoramic radiographs. The cases were examined and scored with the standardized measuring gauge according to the protocol provided by the American Board of Orthodontics (ABO). The records were re-examined 6 weeks later and the individual traits scored by visual inspection (VI). RESULTS: There were no significant differences between the pre- and post-treatment ABO gauge and VI scores. CONCLUSIONS: This study suggests that occlusal traits defined by the ABO Objective Grading System can be accurately assessed by visual inspection. The VI score provides a simple and convenient method for critical evaluation of treatment outcome by a clinician.

A comprehensive survey of retention procedures in Australia and New Zealand.

OBJECTIVES: This survey aimed to identify consistencies in retention procedures. METHODS: Three hundred Australian orthodontists and 70 New Zealand orthodontists were randomly selected for the study. A questionnaire gathered their views regarding the most commonly used retainers, wire types and sizes of bonded retainers, factors influencing the design of retainers, duration of regular retention, definition of permanent retention, percentage of cases that needed permanent retention, factors influencing the decision to use permanent retention, changes in retention protocols over the last five years, and reasons for such changes. RESULTS: Upper invisible and lower canine-to-canine bonded retainers were the most commonly used retainers. Pretreatment tooth position was the major factor influencing the design of retainers, and most respondents preferred bonded retainers. The majority preferred multistrand stainless steel wire for bonded retainers. The most common wire size was 0.0175 inch. Orthodontists more commonly recommended a regular retention period of more than two years, and defined permanent retention as "lifetime". Orthodontists applied permanent retention to either a very high or very low percentage of their cases. A high percentage of respondents made changes to their retention protocols over the past five years. There was no relationship between factors influencing the design of retainers and the preferred type of retainer. There was no consensus on the major factor influencing the decision to use permanent retention. CONCLUSIONS: Retention procedures are variable and dependent largely on personal preferences. There does not seem to be any consistent pattern in the application of retention methodologies.