Psychosocial Factors In Adult Orthodontic Treatment

Objective:With the development of medical science, our know-ledge about medical model has been greatly changed from traditional biological model to bio-psycho-social model. The new model better meets the needs of the modern health concept, in which health means not only on physiology but also on psycho-and social's wellbeing as well. Therefore doctors are required to pay more attention to patients'psycho-and social needs in addition to improvment of clinical symptoms and stabilization of therapeutic effects.As an major branch of maxillofacial aesthetics, orthodontic treatment brings great benefit to the patients who suffer tooth deformity problems. With the technology and materials evolution in orthodontics and the improvement of living standard, more concerns about oral health and beauty are aroused, and more people are seeking for orthodontic treatment. Among them, adult patients are increasing rapidly. Since there're many differences on motivation and concerns about ortho-treatment between adults and children, so it's quite necessary to study the physio-psycho factors in adult patients to understand their worry and expectation, their feelings towards treatment and the potential effects on their daily life. Then we could help them to understand more about the ortho-treatment, enhance the communi-cation with doctors and increase their satisfaction during and after treat-ment.Methods:400 adult patients (90 males and 310 females, aging from 18 to 45 years old), who were receiving orthodontic treatment in Dalian University Stomatology Hospital, had been investigated. Cleft of lip/palate or congenital craniofacial deformity or evident psychologic disorder were not found. The patients were asked to finish a questionnaire independently. The questions were about the general information, the feelings at the beginning and during the treatment, the potential effects on daily life, the expectation for results, and the estimate and demand for the doctor and hospital. Descriptive statistics and correlation analysis were applied to the result evaluation.Results:There were much more females than males among orthodontic patients.71% were below 25 years old and 84% were university educated. Esthetics was the most important purpose for seeking treatment. Most of them got the information about orthodontics from their families or friends. Most of patients were repellent to extraction at first, but could accept it later if indeed necessary. The acceptable treating period ranged from 1.5 to 2.5 years. The expectation for the treatment was generally high. Profession and technique were the the determinant factors when selecting hospitals and orthodontists.Females focused more on the impact of their appearance, marriage, career and personal relationship. Females concerned more about the color and appearance of braces during treatment. Professional level was more considered by female patients at choosing doctors. Females paid more attention to the improvement of their appearance and periodontal health when estimating the standard of the treatment. As to the effects on daily life during treatment, females complained more about oral hygiene, males felt more uncomfortable on social communication, and patients blow 25 years old felt appliance would impact more in smile on daily life.Conclusions:1. Adequate information should be offered to the adult patients at the first time consultation. The treatment plan should be made according to personal physical condition and requirement.2. The oral physical character and the limitation of orthodontics should be explained to adult patients before treatment to avoid dissatisfaction caused by unpractical expectation.3. Good communication should be emphasized for those difficult adult cases with longer treatment time. Detailed explanation about each stage should be illustrated in progress, for patients better understanding their condition, thus enhancing their confidence and compliance.4. Ceremic brackets or lingual appliance could be recommended to those females who concern more about the appearance of braces and males who worry about the impact of treatment on their social life.5. The information about orthodontics was obtained from families or friends for most of adult patients, who would also share their experiences and feelings with others. Then the chain of positive reactions towards orthodontics would be set up.