Direct-to-consumer orthodontics: Exploring laypeople's perception of orthodontic treatment complexity

User Experience, Satisfaction, and Complications of Direct-to-Consumer Orthodontics in Spain: A Cross-Sectional Study

Background/Objectives: Direct-to-Consumer Orthodontics (DTCO) has gained popularity through social media, offering clear aligner treatments without in-person supervision. However, there is limited research on the related user experiences, satisfaction, and complications, particularly in Spain. This study aimed to evaluate user experiences, satisfaction levels, and complications associated with DTCO in a sample of Spanish consumers. Additionally, differences among major DTCO providers were analyzed. Methods: A cross-sectional online survey was conducted over one year. This questionnaire, adapted from previous studies and reviewed by certified orthodontists, assessed user awareness, reasons for treatment selection, communication with providers, discomfort, complications, and satisfaction. A total of 101 valid responses were analyzed using statistical means. Results: The majority of respondents reported that their expectations were not met, and they would not recommend DTCO. Cost was the primary motivation for treatment selection, followed by convenience. Many users experienced complications, leading to dental consultations. While overall satisfaction levels did not significantly differ among providers, variations were observed in discomfort levels, in-person care availability, and the need for additional consultations. Conclusions: DTCO offers affordability and convenience but raises concerns regarding treatment quality and supervision. In most cases, users' expectations were not met, highlighting the need for greater patient education and regulatory oversight.

Knowledge, attitude, and practice toward oral health management among orthodontic patients: a cross-sectional study

BACKGROUND

This study aimed to investigate the knowledge, attitude, and practice (KAP) toward oral health management among orthodontic patients.

METHODS

A cross-sectional study on orthodontic patients was conducted at Suzhou Dushu Lake Hospital from December 20, 2023, to March 19, 2024. Demographic data and KAP scores were collected using self-designed questionnaires. The cutoff for adequate KAP dimension scores was 70%.

RESULTS

The study included 418 orthodontic patients, of whom 274 (65.55%) were female, and 144 (34.45%) were male. The average age was 32.70 ± 8.47 years (33.72 ± 8.46 in females and 32.17 ± 8.44 in males). The mean knowledge, attitude, and practice scores were 11.80 ± 4.06 (possible range: 0-16), 27.00 ± 3.18 (possible range: 6-30), and 31.13 ± 6.01 (possible range: 8-40), respectively. The proportions of participants who scored above a cutoff of 70% were 247 (59.09%) for knowledge, 403 (96.41%) for attitude, and 290 (69.38%) for practice. Multivariate logistic regression showed that knowledge score (OR = 1.243, 95% CI: [1.152-1.342], P < 0.001), attitude score (OR = 1.255, 95% CI: [1.140-1.381], P < 0.001), and wearing an appliance for 3 to 6 months (OR = 4.309, 95% CI: [1.565-11.861], P = 0.005) were independently linked to proactive practice. Structural equation modeling demonstrated that knowledge directly influenced attitude (β = 0.684, P < 0.001) and practice (β = 0.527, P < 0.001), while attitude had a direct impact on practice (β = 0.587, P < 0.001).

CONCLUSIONS

The majority of orthodontic patients demonstrated adequate knowledge, positive attitudes, and proactive practices toward oral health management. Nonetheless, continuous education is still essential for certain groups, such as recently fitted orthodontic patients, to ensure sustained improvement in oral health outcomes.

Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America - a questionnaire study

BACKGROUND

Patients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment.

METHODS

The target group comprised people aged 18-30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender.

RESULTS

The response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor's recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment.

CONCLUSIONS

In both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.