Accuracy of patient reporting as an indication of headgear compliance

Orthodontists struggle daily with the issue of patient compliance. Often, we must rely on patient cooperation with headgear to correct Class II malocclusions. Because there is no way to objectively and accurately gauge headgear cooperation, we must look for clues in assessing compliance. One clue that we use is the patient's own reporting of headgear wear. This study was aimed at determining the accuracy of patient reporting. Twenty patients in a private orthodontic practice were supplied with electronic timing headgears that enabled the author to compare their reported hours of headgear use with electronically measured actual usage. In this sample, 69% of the patients reported their headgear use at an accuracy level of 84% or greater, while 31% reported their use at an accuracy level of 58% or less. If fully one third of our patients are significantly inaccurate in reporting headgear use, this has clear implications in patient education, expected treatment results, and informed consent. Some may consider the timing headgear a useful adjunct in promoting better patient compliance.