The uninformed orthodontic patient and parent: treatment outcomes

In both medical and dental settings, researchers have found that patients do not always adequately comprehend the information given during informed consent discussions. The objective of this study was to evaluate patient and parent understanding of the child's orthodontic treatment in a dental school population, compare this with information in patients' charts, and assess the effects of vocabulary and educational level on patients' and parents' comprehension. Interviews were conducted with 21 children, ages 7 to 12 years, undergoing early orthodontic treatment at a dental school and 1 parent or guardian per child. Open-ended questions were asked regarding reasons for treatment, risks, and patient and parent responsibilities. Children had been in treatment for 1 to 24 months (mean = 7.84 +/- 9.42). Patient and parent responses were compared with information in the children's charts. On average, parents recalled only 2.1 reasons for treatment and children recalled only 1.24; the charts listed an average of 4.1 diagnoses. Children could recall only 0.67 risks and parents 0.60 risks, yet many patients had already experienced problems with their treatment on average. The vocabulary levels of the children and their parents were low; parents' vocabulary and educational levels were correlated with their comprehension of this material. Further research should be aimed at improving methods of preparing child patients and their parents for major dental procedures, especially in a publicly funded clinic.