Factors affecting patients' adherence to orthodontic appointments

Area of Science:

• Orthodontics
• Dental Public Health

Background:

• Patient attendance at orthodontic appointments impacts treatment outcomes, duration, and potential side effects.
• Understanding factors influencing appointment adherence is crucial for optimizing orthodontic care.

Purpose of the Study:

• To identify and predict key factors associated with patient attendance at scheduled orthodontic appointments.
• To analyze the relationship between patient characteristics and orthodontic appointment adherence.

Main Methods:

• A face-to-face guided interview survey was conducted with 153 participants in the Greater Boston area.
• Data collected included self-reported appointment attendance (always, sometimes, rarely), demographics, insurance status, oral hygiene practices, and treatment duration from dental records.
• Multivariable ordered logistic regression and a likelihood ratio test were employed to analyze attendance probabilities and ensure model assumptions were met.

Main Results:

• 76% of participants reported always attending orthodontic appointments, 16% sometimes, and 8% rarely.
• Optimal oral hygiene practices were associated with a nearly 6-fold increased likelihood of appointment attendance (P=0.002).
• Each 6-month increase in treatment duration decreased appointment attendance odds by 23% (P=0.008), and non-Medicaid insurance was linked to 4 times higher attendance likelihood compared to Medicaid (P=0.018).

Conclusions:

• Adherence to orthodontic follow-up visits is significantly correlated with insurance type, treatment duration, and oral hygiene practices.
• Optimal oral hygiene and non-Medicaid insurance are positive predictors of appointment adherence.
• Treatment duration emerged as a negative predictor, with longer treatment times associated with decreased attendance.