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A comparison of children's experiences with fixed and removable functional appliances: A qualitative study
Ohsun Kwon1, Easter Joury2, Fiorella Colonio-Salazar3
1Centre for Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, United Kingdom.
Insights
Children using Hanks-Hurst (HH) and modified Twin-block (MTB) appliances reported negative impacts on daily life and well-being. Most preferred the non-removable HH appliance, highlighting the need for patient involvement in treatment decisions.
Area of Science:
- Orthodontics
- Pediatric Dentistry
- Qualitative Research
Background:
- Functional appliances are used to treat malocclusions in children.
- Hanks-Herbst (HH) and modified Twin-block (MTB) appliances are common treatment options.
- Understanding patient experiences is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To compare children's experiences and perceptions of treatment with Hanks-Herbst (HH) and modified Twin-block (MTB) functional appliances.
- To explore the impact of these appliances on children's quality of life.
Main Methods:
- A pragmatic nested qualitative study was conducted within a randomized controlled trial.
- Semi-structured interviews were performed with 18 participants using HH and/or MTB appliances.
- Framework methodology was used for data analysis until data saturation.
Main Results:
- Both HH and MTB appliances negatively impacted children's quality of life, affecting daily routines and psychological well-being.
- MTB appliances were associated with more speech difficulties, while HH appliances presented issues with chewing and breakage.
- A majority of participants preferred the HH appliance due to its non-removable nature, requiring less self-discipline.
Conclusions:
- Hanks-Herbst and modified Twin-block appliances can adversely affect children's quality of life.
- The non-removable HH appliance was preferred over the MTB appliance.
- Children expressed a desire for greater autonomy and involvement in treatment decision-making.
Introduction:
The objective of this study was to compare children's experiences and perceptions of treatment with Hanks-Herbst (HH) and modified Twin-block (MTB) functional appliances.
Methods:
A pragmatic nested qualitative study was undertaken in a single hospital setting. Participants from a randomized controlled trial (International Standard Randomised Controlled Trial Number 11717011) wearing HH and/or MTB appliances were interviewed using a topic guide in a one-to-one, semistructured format. Interviews were recorded and transcribed verbatim for framework methodology analysis until data saturation was reached.
Results:
Eighteen participants (HH, 7: MTB, 4; switched group, 7) were interviewed. Thirteen codes were constructed and grouped into 3 themes: (1) functional impairment and symptoms, (2) psychosocial factors and impacts, and (3) feedback on appliances and patient care. Both appliances had a negative impact on quality of life, with disruption to children's daily routines and psychological well-being. Speaking was more problematic for MTB participants, whereas HH participants encountered mastication and breakage issues. HH was preferred by most participants, as its nonremovable feature meant less managing and self-discipline was required. MTB was considered a suitable option for children with good self-discipline and who preferred a versatile lifestyle. Feedback included wishes for the availability of multiple appliance options and a degree of autonomy in decision-making processes.
Conclusions:
HH and MTB can negatively affect children's quality of life. Participants preferred HH over MTB because of its nonremovable feature, and children requested to be empowered during decision-making processes.
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