Using photo-elicitation to explore young people's short-term experience of and adherence to orthodontic retainers

To investigate young people's experience of retainer wear in the immediate term and at 6 months after appliance removal, and to explore the factors affecting retainer wear adherence.

Qualitative study.

Orthodontic departments at two teaching hospitals in Yorkshire, UK.

A total of 12 participants aged 13-18 years were recruited using a purposive sampling approach.

Data collection occurred through one-to-one, virtual, photo-elicitation interviews at two time points (immediate and 6 months) with data analysed using interpretative phenomenological analysis (IPA).

Three overarching themes were developed to describe young people's experience of orthodontic retention: immediate experience and expectation of retainers; the process of adaptation; and motivating factors. Barriers to adherence were mostly ascribed to daytime wear, despite normalisation of retainers in young people's lives. Interventions to help individuals overcome the initial adaptation phase and self-manage their foreseen problems of forgetfulness include routines and reminders, which seem to be less important at 6 months. At both time points, internal and external motivation significantly contribute to retainer adherence, with compensatory changes in behaviour being more important at 6 months.

Understanding early experiences of retainer wear can help clinicians to provide timely and well-targeted interventions and information. Co-constructing unique adherence strategies may help to overcome the initial adaptation phase, with particular emphasis on understanding the individual.