Predictors of orthodontic treatment preferences in a large representative UK adult cohort

Introduction The number of adults seeking orthodontic treatment globally continues to rise. This study aimed to clarify how demographic characteristics, treatment-related factors (perceived quality, cost, convenience), psychological factors (dental aesthetics, body image, mental health) and oral health influence adults' interest in pursuing orthodontic treatment.Methods A representative sample of 604 adults with the same proportion of participants as the national United Kingdom population across three core demographics (age, sex, ethnicity) completed an online survey. Data were analysed using chi-squared tests, multinomial logistic regressions, mixed analyses of variance and hierarchical multiple regression.Results A high proportion of respondents had at least some interest in pursuing orthodontic treatment and those with the greatest interest were also more likely to prefer that an orthodontist deliver this treatment. Individuals who reported a preference for an orthodontist (53% of respondents) identified treatment quality as the primary advantage and cost as the most common concern. For those who preferred direct-to-consumer aligners (25% of respondents), quality was the most common concern and convenience the primary advantage. Hierarchical multiple regression revealed that, while demographic control variables explained 10.96% of variance in respondents' interest in pursuing any type of orthodontic treatment, a model that included psychological variables and oral health explained substantial additional unique variance (20.61%; both ps <0.05). Greater negative psychosocial impact of dental aesthetics, better body image and good oral health each made significant unique contributions to predicting orthodontic interest.Conclusions These data provide a more nuanced and comprehensive understanding of the many distinct factors that influence interest in undertaking orthodontic treatment in the adult general population, with implications for ethical and consumer-centred marketing, as well as patient satisfaction and treatment adherence.