Patient experiences with orthodontic retention and retainers: A scoping review

Determining patient experiences with healthcare interventions is a key component of evidence-based care. The aim of this scoping review (ScR) was to systematically collate and synthesize the literature concerning patient experiences with orthodontic retention and retainers.

The ScR adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Overall, 4 databases were systematically searched, and the screening process was independently undertaken by 2 reviewers.

A total of 63 articles, investigating the experiences of at least 6,195 patients, satisfied the inclusion criteria. These included randomized controlled trials, prospective and retrospective clinical investigations, cross-sectional studies, and qualitative studies. Outcomes related to patient experiences were the primary objective in 18 (28.6%) articles. Most (54 [85.7%]) articles employed questionnaires ranging from 1-24 questions/items. Qualitative methodology was employed in 9 articles. Data were reportedly collected at 1 timepoint in 45 (71.4%) of the articles. Most study participants were adolescents or young adults. Discomfort vs comfort and speech were the most investigated domains. There was a general trend for initial negative experiences and perceptions with retainers to be relatively short-lived. The experiences of patients with bonded retainers appeared to be more positive than those with removable retainers, and Hawley retainers appeared to have more deleterious impacts than clear plastic retainers.

There was considerable heterogeneity in study types, interventions, and research methodologies employed in the articles appraised in the present review. Additional pertinent investigations in older age groups are required. The employment of qualitative longitudinal methodologies in future research is likely to provide a valuable and richer understanding of relevant patient experiences.