Original article
Changes in oral health-related quality of life during fixed orthodontic appliance therapy: An 18-month prospective longitudinal study

https://doi.org/10.1016/j.ajodo.2009.08.029Get rights and content

Introduction

There is an increasing research interest in quality of life issues in orthodontics. In this study, we aimed to investigate changes in oral health related quality of life (OHRQoL) among adults during fixed orthodontic appliance therapy (FOAT).

Methods

Two hundred thirty-two adult patients were enrolled from a consecutive sample at a university dental hospital. OHRQoL was assessed by 2 standardized instruments (OHIP-14 and OHQoL-UK) at 4 times: before treatment (T0), 6 months after bonding and banding (T1), 12 months after bonding and banding (T2), and 18 months after bonding and banding (T3). Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the relative changes of OHRQoL among the different time points.

Results

Significant changes in the summary scores of both the OHIP-14 and OHQoL-UK were observed during fixed orthodontic treatment (P <0.001). There were significant OHRQoL deteriorations at T1 and T2 compared with T0; these were reflected by summary scores of both the OHIP-14 and OHQoL-UK as well as some of their domain scores (P <0.05). However, at T3, the OHIP-14 suggested deterioration in OHRQoL, but the OHQoL-UK suggested improvement in OHRQoL.

Conclusions

Changes in OHRQoL occur during fixed orthodontic appliance therapy. In the early phase of treatment, the greatest deterioration in OHRQoL occurs. With ongoing treatment, the detrimental effects to OHRQoL are reduced.

Section snippets

Material and methods

This was a prospective longitudinal study involving a cohort of adults undergoing FOAT at Hong Kong University’s orthodontic teaching center. A consecutive sample of 347 adults seeking orthodontic treatment at the center was screened for suitability to undergo FOAT. Inclusion criteria were adults (aged 16 and older) rated as having a need for comprehensive fixed orthodontic treatment by the consulting orthodontists. Exclusion criteria were patients with untreated dental caries (cavitated

Results

Of the 347 adults screened, 232 met with inclusion and exclusion criteria. Of the 232 subjects who were enrolled in the study, 201 (86.6%) completed the OHRQoL assessments at the 4 times during the study. The median age of the participants was 20 years (interquartile range, 5 years), and 63% (146) were female. There was no significant difference in the baseline OHRQoL assessments of those who completed all assessments (included in the analyses) and those who failed to complete all assessments

Discussion

The response rate to the study was high; this indicates the feasibility of using patient-centered OHRQoL measures in the clinical setting. This can help to provide greater understanding of the effects of treatment on patients’ lives, because this is important in the overall evaluation of the benefits of orthodontic care. These findings are those of an observational treatment cohort and not a case-control study. It would be useful to compare changes in OHRQoL among a treated group and a control

Conclusions

Changes in OHRQoL occur during FOAT. In the early phase of treatment, the greatest deterioration in OHRQoL occurs. With ongoing treatment, the detrimental effects to OHRQoL are reduced, and there is a suggestion that OHRQoL might even be improved during treatment.

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The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

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