Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 8, November, p. 1245–1251
Publication type: original article
Objectively measured patient cooperation during early orthodontic treatment: Does psychology have an impact?
1 Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Poland
2 Institute of Psychology, Faculty of Pedagogical and Historical Sciences, University of Wrocław, Poland
Background. The effectiveness of orthodontic treatment with removable appliances arouses controversy concerning the level of patients’ compliance. The compliance depends on factors controlled by the orthodontists, by the patients themselves and by their caregivers, and those beyond any control.
Objectives. The purpose of this study was to assess the extent to which the personality traits of patients and their caregivers affect the cooperation in removable appliance therapy.
Material and Methods. A total of 38 patients (19 boys, 19 girls) aged 9–12 years, presenting malocclusions suitable for removable appliance therapy were randomly selected. The EAS-C Temperament Questionnaire, Generalized Self-Efficacy Scale, NEO-Five Factor Inventory and Parental Attitude Scale developed by Plopa were employed to evaluate the patients’ and the caregivers’ temperamental dispositions. Electronic sensors were employed to objectively assess patients’ cooperation.
Results. Statistical analysis revealed a high positive correlation between removable appliance wear time and the results of the GSES and the SPR-R, a strongly positive correlation between wear time and the NEOFFIC results and a strongly negative correlation between wear time and the EAS-C-Emo measurement. The level of a generalized sense of efficacy, conscientiousness and the severity of requirements imposed on the child were the factors related to the caregivers, positively correlating with patients’ cooperation.
Conclusion. The cooperation of children treated with removable appliances may be foreseen with observation of the patients’ and their caregivers’ traits. Objective evaluation of the patients’ cooperation and psychological tests may be valuable tools for the re-assessment of the paradigm of early orthodontic treatment.
patient compliance, orthodontics, removable appliances
- Bhardwaj VK, Veeresha KL, Sharma KR. Prevalence of malocclusion and orthodontic treatment needs among 16 and 17 year-old school-going children in Shimla city, Himachal Pradesh. Indian J Dent Res. 2011;22:556–560.
- Ciuffolo F, Manzoli L, D’Attilio M, et al. Prevalence and distribution by gender of occlusal characteristics in a sample of Italian secondary school students: A cross-sectional study. Europ J Orthod. 2005;27:601–606.
- Proffit WR, Fields HW Jr, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: Estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg. 1998;13:97–106.
- Schott TC, Goz G. Young patients’ attitudes toward removable appliance wear times, wear-time instructions and electronic wear-time measurements: Results of a questionnaire study. J Orofac Orthop. 2010;71:108–116.
- Hönn M, Schneider C, Dietz K, Godt A, Göz G. Treating class II patients with removable plates and functional orthopaedic appliances. J Orofac Orthop. 2006;67:272–288.
- Evans CA. Anteroposterior skeletal change: Growth modification. Semin Orthod. 2000;6:21–32.
- Nimri K, Richardson A. Applicability of interceptive orthodontics in the community. British J Orthod. 1997;24:223–228.
- Sergl HG, Zentner A. Predicting patient compliance in orthodontic treatment. Semin Orthod. 2000;6:231–236.
- Berk NW. Perception of orthodontic treatment need: Opinion comparisons of orthodontists, pediatric dentists, and general practitioners. J Orthod. 2002;29:287–291.
- Nanda RS, Kierl MJ. Prediction of cooperation in orthodontic treatment. Am J Orthod Dentofacial Orthop. 1992;102:15–21.
- Southard KA, Tolley A, Arheart KL, Hackett-Renner CA, Southard TE. Application of the millon adolescent personality inventory in evaluating orthodontic compliance. Am J Orthod Dentofacial Orthop. 1991;100:553–561.
- Robertson JS, Maddux JE. Compliance in pediatric orthodontic treatment: Current research and issues. CHC. 1986;15(1):40–48.
- Oniszczenko W. Kwestionariusz temperamentu EAS Arnolda H. Bussa i Roberta Plomina. Version for adults and children. Polish adaptation. Warszawa: Psychological Test Laboratory of the Polish Psychological Association; 1997.
- Buss AH, Plomin R. Temperament: Early Developing Personality Traits. Hillsdale, NJ: Lawrence Erlbaum; 1984.
- Juczyński Z. Narzędzia pomiaru w promocji i psychologii zdrowia. Warszawa: Psychological Test Laboratory of the Polish Psychological Association; 2009.
- Zawadzki B, Strelau J, Szczepaniak P, Śliwińska M. Inwentarz osobowości NEO-FFI Paula T. Costy Jr i Roberta R. McRae. Warszawa: Psychological Test Laboratory of the Polish Psychological Association; 1998.
- Plopa M. Skala postaw rodzicielskich. Version for adults. Warszawa: Psychological Test Laboratory of the Polish Psychological Association; 2008.
- Jarek S. mvnormtest: Normality test for multivariate variables. R package version 0.1-9. 2012. http://CRAN.R-project.org/package = mvnormtest Accessed May 26, 2015.
- Korkmaz S, Goksuluk D, Zararsiz G. MVN: An R package for assessing multivariate normality. The R Journal. 2014;6(2):151–162.
- Mardia KV. Measures of multivariate skewness and kurtosis with applications. Biometrika. 1970;57(3):519–530.
- Domański C. Własności testu wielowymiarowej normalności Shapiro-Wilka i jego zastosowanie. Cracow University of Economics. Rector’s Lectures. 1998;37.
- Hotelling H, Pabst MR. Rank correlation and tests of significance involving no assumption of normality. Annals of Mathematical Statistics. 1936;7:29–43.
- Dyer FMV, McKeown HF, Sandler PJ. The modified twin block appliance in the treatment of class II division 2 malocclusions. J Orthod. 2001;28:271–280.
- Baccetti T, Franchi L, Ratner Toth L, McNamara JA Jr. Treatment timing for Twin-block therapy. Am J Orthod Dentofacial Orthop. 2000;118:159–170.
- Romanyk DL, Lagravere MO, Toogood RW, Major PW, Carey JP. Review of maxillary expansion appliance activation methods: Engineering and clinical perspectives. J Dent Biom. 2010;1–7.
- Jang JC, Fields HW, Vig KWL, Beck FM. Controversies in the timing of orthodontic treatment. Semin Orthod. 2005;11:112–118.
- Press release of the “American Academy of Dental Sleep Medicine”: Comparison of subjective and objective measures of oral appliance compliance during treatment of sleep-disordered breathing. Presentation date: 2011, June 11, ID: 013.
- Smith TW, Ruiz JM. Personality theory and research in the study of health and behavior. In: Handbook of Clinical Health Psychology. Volume 3. Models and Perspectives in Health Psychology. Boll TJ, Frank RG, Baum A, Wallander JL, eds. Washington, DC: American Psychological Association; 2004:143–199.
- Riesch SK, Anderson LS, Krueger HA. Parent-child communication processes: Preventing children’s health-risk behavior. Journal for Specialists in Pediatric Nursing. 2006;11(1):41–56.
- Zadworna-Cieślak M, Ogińska-Bulik N. Zachowania zdrowotne młodzieży – Uwarunkowania podmiotowe i rodzinne. Warszawa: Difin; 2011.
- Lenčová E, Dušková J. Oral health attitudes and caries-preventive behaviour of Czech parents of preschool children. Acta Med Acad. 2013;42(2):209–215.
- Albino JEN, Lawrence SD, Lopes CE, Nash LB, Tedesco LA. Cooperation of adolescents in orthodontic treatment. J Beh Med. 1991;14(1):53–70.
- Mottus R, McNeill G, Jia X, Craig LCA, Starr JM, Deary IJ. The associations between personality, diet and body mass index in older people. Health Psychol. 2013;32(4):353–360.
- Jerant A, Chapman B, Dupberstein P, Robbis J, Franks P. Personality and medication non-adherence among older adults enrolled in a six-year trial. British Journal of Health Psychology. 2011;16:151–169.
- Liberska H, Boniecka K. Postawy rodzicielskie rodziców dzieci otyłych i z nadwagą. Journal of Health Sciences. 2013;3(13):419–432.
- Ryś M. Oddziaływania wychowawcze rodziców a nadzieja na sukces i kompetencje społeczne u ich dzieci. Kwartalnik Naukowy „Fides et Ratio”. 201;3(7):86–108.