ABSTRACT
Background:
Orthodontic treatment is often pursued to improve dental aesthetics and function, but its psychological effects on adult patients are not well-documented.
Materials and Methods:
This mixed-methods study involved 150 adult participants undergoing orthodontic treatment. Quantitative data were collected using the Oral Health Impact Profile (OHIP-14) questionnaire and the State-Trait Anxiety Inventory (STAI) before treatment, mid-treatment, and posttreatment. Qualitative data were gathered through semistructured interviews with 30 participants, selected via purposive sampling, to explore their personal experiences and perceptions of the treatment process. Quantitative data were analyzed using Analysis of Variance (ANOVA) to assess changes over time, while thematic analysis was conducted on qualitative data to identify common themes.
Results:
Quantitative analysis revealed significant improvements in OHIP-14 scores (P < 0.001), indicating enhanced oral health-related quality of life posttreatment. Anxiety levels, as measured by STAI, decreased significantly from baseline to posttreatment (P < 0.01). Qualitative interviews highlighted themes of increased self-esteem, improved social interactions, and initial discomfort during the adaptation phase of treatment. Participants reported a heightened awareness of oral health and a positive shift in self-image.
Conclusion:
Orthodontic treatment in adults leads to significant psychological benefits, including reduced anxiety and improved quality of life.
KEYWORDS: Adults, anxiety, mixed-methods study, orthodontic treatment, psychological effects, quality of life, self-esteem
INTRODUCTION
Orthodontic treatment is traditionally associated with adolescents, but there has been a notable increase in adults seeking such interventions for both aesthetic and functional improvements.[1,2] The motivations for adults to undergo orthodontic treatment extend beyond the desire for straight teeth; they often involve enhancing self-esteem, improving oral health, and increasing social confidence.[3,4] Despite the growing interest in adult orthodontics, the psychological impact of these treatments remains underexplored.
Numerous studies have documented the physical outcomes of orthodontic interventions, including improved occlusion and periodontal health.[5,6] However, understanding the psychological effects is equally crucial, as these can significantly influence patient satisfaction and adherence to treatment.[7,8] Adults may experience unique psychological challenges during orthodontic treatment, such as anxiety related to social perceptions and professional image.[9]
Recent research has begun to highlight the complex relationship between dental aesthetics and psychological well-being. Improved dental appearance can lead to enhanced self-esteem and quality of life, whereas dissatisfaction with dental appearance can negatively impact social interactions and emotional health.[10,11] A mixed-methods approach, combining quantitative and qualitative data, offers a comprehensive understanding of these effects by capturing both measurable changes and personal experiences.[12]
This study aims to investigate the psychological effects of orthodontic treatment in adults, focusing on changes in anxiety levels and quality of life. By employing a mixed-methods design, this research seeks to provide a holistic view of the psychological impact of orthodontic interventions, thereby aiding clinicians in delivering more personalized and effective care.
MATERIALS AND METHODS
Study design and participants
This mixed-methods study was conducted over 12 months, involving a total of 150 adult participants aged 18–50 years who were undergoing orthodontic treatment. Participants were recruited through convenience sampling and provided informed consent before participating in the study. Inclusion criteria included adults who had not previously undergone orthodontic treatment and were willing to participate in follow-up assessments. Exclusion criteria included individuals with significant psychological disorders or those who required complex orthognathic surgery.
Quantitative data collection
Quantitative data were collected using two validated instruments: the Oral Health Impact Profile (OHIP-14) and the State-Trait Anxiety Inventory (STAI). The OHIP-14 assessed the impact of oral health on quality of life, while the STAI measured anxiety levels. Participants completed these questionnaires at three time points: baseline (prior to treatment), mid-treatment (six months after initiation), and posttreatment (12 months after initiation). Data were collected and stored anonymously to ensure participant confidentiality.
Qualitative data collection
To complement the quantitative data, semistructured interviews were conducted with a subset of 30 participants, selected via purposive sampling to ensure diversity in demographics and treatment stages. Interviews focused on participants’ personal experiences, perceptions of orthodontic treatment, and psychological impacts. Each interview lasted approximately 30–45 min and was audio-recorded with participant consent. Transcripts were anonymized for analysis.
Data analysis
Quantitative data were analyzed using SPSS version 28.0.
RESULTS
Quantitative findings
A total of 150 participants completed the quantitative assessments. The mean age of participants was 32 years (SD = 8.4), with 60% being female and 40% male. Changes in OHIP-14 and STAI scores were observed over the course of the treatment.
Table 1 presents the OHIP-14 scores at baseline, mid-treatment, and posttreatment. A significant improvement in the OHIP-14 score was observed from baseline (mean = 32.5, SD = 5.8) to posttreatment (mean = 18.7, SD = 4.3), indicating enhanced oral health-related quality of life.
Table 1.
OHIP-14 scores over time
| Time point | Mean score | Standard deviation | P |
|---|---|---|---|
| Baseline | 32.5 | 5.8 | |
| Mid-treatment | 24.3 | 5.2 | <0.001 |
| Posttreatment | 18.7 | 4.3 | <0.001 |
The STAI scores, as shown in Table 2, decreased significantly from baseline (mean = 45.6, SD = 7.1) to posttreatment (mean = 35.4, SD = 6.2), reflecting reduced anxiety levels among participants.
Table 2.
STAI scores over time
| Time point | Mean score | Standard deviation | P |
|---|---|---|---|
| Baseline | 45.6 | 7.1 | |
| Mid-treatment | 40.2 | 6.5 | <0.01 |
| Posttreatment | 35.4 | 6.2 | <0.01 |
Qualitative findings
Thematic analysis of the semistructured interviews identified three main themes: increased self-esteem, improved social interactions, and adaptation challenges. Participants reported a significant boost in self-confidence and willingness to engage in social activities as their dental aesthetics improved.
Several participants described initial challenges, such as discomfort and embarrassment, during the adaptation phase. However, these feelings diminished as treatment progressed and positive changes became apparent. Participants expressed feeling more confident in their appearance and more satisfied with their smiles. Many reported that these changes positively affected their overall self-image and professional interactions. Participants noted that improved dental aesthetics encouraged more frequent social engagements and enhanced communication skills, leading to better personal and professional relationships.
Initial discomfort and self-consciousness were common, particularly during the early stages of treatment. However, most participants reported that these challenges were temporary and outweighed by the long-term benefits.
DISCUSSION
The findings of this study demonstrate significant psychological benefits of orthodontic treatment in adults, including enhanced quality of life and reduced anxiety. These results align with previous research that highlights the positive impact of improved dental aesthetics on psychological well-being.[1,2]
The significant reduction in OHIP-14 scores from baseline to posttreatment indicates that orthodontic treatment contributes to a substantial improvement in oral health-related quality of life. This aligns with previous studies that have shown similar enhancements in patients’ quality of life following orthodontic interventions.[3,4] The improvement is likely due to the increased satisfaction with dental appearance, leading to greater self-confidence and social acceptance.[5]
Our study found a notable decrease in STAI scores, suggesting that orthodontic treatment can alleviate anxiety related to dental aesthetics and social perceptions. This finding supports previous research indicating that dental improvements can reduce psychological distress and enhance social confidence.[6,7] The reduction in anxiety may be attributed to the decreased self-consciousness regarding dental appearance, which has been identified as a source of stress and anxiety in adults.[8]
The qualitative component of this study provided deeper insights into the personal experiences of adult orthodontic patients. The themes identified, such as increased self-esteem and improved social interactions, underscore the broader psychological benefits of orthodontic treatment beyond mere aesthetic improvements. These findings are consistent with earlier studies that emphasize the importance of considering psychological outcomes when evaluating orthodontic treatment success.[9,10,13]
CONCLUSION
In conclusion, orthodontic treatment in adults not only enhances dental aesthetics but also significantly improves psychological well-being. These findings underscore the importance of a holistic approach in orthodontic care, considering both physical and psychological outcomes.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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