Orthodontic retreatment need and related self-perceived factors among contemporary college freshmen in China

Abstract

Given that an increasing number of patients who received orthodontic treatment during their childhood or adolescence are seeking retreatment in contemporary China, it is of great necessity to comprehensively understand their motivations. A valid and reliable self-designed questionnaire, based on the Index of complexity, outcome and need (ICON), was distributed online to college freshmen who received orthodontic treatment during their childhood or adolescence. After collecting their basic information and orthodontic retreatment needs data from the survey, the participants’ general self-perception of front facial appearance, lateral facial appearance and tooth alignment, as well as their self-perceived dental alignment, occlusal status, oral function and psychological status, were assessed. Correlation analysis, Chi-square test, Kruskal-Wallis test and logistic regression were performed. Reliability was evaluated for 20 paired questionnaires, and all questions were found to be reliable (intraclass correlation coefficient, >0.70). Among the 1609 participants with a history of orthodontic treatment, 45.56% were males and 54.44% were females. Their mean age was 18.48± 0.91 years. Our results showed that self-perceived front facial appearance, lateral facial profile, tooth alignment, occlusal status, oral function and psychological status were significantly correlated with orthodontic retreatment needs. Both appearance and psychological status affected their self-perceived dental alignment and occlusal status. In conclusion, patients who received orthodontic treatment during their childhood or adolescence in contemporary China seek orthodontic retreatment because they desire better aesthetics of their front facial appearance and tooth alignment, especially the anterior region of the tooth, the lower part of the face and a decent pronunciation. Additionally, psychological concerns should be viewed as an urge, while intraoral factors should be viewed as the foundation during future clinical practice regarding orthodontic retreatment in this age group.