June 2006

Volume 23, Issue 2

The impact of fixed orthodontic appliances on daily life

Authors: H.V. Worthington R. Hulland S. Vine N.A. Mandall


Community Dental Health (2006) 23, 69-74 Received 21 February 2003; Accepted 30 November 2004 Objective: i) To develop a measure of the impact of fixed orthodontic appliances on daily life. ii) To assess the impact of fixed appliances over time after initial appliance placement. iii) To investigate factors that may influence the impact of fixed appliances (age, gender and socioeconomic status). Research design: Questionnaire. Clinical setting: University Dental Hospital and Hope Hospital, Manchester. Sample: Sixty-six patients, whose orthodontic appliances had just been placed. Twenty-eight patients whose orthodontic appliances were in place for at least six months were used for the reliability study. Method: The Impact of Fixed Appliances Questionnaire was developed using standard qualitative methods and pre-tested on 10 patients. This resulted in a questionnaire with nine conceptual impact sub-scales: aesthetic, functional limitation, dietary, oral hygiene, maintenance, physical, social, time constraints and travel/cost. The questionnaire was piloted on 66 patients, at the first, second and third visits after their fixed appliance had been placed, to assess the impact of fixed appliances over time. Questionnaire reliability, over a one-month time interval, was assessed on 40 patients who had been in treatment for at least six months. Main outcome measure: Impact of fixed appliances on daily life. Results:. The internal reliability of the questionnaire ranged from moderate to very good (Cronbach’s alpha 0.56-0.89). Test-retest reliability was stable for most subscales (intra-class correlation coefficient 0.26-0.65). The questionnaire was said to have face validity and also content validity because of the method of questionnaire development through interviewing children with fixed appliances. None of the subscales scores reduced over time except aesthetic impact (p< 0.05) but this was probably not a clinically significant change. Age was the predominant variable to influence the impact of fixed appliances with younger children being less affected during their daily life (p<0.05). Conclusions: The questionnaire developed in this study is a reliable tool for assessing the impact of fixed appliances on the daily life of children. It is unlikely that the impact of fixed appliances on daily life reduces as the patient progresses through treatment. Younger patients are probably more adaptable to treatment with fixed appliances, in terms of reduced impact on daily life, so arguably treatment should be started as early as possible. This information could also be used to educate, reassure and motivate patients at the start of treatment. Key words: Aesthetics, fixed appliances, function, oral impact

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Other articles in this issue

Article Pages Access
Editorial - Providing children with the quality dental care they deserve 66-68 £10 single article
The impact of fixed orthodontic appliances on daily life 69-74 £10 single article
Service quality implications of dental undergraduate outreach teaching for Primary Care Trusts in England, UK. 75-79 £10 single article
Prevalence of hypodontia and hyperdontia in paedodontic and orthodontic patients in Budapest 80-82 £10 single article
Psychometric properties of the Arabic version of the Dental Cognition Questionnaire 83-90 £10 single article
Dental caries experience in preschool children in Veneto region (Italy) 91-94 £10 single article
Improving access to dental care in East London’s ethnic minority groups: community based, qualitative study 95-100 £10 single article
The unequal burden related to the risk of oral cancer in the different regions of the Kingdom of Saudi Arabia 101-106 £10 single article
Can oral health promotion help develop masticatory function and prevent dental caries? 107-115 £10 single article
The equity of access to primary dental care for children in the North East of England 116-119 £10 single article
Presidential Address - BASCD Spring Scientific Meeting 120-122 £10 single article


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