Role of Parents in Motivating Children for Orthodontic Treatment; A Cross-Sectional Study Done in Riyadh

Alanoud Abdulrahman M Alsultan¹, Norah Mohamed S Alghusen¹, Gharam Suliman S Alawwad², Khalid Abdullah M Alshamrani², Mutlaq Talal Sahan Aldewaish¹, Taibah Ahmed S Alhabib¹, Badr Soliman AlHussain^3*

¹Private Sector, Riyadh, Saudi Arabia.

²Riyadh Elm University, Riyadh, Saudi Arabia.

³Department of Operative Dentistry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

*Email: [email protected]

ABSTRACT

This cross-sectional study aimed to assess the role of parents in motivating children for orthodontic treatment. The study subjects comprised parents and children who volunteered from different socio-economic classes and had different education levels. The role of parents in motivating children for orthodontic treatment was measured using a 15 items questionnaire. After ensuring the reliability of the questionnaire, differences across gender, education, and family income were seen using a statistical measure Chi-square through SPSS to determine the statistically significant differences (p<0.05). Findings revealed Forty-four percent were male participants, and fifty-five percent were female. Most parents completed their university (82%), and least just ended at the primary level (1.9%). Family income of greater sample falls between 20,000 0r more with stats of 40.3%. Female participants were in higher numbers and mostly parents wanted their child to wear braces for having a beautiful smile. In gender differences both gender wants the treatment for aesthetic purpose. University graduates were self-referred.

Key words:Parents, Motivation, Orthodontics, Early age, Cross-sectional, Riyadh

INTRODUCTION

The most pressing task in modern orthodontics is to improve treatment efficacy, and finding new ways to influence this process is a never-ending pursuit. Orthodontic therapy is sought for a variety of reasons by both children and their parents. Determining and keeping this drive is critical to a positive outcome throughout therapy. If a patient's motivation wanes, his or her compliance may suffer, which might lead to an early treatment termination or a poor treatment outcome. To predict and increase compliance in new patients, several techniques have been presented. However, it has repeatedly been proven to be difficult. Demand for orthodontic treatment continues to rise, according to both orthodontists and dentists. Adults are increasingly seeking orthodontic treatment, which indicates a shift in the typical patient population [1].

An individual's beauty, aesthetics, and quality of life can be negatively impacted by dental and jaw irregularities. It is common knowledge that attractive individuals are perceived as friendlier, smarter, more fascinating, and more positive dispositions. When it comes to treating a variety of malocclusions and therefore improving quality of life, orthodontic treatment is a proven and successful method. However, little research has been done on the motivation to undertake treatment [2]. Taking into account the patient's somatic-psychological status and psycho-emotional condition during orthodontic treatment allows the best treatment option to be selected and its efficacy to be predicted. When treating a kid for occlusal alterations, an orthodontist will exploit the parent's dominating role to their advantage. Because the family is the child's most important social group and decides how other variables will affect his or her development, the doctor's collaboration with the parents is an absolute need throughout orthodontic treatment. This is due in part to the belief that orthodontics would not only enhance their oral appearances but will also have positive effects on their overall health and well-being [3]. Appliance design innovations aiming at minimizing the appearance of orthodontic equipment or enhancing their efficiency, along with the use of current marketing and promotional tactics by orthodontic companies, may also have contributed to the transformation [4]. According to Rolland et al. (2016), Orthodontic treatment for children has risen in demand and availability over the last 30 years despite the NHS providing somewhat less care in 2016–2017 than in 2015–2016 (Health and Social Care Information Centre, 2017) [5].

The process of moving from need to motive goes like this: first, a person feels the need for something, then becomes conscious of the need (motivation), and last, a rational decision arises, i.e., a motive is created. However, motivation is more than just a desire to do something. For the same reason that cognition and action are intertwined, determining the process of cognition is also crucial. Despite this, only the child's parents complain to the doctor about their child's true morphological, functional, and cosmetic problems. Orthodontic therapy is often reserved for adolescents and young adults, and it might take a long time compared to other types of dental care. It was shown that thorough orthodontic treatment takes, on average, 2 years to complete, based on prospective research carried out in academic settings [6].

Orthodontic patients must follow the treatment orthodontist's advice to the letter during treatment. After it is completed, it is possible to describe treatment motivation as a hypothesis describing the conscious or unconscious stimulus for activity in the direction of the desired goal. Children and their parents pick braces for a variety of reasons. One of the less obvious responsibilities of a professional orthodontist is to discover the types of motivation involved (if any) and maintain them during treatment. This is critical if the intended results are to be obtained. Clinical practitioners are all too aware that as a patient's desire wanes, so does compliance. This can result in early treatment discontinuation, a worse outcome, or even harm the patient's dentition [7].

Literature review

A study was conducted in Russia to examine the role of parents in motivating Orthodontic treatment for their children. In a study, the total sample of 532 children from the age group of 6-12 was included. From the total sample, 26.8% showed poor self-discipline during treatment and did not regularly attend to the doctor. Almost 13.4% discontinued the treatment. The findings show that children with dent facial anomalies between the ages of 6 and 12 who receive informative and illustrative knowledge from their parents about the importance and complexity of orthodontic treatment at all stages are more likely to be motivated to undergo this time-consuming procedure [8].

Research of 227 patients and their parents in the United States compared participants' motivation for treatment with their subsequent participation. 3 The authors observed that 93.4 percent of the youngsters ranked aesthetic concerns as the most significant reason for seeking orthodontic treatment. They also highlighted that the higher the patient's motivation before treatment, the better their cooperation looked during treatment. Another research of 207 teenage patients found that parents played an essential role in orthodontic treatment decisions. According to the findings, parents accounted for 41% of the original motivation for treatment, and the general dentist recommended orthodontic treatment [9].     

Another study reported in the Journal of Orthodontics that over 80% of respondents were disturbed by how their teeth looked and wanted a brace to fix that problem. In that order of significance, potential patients had the most prevalent concerns about their teeth' crookedness, jutting out, bite, gaps, and color. 13 percent of those surveyed had been subjected to dental taunts, whereas 67 percent were eager to acquire braces, while 81% had acquaintances with braces and 60 percent had relatives with braces. Seventy-seven percent of the time, the referral was made by the patient's dentist. Over 67% of those polled said they were unconcerned about having braces, and a comparable number of those polled said they knew someone with braces or had a family member who did. While most patients knew that having braces meant changing their diet (98 percent) and cleaning their teeth more frequently (94 percent), 24 percent of patients had no idea how often they should do so while in treatment. Seventy-seven percent of parents' visits were the result of a referral from the dentist. The majority of parents (77%) agreed that orthodontic treatment was essential for their children's oral health. In comparison, the majority (57%) said it would improve their child's smile, 64% said that it would make tooth brushing easier, 63% said that it would improve their child's bite, and 70% said that it would boost their child's self-esteem and confidence. One-fifth thought therapy would take between one and two years, with the remaining one-fifth stating that it would take less than one year [10].

MATERIALS AND METHODS

This is cross-sectional research carried out among the patients and their families in Riyadh by an online survey. Hospitals and clinics in Riyadh were contacted and participants were requested to fill up the survey. The online questionnaire was formed including questions about personal and demographic data followed by questions linked to their opinion and preference regarding orthodontic treatment among their children. The gathered data was analyzed using SPSS version 22, where descriptive as well as inferential statistics were performed. Comparisons between groups will be made with the value of significance kept under 0.05 using the Chi-square test.

RESULTS AND DISCUSSION

In results, Table 1 tells about the frequency of this study. Forty-four percent were male participants, and fifty-five percent were female. Most parents completed their university (82%), and least just ended at the primary level (1.9%). Family income of greater sample falls between 20,000 0r more with stats of 40.3%. 51.9% of the parent has worn braces in their past, and the same percentage was suggested getting this treatment for their child, and firstly parents suggested braces to their child (37.6%), 66.2% think that it is important for their child to have straight teeth, while 75.2% says it would improve their child's smile. 51.9% consider it a lengthy process that takes approximately one to two years, 26.5% think they should wear it for one to two years. 47.6% said they would not allow their kid to miss school to undergo treatment. 51.9% were excited to see their kid after treatment, while 53.3% think the cost is a discouraging factor for treatment, and 38.65 think the length of treatment (Table 1).

Tale 2 tells about gender differences and reports that male participants wore braces in their past 44.5%, while only 38% of females wore them ever in their life. 87% of females were suggested to get this treatment for their child from someone else, but the first decision was their own. 53% of males consider it quite important to have straight teeth, while 50% of females thought it was very important for their child. Both male and female parents think it would improve their kid's smiles. Male participants thought that this process would approximately take 2 years, while females believed it would take less than a year. Fathers said a big no in concern of missing school for treatment, but mothers said yes. Both parents did not agree if treatment costs health teeth for braces insertion. Mothers said that their children never got a piece of advice from dentists on how to clean their teeth (Table 2).

Table 3 tells about differences across education and reports that Most of the participants were university students or graduates, and family income was 20,000 or more. Most University graduates did not wear braces while high school wore them in their life. University graduates got suggestions from others for braces while high school approaches on their own. In university graduates, a referral was from their child, while high schools were self-referred. University graduates think it very important for their kid to have straight teeth and thought it would make their kid's speech better; past research reported that 54% of parents wanted good appearance for their kid while 75% were those having dissatisfaction with teeth and least thought it would make their speech better. Table 4 tells about differences across family income.

Table 1. Frequencies of survey responses

Table 2. Comparison across Gender

Table 3. Comparison across Education

Table 4. Comparison across Family Income