The long-term influence of orthodontic treatment on dental knowledge and behaviour: an Australian cohort study

Abstract

Objectives: Fixed orthodontic treatment (FOT) typically lasts 14–33 months, with regular appointments at short intervals to monitor changes, adjust appliances, and remotivate patients to maintain excellent oral hygiene standards to prevent dental disease. Past experiences are important influencers of dental attitudes and self-care dental behaviours in adulthood. Since FOT comprises a high frequency of appointments compared to other dental visiting, we hypothesised that previous FOT enhances dental knowledge and behaviour in later life. Methods: This cohort study followed-up 30-year-old participants who originally took part in an oral epidemiological study when aged 13-years. Participants completed a questionnaire regarding sociodemographics, dental health behaviours, dental knowledge (prevention of caries and periodontal disease, including questions about popular myths) and FOT. Data analysis comprised un/adjusted binomial logistic regression and multivariate generalised linear regression. Results: Data for 448 participants (56 % female, 35 % received FOT) were analysed; adjusted models controlled for sociodemographics and baseline malocclusion severity. There was no association between FOT and regular toothbrushing (Exp B: 1.35, 95% CI: 0.87–2.10), flossing (Exp B: 1.18, 95 % CI: 0.48–2.90), dental attendance within last 2 years (Exp B: 0.96, 95 % CI: 0.62–1.49) or a non-emergency dental visit (Exp B: 1.01, 95 % CI: 0.51–1.99). Non-FOT participants placed importance on a calcium-rich diet preventing caries (Exp B: 1.99, 95 % CI: 1.14–3.50, P<0.05), while those with a baseline definite malocclusion had higher levels of knowledge about dental visiting compared to those with minimal or more severe malocclusions (P<0.05). Conclusion: Previous FOT appears to have limited impact on dental knowledge and may not affect long-term dental behaviours. Clinical significance: This 17-year follow-up study examined the influence of previous fixed orthodontic treatment on dental knowledge and behaviour later in life. Although patients have numerous and regular appointments during the course of orthodontic treatment, this does not seem to impact on either dental knowledge or behaviour in adulthood.