Subjective Orthodontic Treatment Outcomes in a Medicaid Population

Abstract

Introduction: Orthodontic treatment outcomes have traditionally been determined according to objective measures, but some researchers and clinicians have turned their focus to subjective outcome measures, such as oral health-related quality of life (OHQoL) and body image (BI). A randomized clinical trial (RCT) compared the objective outcomes of interceptive (ETX) and comprehensive (CTX) orthodontic treatment in a Medicaid population. The aim of the current study was to compare the subjective treatment outcomes of these two groups. Methods: An attempt was made to contact all of the subjects who had completed the RCT. Of 134 subjects, 58 (27 ETX, 31 CTX) completed two questionnaires--one for OHQoL and one for BI. The questionnaire results of the two treatment groups were compared using Student's t-tests. Univariate linear regression analyses were performed to identify socio-demographic and occlusal/skeletal variables that predicted OHQoL and BI scores. Predictors of appointment-keeping were also identified using the same statistical method. Results: Mean overall OHQoL and BI scores were better for the CTX group than the ETX group. Incisor irregularity and anterior dental esthetics at the end of the trial were found to predict long-term OHQoL and BI scores, whereas ethnicity was found to predict failed and late appointment rates. Conclusions: In adolescent patients with Medicaid insurance, comprehensive orthodontic treatment produces long-term subjective outcomes, which are superior to interceptive treatment alone.