Youth Perception of Different Orthodontic Appliances

Purpose: To explore youth perception of the esthetics of different orthodontic appliances measured using different concepts of esthetics. Patients and Methods: A questionnaire was answered by 194 youth participants (35.5% were 9-11 years old; 32.5% were 12-14 years old; and 32% were 15-17 years old). Participants evaluated and compared the attractiveness of images of different orthodontic appliances using a Likert scale. They indicated the acceptability of the appliances with a yes/no answer. They then chose which appliance to rank as their most preferred. Results: The highest median attractiveness rating was for clear aligners (Mdn= 8, IQR= 4.25), followed by lingual and standard ceramic brackets (Mdn= 7, IQR= 6). The lowest median attractiveness rating was for hybrid brackets (Mdn= 4, IQR= 4). Clear aligners were significantly more attractive than all other orthodontic appliances (P<0.0001). Clear aligners also had the highest percentage of acceptability (80%), while hybrid brackets scored the lowest (42%). Ceramic and metal brackets fell in the middle range of attractiveness and acceptability but were chosen by male middle schoolers as their preferred appliances. Clear aligners were ranked the highest by this cohort. Conclusion: This study demonstrates the widespread preference and acceptability of clear aligners among the youth. Other orthodontic appliances were acceptable but to a lesser extent than clear aligners. This study informs orthodontists about their youth consumers' behavior and may help inform treatment discussions in the orthodontic clinic.