Patients' motivations for treatment and their experiences of orthodontic preparation for orthognathic surgery

Objective: To determine patients' motivations for undergoing orthognathic surgery and their experiences of the orthodontic aspects of this treatment. Design: Retrospective questionnaire survey using a patient-centred measure. Setting: Thirteen National Health Service (NHS) hospital orthodontic departments. Subjects: Three-hundred-and-twenty-six patients (58% response rate) who underwent orthognathic surgery during the period 1 January 1995 to 30 September 2001 completed a questionnaire. Main outcome measures: Motivations for treatment and perception of information about treatment and experiences of orthodontic treatment. Results: Major motivations for treatment were to have straight teeth (80%), to prevent future dental problems (69%) and to improve self-confidence (68%). Females sought treatment to improve self-confidence and their smile. Males wanted treatment to improve their social life. Most of these issues had improved following surgery. Most (94%) respondents felt well-informed about their orthodontics. However, 36% wore braces for longer than they expected. Males and younger patients knew less about the duration of treatment than other groups. Fifty-eight per cent of subjects found their braces difficult to clean and 9% reported that they were very painful. Older patients experienced fewer problems wearing braces than younger patients. Conclusions: Improving dental appearance and preventing future dental problems are major motivators for orthognathic patients. Although patients felt well informed about what to expect from their orthodontic treatment, a significant proportion, particularly younger patients and males, were surprised at the length of treatment and the need to wear retainers. This suggests that orthognathic patients might benefit from better information regarding the orthodontic aspects of their care.