Self-perception of smile attractiveness as a reliable predictor of increased patient compliance with an orthodontist.

Background. Predicting the cooperation of orthodontic patients seems to be of the utmost importance for successful results in treatment with removable appliances, especially if their cost is to be covered from public funding. Therefore, the issue of unbiased pre-treatment assessment of cooperation still calls for an investigation. Objectives. The objective of this study was to check whether smile attractiveness and its importance, subjectively evaluated by the patients/their caregivers, are reliable predictors of a patient's compliance during treatment with removable appliances. Material and methods. The study group comprised 97 patients aged 9-12 years, treated with active plates or twin-blocks, equipped with the TheraMon® system. Before treatment, the caregivers and the patients filled out the questionnaires ranking both of the investigated variables. After 9 months of treatment, we analyzed the correlations of the daily wear time (DWT) and other variables. Results. The analysis revealed the following: no relevance of the DWT to the type of removable appliances; negative correlation between the DWT and smile attractiveness assessed by the children and their caregivers; evidently elongated DWT (up to 9.68 h in children), who, together with the caregivers, evaluated their smile attractiveness as poor; coherence of children's and their caregivers' responses evaluating smile attractiveness and its importance, as well as the lack of consistency when comparing responses provided separately by the children and their caregivers. Conclusions. Application of the TheraMon® sensors objectively proved that the patient's smile attractiveness ranked subjectively as low predicts the orthodontic patient's irreproachable cooperation. Therefore, our easy-to-use questionnaire calls for changing the protocol regarding the wearing time of removable appliances during treatment and introducing an evidence-based policy of reimbursement for such therapy from public funds. Further investigation of the effectiveness of removable appliances worn shorter than previously presumed and of the motivation to continue treatment, once smile attractiveness has been improved, is necessary. [ABSTRACT FROM AUTHOR]