Orthodontic Patients' Motivation and Decision‐Making for Seeking Treatment With Traditional Fixed Appliances, Clear Aligners and Direct‐To‐Consumer Clear Aligners: A Qualitative Study—Part I

OBJECTIVE: Qualitative data helps explore factors surrounding patients' decisions with orthodontic treatment. The objectives were (1) to understand patients' motivation to undertake orthodontic treatment, (2) to understand their choices of a specific treatment modality, and (3) to determine the kinds of information provided to patients prior to receiving treatment. MATERIALS AND METHODS: The study was an exploratory case study design. Thirty adults who completed orthodontic treatment with three different treatment modalities within the last twelve months in New Zealand were recruited. Patients undergoing treatment and those who had orthognathic surgery were excluded. Semi-structured, one-to-one interviews were conducted. The transcripts were analysed with NVivo software using a qualitative thematic analysis inductive approach. RESULTS: Three principal themes were identified in the data: Motivation for orthodontic treatment, the decision for treatment with a specific treatment modality, and patient information and education. Self-consciousness, aesthetics, relapse of previous orthodontic treatment, cleanability, and a previous financial barrier to seeking orthodontic treatment were motivating factors. Patients opted for traditional fixed appliances due to recommendation and trust; clear aligners due to age, working environment, and aesthetics; and direct-to-consumer clear aligners due to low cost. All participants had little knowledge about orthodontics prior to commencing treatment, and the provision of information for informed consent was not equal for each of the three groups. CONCLUSION: The primary motivators of individuals seeking treatment were self-consciousness, aesthetics, and previous financial constraints. Cost had the most significant impact when selecting a specific treatment modality.