Self-perception of smile attractiveness asareliable 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 intreatment with removable appliances, especially if their cost is tobe covered from public funding. Therefore, the issue of unbiased pre-treatment assessment of cooperation still calls for aninvestigation. Objectives. The objective of this study was to check whether smile attractiveness and its importance, subjectively evaluated bythepatients/their caregivers, are reliable predictors ofapatient's compliance during treatment with removable appliances. Material and methods. Thestudy group comprised 97patients aged 9-12years, treated with active plates ortwin-blocks, equipped with the TheraMon® system. Before treatment, thecaregivers and thepatients filled out thequestionnaires ranking both of theinvestigated variables. After 9months of treatment, weanalyzed thecorrelations of thedaily wear time (DWT) and other variables. Results. Theanalysis revealed thefollowing: no relevance of the DWT tothetype 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 thecaregivers, 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 bythechildren and their caregivers. Conclusions. Application of the TheraMon® sensors objectively proved that thepatient's smile attractiveness ranked subjectively aslow predicts theorthodontic patient's irreproachable cooperation. Therefore, our easy-to-use questionnaire calls for changing theprotocol regarding the wearing time of removable appliances during treatment and introducing anevidence-based policy of reimbursement for such therapy from public funds. Further investigation of theeffectiveness of removable appliances worn shorter than previously presumed and ofthemotivation tocontinue treatment, once smile attractiveness has been improved, isnecessary.