Association between orthodontic treatment and psychosocial factors in adolescents: a cross-sectional study

Background: Orthodontic treatment is one of the longest and most common medical interventions in adolescence. There are certain inequalities in care leading to risk factors associated with higher rates of untreated tooth malocclusion, resulting in a significant burden on oral health. Little is known about that certain psychosocial and personal risk factors influence the uptake of orthodontic treatment. Therefore, the aim was to explore factors that might influence orthodontic treatment and psychosocial and personal factors in a representative sample in Germany. Methods: The data are based on the KiGGS Survey Wave 2, a representative cross-sectional study of children and adolescents in Germany. Sociodemographic data, uptake of orthodontic treatment, parental socioeconomic status, social support, self-efficacy, and perceived health status were collected through a self-reported questionnaire. Results: A total of 6599 children and adolescents between 11 and 17 years were included in the analysis. Girls, non-immigrants, children, and adolescents with higher levels of social support, and children and adolescents who have visited a dentist or orthodontist more often in the past 12 months are more likely to have received orthodontic treatment. Among 14- to 17-year-olds, the likelihood of seeking orthodontic treatment is also associated with an increasing parental socioeconomic status (odds ratio 1.07 [95% CI 1.02; 1.14] P = .013). Conclusions: Certain protective and risk factors as well as personal and psychosocial factors are associated with orthodontic treatment. This knowledge can be used to determine which individuals should be targeted for need-based care to ensure that health care is provided without over- or undertreatment.