Objective: To investigate adolescent orthodontic patient experiences with fixed appliances compared to Invisalign® by means of a quality of life questionnaire.

Materials and Methods: Ethical approval was obtained by the University of Manitoba’s Health Research Ethics Board. Adolescent patients between the ages of 11-18 from the University of Manitoba Graduate Orthodontic Clinic and from four private practices in Winnipeg currently undergoing orthodontic treatment with either Invisalign® or fixed appliances were provided a questionnaire. Pearson's chi-squared test was used to evaluate whether the participants in the fixed appliances group answered each item differently than those in the Invisalign® group (p < 0.05), and unpaired t-tests (p < 0.05), were used to test for differences in mean satisfaction, quality of life, and domain scores.

Results: Overall, 74 patients (37 in each group) participated. No significant difference was noted in the mean quality of life, domain, or satisfaction score between the two groups. A significant difference was noted in the time taken to adjust to appliances with the Invisalign® group demonstrating faster adaption. Additionally, the fixed appliances group was 3.8 times more likely to report missing school because of their appliance (95% CI: 1.2, 12.5, p= 0.02) and 2.7 times more likely to report having difficulty eating certain foods compared to the Invisalign® group (95% CI: 1.1, 7.1, p= 0.04). When the subgroup of females between the ages of 14-18 was analyzed, a higher proportion of the Invisalign® group reported feeling attractive compared to the fixed appliances group.

Conclusion: The overall oral health-related quality of life of adolescent patients undergoing treatment in fixed appliances and Invisalign® for a minimum of six months is similar. Both groups expressed high satisfaction with treatment, and the majority would choose their current modality again.