The influence of the changing external environment and demographics on orthodontics
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Date
2022-03-28
Authors
Brown, Matthew
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Abstract
Purpose: To evaluate the factors that influence potential orthodontic patients’ choice between an
orthodontist, general dentist (GPs), and direct-to-consumer (DTC) providers for their treatment.
To evaluate orthodontists’ perceived impact from GPs and DTC providers providing orthodontic
treatment and determine the adaptive changes they have made to the administration of their
practices in the past ten years.
Methods: An electronic survey was administered to 330 individuals among the general population
of adults in Canada. Questions were designed to determine the participants’ demographic
background, choice of orthodontic treatment provider, preferred mode of treatment, orthodontic
issues they wished to address, and motivation for treatment. An electronic survey was also
administered to 270 orthodontists in Canada and the United States. Questions were designed to
determine the orthodontists’ demographic background, practice profile, perceived impact from
non-specialist orthodontic providers, and recent changes to the administration of their practices.
For both surveys, Pearson’s chi-squared tests were used to evaluate the factors influencing
participants.
Results: When laypersons were asked their preference in provider type, 49.4% of participants
selected an orthodontist, 19.2% would follow the recommendation of their general dentist, 18.9%
selected a general dentist, and 12.5% selected DTC providers. When asked their preference in
mode of orthodontic treatment, 45.4% selected clear braces, 34.1% selected clear aligners, 14.3%
selected metal braces, and 6.1% indicated they currently have no interest in orthodontic treatment.
When orthodontists were asked if they perceived an impact from GPs providing orthodontic care,
67.7% indicated yes, 19.3% indicated no, and 13.0% were unsure. When orthodontists were asked
if they perceived an impact from DTC providers offering orthodontic care, 40.1% indicated yes,
33.1% indicated no, and 26.8% were unsure. When orthodontists were asked if they have perceived
a reduction in the number of referrals received from GPS in the past ten year 61.1% indicated yes,
23.3% indicated no, and 15.6% were unsure. When orthodontists were asked if they feel the need
to make their practice more competitive 74.0% indicated yes, and 26.0% indicated no.
Conclusions: Adults in Canada have a high preference for orthodontic treatment to be performed
by orthodontists, and a subsequent lesser extent for GPs and DTC providers. Younger respondents
were more likely to prefer metal braces, while older respondents were more likely to prefer clear
braces. Preference for clear aligners is positively correlated to a larger community size. The
perceived impact of GPs providing orthodontic care was greater than that of DTC providers.
American orthodontists were significantly more likely than Canadian orthodontists to perceive an
impact on their practice from DTC providers. Orthodontists have experienced a reduction in
referrals from GPS and an increase in referred case difficulty. Orthodontists in Canada and those
who are female have made significant changes to the administration of their practices in the last
ten years.
Description
Keywords
Orthodontics, Direct-to-consumer, General dentist orthodontics, Patient preferences, Orthodontic care provider, Orthodontic practices