A qualitative meta-synthesis of research into patients' past experiences and perceptions of orthodontic treatment outcomes

Abstract

Background: There is a growing body of evidence emphasizing the importance of research into patient-centred experience in orthodontics. Benefits following orthodontic treatment are mainly related to improved aesthetics and psychosocial outcomes. However, treatment experience from the perspective of orthodontic patients is yet to be fully understood.

Objective: To understand the past experiences and current perceptions of treatment outcomes of orthodontic patients.

Study design: A qualitative meta-ethnography.

Selection criteria: Qualitative studies and mixed-methods articles with a distinct qualitative component presenting patients' perception of outcomes and overall experiences after an active course of orthodontic treatment were included.

Search methods: Comprehensive electronic searches were conducted in MEDLINE, Scopus, Web of Science, PsycINFO, and EMBASE up to May 2021, supplemented by grey literature and manual searches.

Data collection and analysis: Two independent reviewers were involved in study selection, data extraction, and quality appraisal. The Critical Appraisal Skills Programme tool for qualitative research was used to assess the quality of included studies. Analysis of data was conducted using meta-ethnographic methods.

Results: Out of 801 retrieved search hits, six studies fulfilled the inclusion criteria and were included in the synthesis. The analysis revealed three main themes and associated sub-themes: (1) Reflection on the past treatment experience, (2) Patient satisfaction with treatment outcomes, and (3) Learning to live with retainers.

Limitations: Results express patients' opinions shortly after treatment, and the long-term impact of orthodontic treatment is yet to be understood.

Conclusions: Orthodontic patients mainly viewed their experiences and treatment results positively. Desirable aesthetic outcomes, psychosocial outcomes, and satisfaction with smiles were often reported in the studies reviewed. However, some barriers to optimal experiences were noticed concerning orthodontic retention.

Registration: PROSPERO (CRD42020180121).