Developments in making patients' orthodontic choices better

Context: Orthodontics is an unusual speciality as out-patient treatment requires patients to attend services regularly for two to three years. Contact with services is even longer for some patients referred as children, with their parent or carer, and ultimately finishing treatment as autonomous adults. Treatment success is highly dependent on patient co-operation. It is vital for patients to have as good an understanding as possible of what treatment entails, and whether or not it aligns with their expectations, before and during treatment. Method: This article reviews evidence of the effectiveness of orthodontic information to enable patient involvement in treatment regimens. It critiques the current provision of information with reference to research from the decision and behaviour sciences about how people make sense of information when making treatment decisions. Findings: Orthodontists provide a lot of verbal and written information about the 'facts' of treatment. This type of information is unlikely to facilitate patients' decisions about, or adherence with, treatments. There is a paucity of evidence describing how: (1) patients make sense of orthodontic problems and treatments, (2) parents manage decision making about their child's treatment, and (3) variation in information needs across the lifespan and treatment experience. Practice implications: We identified a set of questions to help service providers think critically about the effectiveness of their information provision. Further empirical research is needed to provide evidence to ensure the information included within orthodontic leaflets is relevant to patients and can be assimilated into their existing representations of the problem and treatment.