TY - JOUR
T1 - Issues in decision making
T2 - Should i have orthognathic surgery?
AU - Broder, Hillary L.
AU - Phillips, Ceib
AU - Kaminetzky, Sharon
N1 - Funding Information:
From the Department of Gen~'al Dentistry and Community Itealth, University of Medicine and Dentistry of New Jersey, Newark, NJ," the Department q[" Orthodontics, University of North Carolina, Chapd Hill, NC," and the University of Medicine and Dentistry of New Je~:~ey, Newark, NJ~ Supported in part by NIH NIDCR De 10028. Address correspondence to Hillary Brode~; PhD, MEd, 110 Bergen St, UMIJNJ-Nfl)S, Department of General Dentistry and Community Health, Newark, NJ 07103-2400. Copyright © 2000 by W.B. Saundera Company 1073-8746/00/0604-0008510. 00/0 doi: 10.1053/sodo. 2000.19073
PY - 2000
Y1 - 2000
N2 - This article reviews theoretical issues related to self-perception and decision making in patients with dentofacial disharmony. The decision-making process among patients seeking treatment for severe malocclusion is not well understood. Using phone interviews and chart audits, attitudes, behaviors, and demographics of 118 patients for whom orthognathic surgery was recommended within the past 2 years at 2 university-based dentofacial centers were examined. The mean age was similar (24.6 and 24.2 years) at both sites. Gender and ethnic distributions differed slightly. The northeast site (UMDNJ) had 50% females and 36% white, while the southeast site (UNC) had 77% females and 79% white. Treatment decisions were comparable across sites: approximately 60% of the patients chose orthognathic surgery, 30% chose orthodontics only, and 10% were undecided, waiting, or under observation. No perceptual differences across sites were observed. More than 50% of patients reported awareness of their condition since early adolescence: 11% indicated that someone else (eg, dentist) made them aware of their problem. Twenty percent said the timing for seeking care was related to financial security or schedule flexibility. Fifty percent reported aesthetics and function were their primary motives. Focus groups/interviews were held (orthognathic v orthodontics only; 2 groups per site). Emerging themes included the importance of patientdoctor communication and interpersonal skills (patient education, patience, and willingness to use "my words," take time to explain), the importance of the patients' readiness to change, and availability of resources such as social support and finances/insurance. Knowing someone who had completed treatment at their facility was a significant facilitator expressed across sites. No insurance and fear were relevant barriers in the orthodontic group only. The decision-making process is murtifaceted. Interpersonal communication skills (rapport, understanding), enabling resources (financial, social support), and psychosocial factors (stress, motivation) were primary factors in patients' decision making. Implications for clinicians are presented as well. (Semin Orthod 2000;6:249-258.)
AB - This article reviews theoretical issues related to self-perception and decision making in patients with dentofacial disharmony. The decision-making process among patients seeking treatment for severe malocclusion is not well understood. Using phone interviews and chart audits, attitudes, behaviors, and demographics of 118 patients for whom orthognathic surgery was recommended within the past 2 years at 2 university-based dentofacial centers were examined. The mean age was similar (24.6 and 24.2 years) at both sites. Gender and ethnic distributions differed slightly. The northeast site (UMDNJ) had 50% females and 36% white, while the southeast site (UNC) had 77% females and 79% white. Treatment decisions were comparable across sites: approximately 60% of the patients chose orthognathic surgery, 30% chose orthodontics only, and 10% were undecided, waiting, or under observation. No perceptual differences across sites were observed. More than 50% of patients reported awareness of their condition since early adolescence: 11% indicated that someone else (eg, dentist) made them aware of their problem. Twenty percent said the timing for seeking care was related to financial security or schedule flexibility. Fifty percent reported aesthetics and function were their primary motives. Focus groups/interviews were held (orthognathic v orthodontics only; 2 groups per site). Emerging themes included the importance of patientdoctor communication and interpersonal skills (patient education, patience, and willingness to use "my words," take time to explain), the importance of the patients' readiness to change, and availability of resources such as social support and finances/insurance. Knowing someone who had completed treatment at their facility was a significant facilitator expressed across sites. No insurance and fear were relevant barriers in the orthodontic group only. The decision-making process is murtifaceted. Interpersonal communication skills (rapport, understanding), enabling resources (financial, social support), and psychosocial factors (stress, motivation) were primary factors in patients' decision making. Implications for clinicians are presented as well. (Semin Orthod 2000;6:249-258.)
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U2 - 10.1053/sodo.2000.19073
DO - 10.1053/sodo.2000.19073
M3 - Article
AN - SCOPUS:73049109574
SN - 1073-8746
VL - 6
SP - 249
EP - 258
JO - Seminars in Orthodontics
JF - Seminars in Orthodontics
IS - 4
ER -