What does this research mean for the field?

Adult orthodontic patients generally report positive treatment experiences and increased self-confidence despite common challenges like pain and gingival trauma, while users of direct-to-consumer clear aligners exhibit lower expectations for treatment outcomes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to understand orthodontic patients' experiences regarding their treatment and the challenges they faced.

May 18, 2026Open Access

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Patients' Treatment Experiences With Orthodontic Fixed Appliances, Clear Aligners and Direct‐to‐Consumer Clear Aligners: A Qualitative Study—Part II

SLSherry LeeUniversity of Otago BDBen K. DanielUniversity of Northern British Columbia LMLi MeiUniversity of Otago

Key Points

The study aims to understand orthodontic patients' experiences regarding their treatment and the challenges they faced.
Exploratory qualitative case study with 30 adults who completed treatment.
One-to-one, semi-structured interviews conducted and analyzed using NVivo software.
Three main themes identified: overall positive treatment experiences, challenges during treatment, and suggestions for improvements.
Participants reported increased self-confidence and positive interactions with their orthodontic team.
Common issues included gingival trauma and pain, with specific concerns noted in the direct-to-consumer clear aligner group.

Abstract

ABSTRACT Aim Understanding the orthodontic patient experience is critical in providing enhanced patient‐centred care. Qualitative methods were employed to gain insight into the factors shaping an individual's orthodontic treatment experience. Objectives (1) To understand orthodontic patient experience regarding treatment progress, interactions with their treating practitioner and treatment outcome. (2) To explore the challenges patients faced during treatment. Materials and Methods An exploratory qualitative case study was completed. Thirty adults who completed orthodontic treatment either with fixed appliances, clear aligners, or direct‐to‐consumer clear aligners were recruited. One‐to‐one, semi‐structured interviews were conducted, and the interview transcripts were analysed with NVivo software. Results Three principal themes were identified: patients' experiences with orthodontic treatment, challenges encountered during treatment, and suggested improvements to enhance the patient experience. Most participants reported positive experiences with orthodontic treatment. They also reported an increase in self‐confidence following treatment. Positive interactions with the orthodontic team elevated the overall experience. In addition, participants revealed their experience of pain and trauma to the soft tissues. A few participants suggested improvements to enhance their overall experience, including flexibility in appointment times and more emphasis on the importance of elastic wear. Conclusions Patient experience with orthodontic treatment in New Zealand was primarily positive, with few suggested improvements. There was increased self‐confidence and dental health awareness following treatment. Commonly encountered problems included gingival trauma, pain, and the effects of the COVID‐19 pandemic. Lower expectations of treatment outcomes emerged as a critical theme in the direct‐to‐consumer clear aligner group.

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Patients' Treatment Experiences With Orthodontic Fixed Appliances, Clear Aligners and Direct‐to‐Consumer Clear Aligners: A Qualitative Study—Part II

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