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Factors associated with discontinued and abandoned treatment in primary care orthodontic practice part 2: a practice-based study

From Volume 10, Issue 2, April 2017 | Pages 52-58

Authors

Neil I McDougall

BDS(Dund), MSc(Dent Sci)(Glas)

DwSI in Orthodontics, Wearside Orthodontic Centre, Frederick Street, Sunderland, Tyne and Wear

Articles by Neil I McDougall

Andrea Sherriff

BSc(Hons), PhD

Senior Lecturer in Statistics, Glasgow Dental Hospital and School, Sauchiehall Street, Glasgow G2 3JZ, UK

Articles by Andrea Sherriff

Abstract

Discontinued and abandoned cases are an undesirable outcome of orthodontic treatment. Several patient and treatment variables have been identified as being associated with this treatment risk. The second paper of this two part series will describe a study that attempts to identify specific factors that are implicated in discontinued treatment within a specialist orthodontic practice.

CPD/Clinical Relevance: Discontinued treatment is an unwelcome risk of orthodontic practice. By having a better understanding of the factors that may be relevant, clinicians can be more careful in their selection and management of patients suited to the demands imposed by orthodontic treatment.

Article

The factors that are associated with discontinued and abandoned treatment are many and complex, and have been detailed in the first paper in this two part series. As the literature is sometimes conflicting and inconclusive, it would seem sensible to explore factors that may be relevant within a clinician's own practice environment. Specialist orthodontic practices provide a large pool of patients that allow for the investigation of variables that may be implicated in such cases. A study of completed and discontinued cases within an orthodontic practice in Northern England was conducted in order to identify factors that are associated with abandoned treatment.

The data source for this study were the patient records of two orthodontic specialists and an orthodontic clinical assistant working in a specialist orthodontic practice in Sunderland, Tyne and Wear, UK. The NHS in England and Wales recognizes four different treatment completion codes:

For the purpose of the study, the three termination codes were considered under the one umbrella of failed treatment. The schedules of six consecutive months, May to October 2014, for each of the three clinicians, were used to identify every patient that had either completed or failed his/her treatment. Of the 438 patients identified, one case was excluded as it was a transfer case from another practice, giving a total of 437 cases.

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