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Study establishes patient motivations for seeking clear aligner therapy across five European countries

A retrospective study has compared the demographic background of patients seeking clear aligner therapy between five European countries and found many similarities but also a number of socio-economic, oral health and age factors that differed widely by country. (Image: Vladimir Trynkalo/Shutterstock)

BERLIN, Germany: There is increasing demand for CAT for mild to moderate malocclusion in adults. However, there is a lack of information on the motivations of adults seeking CAT, as well as their socio-demographic information and oral health status, across countries. Researchers in Germany compared this in adult patients in Austria, Germany, Italy, Poland and Spain to provide clinicians with country-specific information for their treatment selection and planning. They found that adult patients who are dissatisfied with their appearance and who generally have good oral health are more likely to seek CAT.

The main demographic findings were that adults seeking CAT were mostly younger than 35 and female. Patients in Italy and Germany were the youngest, the majority being in the 18- to 35-year-old age group. The highest proportion of men seeking CAT was in Italy and the lowest in Poland.

When it came to motivation for seeking CAT, crowding was the top reason, but this was more frequent among the Spanish and Italian patients, and tooth spacing was a more common reason among the German and Austrian patients. Men more often gave spacing as their primary motive, and women more frequently indicated crowding as their reason for pursuing CAT.

Certain trends in oral health status were also noted. Patients older than 55 had a higher prevalence of periodontal disease than their younger counterparts, who were more likely to have untreated caries. Patients in Spain had a higher rate of untreated caries and of periodontitis and had a significantly higher rate of missing teeth. Poland, however, had the highest number of patients missing more than five teeth.

The researchers noted that the patients had an overall better quality of oral health than the general population, likely because they are more concerned about their oral health as evidenced by seeking CAT. As the treatment is mostly an out-of-pocket expense, the researchers also noted that the socio-economic status of the patients likely differs from that of the general population, giving greater access to oral care and oral health literacy. Because spending on healthcare in countries such as Spain and Poland is lower, the researchers drew the conclusion that this, combined with the nature of healthcare systems in each country (such as more privatised healthcare in Spain), was reflected in the patients’ overall oral health status.

The team used anonymised data from Berlin-based CAT provider DrSmile to retroactively evaluate dental records, socio-demographic information, general health history, self-reported motivations for seeking CAT, data on caries, missing teeth, periodontal disease and craniomandibular dysfunction, and other evidence to contraindicate CAT as an appropriate therapy. The records from DrSmile were compiled from over 500 associated practitioners across Europe. The resulting sample size was 15,015 patients.

The study, titled “Who seeks clear aligner therapy? A European cross-national real-world data analysis”, was published in the January 2023 issue of Life.

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