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Who’s getting braces in Cuyahoga County? Case researchers survey students, find out

Braces imageIf the dentist recommends braces, 71 percent of Cuyahoga County’s youth will follow the doctor’s advice and get them, according to results of a survey from the department of orthodontics at the Case Western Reserve University School of Dental Medicine. The researchers also found that higher the family’s social economic status, the more likely the students would seek orthodontic care—and in some instances seek treatment even without a dentist’s recommendation.

Mark Hans, chair of the orthodontics department at the Case dental school and the principal investigator on the study, “Orthodontic Care in Cuyahoga County, Ohio: Who provides orthodontic treatment and who do they treat,”—set out to find out who recommended orthodontic care, who got it and who was providing it.

Prior studies have used third party reporting to derive statistics about orthodontic care. Case researchers went directly to student consumers to gather information.

Some 2,808 tenth grade public and parochial students were given a 12-question survey during their English classes at 17 suburban and three inner-city high schools. In addition to answering questions, all students marked on a 100 mm scale their feelings about how much they liked their teeth and smile, with student treated with braces asked additionally to provide before and after reactions.

Most (84 percent) of the students had visited the dentist within the past year of being surveyed.

In Ohio, a licensed dentist can provide orthodontic care but cannot limit the private practice to the specialty.

Past reports in orthodontic literature indicate between 20-50 percent of orthodontic treatment is done by the general dentists with no advance university training in the dental specialty for the nearly 40 percent of America’s youth that require some form of orthodontic care.

Case researchers found that the 37 percent, who had braces, recommended for orthodontic care received treatment from 171 providers, with 87 percent seeking care from an orthodontists and only 11 percent by their general dentist and less than one percent by a pediatric dentist.

“We concluded that orthodontic specialist provided the major of orthodontic services for these Cuyahoga County high school students and visiting a general dentist was positively associated with utilization of orthodontic services,” wrote the researchers.

What the researchers found “predictable and surprising” was that the data continued to support the popular views that “braces are a quality of life service with status symbol appeal.”

“If the student wants braces and the family can afford them, they might still be treated even without a dental referral,” said the researchers. They found the utilization rate at some affluent suburban schools approached 70 percent.

The students surveyed were from Beachwood, Berea, Brooklyn, Cleveland, Cleveland Heights, Cuyahoga Heights, East Cleveland, Fairview, Lakewood, Lutheran East and West, Mid Park, North Royalton, Olmsted Falls, Orange, Richmond Heights, Solon, Strongsville and Westlake.

The study was supported by the American Association of Orthodontists Foundation. The research project’s collaborators were Yumi Abei and Suchitra Nelson from the Case dental school; Lowell Bernard from the Case School of Medicine; and two former residents in the Case orthodontic training program Nhat Le, an orthodontist in Ft. Lauderdale, Fla., and Vidya Armogan, who now has an orthodontic office in Barbados.


About Case Western Reserve University

Case is among the nation's leading research institutions. Founded in 1826 and shaped by the unique merger of the Case Institute of Technology and Western Reserve University, Case is distinguished by its strengths in education, research, service, and experiential learning. Located in Cleveland, Case offers nationally recognized programs in the Arts and Sciences, Dental Medicine, Engineering, Law, Management, Medicine, Nursing, and Social Work.