{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:09:35Z","timestamp":1787724575866,"version":"build-2784847793"},"reference-count":56,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the predictors of willingness to uptake orthodontic treatment and to explore the reasons for postponing its initiation in young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Students, aged 18\u201330 years old, were randomly approached at the Central Library of the Aristotle University of Thessaloniki Campus and invited to complete the study tool anonymously and voluntarily. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the esthetic component of the Index of Orthodontic Treatment Need (IOTN-AC) were used to evaluate students\u2019 psychosocial impact of dental esthetics and severity of malocclusion, whereas the rationale for postponing the initiation of orthodontic treatment was recorded through an open-ended question, analyzed using thematic content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 270 students, 55.2% female, participated. The single statistically significant factor predicting willingness to uptake orthodontic treatment was the PIDAQ-Psychological Impact subscale (OR: 1.24; 95% CI: 1.11\u20131.37,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Gender and age were not associated with willingness to pursue treatment. Seven main themes emerged regarding reasons for postponement: fear of the procedure, embarrassment regarding appearance during treatment, low prioritization of esthetics, insufficient information, high cost of treatment, prolonged duration of treatment, and residential mobility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that psychological impact of dental esthetics constitutes the main driver to pursue orthodontic treatment. A patient-centered orthodontic approach should address the possible barriers to its initiation. Increasing young adults\u2019 oral health literacy could be key in empowering them to make better informed decisions regarding their oral health-related quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/070724-541.1","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T19:02:32Z","timestamp":1739473352000},"page":"290-295","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of willingness to uptake orthodontic treatment and qualitative insights into the reasons for its postponement in young adults"],"prefix":"10.2319","volume":"95","author":[{"given":"Chrysanthi","family":"Anagnostou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis P.","family":"Zogakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilias","family":"Pagkozidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Dardavesis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Matiakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoi","family":"Tsimtsiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-95-3-290-b01","series-title":"Eur J Orthod","first-page":"507","article-title":"Dental aesthetics, self-awareness, and oral health-related quality of life in young adults","volume":"26","author":"Klages","year":"2004","unstructured":"Klages U,\nBruckner A,\nZentner A. Dental aesthetics, self-awareness, and oral health-related quality of life in young adults. Eur J Orthod. 2004;26:507\u2013514. doi:10.1093\/ejo\/26.5.507"},{"key":"i1945-7103-95-3-290-b02","series-title":"J Int Oral Health","first-page":"27","article-title":"Dental caries and its relationship to malocclusion in permanent dentition among 12\u201315 year old school going children","volume":"6","author":"Gaikwad","year":"2014","unstructured":"Gaikwad SS,\nGheware A,\nKamatagi L,\nPasumarthy S,\nPawar V,\nFatangare M. Dental caries and its relationship to malocclusion in permanent dentition among 12\u201315 year old school going children. J Int Oral Health. 2014;6:27\u201330."},{"key":"i1945-7103-95-3-290-b03","series-title":"Nat Rev Dis Primers","first-page":"17038","article-title":"Periodontal diseases","volume":"3","author":"Kinane","year":"2017","unstructured":"Kinane DF,\nStathopoulou PG,\nPapapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:17038. doi:10.1038\/nrdp.2017.38"},{"key":"i1945-7103-95-3-290-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"384","article-title":"Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population","volume":"149","author":"Choi","year":"2016","unstructured":"Choi SH,\nKim JS,\nCha JY,\nHwang CJ. Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population. Am J Orthod Dentofacial Orthop. 2016;149:384\u2013390. doi:10.1016\/j.ajodo.2015.08.019"},{"key":"i1945-7103-95-3-290-b05","series-title":"Eur J Orthod","first-page":"103","article-title":"Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults","volume":"28","author":"Klages","year":"2006","unstructured":"Klages U,\nClaus N,\nWehrbein H,\nZentner A. 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Br J Orthod. 1996;23:331\u2013334. doi:10.1179\/bjo.23.4.331"},{"key":"i1945-7103-95-3-290-b08","series-title":"Eur J Orthod","first-page":"271","article-title":"Lay attitudes to dental appearance and need for orthodontic treatment","volume":"19","author":"Stenvik","year":"1997","unstructured":"Stenvik A,\nEspeland L,\nLinge BO,\nLinge L. Lay attitudes to dental appearance and need for orthodontic treatment. Eur J Orthod. 1997;19:271\u2013277. doi:10.1093\/ejo\/19.3.271"},{"key":"i1945-7103-95-3-290-b09","series-title":"Angle Orthod","first-page":"224","article-title":"Desire for orthodontic treatment and associated factors among adolescents in Southern Brazil","volume":"85","author":"Feldens","year":"2015","unstructured":"Feldens CA,\nNakamura EK,\nTessarollo, FR,\nCloss LQ. Desire for orthodontic treatment and associated factors among adolescents in Southern Brazil. 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Eur J Orthod. 1996;18:349\u2013357. doi:10.1093\/ejo\/18.4.349"},{"key":"i1945-7103-95-3-290-b22","series-title":"Dental Press J Orthod","first-page":"81","article-title":"Assessment of motivation, expectations and satisfaction of adult patients submitted to orthodontic treatment","volume":"18","author":"Oliveira","year":"2013","unstructured":"Oliveira PG,\nTavares RR,\nFreitas JC. Assessment of motivation, expectations and satisfaction of adult patients submitted to orthodontic treatment. Dental Press J Orthod. 2013;18:81\u201387. doi:10.1590\/s2176-94512013000200018"},{"key":"i1945-7103-95-3-290-b23","series-title":"Br Dent J","first-page":"E15","article-title":"Inequality in uptake of orthodontic services","volume":"202","author":"Drugan","year":"2007","unstructured":"Drugan CS,\nHamilton S,\nNaqvi H,\nBoyles JR. Inequality in uptake of orthodontic services. 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Am J Orthod Dentofacial Orthop. 1996;110:197\u2013205. doi:10.1016\/s0889-5406(96)70109-9"},{"key":"i1945-7103-95-3-290-b26","series-title":"Am J Orthod Dentofacial Orthop","first-page":"e263","article-title":"Assessment of motivation and psychological characteristics of adult orthodontic patients","volume":"140","author":"Pabari","year":"2011","unstructured":"Pabari S,\nMoles DR,\nCunningham SJ. Assessment of motivation and psychological characteristics of adult orthodontic patients. Am J Orthod Dentofacial Orthop. 2011;140:e263\u2013e272. doi:10.1016\/j.ajodo.2011.06.022"},{"key":"i1945-7103-95-3-290-b27","series-title":"Dent Update","article-title":"An update in adult orthodontics","volume":"34","author":"Scott","year":"2007","unstructured":"Scott P,\nFleming P,\nDiBiase A. An update in adult orthodontics. 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Nat Rev Dis Primers. 2017;3:17038. doi:10.1038\/nrdp.2017.38"},{"key":"i1945-7103-95-3-290-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"384","article-title":"Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population","volume":"149","author":"Choi","year":"2016","unstructured":"Choi SH,\nKim JS,\nCha JY,\nHwang CJ. Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population. Am J Orthod Dentofacial Orthop. 2016;149:384\u2013390. doi:10.1016\/j.ajodo.2015.08.019"},{"key":"i1945-7103-95-3-290-b05","series-title":"Eur J Orthod","first-page":"103","article-title":"Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults","volume":"28","author":"Klages","year":"2006","unstructured":"Klages U,\nClaus N,\nWehrbein H,\nZentner A. 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Angle Orthod. 2015;85:224\u2013232. doi:10.2319\/021014-105.1"},{"key":"i1945-7103-95-3-290-b10","series-title":"Br J Orthod","first-page":"133","article-title":"An investigation into factors which may deter patients from undergoing orthodontic treatment","volume":"12","author":"Gosney","year":"1985","unstructured":"Gosney MB. An investigation into factors which may deter patients from undergoing orthodontic treatment. Br J Orthod. 1985;12:133\u2013138. doi:10.1179\/bjo.12.3.133"},{"key":"i1945-7103-95-3-290-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"704","article-title":"What factors predict the uptake of orthodontic treatment among adults","volume":"147","author":"Johal","year":"2015","unstructured":"Johal A,\nJoury E. What factors predict the uptake of orthodontic treatment among adults? 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