Saudi Arabians prefer lingual brackets and clear aligners

Dental Tribune International

Mon. 6. January 2020

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JEDDAH, Saudi Arabia: Adult consumers prefer lingual brackets and clear aligners over traditional fixed appliances, according to a cross-sectional survey conducted by researchers at King Abdulaziz University in Jeddah. The study of the perceptions of adult laypersons in Saudi Arabia found that consumers were willing to pay more for these more aesthetically pleasing treatments when it came to their own orthodontic care but not for the orthodontic care of their children.

In the survey, 199 Saudi adults (55% of whom were female) were asked to evaluate images of adults wearing a variety of orthodontic appliances. Participants were shown images of different appliances and asked to rate them on attractiveness, acceptability of having them placed on both themselves and their children, order of preference, and economic value. The appliances pictured were metal brackets with either colourless or coloured o-ties, self-ligating metal brackets, hybrid half-metal and half-ceramic brackets, ceramic brackets, self-ligating ceramic brackets, shaped brackets, and clear aligner trays. Lingual brackets were shown by pictures of subjects who had no visible appliances, together with an inside view of the mouth.

Participants in the study rated clear aligners and lingual brackets as the most attractive of the treatment options. Coloured o-tied brackets and shaped brackets were rated as the least attractive.

A clear majority (86.9%) said that clear aligners were the most acceptable of the pictured appliances for placing on themselves, and that clear aligners were also the preferred treatment option for the participants’ children (84.9%). The least acceptable for placement were shaped brackets: only 24.1% of participants rated these as the most acceptable option to have placed for their own treatment, and only 36.2% rated them as the most acceptable option to have placed on their children.

The least acceptable of the appliances were coloured o-tied brackets, at 4%.

When it came to cost, which the authors identified as a factor in participants’ responses, the majority said they were willing to pay more for orthodontic treatment using the aesthetically preferred clear aligners and lingual brackets, but that they were not willing to pay more to have these appliances placed on their children.

In discussing the findings, the authors wrote: “Our findings showed that our participants were willing to pay more to have aesthetically pleasing, least visible appliances placed for them rather than the standard metal braces.” They speculated that this willingness to pay could indicate the participants’ perception of the impact of orthodontic appliances on aesthetic appearance and possibly how they are perceived in social situations.

They added that participants’ unwillingness to pay more for what they had identified as the more aesthetically pleasing treatment option for their children was perhaps due to a perceived lower level of judgement being placed on children by themselves and their peers. “[The results] may mean that parents perceive that it is not necessary for their children to have the most aesthetically pleasing appliance. Parents may feel that their children will not suffer from negative self-perception or judgement in social situations as it is perhaps more common to see children wearing visible braces than adults,” the authors wrote.

The study, titled “Adult perceptions of different orthodontic appliances”, was published online on 13 December 2019 in Patient Preference and Adherence.

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