Dentist’s knowledge and attitude towards using Invisalign in orthodontic treatment

M Zakirulla^1*, Rayed Ahmed M Al Shehre², Abdulaziz M Al Hosainah², Hussein Mahdi A Alamer², Nawaf Abdulrahim A Alhamood², Demah Saleh M Alharthi², Aliya Salem Alqhatani², Faisal Mubarak H Alqahtani³, Abdulmajeed Ali Alaamri⁴, Saad Awdah Aldail⁴, Aisha Ali M Alammari², Ahmad Mohammed M Alqahtani⁵, Haitham Mohammed Alsalem⁵ and Naif M Alzahrani⁴

^*Correspondence: M Zakirulla, Department of Pediatric Dentistry & Orthodontic Sciences, College of Dentistry, King Khalid university, Saudi Arabia, Email:

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Introduction

A malocclusion is defined as an irregularity of one's teeth or a mal relationship of the dental arches beyond the number of what is accepted as normal. Malocclusion teeth can cause esthetic and psychosocial problems [1]. Malocclusion could also lead to problems of the oral cavity (traumatic bite and cheek bite), and it can also be one of the factors for rejection during marriage proposals. The uptake of orthodontic treatment is influenced by the need to look attractive, self-esteem, and self-perception of dental appearance [2]. Malocclusion is currently just next to the other oral health such as dental caries, periodontal diseases and problems. It's been established to be the third most typical oral health problem, which are results in various environmental and genetic elements [3]. Prevalence of malocclusion was 62.3%, 28.4%, and 9.3% respectively seen among 15- to 17-year-old children that were reported in earlier research done in Aseer region [4]. Malocclusion affects esthetics, the physical, psychological, and social life of an individual. It is vital to take the orthodontic treatment, which mainly depends upon knowledge and knowing of the person towards orthodontic treatment.

Early orthodontic treatment is a precursor to the original therapy protocol in which braces and bands which are placed on permanent teeth. This early treatment starts with during either primary or transitional teeth to intercept malocclusion in a manner that ultimately leads to a better and more stable result than if treatment were initiated later. Many doctors offering early treatment aim to decrease the time and complexity of treating fixed devices [5]. The clinicians who want to use Clear aligners (CA) to deal with their patients have to depend on their own clinical experience, expert opinions, and limited published evidence-based results [6]. CA could be provided by both orthodontists and general dentists; however, some significant differences were evinced between your two groups in the usage of a CA treatment within their clinical practice [7].

Clear orthodontic aligners are used to straighten a patient’s teeth minus the use of wires and brackets of traditional braces. They contain a sequence of clear, removable trays that fit over the teeth to straighten them. These trays should be worn by the patient for a specified period of time, usually around 20h a day for 2 weeks prior to the affected person can progress to the next tray [8]. Clear orthodontic aligners are ideal for patients with mild or moderate crowding or minor spacing issues but can't be appropriate for sufferers with severe crowding or spacing. Since the aligners can correct just a mild malocclusion, so patients with severe under bites, overbites, or cross bites may necessitate more complex orthodontic treatment. Invisalign system also boasts increased hygiene over traditional braces. Since this appliance is removable, patients can maintain oral hygiene because they usually would, decrease the prospects of potential discoloration and decay that regularly occur with conventional braces. Food and drink choices are less strict, as well. Patients who would like to eat sticky candy can do so after removing their clear Invisalign retainer [9]. Therefore, the aim of the present study is to assess the knowledge, attitude, and perception among dentists toward using Invisalign in orthodontic treatment.

Materials and Methods

A cross-sectional study was carried out on a total number of 300 dental surgeons (Male=150; Female=150) were participated in the study with age ranges from 20- to 55-year-old to know the knowledge, attitude, and perception among dentist's toward using Invisalign in orthodontic treatment. Written informed consent was obtained from the participants after explaining to them the purpose of the study. The sampling method included in this study was simple random sampling method. Ethical approval for performing the survey was obtained from the Scientific Research Committee of King Khalid University, College of Dentistry.

The questions were designed and circulated through online google forms among dental surgeons practicing in the Abha region of Saudi Arabia. The questionnaire was formulated, which comprised of two parts: The first portion included the questions related to the demographic information of participants, such as age, gender, year of experience, and level of education. The other part of the questionnaire comprised of 10 questions with ‘yes’ and ‘no’ pattern, and the multiplechoice question was prepared, and piloting was done. Questionnaire was tested for reliability and validity. A self-administered structured questionnaire originated and was tested among a comfort sample of 20 dental surgeons. These were interviewed to get feedback on the entire acceptability of the study when it comes to length and language clearness; in accordance with their feedback, the queries were corrected. Validity was furthermore assessed before the start of research. Both descriptive and analytical statistical dimensions were used to describe the primary variables by SPSS 18 (IBM Corporation, Armonk, NY, USA) software.

Results

A total of 300 (150 males and 150 females) dental students, general dentists, and specialists responded to the questionnaire. 77% of study subjects were of 20- 30 years, 18% were of 31-40 years, 4% were of 41-50 years, and 1% were >50 years. The distribution of study samples according to a level of education was shown in Figure 1. Knowledge and attitude among dentists towards using Invisalign in orthodontic treatment were shown in Table 1. The majority of participants, 285 (95%) were agreed that they have visited a dentist for orthodontic treatment. 110 (58%) and 66 (35%) said that they have undergone orthodontic treatment with fixed and Invisalign respectively. Majority of dentists got to know regarding Invisalign are from family (41%) sources. 228 (76%) participants said they know the translucent try (Invisalign). When question was asked regarding whether Invisalign better than traditional braces? the distribution of results shown in Figure 2.

Figure 1. Distribution of study sample according to level of education.

Figure 2. Is Invisalign better than traditional braces?

Table 1: Knowledge of dentists towards using Invisalign in orthodontic treatment.

Discussions

In recent years, the use of clear dental aligners has significantly grown in popularity, with more and more advertisements promoting it and garnering public exposure [10]. This study examined the dentist’s knowledge regarding Invisalign treatment and found that 76% of the respondents were familiar with Invisalign aligners. This figure was higher than that was previously found in a report on direct-to-consumer aligners (45%) [11]. The insight into the type of malocclusions and patients demanding for CA in the clinical practice was an original point of this survey, and it was underlined which increasingly focus on the esthetic appearance of adults and the importance of advertising and marketing in the great interest in invisible orthodontic treatment with CA. Given the growing patient interest in clear aligner treatment, health providers must strive to deliver credible and evidence-based information to patients [12]. The present study found that participants had concepts about the Invisalign clear aligner treatment, with most respondents (58%) believing that such devices were generally better than traditional braces. Clear aligners are often promoted as an equally effective orthodontic treatment modality to traditional fixed appliances. Nonetheless, the current evidence-based research suggests that clear-aligner treatment is more suitable for mild-to-moderate malocclusions, whereas traditional braces remain the gold standard treatment choice in orthodontics [13].

Most respondents in the present study (71%) believed that Invisalign treatment produces superior results to traditional braces. Very few studies have employed occlusal indices to measure the quality of treatment outcomes with clear aligners. Previous studies showed that over 80% of orthodontic patients use social media, with the most popular platforms being Facebook and Instagram [14,15]. In addition, Hanzell, et al. found that only 6.7% of participants use social media to seek orthodontic information, whereas Siddiqui et al. found this figure to be 30% [15]. The present study found that around 32% of the participants use social media to seek orthodontic information. The differences between these findings and those of the previous studies may be due to the research time frame, as well as participants’ ages and ethnicity. Moreover, research participants in this study were selected through social media sites, and thus their social media use may be over-represented. Only 38% of our study participants reported that Invisalign was a better treatment option than traditional braces. A study conducted by Miller et al. (2007) demonstrated substantial variances between the two treatment types in how they influence patients during the initial days of treatment [16].

The Invisalign patient's general quality of life was superior to that of the fixed orthodontics patients. Several aspects affect the choice of suitable orthodontic equipment. The outcomes of this investigation provide the orthodontist and the patient supplementary evidence that can be taken into account when selecting appliance variety. Main reason why adult patients choose clear aligners is that they appear invisible. This helps conceal the fact that the patient is undergoing orthodontic treatment, which can be embarrassing for some adults [17]. Clear aligners also help hide existing gaps, another esthetic benefit. Unlike traditional braces, patients prefer to remove their clear aligners when they eat and brush their teeth [18]. This allows them to continue their usual hygiene routine of brushing and flossing. Overall, these survey research participants indicated satisfaction and positive outcomes.

Conclusion

A questionnaire study evaluated the awareness of orthodontic aligners among dentists of Abha, Saudi Arabia by putting forward 10 questions and the responses were noted. From our study, we conclude that though the population was moderately aware of the Invisalign. Most participants perceived Invisalign treatment to be generally better, quicker as compared to traditional appliance. The main part of respondents not currently using clear aligners in their practice was willing to use them in the future.

Conflicts of Interest

The authors declare that there is no conflict of interest regarding the publication of this article.

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