Aligner treatment: patient experience and influencing factors

Abstract Objectives To investigate patient experience of aligner treatment and associated influencing factors. Methods A total of 102 patients wearing Invisalign clear aligners (Align Technology, California, USA) were recruited in an initial treatment group (N = 62) and a refinement group (N = 40). Clinical diagnoses and treatment designs were collected. Data from a Visual Analogue Scale (VAS), a Self-Rating Anxiety Scale (SAS), and an Oral Health Impact Profile-14 (OHIP-14) were recorded at the commencement (Day 0, before wearing the first set of aligners) and during the first 7 days (Days 1–7) after wearing the first set of aligners. Results The patient experience of aligner treatment (i.e., pain, anxiety and quality of life) was poorest during the first two days (P < 0.05), and returned to a normal level within a week. The level of patient experience during the initial phase was greater than that during the later refinement phase (P < 0.01). During the initial treatment, the studied factors did not significantly influence the level of pain (VAS) (P > 0.05 for all) nor anxiety (SAS) (P > 0.10 for all); the number of teeth with optimised attachments significantly (R = 0.28, P = 0.03) influenced the quality of life (OHIP-14). During the refinement phase, the studied factors did not significantly influence the level of pain (VAS) (P > 0.09 for all); the number of aligner sets significantly influenced the level of anxiety (SAS) (R = 0.41, P < 0.01); the Index of Treatment Complexity Outcome and Need (ICON) (R = 0.44, P < 0.01) and whether elastics were required significantly influenced the quality of life (OHIP-14) (R = 0.349, P = 0.03). Conclusions Patient experience of aligner treatment was poorest during the first two days and improved over a week. Patient experience during the initial phase was generally worse than that during refinement. Four clinical factors were found to have an influence, including the number of teeth with optimised attachments, the number of aligner sets, the ICON, and the need for elastics.