Abstract
Background: Orthodontic treatment is widely recognised for its capacity to improve oral health, aesthetics and overall quality of life. In New Zealand, the demand for orthodontic care has increased, influenced by societal expectations and impact from social media. Orthodontic services are provided by specialist orthodontists, general dental practitioners (GDPs), and direct-to-consumer (DTC) companies. However, public understanding of the distinctions between these provider types, particularly regarding qualifications and scope of care, remains limited. Access, affordability, and provider transparency continue to present significant challenges.
Objective: The thesis aims to assess public awareness of various orthodontic providers in New Zealand, evaluate the ability of individuals to distinguish between specialist orthodontists, GDPs and DTC companies, and examine how demographic variables influence these perceptions. Additionally, the study explores public preferences in provider selection, barriers to seeking orthodontic care, and the key themes shaping perceptions of orthodontic treatment.
Methods: A cross-sectional online questionnaire was administered to 996 adults representative of the New Zealand population. The questionnaire included both quantitative and qualitative elements: closed-ended questions assessed awareness, perceptions, and preferences regarding provider qualifications and training, while open-ended responses were thematically analysed to identify principal themes and subthemes related to provider trust, access, cost and treatment outcomes.
Results: Quantitative findings revealed the public is generally aware of the differences of qualifications among orthodontic providers. While 77% of respondents recognized the advanced training required to become a specialist orthodontist, only 60.1% preferred treatment from a specialist orthodontist, and a small minority (1.6%) expressed interest in DTC services. Cost and provider qualifications were the most influential factors in provider selection, with female and older respondents more likely to favour specialist orthodontists. Qualitative analysis identified six principal themes, highlighting trust in specialist orthodontists, concerns about GDP transparency, geographic and workforce barriers to specialist access, and significant financial obstacles. Despite these challenges, respondents acknowledged the substantial physical, psychological, and social benefits of orthodontic treatment, although, there are gaps in public knowledge and awareness.
Conclusion: The findings from this study highlight the importance of increasing transparency around the roles and qualifications of orthodontic providers, as well as the need to improve access to care and make orthodontic treatment more affordable in New Zealand. Enhancing public education and strengthening regulation and policy are crucial steps to allow individuals to make informed choices.