EFFECT OF BEHAVIOR-MODIFICATION ON PATIENT COMPLIANCE IN ORTHODONTICS

The purpose of this study was to evaluate the effects of a reward syst em for improving patient compliance in orthodontic treatment. The samp le consisted of 144 orthodontic patients (63 male, 81 female, average age 12.8 years), 6 to 12 months into their treatment. The sample was d ivided into above-average and below-average compliers, based on the or thodontic patient cooperation scale (OPCS). Each group was further div ided into three subgroups: (a) a control group, which received only st andard instructions; (b) an award group, which received compliance ins tructions and a written evaluation of compliance; and (c) a reward gro up, which received compliance instructions, a report card, and eligibi lity to receive rewards for adherent behavior. Two measurements of pat ient compliance were used: (1) the OPCS, which divided the sample into high and low compliers and was used to compare compliance before and after the 6-month experimental period; and (2) a clinical evaluation o f compliance that was based on oral hygiene, appointment punctuality, appliance wear, and appliance maintenance. Evaluations were completed at each monthly appointment. Average compliance scores of above-averag e compliers showed no significant improvement with rewards. The averag e scores of patients with below-average compliance did not improve sig nificantly. Only oral hygiene scores in the low compliance reward grou p were better than in the low compliance control group. Academic perfo rmance in school was found to be correlated (p<0.001) with compliance. Above-average compliers remained above average in their compliance. T he award/reward system may help motivate below-average compliers to co mply with prescribed instructions.