Patient Perceptions and Perceived Barriers to Orthodontic Treatment: Correlation with Screening-Based Orthodontic Needs and Socioeconomic Status in a Central Government Hospital

Objectives: Many dental patients report perceived barriers that discourage them from seeking orthodontic treatment, even when clinical needs are present. In contemporary practice, barriers such as high cost, limited availability, or prolonged treatment may be less substantial than commonly assumed, yet patients continue to perceive them as significant. Furthermore, even individuals with no or only mild orthodontic needs may hold perceptions that influence the attitudes and decisions of others. This study assessed perceptions and perceived barriers toward orthodontic treatment among dental patients and examined their correlation with screening-based orthodontic treatment needs and socioeconomic status. Methods: A cross-sectional study was conducted among 125 patients attending the Outpatient Department at CDER, AIIMS, New Delhi, for reasons other than orthodontic treatment. Patients previously diagnosed with orthodontic needs but not initiated on treatment were also included. Perceptions and barriers were assessed using a structured questionnaire, and exploratory factor analysis grouped items into five domains: knowledge and awareness, attitudes and perceptions, psychological and cultural, logistical and accessibility, and financial and socioeconomic. Orthodontic needs were screened using a simplified Orthodontic Aesthetic Index. SES was measured using the Kuppuswamy scale. Data were analyzed using descriptive and inferential statistics, with statistical significance set at p < 0.05. Results: Financial concerns, long treatment duration, fear of pain, and logistical difficulties were the most frequently reported barriers. Screening identified orthodontic treatment needs ranging from none to definite requirement. Significant correlations revealed that patients with greater orthodontic needs and lower SES more often reported psychological and cultural barriers. Conclusions: Perceived barriers to orthodontic care remain prevalent, even when treatment is accessible. Associations with orthodontic need and SES suggest that disparities in perception continue to shape treatment decisions. Addressing these misperceptions through SES-sensitive and perception-focused strategies is essential to improve acceptance and utilization of orthodontic services.