Influence of treatment experience on awareness and re-selection of orthodontic appliances among adolescents receiving fixed orthodontic therapy

This study aimed to evaluate awareness, perceptions, and treatment preferences regarding alternative orthodontic appliances among adolescents undergoing fixed orthodontic treatment. This cross-sectional study included 302 adolescents (mean age: 16.57 ± 1.11 years; range, 15–18 years) receiving fixed orthodontic treatment with metal brackets at the Department of Orthodontics, Faculty of Dentistry, Ege University. Data were collected using a structured 15-item online questionnaire assessing treatment experiences, awareness of orthodontic options, perceived effectiveness, esthetic perceptions, and oral hygiene considerations. Descriptive statistics and chi-square tests were used, with Cramer’s V calculated to quantify effect sizes. Binary logistic regression was performed to evaluate whether gender and treatment duration were independently associated with treatment re-selection. Peers and social media were the primary sources of treatment-related information. Metal brackets were the most recognized modality, whereas lingual appliances were the least known. Difficulty eating and maintaining oral hygiene were the most frequently reported treatment-related challenges. Although clear aligners were associated with easier oral hygiene and fewer clinical visits, metal brackets were more frequently perceived as the most effective modality and remained the most commonly preferred option. Gender was significantly associated with treatment re-selection (χ 2 = 6.30, p = 0.012). After adjustment for treatment duration, male participants had higher odds of selecting clear aligners than female participants (adjusted odds ratio = 2.31, 95% confidence interval: 1.25–4.30; p = 0.008), whereas treatment duration was not independently associated with re-selection ( p = 0.421). Adolescents generally preferred the appliance with which they had direct treatment experience. Perceived effectiveness and gender-related differences were associated with treatment re-selection, whereas treatment duration was not. Because the study was conducted at a single center and included only adolescents treated with metal brackets, the findings should be interpreted primarily within this population. Providing balanced information on available treatment options before treatment initiation may support informed and patient-centered decision-making.