# Impact of Awareness, Motivation, and Willingness on the Perception of Age as a Barrier in Adult Orthodontic Treatment: A Questionnaire-Based Study

## TL;DR

This study explores how awareness, motivation, and willingness affect adult perceptions of age as a barrier to orthodontic treatment.

## Contribution

The study introduces a questionnaire-based approach to evaluate how age is perceived as a barrier in adult orthodontic treatment.

## Key findings

- Younger adults showed higher awareness of orthodontic treatment options compared to older adults.
- Cosmetic improvement was the primary motivation for orthodontic treatment among participants.
- Despite concerns about time, cost, and appearance, a majority of participants expressed willingness to undergo treatment.

## Abstract

Background and aim

Orthodontic treatment has traditionally been associated with children and adolescents, as growth potential and skeletal adaptability were believed to optimize treatment outcomes. Adult orthodontics, however, was often overlooked due to concerns about aesthetics, treatment duration, and limited awareness. With the advent of advanced appliances such as ceramic brackets, lingual braces, and clear aligners, alongside a growing emphasis on aesthetics and self-image, orthodontic care has become increasingly relevant for adults. Despite these advancements, perceptions of age as a barrier to treatment persist, highlighting the need to evaluate awareness, motivation, and willingness among adults seeking orthodontic care. This study aimed to assess how awareness, motivation, and willingness influence adult patients’ perceptions of age as a barrier to orthodontic treatment through a questionnaire-based survey.

Objectives

The objectives of the study were to determine whether varying levels of awareness about modern orthodontic treatment options affect perceptions of age as a limiting factor, to analyze how different types of motivation relate to the perceived influence of age on treatment decisions, and to evaluate the role of willingness to undergo orthodontic treatment in mitigating the perception of age as a barrier.

Materials and methods

A quantitative, cross-sectional study was conducted to explore adult perceptions of age as a barrier to orthodontic treatment. The structured questionnaire was validated through expert review, achieving adequate content validity. A total of 118 adult participants, divided into two age groups (below and above 40 years), completed the online questionnaire distributed via convenience sampling. Data were systematically cleaned and analyzed using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, NY, USA). Descriptive statistics summarized participant responses, and chi-square tests examined associations between categorical variables, with significance set at p < 0.05. Ethical approval was obtained from the Institutional Ethics Committee.

Results

Among 118 participants, 83 (56.8%) were over 40 years of age and 63 (43.2%) were under 40; 89 (61%) were male and 57 (39%) were female. Forty-nine (96.1%) participants under 40 years were aware of an orthodontist compared with 57 (85.1%) of those over 40 years. Age was perceived as a barrier by 51 (76.1%) older adults compared with 29 (56.8%) younger adults. Clear aligners were the most preferred treatment option, chosen by 62 (52%) participants across both groups, while cosmetic improvement was the primary motivation for 55 (~47%) participants. Time, cost, and appearance during treatment were the main obstacles. Despite these concerns, 34 (66.7%) younger participants and 42 (62.7%) older participants expressed interest in treatment, with a high willingness to invest, particularly among 43 (84.4%) younger participants.

Conclusions

Awareness and motivation for orthodontic treatment among adults are increasing, with younger adults showing greater knowledge and willingness to invest. Cosmetic enhancement remains the leading motivator, while time, cost, and aesthetic concerns during treatment are major barriers. Tailored educational strategies addressing age-related perceptions can encourage more adults to pursue orthodontic care, ultimately improving dental health, aesthetics, and self-confidence.