Senior orthodontic treatment: A comprehensive analysis of patient motivation, distribution, and treatment outcomes

Abstract

Objective: This study aimed to investigate the clinical characteristics of senior orthodontic patients. Methods: The cohort consisted of consecutive senior patients (age >= 60 years, n = 146) who visited the orthodontic clinic of a university hospital between 2020 and 2025. Host factors, treatment or referral motives, path of visit, orthodontic diagnosis and treatment acceptance rates, oral health status, severity of malocclusion, and treatment outcomes were evaluated using medical records and the modified discrepancy index (DI). Results: A higher proportion of females (65.1%) than males (34.9%) was observed. The primary treatment motives were improvement of anterior crowding or spacing (65.0%), followed by intrusion of supraerupted molars (9.6%) and space management for edentulous or hopeless sites (8.2%). Direct visits and referrals from other specialties accounted for 24.7% and 75.3% of cases, respectively. The prevalence of retaining 20 or more natural teeth was 94.9%. The orthodontic treatment acceptance rate was 70.9%, peaking at 84.6% among seniors who directly visited the orthodontic clinic for anterior alignment. Orthodontic treatment primarily focused on the anterior segment (83.6%), with a significant decrease in DI (P = 0.001). Conclusions: Seniors who visited the orthodontic clinic were predominantly females in their 60s with a high retention rate of natural teeth. Orthodontic consultations were driven not only by esthetic needs for anterior alignment, but also by recommended referrals as part of interdisciplinary care. The orthodontic treatment acceptance rate was higher when orthodontic goals aligned with the patient's intrinsic motivation for anterior alignment or edentulous space management. Orthodontic treatment in senior patients led to significant improvements in malocclusion.