Adherence to gynecological screening impacted by experienced orthodontic treatment in childhood
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Dental and cervical controls are two established screening programs in Germany. Compliance to orthodontic treatment in childhood is essential for dental health and one of the first health interventions that requires adherent behavior; therefore, it may be associated with participation in further screening programs in adulthood. However, it is not yet known whether early orthodontic treatment influences long-term screening adherence.
Using a questionnaire administered during a visit to a special dysplasia outpatient service, this case–control study evaluated women’s personal history of orthodontic care, long-term satisfaction, and dental and gynecological screening adherence. Oral health status and dental anxiety were assessed with validated instruments. Cases were categorized as cervical dysplasia only (S2) or cervical dysplasia with conization (S1) and compared to healthy controls with a normal PAP smear.
A study population of 233 participants included 132 cases and 101 controls. The control group had had orthodontic treatment during childhood more often than our study population with abnormal PAP smears (68.3% controls versus 56.1% subjects; p < 0.005). Orthodontic treatment was not associated with attending dental appointment or gynecological check-ups. However, women with an orthodontic treatment in childhood were significantly more often vaccinated against human papillomavirus than women without orthodontic treatment (p < 0.03).
Data suggest that women with orthodontic treatment in childhood are more conscious about prevention strategies in adulthood; therefore, compliant behavior might be established in childhood.
KeywordsCompliance Adherence Screening Orthodontic treatment
The authors thank Dr. Katja Weimer, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen and Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm for discussing the study planning and PD Dr. Phil. Peter Burgard, Children’s Hospital Heidelberg for inspiring discussions and critical reading as well as Kathy Taylor, IMBEI Mainz for critical reading. We thank all study participants and supporting colleagues from the participating University Hospitals supporting this study.
SS: Project development, data collection, data analysis, manuscript writing, manuscript editing, and supervision. JH: data collection, data management, data analysis, and manuscript editing. NR: patient recruitment, data analysis, and manuscript editing. TB: data analysis and manuscript editing. JB; JH: project development, patient recruitment, and manuscript editing. ND; CD: patient recruitment and manuscript editing. SS; JR: project development and manuscript editing. CS: project development, manuscript editing, and supervision. TCS: project development, manuscript writing, data analysis, and manuscript editing.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest by any author.
This study was approved by the local ethical committee (S-399/2015) and the ethical committee in Leipzig (091/17-lk) and performed in accordance with the Declaration of Helsinki.
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