Orthodontic Care for Underserved Patients: Professional Attitudes and Behavior of Orthodontic Residents and Orthodontists

Objectives: To explore whether orthodontic residents and orthodontists differ in their attitudes and behavior concerning the treatment of underserved patients and to investigate how background factors such as the providers' gender, ethnicity/race, and age affect these attitudes and behavior.

Materials And Methods: Survey data were collected from 135 residents in US and Canadian graduate orthodontic programs and from 568 active members of the American Association of Orthodontists. Attitudes toward various aspects of treating underserved patients were rated on a five-point scale, with 1 indicating the most negative attitude and 5 indicating the most positive.

Results: Orthodontic residents had more positive attitudes about treating poor patients (3.02 vs 1.99; P < .001), pro bono cases (3.87 vs. 3.45; P < .001), and patients with craniofacial anomalies (3.64 vs 3.01; P < .001) or mental retardation (3.13 vs 2.72; P < .001) than orthodontists. However, compared to orthodontists, lower percentages of residents intended to treat pro bono cases (73.5% vs 83%; P = .009) and patients with craniofacial anomalies (63.6% vs 82.9%; P < .001) or mental retardation (55% vs 81.5%; P < .001). The providers' gender did not have an effect on these attitudes and related behavior, while ethnicity/race and age of the providers were relevant.

Conclusions: Residents had more positive attitudes concerning the treatment of underserved patients than orthodontists. However, their behavioral intentions did not indicate an increased willingness to provide care for these patients.