Effect of Attending Doctor Changes on Orthodontic Treatment Times and Results

Introduction: The objective of this study was to determine if there was any significant difference in treatment time or results due to varying levels of attending doctor coverage in the Loma Linda University (LLU) graduate orthodontics clinic. Methods and Materials: The main study group of 191 subjects was split into high, medium and low coverage groups by primary attending doctor coverage and then by original attending doctor coverage. Treatment times, treatment results, and other variables were evaluated for each of the groups. Treatment results were evaluated using UK Peer Assessment Rating (PAR) scores. A second study group (289 subjects) included an additional 98 subjects who met all of the inclusion criteria but lacked PAR scores. Statistical tests included one-way ANOVA and Pearson Correlation. Results: No statistically significant differences were found in treatment time (P ≥0.128) or results (P ≥0.052). There were no statistically significant differences in the mean scores for T1 PAR (P ≥0.056), T2 PAR (P ≥0.602), patient age at T1 (P ≥0.747), total appointments (P ≥0.128), missed appointments (P ≥0.050), or cancelled appointments (P ≥0.183). When the main subject group was divided into thirds by T1 PAR (low, medium, and high T1 PAR), there were statistically significant differences in percent change in PAR (P =0.000), treatment time (P =0.008), and the percent of primary attending coverage (P =0.001) between the low T1 PAR and the medium T1 PAR groups as well as between the low T1 PAR and high T1 PAR groups. In the second study group (n =289), T1 PAR was weakly correlated with treatment time (r=0.280) and with appointment number (r =0.248). Treatment time was strongly correlated with the number of appointments (r =0.822), and moderately correlated with missed appointments (r =0.333). Subjects who had treatment involving the extraction of permanent teeth had longer treatment times (P =0.003), but had no statistically significant differences in results (as measured by percent change in PAR score) (P =0.454). Conclusions: This study shows that variation in attending doctor coverage in the LLU graduate orthodontic clinic does not lengthen time of orthodontic treatment or reduce the quality of treatment results