Use this URL to cite or link to this record in EThOS:
Title: Studies investigating dietary changes during fixed orthodontic treatment and food advertisement content analysis
Author: Palermo, Daniel
ISNI:       0000 0004 7970 5037
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2019
Availability of Full Text:
Access from EThOS:
Access from Institution:
Aim: To use a qualitative research method to investigate adolescent patient perspectives of, and actual alterations in dietary intake in relation to concurrent fixed appliance treatment, and the patients' thoughts and reasoning behind such changes. Furthermore, it aims to identify whether any initial changes are maintained following acclimatisation with appliances. Design: A multi-centre qualitative study utilising semi-structured interviews. Diet diaries were also used to aid data generation during interviews. Setting: Liverpool University Dental Hospital and Halton General Hospital, both in Merseyside, UK. Subjects: Nine participants (eight females and one male) aged between 11-14 years old (mean 13.3 ± 1.2 years). Methods: A purposive sampling method was employed to recruit participants from two centres. Participants completed semi-structured interviews at two time points (T1 = six weeks into treatment, T2 = six months into treatment) to investigate developments over time. An iterative process was used, starting with a topic guide and then guided by the participants answers to focus interviews, and following data saturation, a thematic analytical process (framework analysis) was used to analyse the data with NVivo qualitative data analysis software. Two researchers independently coded the transcripts (DP, ADH). Diet diaries were required before and after appliance placement and also at 6 months. Results: A total of 17 interviews were conducted with 9 participants (1 participant refused to participate in the final interview and final diet diary), and 3 main themes were identified as 1) Aetiology of changes, 2) Adaption, and 3) Behaviour. Participants changed their dietary intake with fixed appliances for 5 main reason: pain, difficulties such as food trapping, concerns such as breakages, barriers such as time, and aesthetic motivations for changes. They adapted their diets via 5 fundamental methods: physical alterations such as cutting foods up further, restrictions, substitution, temporal changes i.e. in ability, and adjunct use such as interproximal brushes. Their dietary alterations were modified by 4 primary behaviours: social behaviours, learning behaviour through trial and error, habits and rountines, and attitude towards appliance wear. Conclusion: In the long term, reliance on modifications and adjuncts were generally reduced and some patients were able to return to their previous dietary habits. The results have elucidated the difficulties which our patients face with fixed appliances and this knowledge could be used in formal orthodontic training programmes and also to both motivate and educate patients using a more precise prediction of what they will experience, therefore facilitating the informed consent process. Such information also has implications for the dietary health of patients, their clinical management (such as reducing breakages), and therefore the cost of treatments.
Supervisor: Flannigan, Norah ; Higham, Susan ; Boyland, Emma ; Burnside, Girvan Sponsor: Not available
Qualification Name: Thesis (D.D.Sc.) Qualification Level: Doctoral