PSYCHOLOGICAL INTERVENTIONS TO IMPROVE ORTHODONTIC TREATMENT ADHERENCE AMONG ADOLESCENTS: A MINI REVIEW

Abstract

Adolescent adherence to orthodontic treatment is often suboptimal, leading to longer treatment times, increased appliance failures, and poorer clinical outcomes. Compliance is influenced by developmental, motivational, cognitive–emotional, and family–social factors. This narrative mini-review summarizes recent evidence on psychological interventions designed to enhance adherence in children and adolescents using fixed or removable orthodontic devices. A targeted literature search of PubMed, Scopus, and Google Scholar was conducted to identify relevant studies published between 2010 and 2025. Studies related to adherence outcomes such as appliance wear time, oral hygiene, appointment attendance, motivation, and self-efficacy, as well as concepts related to orthodontic adherence with specific intervention strategies, including motivational interviewing (MI), cognitive behavioral therapy (CBT), digital reminders or telemonitoring, and family or social support, are reviewed. MI and CBT demonstrated promising improvements, strengthening intrinsic motivation, self-efficacy, and self-regulation. Digital supports provided modest, scalable gains, though engagement often declined over time, while family- and peer-focused interventions showed promise but remain under-evaluated. This review highlights gaps in standardized adherence outcome measures and limited evidence for combined or multi-tiered interventions. Its added value lies in synthesizing current psychological strategies, identifying research gaps, and providing practical guidance for optimizing adolescent orthodontic adherence. Overall, a stepped-care approach combining universal digital support with targeted psychological interventions and structured family involvement appears most practical. Future research should standardize outcome measures and evaluate combined, cost-effective strategies to optimize adolescent orthodontic adherence.