The influence of the changing external environment and demographics on orthodontic practices (used on final report form)
Bibliographic record
Abstract
Purpose: To evaluate the factors that influence potential orthodontic patients’ choice between an orthodontist, general dentist (GPs), and direct-to-consumer (DTC) providers for their treatment. To evaluate orthodontists’ perceived impact from GPs and DTC providers providing orthodontic treatment and determine the adaptive changes they have made to the administration of their practices in the past ten years. Methods: An electronic survey was administered to 330 individuals among the general population of adults in Canada. Questions were designed to determine the participants’ demographic background, choice of orthodontic treatment provider, preferred mode of treatment, orthodontic issues they wished to address, and motivation for treatment. An electronic survey was also administered to 270 orthodontists in Canada and the United States. Questions were designed to determine the orthodontists’ demographic background, practice profile, perceived impact from non-specialist orthodontic providers, and recent changes to the administration of their practices. For both surveys, Pearson’s chi-squared tests were used to evaluate the factors influencing participants. Results: When laypersons were asked their preference in provider type, 49.4% of participants selected an orthodontist, 19.2% would follow the recommendation of their general dentist, 18.9% selected a general dentist, and 12.5% selected DTC providers. When asked their preference in mode of orthodontic treatment, 45.4% selected clear braces, 34.1% selected clear aligners, 14.3% selected metal braces, and 6.1% indicated they currently have no interest in orthodontic treatment. When orthodontists were asked if they perceived an impact from GPs providing orthodontic care, 67.7% indicated yes, 19.3% indicated no, and 13.0% were unsure. When orthodontists were asked if they perceived an impact from DTC providers offering orthodontic care, 40.1% indicated yes, 33.1% indicated no, and 26.8% were unsure. When orthodontists were asked if they have perceived a reduction in the number of referrals received from GPS in the past ten year 61.1% indicated yes, 23.3% indicated no, and 15.6% were unsure. When orthodontists were asked if they feel the need to make their practice more competitive 74.0% indicated yes, and 26.0% indicated no. Conclusions: Adults in Canada have a high preference for orthodontic treatment to be performed by orthodontists, and a subsequent lesser extent for GPs and DTC providers. Younger respondents were more likely to prefer metal braces, while older respondents were more likely to prefer clear braces. Preference for clear aligners is positively correlated to a larger community size. The perceived impact of GPs providing orthodontic care was greater than that of DTC providers. American orthodontists were significantly more likely than Canadian orthodontists to perceive an impact on their practice from DTC providers. Orthodontists have experienced a reduction in referrals from GPS and an increase in referred case difficulty. Orthodontists in Canada and those who are female have made significant changes to the administration of their practices in the last ten years.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".