FACTORS ASSOCIATED WITH TERMINATION OF FIXED ORTHODONTIC TREATMENT BEFORE COMPLETION

Abstract

Premature discontinuation of fixed orthodontic treatment may occur before the agreed clinical objectives have been achieved and may compromise treatment continuity. This narrative literature review examines factors potentially associated with discontinuation among patients treated in private dental clinics. Literature published primarily between 2021 and 2026 was considered, with emphasis on orthodontic adherence, appointment attendance, treatment duration, socioeconomic circumstances, patient experience, communication, and retention. The available evidence indicates that adherence is multidimensional and that the factors influencing it are measured inconsistently across studies. Financial affordability, motivation and expectations, discomfort, treatment duration, missed appointments, family support, communication, and access to care are relevant domains for further investigation; However, evidence directly linking each factor to premature discontinuation of fixed appliances remains limited. Findings from studies of removable appliances or retainers should not be generalized uncritically to fixed orthodontic treatment. Private clinics may consider structured pretreatment education, transparent cost information, appointment reminders, systematic follow-up after missed visits, and documentation of discontinuation reasons. These measures should be evaluated using clearly defined clinical and service indicators. A more rigorous review with a reproducible search strategy and primary studies from Indonesia is needed to establish the consistency and magnitude of associations.