Treatment Outcomes and Retention in Medicaid and Non-Medicaid Orthodontic Patients

Medicaid patients have been shown to miss more appointments and break more appliances than self-pay patients, indicating a greater tendency toward non-compliance. Lack of compliance during the post-treatment phase can be detrimental to retention. Objectives: The purpose of this study was to determine whether there is a difference in PAR score changes during and after orthodontic treatment between Medicaid and non-Medicaid patients. Methods: PAR scores were determined using study models of 43 Medicaid and 39 non-Medicaid patients before and at the end of active treatment and 24 Medicaid and 42 non-Medicaid patients at the end of treatment and an average of 13 months post-treatment. PAR scores generally reduce during treatment and will increase if relapse occurs. Rates of PAR score change during and after treatment were compared between Medicaid and non-Medicaid patients using t-tests. Results: The mean initial PAR score was greater in the Medicaid group (31.95 versus 23.28; p=0.001) while there was no significant difference found between groups for the end of treatment PAR scores (3.22 versus 2.93; p=0.700). The rates of PAR score improvement during treatment (14.07/year versus 12.14/year; p=0.196) and worsening after the removal of orthodontic appliances (2.04/year versus 2.91/year; p=0.592) were found not to differ between the two groups. Conclusion: It was found that the rate of PAR score improvement during treatment does not differ between Medicaid and non-Medicaid patients. During the post-treatment period, the rate of PAR score worsening was also found not to differ between the two groups.