Date of Graduation


Document Type


Degree Type



School of Dentistry



Committee Chair

Chris Martin.


Orthodontic intervention enhances not only esthetics and psychosocial health, but also improves the function of the human dentition. Many insurance programs now offer orthodontic coverage; however, proper adherence and good oral hygiene habits are poor among those Appalachian individuals undergoing orthodontic care. This research study was conducted to determine the contributing factors in poor orthodontic compliance in Appalachia. Investigators completed a retrospective chart review, assessing inactive orthodontic patients from 2007-2012 at a private practice in North Central West Virginia. The general dentist at this rural office practices both general dentistry, as well as, orthodontics. Information regarding demographics, form of payment, and distance traveled was collected. Data analysis using these variables was conducted. Statistical analysis included, but was not limited to a Chi Square Fisher's Exact Test, One-way ANOVA, and logistic regression. The results of this study demonstrate that there is significant difference in completion rates based on payment type among Northern Appalachian orthodontic patients. The results also demonstrate that treatment length and oral hygiene ratings are associated with completion rate. The findings validate that psychoeducational interventions may be needed to address these disparities in orthodontic patients of Appalachia. By encouraging oral heath values and requiring appointment adherence, an expected outcome will be the improvement of orthodontic completion rates in Appalachia.