Comparing subjective and objective measures of headgear compliance

Introduction: Many studies have used subjective measures to examine patient compliance during orthodontic treatment. Objective measurement of compliance has been confined to only a few studies that used electronic timing devices built into removable appliances. Our aim in this study was to compare subjective and objective methods of measuring compliance with headgear wear. It was hypothesized that orthodontists, patients, and patients' parents overestimate compliance and report more wearing hours than the headgear timers indicate. Also, relationships between sex, age, treatment time, and headgear compliance were explored. Methods: A headgear timer device and 3 questionnaires were developed to assess compliance. The subjects were unaware that their headgear use was being measured. Results: Significant differences between the estimates of orthodontists, patients, parents, and headgear timer scores were found. Also, there were differences regarding age and treatment time. Conclusions: Subjective measures might result in overestimation of compliance. This suggests that the use of an objective instrument to measure headgear compliance should be continued in future studies.