Objective: Facial visible difference has a range of impacts not only functional and aesthetic but also in terms of the emotional and social wellbeing of patients. The aim of the study is to develop a theory that explains a person’s experience of the orthognathic treatment.
Methods: The study was a qualitative cross-sectional grounded theory study. Semi-structured interviews were used to explore the experience of orthognathic patients undergoing treatment in a NHS hospital in the UK. Face to face interviews with 22 orthognathic patients (4 male and 18 female; age range 18-66 years) were conducted. Of these, 12 participants had had surgery six-eight weeks prior to the interview, six were in the decision making phase for orthognathic treatment and four participants had had the surgery one-two years prior to the interview. Further theoretical sampling and data collection was carried out from online blogs and forums on orthognathic treatment. Grounded theory methodology was used for the analysis of the data collected.
Results: Analysis of the interviews indicated that during the process of orthognathic surgery, patients go through a status passage of ‘normal facing’. Orthognathic patients were inducted into this passage through their dentists, peer influence in the form of teasing and bullying about facial appearance, knowledge of orthodontic treatment gained from peers and their own perceptions of self-image. Decision making for orthognathic treatment influenced this status passage of ‘normal facing’, which, in turn, was influenced both positively and negatively by external factors. Temporality played a key role in normal facing. The factors that influenced the shape of this passage were the patient’s social support system, post-surgery recovery, quality of care, age of the patient, patient’s own life priorities, the preparedness of the patients in the form of information about the treatment, and the role of professionals involved in care provision. ‘Normal facing’ appeared to positively influence the patient’s coping behaviour and self-perception.
Conclusions: Orthognathic patients undergo a scheduled status passage of ‘normal facing’, which appears to be influenced by various clinical, demographic and psychosocial factors. This status passage consequently influenced the person’s self-perception.
