What Do Chinese Patients Value in Orthodontic Treatment? A Discrete Choice Experiment

Objective: Malocclusion is a common dental condition affecting both function and appearance, with significant implications for psychological well-being and health-related quality of life. Despite advances in orthodontic technologies, limited evidence exists on patient preferences for treatment options. This study aimed to quantify young adult patients’ preferences and willingness-to-pay (WTP) for key orthodontic treatment attributes in China. Methods: A discrete choice experiment (DCE) was conducted in Anhui Province, China, with 349 young adults diagnosed with malocclusion. The DCE evaluated preferences across four attributes: follow-up intervals, appliance comfort, aesthetics, and treatment cost. Data were analyzed using a mixed logit model, with subgroup analyses exploring preference heterogeneity. WTP was estimated via simulation, and scenario analysis was used to assess market uptake under different pricing strategies. Results: Participants showed strong preferences for treatments offering better comfort (coefficient for 'very good': 2.255, p<0.001) and aesthetics (coefficient for 'very good': 2.269, p<0.001). Clear aligners were the preferred option, even at higher prices. Median WTP was substantial for improved comfort (18,110 CNY) and aesthetics (18,633 CNY). Notable preference heterogeneity was observed: females prioritized aesthetics, males emphasized comfort, and lower-income patients were more cost-sensitive. Scenario analysis indicated that pricing clear aligners at the same level as ceramic brackets could raise their market share by 82%. Conclusion: This study underscores the importance of incorporating patient preferences into orthodontic care. Tailoring treatment options to individual needs and reducing financial barriers, such as through insurance coverage for preferred treatments, could enhance patient satisfaction, adherence, and health outcomes. These findings support more patient-centered and equitable approaches in orthodontic service delivery and policy design. Patient or Public Contribution: The development of the DCE included a qualitative research component to ensure that the content accurately reflected patients’ experiences when seeking orthodontic care. Prior to data collection, 30 pilot interviews were conducted with members of the target population to gather feedback on the survey’s relevance and clarity.