Cultural barriers to successful communication during orthodontic care.

OBJECTIVE: To determine to what extent barriers related to culture and language, and how inappropriate expectations might impede orthodontic care, among Pakistani Muslims when compared to white Caucasians from similar socio-economic backgrounds in Bradford, UK. DESIGN: Semi-structured interviews. SETTING: Dentists were interviewed in the clinic. Parents and children were interviewed separately in the waiting room or in adjacent rooms depending on availability. PARTICIPANTS: Four dentists working in the Community and Hospital Dental Services, 30 children and 10 parents of white and Pakistani origin. RESULTS: Among the white Caucasian groups, three-way communication involving parents, children and dentist enhanced understanding, supported orthodontic treatment and reinforced the need for good home care. Among Pakistani families communication was primarily two-way, involving the dentist and the child. Parents and families had limited understanding of the process and were unable to offer a comparable level of support that would benefit their children most. This can place additional burdens on the Pakistani child patient and requires a very positive approach from the dental team. CONCLUSIONS: There is a clear need for chairside support, through patient advocates or interpreters, as well as the provision of appropriate educational material to match parents' educational needs on behalf of their children.