• Mohammad Moslem Imani, Amir Jalali, Ebraheim Ezzati, Zeinab Heirani, and Mohammadreza Dinmohammadi.
• Department of Orthodontics, Faculty of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
• Patient Prefer Adher. 2018 Jan 1; 12: 2243-2251.

BackgroundOrthodontics is a medical treatment and a rehabilitation service provided for individuals in need. Due to the high cost involved in performing this type of treatment along with the current attitude in communities toward it as a cosmetic service, it is essential to investigate the decision-making process to undergo orthodontic interventions among Iranian individuals and families.MethodsTo conduct this qualitative study using grounded theory, 18 participants were selected through purposive sampling method and received semi-structured interviews each lasting 50-70 minutes. Eventually, the data were saturated after the fulfillment of 19 interviews. During the interviews, simultaneous analysis was also performed according to the method proposed by Strauss and Corbin (1998) and then the data were analyzed within three stages of open, axial, and selective coding.ResultsAnalysis of the clients' statements produced 207 codes, 22 sub-categories, and 9 main categories, including distorted mental self-image, hope to look more attractive, inappropriate interactions with family and those around, family's views toward the problem, social conditions, financial constraints, challenges in the family, as well as decision making to undergo orthodontic treatment, and finally, the main factor of hope for a better future were highlighted.ConclusionThe results showed that the main facilitating factor was "hope for a better future" for which families could accept numerous difficulties, such as high cost and repeated follow-ups due to the importance of beauty and meeting their children's sense of satisfaction.

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