Differences in the cooperation of teenagers for orthodontic treatment: Z Generation versus Y Generation

Objectives: To compare orthodontic treatment cooperation between Generation Y and Generation Z teenagers and evaluate influence of age on compliance. Materials and Methods: This was a retrospective cohort study analyzing records of 124 patients (62 from each generation) treated at Tel Aviv University Dental School between 2007 and 2021. Patient cooperation was assessed through weighted noncompliance scores incorporating elastic or headgear wear, oral hygiene, appointment attendance, appliance breakage, and new caries development. Each noncompliance incident was weighted (1.0 point for major incidents, 0.5 for minor) and standardized by treatment duration. Multiple regression analysis accounted for age differences. Results: Mean age differed significantly between Generation Y (15.5 ± 1.7 years) and Generation Z (13.1 ± 1.6 years; P <.001). Initial noncooperation scores were similar (Generation Y: 36.8% ± 16.4%; Generation Z: 35.8% ± 15.8%; P =.732). After age adjustment, regression analysis revealed significantly higher noncooperation in Generation Y (B = 8.29; P =.014). Age independently influenced cooperation, with each year increase associated with a 3% decrease in noncooperation scores (B = −3.04; P <.001). Conclusions: Generation Z teenagers exhibited better orthodontic treatment cooperation than Generation Y after age adjustment. Age independently predicted cooperation, with older teenagers showing better compliance regardless of generation. Treatment planning should consider both generational differences and individual patient factors when selecting compliance-dependent treatment options.