Outcome of orthodontic care in 19-year-olds attending the Public Dental Service in Sweden: Residual need and demand for treatment

The study analyses residual need and demand for orthodontic treatment in 19-year-olds attending the Swedish Public Dental Service (PDS). The general practitioners (GPs) had selected individuals for orthodontic specialist consultation and some were treated by GPs or specialists or not considered to be in need for treatment. Altogether 164 individuals were called for clinical investigation at the age of 19 years and also given a questionnaire asking for residual orthodontic treatment demand and satisfaction with information and orthodontic care. Ninety-one per cent of the individuals who had had an orthodontic consultation and 53 per cent of those who had not seen an orthodontist took part in the investigation. The study revealed that half of the 19-year-olds at the PDS clinic had received orthodontic consultations and one third had received orthodontic appliance treatment. Seven per cent of the investigated individuals had a residual subjective demand for treatment. Several individuals with removable appliance treatment had overjet and deep bite and laterally forced cross-bite, but with little remaining subjective demand for treatment. Individuals with fixed appliance treatment showed few malocclusions. Nineteen-year-olds in general were uncertain about their present need for orthodontic treatment. The following conclusions were drawn: the total amount of orthodontic treatment in different areas in Sweden is comparable but the distribution between GP and specialist treatment differs. Interceptive treatment to reduce overjets seemed not successful. Fixed appliances seemed to reduce the majority of the malocclusion traits. The information given in connection with orthodontic consultation or treatment was clearly inadequate.