Choice of appliance in relation to demand for orthodontic treatment.

Abstract

The demand for orthodontic treatment is increasing within most of the developed countries of the world but in many areas there are insufficient fully trained orthodontists to meet this demand. Large numbers of patients who need or request treatment are precluded from receiving it by inadequate services or because of financial barriers. This statement places a responsibility on orthodontists to look at their objectives in treatment. It may be that some cases are ‘overtreated’ in order to satisfy the criteria of the orthodontists rather than the real needs of the patient. This raises questions in terms of the standards to which cases should be finished and the best use of clinically available resources. It also poses the question as to what is required for long-term maintenance of the adult dentition. The problem of which cases can be treated satisfactorily by relatively simple means and which require the skills of complicated multiband appliance therapy is considered. Cases demonstrating different methods of appliance therapy are illustrated. The results are compared, with emphasis on the clinical time needed. A case is made for simple orthodontic treatment to be done by the General Dental Practitioner, thus saving the clinical time of the highly trained specialist.