Need and demand for orthodontic services: The final report

Abstract

T he Golden Age of orthodontics occurred in the 1950s and 1960s, when practitioners had more patients seeking care than they could start; some even had waiting lists as long as 6 months. Much has changed in the way treatment is delivered today, with the expanded use of well-trained auxiliary personnel and the availability of more efficient materials enhanced by technology. But do we have adequate data to determine who needs orthodontic treatment, and more importantly, are there enough orthodontists to get the job done? Some believe that there are not enough professionals to treat everyone in need, yet there are insufficient data to prove how many people in need would seek care even if it were available. A 30-year longitudinal study of the population in Manchester, United Kingdom, discovered that people’s level of orthodontic care fell into 4 categories: those who needed treatment and received it, those who needed treatment and did not receive it, those who did not need treatment and never received it, and those who did not need treatment but received it anyway. These data came from a country in which much orthodontic treatment was funded by the government. From this single long-term study, you can see that the evaluation of unmet need is difficult to calculate based on the underlying populations. Financial and psychosocial reasons for not seeking professional orthodontic treatment might play a larger role in determining the public’s effective demand. According to L. Jackson Brown, president of a consulting firm employed by the American Association of Orthodontists (AAO) to study the issue of access to care, ‘‘Considering only unmet need without factoring in the role of economic, social, and cultural factors can lead to large miscalculations of the amount of orthodontic care that will actually be used, which in turn, can result in large miscalculations on the workforce.’’ So, when trying to calculate a more realistic amount of unmet need, including economic, social, and cultural factors might result in adjusting the workforce downward from other estimates.