Abstract
Background: There are no population-based longitudinal data on the longer-term outcomes of orthodontic treatment. In this study, long-term orthodontic treatment outcomes were examined using orthodontic index data from phases 12 (dental only), 15, 18, and self-report measures of orthodontic treatment history and success, and dental appearance from phases 15, 18 and 26.
Methods: Data are reported for only those 478 Study members who were residing in the greater Dunedin area and were dentally examined at age 12. Malocclusion data from age 12 were used to categorise Study members into four discrete orthodontic treatment need categories ("Minor/none", "Definite", "Severe" or "Handicapping"). The receipt, manner and outcome of orthodontic treatment for each of those groups was examined using criteria for equity, efficacy and long-term effectiveness. The safety of orthodontic treatment was also examined.
Results: The allocation of orthodontic treatment appeared to be equitable, although about half of those with severe or handicapping malocclusions had not received treatment. There was convincing evidence of the efficacy of the orthodontic treatment for most of those who were treated, particularly where fixed-appliance therapy was used, and of the long-term effectiveness of orthodontic treatment. Where safety was concerned, there were no differences in caries occurrence, periodontal disease or tooth loss between those who had and those had not been treated.
Conclusion: Orthodontic treatment is efficacious, effective and safe, but questions remain about the equity of the private funding model for allocating care.