Interceptive orthodontics in the real world of community dentistry

To test the applicability and effectiveness of interceptive orthodontics in a community field trial.

Prospective screening for suitable malocclusions, implementation of treatment and analysis of outcomes 12 months later.

Community dentistry in urban and rural areas of Northern Ireland, 1996-98.

The initial sample consisted of 2002 children (1014 boys, 988 girls) who were screened in routine community dental inspections. One thousand and sixty (523 aged 9 years, 537 aged 11 years) were domiciled in the urban area of greater Belfast and 942 (479 aged 9 years, 463 aged 11 years) in the rural area of Enniskillen and Omagh, Co. Tyrone.

Interceptive orthodontic treatment.

Dental health component of the Index of Orthodontic Treatment Need (IOTN) and specially devised local indices of treatment outcomes.

With the use of an interception gauge, orthodontic screening was included in the community dental inspections without difficulty. Thirty-three per cent of children were in need of interceptive treatment. Only 20% of those in need both attended for recall and underwent treatment. Compliance was better in the rural area but the need, with particular reference to extraction of carious first molars, was greater in the urban area. The numbers of children in IOTN grades 4 and 5 fell from 69% at the beginning of the study to 42% at the end. The outcome judged by local indices was 94% in the range of complete success to minimal improvement with only 2% showing deterioration.

One in three children screened in community dental inspections at age 9 and 11 years would benefit from interceptive orthodontics. Parents and children seem reluctant to accept offers of interceptive orthodontics and to having the treatment carried out. Among those complying fully, the interceptive measures are very successful. Not only does community interceptive orthodontics improve the condition being treated but also reduces the need for further treatment.