Objective and subjective need for orthodontic treatment in Stockholm County

The objective and subjective need for orthodontic treatment according to a modified version of the treatment priority index of the Swedish National Board of Health and Welfare (index scores 0 to 4), was studied in 1281 children and teenagers, aged between 8 and 16 years and living in the Stockholm area. Furthermore, differences between different parts of the Stockholm County with respect to need for orthodontic treatment, and the subjective demand for treatment were also recorded. Five areas with varying population structures were studied. The results showed that the prevailing objective and subjective need for treatment varied in the areas studied. The prevalence of objective need for treatment varied between 23.8% and 28.9%. The subjective need for treatment ranged from 21.6% to 30.3%. The highest prevalence of treatment need was found in areas with a large immigrant population. In all the investigated areas was the subjective demand for treatment 1-1.5% less than the objective need for treatment. On the basis of the present data, it can be concluded that neither the objective, nor the subjective need for orthodontic treatment exhibits any tendency to decline. The results do not, therefore, support the policy that the public financial resources for orthodontic treatment could be reduced due to a lowered need for treatment. Severe malocclusions may result in impaired craniomandibular function and have an unfavourable influence on facial and dental attractiveness, which may in turn have psychosocial implications. There is an obvious risk that the frequency of such problems may increase in the population, if children with great or very great need for treatment are denied adequate orthodontic care due to lack of sufficient resources.