Effectiveness of community-based salaried orthodontic services provided in England and Wales

To assess the effectiveness of the salaried Community Orthodontic Services in England and Wales, using occlusal indices, and to determine the predictors of treatment outcome.

A retrospective investigation. A random stratified sample of districts where Community Orthodontic Services are provided was selected and visited during 1997.

All community orthodontists in England and Wales, and CDS managers who could be identified were asked to take part in this study. A stratified random sample of 15 per cent of the districts where community orthodontic services were provided was selected and a sample of the records of treated patients was examined.

The orthodontists in the sample were providing treatment for patients clearly in need of treatment. There were, however, some variations between districts. Similarly, when the effectiveness of treatment in terms of dento-alveolar change was evaluated, the mean change in PAR and percentage PAR reduction was high. Again, there were variations between the districts.

The Community Orthodontic Service provides effective orthodontic treatment to many individuals clearly in need of that treatment. The most significant predictor of treatment outcome was the use of two-arch fixed appliances, which produced the best treatment outcome