Orthodontics in 12-year old children. Demand, treatment motivating factors and treatment decisions

Ninety-three per cent of all 12-year old patients at a clinic in western Sweden accepted an invitation to take part in a dental examination in order to evaluate early orthodontic treatment. Treatment in the primary or mixed dentition periods should aim at creating normal craniofacial, occlusal and dental development and, if possible, at reducing the need for later, more complicated treatment. The treatment success was low regarding overjet correction but fairly good with regard to diagnosis and treatment of crossbite/forced occlusion, ectopic eruption and congenitally missing teeth. Whether correction of crossbite had reduced crowding was impossible to evaluate in this study. However, relatively few subjects with a history of crossbite correction desired alignment of teeth. The study confirmed earlier observations that TMD prevention is not a major motivating factor for orthodontic treatment. The majority of the children, including those desiring treatment, judged their dental appearance to be fairly average. The dentists more often than the children regarded the subjects' appearance to be better than average. Prediction of later orthodontic treatment, recorded at the age of 14 years, turned out to have a weak association to evaluation of aesthetics both by the children and the dentists. Nor did recording of TMD improve prediction. The study confirms earlier observations that discussions about orthodontic treatment on mainly aesthetic grounds ought to be postponed well into the permanent dentition period, and by attempting to avoid "making the normal abnormal".