The public health interest in assessment for orthodontic treatment

In dental public health care programs the occlusion of the teeth is of interest from several different viewpoints: clinical treatment, screening for treatment need and priority, resource planning, and funding. Aspects of occlusion which are of interest are occlusal features, the need for treatment, the difficulty of treatment and the social factors affecting the practicability of treatment. Most of the interested parties are particularly concerned with the need for treatment--an area where objective assessment is not possible. Several methods of assessment of treatment need have been devised. Many of these are reasonably objective methods of assessing occlusal features, but involve the subjective concept that occlusal variation needs correction. In the absence of an objective measurement of treatment need, screening programs could be carried out by personnel who have training in the use of indices but not in clinical orthodontics. Resource planning, however, needs a knowledge of clinical orthodontics to determine types and relative difficulties of treatment required. For public health purposes there is a need for an assessment which would include the etiological factors of malocclusion which govern the difficulty of treatment, and the social factors governing the practicability of treatment.