Craniofacial anomalies--are they a public health problem?

Craniofacial anomalies represent a diverse range of developmental defects. Some of the more uncommon conditions are severely disabling and place a heavy demand upon health care resources. Of primary interest in dental public health are the group of conditions referred to as dentofacial anomalies. A minority of dentofacial anomalies may be damaging to the integrity of the dentition or may interfere with function, some may also constitute a genuine cosmetic problem for the individual. Two important questions to be addressed are first, how can those conditions where treatment at public expense is justified on health grounds be defined and secondly, how can criteria be applied to the individual case in a way that is fair and acceptable. While it may be feasible to develop an index of priority for orthodontic treatment need, the more difficult challenge is having it accepted by the public and profession and adopted as an effective management instrument. Use of a valid and reliable index could lead to finite resources for orthodontic treatment being distributed in a more beneficial way.