Orthodontic treatment outcome in three Swedish counties with different orthodontic resources

The orthodontic treatment outcomes of 350 19-year-old individuals in three Swedish counties (A, G, and W) with different orthodontic resources and geographic structures were analyzed. The aim was to evaluate the qualitative outcome of orthodontic treatment provided by general practitioners or specialists. In a small rural area (county G), with most specialist resources, the standard of the treatments was high in both specialist treated as well as in nonspecialist treated individuals. The possibilities for the specialists to supervise the nonspecialist care and to treat individuals in need of specialist treatment were good. In an urban area (county A), with less specialist resources (than county G), the standard of the treatments provided by the specialists was high, and higher than the untreated individuals in the same county. The standard of the treatments provided by general practitioners was, however, low. The lack of specialist resources had implied a greater restriction on starting treatments, and the treatments were performed in a higher age than in the other two counties. In a large rural area (county W), with the fewest specialist resources, the standard of the treatments was in general lower than in the other two counties and did not attain the standard of the untreated individuals in county W. Attempts to compensate for a sparsity of orthodontic specialists by an extended engagement of general practitioners resulted in a generous attitude of providing orthodontic treatments, and a lower standard of the treatments in general. The orthodontic treatments substantially improved the malocclusions, especially treatments provided by specialist. The standard of the treatments in the counties showed a good correlation with the available resources in terms of orthodontic specialists and the ability to supervise the treatments of general practitioners. The lack of sufficient supervision of non-specialist orthodontic treatment had negative influence on the quality.