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Referring adult patients for orthodontic treatment
1School of Dentistry, University of North Carolina at Chapel Hill 27599-7450, USA.
Background:
An increasing number of adults are undergoing orthodontic treatment, but they still make up only a small proportion of all adults who could benefit from such therapy. The purpose of this article is to illustrate the appropriateness and value of orthodontic treatment in adults.
Methods:
The authors review and summarize previous studies regarding adult orthodontic treatment. Data from these studies are compared to determine the prevalence of orthodontic treatment in adults, the reasons why many adults do not seek treatment and the outcomes of orthodontic treatment in adults. In addition, the authors describe a case to demonstrate how a combination of orthodontic therapy and orthognathic surgery can facilitate and complement prosthetic rehabilitation.
Results:
Numerous studies indicate that two-thirds to three-fourths of adults possess some form of malocclusion, yet adults make up only 15 percent of all orthodontic patients. Reasons given by adults for not seeking treatment include a lack of awareness that orthodontic treatment can be performed in adults, apprehension about possible pain or discomfort and concern about social acceptance. However, most patients who underwent orthodontic treatment reported only mild discomfort of one to two days' duration, and only 20 percent of patients felt that the appliances had an adverse social effect. Overall, patients reported high levels of satisfaction with treatment. Orthognathic surgery in addition to orthodontics may be required for the most severe problems, and is compatible with subsequent fixed and removable prosthetic treatment.
Conclusions:
Adjunctive and comprehensive orthodontic treatment is feasible for adults of all ages. Correction of malocclusion makes it possible to improve the quality of periodontal and restorative treatment outcomes, in addition to providing psychosocial benefits.
Clinical Implications:
General dentists are often the first dental professionals to suggest orthodontic treatment and to refer patients to orthodontic specialists. Moreover, with the growing emphasis on cosmetic dentistry, more adults are likely to seek information regarding orthodontic surgery. This article provides general dentists with the information needed to communicate with patients about treatment.