From Volume 43, Issue 8, October 2016 | Pages 706-720
Many of the orthodontic patients in the UK are treated in early adolescence. This occurs when most of the permanent dentition has erupted and after the general dental practitioner (GDP) has had the opportunity to assess the patient using the index of orthodontic treatment need (IOTN). There are certain types of malocclusion that present before this age and would undoubtedly benefit from earlier referral.
The majority of orthodontic treatment performed in the UK is undertaken when children are in their early adolescence (12–14 years old).1 The reasons for this are both patient- and health service-related. Most of the permanent dentition is erupted by 12 years of age,2 which makes complete assessment of the clinical situation possible and allows the use of full upper and lower fixed appliances. Other treatment modalities, such as the use of functional appliances, hope to ‘harness’ the growth potential of the child, and improve a moderate to severe sagittal discrepancy. Children are usually actively growing as they reach the final stages of the mixed dentition. Finally, orthodontists in primary care are only paid once for providing treatment for a patient, which may act as a disincentive for earlier intervention. It is the authors' opinion that this has resulted in a system that generally intends that only ‘one bite of the cherry’ is offered for maximum clinical effect and therefore benefit to the patient.
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