Residual need in orthodontically untreated 16-20-year-olds from areas with different treatment rates

Knowledge concerning residual orthodontic need among individuals who have passed the age at which orthodontic treatment is normally provided, is important in the discussion of guidelines for the provision of care. The purpose of the present study was to examine and compare orthodontic need (objective and subjective) in cohorts of orthodontically untreated individuals from areas with various treatment rates. A total of 250 individuals, aged 16-20 years, comprised four samples representing cohorts from areas in Norway with low, medium, and high treatment rates. The occlusion was assessed according to a treatment need index (NOTI) from clinical and radiographic records, and dental cast measurements. Attitudes were assessed from questionnaires addressing satisfaction with dental arrangement, desire for treatment, and value placed upon well-aligned teeth. A significant decrease in occurrence of normative need (P < 0.001) and reported dissatisfaction (P < 0.05) was observed in samples representing increasing treatment rates. Dissatisfaction was completely eliminated among individuals from the high treatment rate area. Although a significant association between severity of malocclusion and desire for treatment existed within samples, this was not reflected in a corresponding trend for a decrease in desire across the samples. Well-aligned teeth seemed to be taken for granted among individuals from the area with a high treatment rate. From the present observations, a 'correct' level of treatment provision could not be identified.