The aim of the study was to investigate the costs of orthodontic care
provided for children and adolescents up to the age of 18 by municipal
health centers in Finland, and to study the productivity of these ser
vices. The data were gathered by a questionnaire sent to all health ce
nters; 96% responded. The majority of respondents estimated the share
of orthodontic care as 10% of the total gross costs of dental care, gi
ven that 14% of all dental visits were for orthodontic reasons. To stu
dy the productivity in individual health centers, the output was measu
red by the estimated number of completely treated patients. The cost o
f orthodontic treatment per completely treated patient was, on average
, FIM 7358, ranging from FIM 1299 to FIM 24 751. The strongest explana
tory factor for the average total costs of orthodontic clinics was the
number of general dentists with little experience in providing orthod
ontic treatment. Other explanatory factors were the number of orthodon
tists or experienced dentists, the percentage of orthodontic tasks per
formed by auxiliary personnel, and the timing of treatment. Savings mi
ght be obtained by devolving treatment to orthodontists or experienced
dentists instead of to dentists with little orthodontic experience, a
nd by starting treatment early. The estimated optimal size for an orth
odontic clinic was found to be a unit with 830 completely treated pati
ents per year, but most of the orthodontic clinics were in fact much s
maller with, on average, 133 completely treated patients per year.