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

Knowledge concerning residual orthodontic need among individuals who have p assed the age at which orthodontic treatment is normally provided, is impor tant in the discussion of guidelines for the provision of care. The purpose of the present study was to examine and compare orthodontic need (objectiv e 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 wit h low, medium, and high treatment rates. The occlusion was assessed accordi ng 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 repo rted dissatisfaction (P < 0.05) was observed in samples representing increa sing treatment rates. Dissatisfaction was completely eliminated among indiv iduals from the high treatment rate area. Although a significant associatio n 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 grante d among individuals from the area with a high treatment rate. From the pres ent observations, a 'correct' level of treatment provision could not be ide ntified.