Efficiency and effectiveness of orthodontic treatment within United Kingdom secondary care: a service evaluation

Objectives: To evaluate the efficiency and effectiveness of Orthodontic treatment in the National Health Service (NHS) hospitals in England and to identify factors that may be predictive of the duration of Orthodontic treatment and number of patients’ visits. Design: Retrospective service evaluation. Setting: The orthodontic departments of two NHS hospitals. Methods: The data were collected from the clinical notes, the hospital data base and the pre- and post-treatment study models of 70 patients who were treated with fixed appliances. The pre- and post-treatment models were assessed using the Index of Orthodontic Treatment Need (IOTN) and the Peer Assessment Rating (PAR) index. Results: (1) 98.5% of the patients treated with fixed appliances in both hospitals were in definite need for treatment, (2) The mean percentage PAR score reduction was 81.5%, (3) The mean treatment duration was 27 months with an average of 21 appointments, (4) Factors increasing treatment duration included being a female patient, class I malocclusion, IOTN 5, extractions, prescribing headgear wear, using functional appliances or quadhelixes and increased number of missed appointments, (5) Factors reducing the treatment time were male patients, class II or class III malocclusions and an increased number of emergency appointments. Conclusions: The hospitals demonstrated a high standard of orthodontic treatment.