Jenny J
Int Dent J. 1975 Dec;25(4):248-56.
In addition to needs fostered by actual physical disabilities resulting from malocclusion, need and demand for orthodontic treatment may develop entirely apart from any consideration of health needs. In fact, improvement of physical function is not the primary motivation of many persons who receive orthodontic care. A variety of social factors are related to perceived needs for acceptable dentofacial appearance and to public demand for orthodontic services. Since early times human teeth have been the object of mutilations to satisfy sociocultural expectations. The mutilation, and even removal of teeth, to achieve dental cultural norms in, so-called, primitive societies may appear barbaric to an ethnocentric society. However, a significant sociocultural need can be met equally by the African or Brazilian who has had teeth filed to a point and by the Western adolescent who having had four teeth surgically removed to provide space in the arch then undergoes two years of orthodontic therapy to reposition and straighten the remaining teeth. From a sociological point of view, the need and desire of members of a society to achieve a culturally acceptable body image constitutes neither frivolity nor luxury. If children's teeth do not naturally meet the norm for esthetic dental appearance, the response of families to sociocultural expectations and pressures produces a culturally valid need for orthodontic intervention. Other social factors affecting perceived need and demand for orthodontic care are socioeconomic, desire for upward social mobility, and social change with regard to public attitudes toward the availability of dental health services and the increasing removal of financial barriers. Potential changes in present US orthodontic practice may be required if care is to be delivered to significantly larger segments of the population.
除了因错牙合畸形导致的实际身体残疾所引发的需求外，正畸治疗的需求和要求可能完全脱离对健康需求的任何考虑而产生。事实上，改善身体功能并非许多接受正畸治疗者的主要动机。多种社会因素与人们对可接受的牙颌面外观的感知需求以及公众对正畸服务的需求相关。自古以来，人类的牙齿就一直是为满足社会文化期望而遭受毁损的对象。在所谓的原始社会，为达到牙齿文化规范而进行的牙齿毁损甚至拔除，在一个以种族为中心的社会看来可能显得野蛮。然而，非洲人或巴西人将牙齿锉尖，以及西方青少年通过手术拔除四颗牙齿以在牙弓中提供空间，然后接受两年正畸治疗来重新定位和排齐其余牙齿，都同样满足了重大的社会文化需求。从社会学角度看，社会成员对获得文化上可接受的身体形象的需求和渴望既非轻浮之举也非奢侈之事。如果儿童的牙齿自然不符合美观的牙齿外观标准，家庭对社会文化期望和压力的反应就会产生对正畸干预的文化上合理的需求。影响正畸治疗感知需求和要求的其他社会因素包括社会经济状况、向上的社会流动愿望，以及公众对牙齿健康服务可及性的态度变化和经济障碍的日益消除。如果要为规模大得多的人群提供正畸治疗，可能需要改变美国目前的正畸治疗实践。
