Influence of economic restraints and reduced specialist resources on delivery and quality of orthodontic care.

In 1993 and 1994, economic restrictions were introduced in the County of Ostergötland. The aim of this study was to investigate the influence on delivery and quality of orthodontic care, i.e. any subsequent change in number of patients receiving orthodontic treatment both by General Public Dental Service (GPDS) and by specialist clinic, the choice of appliance, and treatment outcomes, and also any changes in the total number of appliance treatments by general practitioners. Records were examined for 236 and 213 patients registered in 1994 and 1997, respectively, at an orthodontic clinic in the western district of Ostergötland. The total number of appliance treatments by general practitioners was estimated. The number of patients receiving initial treatment by a general practitioner and subsequently by an orthodontist, was relatively unchanged during the period. Quad helix predominated in both 1994 and 1997. The best treatment outcomes were achieved by quad helix and maxillary removable appliances, and the poorest by activators and headgear. In conclusion the total number of appliance treatments by general practitioners decreased as well as treatments requiring patient compliance over an extended period, findings which might be a consequence of the coincident economic restriction.