The role of minimal intervention in orthodontics.

Less than 15% of the population develops a normal occlusion as defined by Angle in the permanent dentition. The term 'ideal' may therefore be a more appropriate description, and deviations from this esthetic and functional optimum should not be considered abnormalities in the true sense of the word. Current research indicates that few malocclusions compromise dental, periodontal or temporomandibular health. To determine whether or not protruded, irregular or maloccluded teeth merit orthodontic intervention is therefore a major challenge. Another challenge is to determine to what extent a limited treatment strategy may be successful in correcting the occlusal problems according to the perceived needs of the patients. I discuss these issues in my present communication and conclude that the major reasons for recommending orthodontic treatment are psychosocial in nature. I also conclude that the majority of the orthodontic cases require comprehensive treatment to achieve successful results. Orthodontic patients are typically satisfied with the outcome of the orthodontic intervention, reporting that the esthetic improvements and the increased functional comfort of the dentition have made significant contributions to their quality of life. Technological advances have made orthodontic treatment simpler and safer over the years. Considering the potential for long-lasting results and the low risk of iatrogenic effects if the patients comply with appropriate oral hygiene measures during active appliance therapy, I conclude that treatment of minor occlusal deviations may also be justified in subjects expressing a clearly defined subjective need for treatment.