The provision of fixed appliance orthodontic treatment is very expensive. It is important therefore that resources be used to best advantage and for those most severely affected/handicapped. Accordingly in 1985 my Department issued guidelines to health boards on the classification of cases awaiting treatment in descending order of severity/handicap.
These guidelines provide the following classifications: Category A — The most severe cases, e.g. cleft lip and palate, somewhat less than 1 per cent of all children. Category B — Cases with severe functional handicap, e.g. marked disproportion between the upper and lower jaws — and, therefore, teeth — about 6 per cent — 8 per cent of children. Category C — Non-handicapped cases about 12 per cent — 16 per cent of children.
A further category, sometimes called D, caters for the simpler type of cases which can often be treated at primary care level by a non-specialist having sufficient skill and experience. These guidelines are currently under review. In mid-1990, the Department wrote to each health board asking that all orthodontic waiting lists be reviewed and all children be reassessed to determine their orthodontic need and to place them in the appropriate priority category in accordance with the existing guidelines.
