Asymmetries of the public and providers views of the orthodontic treatment need Orthodontic practice and orthodontic standards as an area of conflicts between patients, physicians and society

作者：Bettin Hartmut^*; Spassov Alexander; Werner Micha H

来源：Ethik in der Medizin, 2015, 27(3): 183-196.

DOI：10.1007/s00481-014-0293-9

• Ethics in orthodontics
• Definition of disease
• Principles of orthodontic care
• Guidelines for orthodontic treatment need

Definition of the problem While the majority of the general public believes that orthodontic treatment is for improving dentofacial appearance, dentists, orthodontists, and health insurance companies see it almost exclusively as a response to potential threats to oral health and orofacial functioning. Accordingly, public funding of orthodontic treatment is considered to be justified only when there are well-defined indications of potential health risks. However, current clinical studies indicate that many of those orthodontic conditions, usually thought to justify orthodontic treatment would produce little if any health risks if they remained untreated. The objective of this paper is to analyze this inconsistency.
We discuss the factors that influence providers of orthodontic treatment, the reasons and criteria for treatment, and the facts that guide the decisions of health insurance companies to cover the respective costs. It is maintained that the expectations of those seeking orthodontic treatment, the formal criteria for treatment and coverage, the clinical evidence of the consequences to be expected from variations in tooth position and occlusion, as well as the actual practices of dentists and orthodontists, are mutually inconsistent.
An interdisciplinary normative discussion seems necessary to decide how we should resolve these inconsistencies. In the outlook of this paper, we try to provide stimulation for such discussions by sketching some alternative solutions.

• 出版日期2015-9