Ethnic variations in orthodontic treatment need in London schoolchildren

A cross-sectional study in North West London, 14 schools were randomly selected from the 27 schools in the two boroughs of Harrow and Hillingdon. Comparison between objective and subjective treatment need was carried out using IOTN AC index. Clinical orthodontic treatment need was also recorded using the dental health component of Orthodontic Treatment Need Index (IOTN DHC).2,788 children were examined and completed the questionnaire. 16% of the study population were already wearing appliances or had finished orthodontic treatment. Of the remaining children; 15% had definite need for treatment using the dental health component of the IOTN. There was no significant variation in the need for orthodontic treatment between different ethnic backgrounds (P > 0.05) whether using the AC or DHC components of the IOTN index. However, poor agreement was detected between professional and subjective assessment of ethnic minority of orthodontic treatment need using IOTN AC index.Orthodontic treatment need in children of ethnic minorities does not differ significantly from the vast majority of white children. However treatment need based on aesthetic index continues to vary in all ethnic groups from the professional aesthetic assessmentOrthodontic treatment is one of the most costly and challenging issues to NHS dentistry. In 2003, fees for orthodontic treatment accounted for more than a quarter of all child fees [1]. Whilst the focus has been often on strategies to improve access and increase budget of orthodontic care, evaluation of the criteria used for defining the need has received little attention. Most orthodontic indices have been primarily based on white populations; this may raise a concern since the demography of the United Kingdom has changed rapidly in the last few decades. The majority of ethnic minorities reside in the England region with London being the most diversified city; almost 30% of London inhabitants are of ethnic minorities [2].The health needs of ethnic