Interceptive orthodontics in practice: a 5-year population-based study

OBJECTIVE: To evaluate the scope and short-term outcomes of interceptive orthodontic treatment delivered by general dental practitioners (GDPs) under the supervision of specialist orthodontists within a publicly funded healthcare system. SUBJECTS AND METHODS: This retrospective cohort study included all patients aged ≤18 years who received publicly funded interceptive orthodontic treatment in Region Västra Götaland, Sweden, during 2020-2024; the pediatric population (0-18 years) was approximately 400 000. In total, 22 000 cases were identified from electronic records. Analyses focused on four appliances: Activator, Extraoral Traction, Quad Helix, and Removable Plate. Detailed outcome assessment was performed for all cases from year 2020 (n = 4400), with extraction of age, sex, treatment indication, treatment duration, number of visits, and appliance-specific outcomes. RESULTS: In total, 21 946 treatments were registered over 5 years. The most common appliances were Removable Plates (n = 10 511), Activators (n = 6455), Quad Helix (n = 3164), and Extraoral Traction (n = 1816). On average, 4389 interceptive treatments were delivered annually, accounting for nearly 100 000 visits. Treatments were typically initiated in the late mixed dentition (mean age, 10.2-11.2 years; range, 8-13 years), with equal gender distribution. Mean treatment duration ranged from 11 months (Quad Helix) to 20 months (Activator). Success rates were highest for Quad Helix (82%) and Removable Plates (65%), while lower rates were recorded for Extraoral Traction (57%) and Activators (56%). Failures were mainly linked to poor compliance. CONCLUSION: The results from this large cohort study on interceptive orthodontics provide real-world evidence that although success rates were lower than in randomized trials, the outcomes reflect routine care conditions. The findings highlight the importance of compliance, appliance selection, and treatment timing. The dataset offers a foundation for future longitudinal evaluations of long-term outcomes and cost-effectiveness.