Orthodontic treatment among children and young adults

Orthodontic treatment is not part of the public dental service, and children and young adults who need orthodontic treatment are referred to specialized dentists for further examination and treatment. Expenditure is covered by the government at fixed rates. Patients with the greatest need are covered for the entire treatment, while those with the least need, must pay a deductible in addition to what is covered by public funds.

In addition to any deductible, patients must pay an additional fee if the dentist's own prices are higher than the fixed rates. The treatment costs can thus be quite large, even in cases where the entire treatment is initially financed by the public sector. Because much of the treatment cost falls on the parents, social differences may occur, depending on factors such as parents' income and educational level.

In line with rising government spending on orthodontic treatment, more knowledge is needed about children and young adults receiving support for orthodontic treatment and what characterizes them. We are studying the receipt of reimbursements for orthodontic treatment among children and young adults in the age group 6-20 years in the period 2012-2018.

In the first part of the analysis, the purpose is to uncover what a typical course of treatment looks like. In this part of the analysis we study the course of treatment for patients who have completed complete treatment. We describe how long it is usual for the treatment to last, how the course of treatment varies with severity, and estimate the total treatment cost and distributed according to treatment needs. We also calculate the proportion of a birth cohort that is in contact with the orthodontics.

The results from this part of the analysis show that there are 112,000 patients who have completed a complete course of treatment during the period 2012-2018. For those who started treatment in 2012, the median duration of treatment is 3 years. For patients with very large treatment needs, the total cost is estimated at just under 33,000. For patients with large and clear treatment needs, estimated cost is 30,000. However, these patient groups pay 25 percent and 60 percent of the cost themselves, respectively. When we follow different birth cohorts throughout the period, our calculations show that roughly 60 percent of children and young adults are in contact with the orthodontics.

In the second part of the analysis, the purpose is to carry out a socio-economic analysis of children and young adults receiving orthodontic treatment. The goal is to discover how receiving reimbursement varies with factors such as gender, age, severity, place of residence, as well as parents' educational and income levels. In this part of the analysis, cross sections of treated patients are studied in 2012-2018.

The results from this part of the analysis show that in 2018, 201 458 children and young adults aged 6-20 years received reimbursements for orthodontic treatment. It is most common to have regulation at the age of 13-14. The results show that there are social and regional differences in children and young adults’ receipt of reimbursements for orthodontic treatment. It is more common to have dental regulation among children with parents with a high level of education and income than among those with parents with a lower level of education and income. Children living in counties in western Norway also have a larger proportion of dental regulation than children living in other counties. In addition, the results show that immigrant children and young adults have less regulation compared to all children and adolescents in the population.