Orthodontic treatment for disabled children-A survey of patient and appliance management

The objective of this article was to investigate the management problems encountered during the orthodontic treatment of children with disability, and took the form of a retrospective analysis. The investigation took place at the Center for the Treatment of Cranio-facial Disorders,Department of Orthodontics, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel, between years 1989 and 1997. The subjects were the 37 children with mental and/or physical disability whose orthodontic treatment was either completed or nearly completed, whose parents were given a questionnaire. Thirty-five patients responded with a mean age of 13 years (range 7-21 years), representing 94·6 per cent of the sample. Most of the patients (94·3 per cent) were able to conclude the orthodontic treatment and 91·4 per cent of the parents reported that the added responsibilities were either negligible or bearable. In 63 per cent of the children, compliance increased during the treatment as anxiety decreased. The problems encountered with fixed appliances were generally more severe than with removable appliances. The two major obstacles were attendance at frequent and regular intervals (37·1 per cent) and maintaining an appropriate level of oral hygiene (37·1 per cent). Children with a disability are able and willing to undergo orthodontic treatment. Recommendations intended to facilitate management are presented.