Effectiveness of the General Orthodontic Service in England and Wales

Orthodontic outcome when fixed appliances were used on both arches was affected by different, and fewer, factors compared with cases treated with removable appliances, or fixed appliances to only one arch.Outcome when fixed appliances were used on both arches was better overall, and was unaffected by the Starting PAR score, in contrast to other appliance regimes.Social class had only small statistically significant effects on outcome, and these were of negligible clinical significance.However, the data suggested that GDS orthodontic treatment may be less readily available in areas with a high proportion of 'manual class' heads of household.Overall, the findings reinforce the need to encourage greater use of fixed appliances in GDS orthodontics.