Sir, adult patients that could possibly benefit from orthodontics commonly present to us with degenerating dentitions, missing teeth, poor aesthetics and compromised periodontal health. This makes it difficult if not impossible to achieve Andrew's six keys of ideal occlusion.1

Therefore, all adult orthodontic treatments require an inter-disciplinary approach to facilitate optimal aesthetics, stability and function. Graber2 recommends the following treatment objectives which can be offered after a thorough assessment:

  1. 1

    Parallelism of abutment teeth

  2. 2

    Most favourable distribution of teeth

  3. 3

    Redistribution of occlusal and incisal forces

  4. 4

    Adequate embrasure space and proper tooth position

  5. 5

    Acceptable occlusal plane and potential for incisal guidance at satisfactory vertical dimension

  6. 6

    Adequate occlusal landmark relationships

  7. 7

    Better lip competency and support

  8. 8

    Improved crown to root ratio

  9. 9

    Improvement of self-correction of mucogingival and osseous defects

  10. 10

    Improved self-maintenance of periodontal health

  11. 11

    Aesthetic and functional improvement.

Comprehensive orthodontics will always attempt to fulfil all treatment objectives that are set out above. Short-term orthodontics may fulfil some of the above treatment objectives in the form of a compromised treatment or as an adjunctive treatment.

A standardised approach for record taking, diagnostic procedures and assessment is required for both comprehensive and short term orthodontics. Only then can patients be well informed of possible treatment objectives and the advantages and disadvantages of alternative treatment plans.

The quicker the dental profession work towards a standardised approach, the better it will be for the future of adult orthodontics.