According to studies carried out in Sweden, society could save millions each year if more children were fitted with fixed braces.

Calculations by Sofia Petrén, a dentist and orthodontic specialist at Malmö University, indicate that at least 10% of all eight- and nine-year-olds in Sweden have a crossbite. In randomised studies, Dr Petrén investigated four methods of treatment: fixed appliance (Quad Helix), removable appliance (expansion plate), composite construction on the molars of the lower jaw, and no action in the hope that the problem would straighten itself out. A total of 70 children were involved in the four groups.

The composite construction had no effect on crossbite; neither did taking no action. The other two treatments proved effective, both in the short and long term, but the fixed appliance yielded clearly superior results.

'The fixed braces entail that the children are treated 24 hours a day. The removable plate means that the children need the help of their parents, and it happens that they forget it sometimes, which affects the outcome of treatment,' said Dr Petrén.

The fixed appliance is also the cheapest. Dr Petrén compared the costs, both direct and indirect, and found that Swedish society could save SEK 32 million per year (over £3 million) if all children with unilateral crossbite were treated with fixed braces. Part of the difference is due to the fact that children who are treated with removable appliances sometimes need to be treated again because the treatment failed. But even if all treatments with removable appliances were successful, the annual cost would still be more than SEK 12 million (over £1 million) compared with fixed braces.

The finding in Sofia Petrén's dissertation that children's bite problems do not sort themselves out spontaneously means that regions that postpone treatment to save money will be facing even higher costs in the long run. http://dspace.mah.se/handle/2043/11823