Braces 'may not boost happiness'

Braces may not be beneficial for minor teeth problems

Having braces to correct crooked teeth as a child does not improve mental well-being or quality of life in adulthood, a UK study suggests.

A 20-year study found that orthodontic treatment had little positive impact on future psychological health.

The researchers said more funding was needed for children with severe teeth problems instead of focusing on those with minor irregularities.

The study is published in the British Journal of Health Psychology.

The researchers said there was a widespread belief in the dental profession that orthodontics improved self-esteem and psychological well-being but evidence was lacking.

Before your child starts treatment there should be a careful discussion about whether there's any benefit. It shouldn't just be an automatic thing Professor Bill Shaw

Around 1,000 Welsh schoolchildren were followed from 1981, when they were 10 or 11 years old to 2001, when they were in their 30s.

Those who had received treatment such as braces had better tooth alignment and were happier with their teeth, but this had not had an impact on their self-esteem or emotional health compared with those who hadn't had any work done, the study concluded.

Lack of treatment in children who would have qualified did not lead to psychological difficulties in later life, the study reported.

Previous research published by the same team found that not having orthodontic work done as a child did not have an adverse effect on future dental health.

Strict criteria

Thousands of children have orthodontic work done each year.

Study leader Professor Bill Shaw, professor of orthodontics at the University of Manchester dental school said the dental profession had been getting more strict about which children should have treatment.

"The findings confirm early work that has influenced British orthodontics in recent years."

He said hospital orthodontists had been working to a 10-point scale for the past decade to decide whether children needed braces to correct their teeth for dental health or cosmetic reasons.

However, it has only recently become mandatory for dentists and orthodontists working in the community to stick to the same scale for NHS work.

It has been estimated that around 15% fewer children will now have braces on the NHS.

"Before your child starts treatment there should be a careful discussion about whether there's any benefit. It shouldn't just be an automatic thing," he said.

He said more funding was needed because in some areas of the country children with severe teeth problems did not have access to orthodontists.

"It's about making sure it's available and done well and not squandering money the NHS doesn't have on treatments that are marginal."

Iain Hathorn, chair of the British Orthodontic Society, said that the results of the study had contributed to the dental profession's understanding of orthodontics on the well-being of patients.

But he added: "What must be taken into account, however, is that we live in a very different era; attitudes to beauty have changed and orthodontic techniques and materials have improved; so has patients' willingness to wear retainers to maintain the benefits of treatment.

"If the survey was under way today, the picture would perhaps be very different."

"There are patients around the UK clamouring for treatment who would find it very hard to believe that orthodontics did not impart a psychological health gain," Mr Hathorn said.