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Objective: To compare the opinions of Swedish orthodontists and American orthodontists regarding the association between third molar eruption and dental crowding., Materials and Methods: A survey was distributed to Swedish orthodontists (n = 230) asking their views on the force exerted by erupting third molars, its relationship to crowding, and their recommendations for prophylactic removal. Results were compared with those from a similar study conducted in the United States. Chi square analysis was used to determine differences in responses to questions between Swedish and American orthodontists. P < or = .05 was considered significant., Results: Both Swedish and American orthodontists believed that lower third molars were more likely than upper third molars to cause force (65% and 58% for Swedish and American orthodontists, respectively) and crowding (42% and 40%, respectively). No statistically significant differences were seen between the answers of American and Swedish orthodontists regarding the role of upper and lower third molars in causing crowding. Although only 18% of Swedish orthodontists "generally" or "sometimes" recommended prophylactic removal of mandibular third molars, 36% of American orthodontists "generally" or "sometimes" recommended removal (P < .0001)., Conclusions: Most orthodontists in the United States and Sweden do believe that erupting lower third molars exert an anterior force; however, they also believe that these teeth "rarely" or "never" cause crowding of the dentition. The reason that more American orthodontists recommend prophylactic removal of mandibular third molars remains unexplained.

Introduction: State Medicaid programs were established to care for the poor by eliminating financial barriers that otherwise prevent them from being treated in the mainstream health care system. The number of children eligible for Medicaid services is increasing, yet the number of Medicaid providers remains low. Health care providers cited failed appointments as a major problem with Medicaid patients and a great deterrent to participating. The purpose of this study was to determine whether a difference in appointment-keeping behavior exists between Medicaid and non-Medicaid orthodontic patients., Methods: During a 12-month period, a tally of appointments was kept for all active patients (n = 707) at Virginia Commonwealth University's Department of Orthodontics. Patients were categorized as either Medicaid or non-Medicaid, and their appointment-keeping behavior was evaluated., Results: A significant difference was found in the number of failed appointments between the groups. The Medicaid patients failed 247 (15.4%) of 1609 appointments, and the non-Medicaid patients failed 367 (8.3%) of 4438 appointments. Medicaid patients accounted for 26.6% of all appointments but were responsible for about 40% of all appointment failures. In addition, 104 (56.2%) of 185 Medicaid patients missed 1 appointment or more during the year, compared with 211 (40.4%) of 522 non-Medicaid patients., Conclusions: The findings from this study support the concern among dental practitioners and orthodontic specialists that Medicaid patients have a higher rate of appointment failures than non-Medicaid patients, although the frequency of missed appointments was substantially lower for orthodontic appointments than that reported for general dental appointments.

Approval for state sponsored funding of orthodontic treatment is often decided using an index of malocclusion. The purpose of this study was to determine whether two indices used for prioritizing patients would identify different groups of individuals qualifying for orthodontic treatment funding approval. In addition, the characteristics of patients approved using different indices were compared. The records of 40 patients previously submitted for state medicaid funding approval were evaluated by three study examiners using two orthodontic treatment priority indices, the Salzmann Handicapping Malocclusion Assessment (Salzmann) and the Index of Orthodontic Treatment Need (IOTN). Comparisons were made between state medicaid and study examiner Salzmann scores, rankings, and funding decisions, and between study examiner Salzmann rankings, IOTN rankings, and funding decisions. Correlation and rank correlation coefficients between the state and study examiners' Salzman scores were high (r = 0.74; p < 0.001, and R = 0.77; p < 0.001). Rank correlation analysis of the study examiners' Salzmann and IOTN values demonstrated a weaker relationship (R = 0.40; p < 0.02). Agreement on funding decisions, evaluated by the Kappa statistic, was greater between the two Salzmann evaluations (K = 0.57) than between the study examiners' Salzmann and IOTN evaluations (K = 0.14). As expected, depending on the method used to determine orthodontic treatment funding priority, different patients were likely to be identified for treatment approval. The characteristics of patients whose treatment was approved was closely related to the criteria defined by the method employed.