“Medically necessary” orthodontic care: Challenges and applications

Medicine targets health in issues of saving life and improving quality of life. Most orthodontic procedures deal with the latter goal. Medical necessity is presented within the scope of pediatric orthodontics, stratified in medically guided treatment, when orthodontic procedures contribute to the correction of a systemic problem, whether or not associated with a local orofacial problem (respiration and sleep disorders, emotional problems, and hospital calls); and orofacial-guided treatment, when addressing growth matters, craniofacial anomalies, and orofacial functions (mastication, understandable speech, and temporomandibular pain). Medical necessity that may involve the care of the orthodontist alone or in a medical team, also brings up the issue of separation between dentistry and medicine, at educational and various operational levels, posing a challenge regarding their integration in the context of health being indivisible.