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Infra-occluded primary molars can be challenging in terms of their surgical management and potential sequelae. The prognosis of these teeth needs to considered allowing treatment planning for a stable long-term outcome for the patient. This article outlines the key principles to consider following a diagnosis of an infra-occluded primary molar, and it provides a management tool to aid decision making. CPD/Clinical Relevance: Timely diagnosis and management of infra-occluded primary molars is vital within the overall care pathway for these patients.

Introduction: Across the United Kingdom (UK), National Health Service (NHS) orthodontic treatment is commissioned differently across the devolved nations. There is a relative paucity in the literature describing the way in which the orthodontic services in each country are commissioned and treatment outcomes measured. Objective: To highlight the differences in the following: commissioning of primary care orthodontic services across the UK; assessment of treatment outcomes; and the potential impacts these differences have on contractors, performers and patient care. Materials and methods: Data were collected using an online mixed-methods approach. Systematic content analysis was used to extract the required information from the websites and guidance documents of orthodontic service providers, which was then catalogued and verified electronically by senior dental advisors in the four devolved UK nations. Results: The Index of Orthodontic Treatment Need (IOTN) is a mandatory needs assessment tool used across all four nations, with an agreed minimum threshold of a dental health component (DHC) score of 3 and an aesthetic component (AC) score of 6 for NHS treatment. While the peer assessment rating (PAR) is the most utilised method of assessing post-treatment outcomes, it is applied differently by each country. Conclusion: While NHS orthodontic services across the UK share mutual elements of service delivery, there are significant differences in the prior approval process and assessment of treatment outcomes. More research is required to assess the economic feasibility of orthodontic treatment from the associated treatment outcomes.