Four years of free orthodontic care for vulnerable children: a community case study from the Caritas Dental Clinic in Rome

Background: Access to orthodontic treatment remains limited for many socially vulnerable children and adolescents due to financial, administrative, and social barriers. Despite the high prevalence of malocclusion and its potential impact on oral health and quality of life, few reports have described practical models aimed at improving access to orthodontic care for underserved populations. This study describes a community-based model developed at the Caritas Dental Clinic in Rome to provide free orthodontic treatment to vulnerable minors. Methods: This Community Case Study reports the implementation of a free orthodontic care pathway between January 2022 and December 2025. Patients were referred through Caritas social services, family homes, and therapeutic communities. Orthodontic treatment was provided free of charge through collaboration between volunteer orthodontists, postgraduate students, Caritas staff, and partner dental laboratories. Descriptive statistics were used to summarize patient characteristics and treatment activity. Results: A total of 133 patients were assessed for eligibility, and 93 initiated orthodontic treatment. The mean age of treated patients was 12.5 years; 55.9% were male and 44.1% female. Most patients were foreign-born (74.2%), while 25.8% were Italian. Forty patients (30.1%) did not proceed to treatment, mainly because of missed appointments and difficulties in maintaining regular follow-up. Fixed appliances represented the most frequently used treatment modality, often combined with interceptive and orthopedic approaches. Conclusions: The experience of the Caritas Dental Clinic demonstrates the feasibility of a community-based model for delivering free orthodontic care to socially vulnerable children and adolescents. Collaboration among healthcare professionals, volunteers, educational institutions, and social services may help reduce barriers to orthodontic treatment and improve access to care for underserved populations. Further studies are needed to evaluate long-term clinical outcomes and the broader impact of similar programs.