Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation.
OBJECTIVE
The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred.


METHODS
The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment.


RESULTS
The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment.


CONCLUSIONS
The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.
Chew
Ming Tak
MT
Department of Orthodontics, National Dental Centre, Singapore. mingtak@pacific.net.sg
Aw
Andrew Kian-Li
AK
D002648:Child; D003753:Dental Health Surveys; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D009971:Orthodontics, Corrective / Q000706:statistics & numerical data*; D009972:Orthodontics, Interceptive / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012649:Self Concept; D012647:Self-Assessment; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires