title: Retrospective study to determine the change in referral pattern to St George's Hospital Orthodontic Department before and after the 2006 NHS Dental Contract changes.
abstract: OBJECTIVE
  The aim of this study was to determine the possible effects of the 2006 National Health Service General Dental Services contract changes on the referral pattern to the orthodontic department at St George's Hospital, South West London.
  
  
  METHODS
  This study was carried out on a retrospective basis. The notes of consecutive patients referred between 1st May and 30th September in 2005 and 2008 were assessed, and the patient's Index of Orthodontic Treatment Need (IOTN) and the source of referral noted.
  
  
  RESULTS
  The total numbers of referrals increased from 260 in 2005 to 405 in 2008. The number of referrals from general dental practitioners decreased slightly from 165 to 156, as did the numbers of referrals from other sources, such as tertiary referrals. The number of referrals made by specialist practitioners increased from 41 in 2005 to 207 in 2008, representing an increase from 16% to 51% of overall referrals. Overall, the number of patients being referred with an IOTN dental health component grade of 5 increased from 27% to 55%.
  
  
  CONCLUSIONS
  The increase in referrals from specialist practitioners may be partly due to the changes brought to the commissioning of orthodontic services for specialist practitioners. Overall, the number of cases being referred with IOTN grades 4 and 5 remains high at St George's Hospital, indicating that appropriate referrals are being made.
authors.affiliation: Specialist Registrar in Orthodontics, Kingston Hospital, Kingston-upon-Thames, Surrey, UK.
authors.forename: Maryam
authors.initials: M
authors.lastname: Izadi
authors.forename: Daljit S
authors.initials: DS
authors.lastname: Gill
authors.forename: Farhad B
authors.initials: FB
authors.lastname: Naini
mesh_terms: D032982:Contracts; D003796:Dental Service, Hospital / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D008310:Malocclusion / Q000145:classification*; D020380:Needs Assessment; D009970:Orthodontics / Q000458:organization & administration*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013218:State Dentistry / Q000331:legislation & jurisprudence*