Ortho clinic reading

Question 1

Why is appropriate timing of orthodontic referral important?

Answer 1

Essential to maximise benefit to pt and efficiency and effectiveness of service

Question 2

Most useful age of pts for orthodontic referral and why

Answer 2

~10 yrs for girls
~11 yrs for boys
-for definitive opinion to be given
-still time for interceptive XLA

Question 3

Responsibility of GDP

Answer 3

Monitor development of dentition
Be aware of potential problems which may arise
Knowledge of eruption times of teeth
Digital palpation for upper canines from ~9 yrs
-should be palpable by 10 yrs
-rads taken and referral made if no evidence by 10 1/2

Question 4

Suspicion –> referral (GDP)

Answer 4

Asymmetry in eruption sequence
Deciduous tooth in place 6 months after opposite number
-take rads to confirm permanent successor (then consider XLA deciduous)

Question 5

Problems found by GDP discussed with

Answer 5

Pts and parents prior to referral

• correction of malocclusion may not be desired/ necessary but both need to receive adequate info to make informed decision
• pt motivation for tx need to be assessed

Question 6

Inappropriate referrals

Answer 6

Waste clinical time

Contribute to waiting lists

Question 7

pt motivation for tx need to be assessed by GDP

Answer 7

2 - 2 1/2 yrs, may include XLA and headgear etc.
Poor OH or active caries corrected prior to referral
Pts with no interest may still benefit from consultation

Question 8

What ‘scenario’ may be given by GDP

Answer 8

~ 2 1/2 yrs of active ortho tx probably including upper and lower fixed appliances
Possible XLA followed by extended retention period

Question 9

Info to be included in referral letter

Answer 9

Addressed to individual named specialist or ‘the orthodontist’
Pt details
-full name
-DOB
-address including postcodes
-contact number
Reason for referral and whether it is at request of GDP/ pt/ parent
-presenting problem as pt perceives it
-general description of overall malocclusion
Attitudes towards dental care and ortho
Whether consultation is for advice, tx planning or request for tx
Significant MH which may affect tx approach
-include GMP details
Whether pt is psychologically disturbed because of malocclusion
Date of referral

Question 10

Records required in ortho referral

Answer 10

Radiographs and study models if requested
-following full clinical exam
Any rads taken recently

Question 11

Need and eligibility for ortho treatment

Answer 11

IOTN (since April 2006)

• dental health component
• aesthetic component

Question 12

Clinical reasons for early referral

Answer 12

Interceptive treatment
-eliminates or < severity of developing malocclusion
Unerupted incisors
Marked mandibular displacement on closure
Severe overjet
Teasing or bullying
Permanent tooth extraction required resulting from dental disease or for other reasons
Impacted/ ectopic canines
Trauma due to misplaced teeth

Question 13

How often are canine impactions encountered

Answer 13

1.7% of population

Question 14

Impacted tooth definition

Answer 14

Tooth that is prevented from erupting into position due to malposition, lack of space of other impediments