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Orthodontics referrals

Orthodontics outpatients is now a Directly Bookable Service (DBS) via e-Referral.

Please see 'Maxillofacial Surgery referrals'
e-Referral at OUH

The orthodontic department will see any referral for diagnosis, advice and treatment planning.

Patients can only be accepted for treatment if they fall within grades 4 or 5 of the Index of Treatment Need (IOTN). A small number from Grade 3 patients are accepted for registrar training.

IOTN Grade 3: moderate treatment need

Increased overjet greater than 3.5mm but less than or equal to 6mm with incompetent lips.
Reverse overjet greater than 1mm but less than or equal to 3.5mm.
Anterior or posterior crossbites with greater than 1mm but less than or equal to 2mm discrepancy between retruded contact position and intercuspal position.
Displacement of teeth greater than 2mm but less than or equal to 4mm.
Lateral or anterior open bite greater than 2mm but less than or equal to 4mm.
Increased or complete overbite without gingival or palatal trauma.

IOTN Grade 4: great treatment need

Increased overjet greater than 6mm but less than or equal to 9mm.
Reverse overjet greater than 3.5mm with no masticatory or speech difficulties.
Severe displacements of teeth greater than 4mm.
Extreme lateral or anterior openbites greater than 4mm.
Increased and complete overbite with gingival or palatal trauma.
Less extensive hypodontia requiring pre-restorative orthodontics or orthodontic space closure.
Posterior lingual crossbite with no functional occlusal contact in one or more buccal segments.
Reverse overjet greater than 1mm but less than 5mm with recorded masticatory or speech difficulties.
Partially erupted teeth tipped and impacted against the other teeth.

IOTN Grade 5: very great treatment need

Increased overjet greater than 9mm.
Extensive hypodontia with restorative implications.
Impeded eruption of teeth due to crowding, displacement, the presence of supernumerary teeth, retained deciduous teeth and any pathological cause.
Reverse overjet greater than 5mm with reported masticatory and speech difficulties.
Defects of cleft lip and palate.
Submerged deciduous teeth.