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.