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Public Assistance Orthodontic Treatment Needs: A Report from the State of Indiana
Author(s) -
Dean Jeffrey A.,
McDonald Shelley M.,
Walker Paul O.
Publication year - 2005
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/j.1752-7325.2005.tb02802.x
Subject(s) - malocclusion , medicine , medicaid , occlusion , dentistry , orthodontics , reimbursement , surgery , health care , economics , economic growth
Abstract Objective: To determine how many of the orthodontic cases covered by Indiana Medicaid between 1999–2001 would be classified pretreatment as having a malocclusion severe enough to warrant treatment. Methods: Six examiners were trained and then paired together to examine 249 patient orthodontic case records, consisting either of pre‐treatment photographs only, pre‐treatment models only, or both pre‐treatment models and photos. The examiners applied the Index of Orthodontic Treatment Needs (IOTN) to assign each case a Grade of One to Five, with Grade One representing Ideal Occlusion and Grade Five being Extreme Malocclusion. When two examiners within a pair could not agree, a third examiner reviewed the case record to determine agreement. Results: Of the 249 patient cases examined, 9 were not gradable. In the cases where only pretreatment models were available (n/157), 10% received a Grade of One or Two (Ideal Occlusion or Mild Malocclusion, respectively). Among the cases in which both pretreatment models and photos were available (n/46), 44% of the photos were graded One or Two, while only 2% of the models were graded as One or Two. In the cases where only pretreatment photographs were available (n=37), 27% of cases were Grade One or Two. Conclusion: While several of the cases (11%) submitted during the time period of 1999 to 2001 to the Indiana State Medicaid Division for reimbursement were rated as having Ideal Occlusions or Mild Malocclusions, the vast majority (89 %) were scored as having either Moderate, Severe, or Extreme Malocclusion.