Orthodontic Assessment
(please note that the following explanation is taken from Department of Health guidance)

As orthodontic treatment needs to be justified on either dental health or aesthetic needs, there are two components to the IOTN index:

• The Dental Health Component (DHC)
• The Aesthetic Component (AC)

The Dental Health Component of the IOTN has five categories ranging from 1 (no need for treatment) to 5 (great need) which may be applied clinically or to a patients study casts. The Aesthetic Component of the IOTN consists of a ten-point scale illustrated by a series of photographs which in development were rated for attractiveness by a lay panel and selected as being equidistantly spaced through the range of grades. The patient is involved at this stage of the assessment and compares their appearance with the series of photographs. The final AC value therefore reflects the treatment need on the grounds of perceived aesthetic impairment and by implication the socio-psychological need for orthodontic treatment.

In terms of the provision of primary care orthodontic treatment within the NHS regulations, patients can be treated who have a DHC score of 4 or 5 with any AC score or a DHC score of 3 with an AC score of 6 or more. Within secondary care services there seems to be a general agreement that a DHC of less than 4 and an AC score of below 7 do not justify treatment by a hospital based consultant led team except for teaching or research purposes.

The images below have been reproduced with kind permission, and are the Copyright of Orthocare UK Limited.

The Dental Health Component (DHC)

The Aesthetic Component (AC)

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