Iotn Training Slides

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Index of OrthodonticTreatment

Need modified for use inEpidemiological Surveys :

Modified IOTN

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Written by

Donald Burden and Cynthia Pine

w ith assis tance

f rom the BASCD Working Party onOrthodont ics

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Modified IOTN consists of two

components:

1. Aesthetic Component

2. Dental Health Component

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Aesthetic Component

Grades 1-7

No Definite Need for treatment

Grades 8-10

Definite Need for treatment

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Recording the Aesthetic

Component

Ask subject to close on their back

teeth

Retract lips

Grade the dental attractiveness of

the anterior teeth

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Recording the Aesthetic Component

The grade awarded is for overall dental

attractiveness rather than specific

morphological similarity to the

photographs

First impressions are usually correct

Main aim is to differentiate those at8 - 10

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Dental Health Component

IOTN has been simplified to two

categories:

Definite Need for Treatment

No Definite Need for Treatment

The subject is examined for specific

conditions and if one is found, aDefinite Need for Treatment is recorded

and no further conditions are sought.

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Recording the DHC

Examine each subject for:

Missing teeth

Overjets Crossbites

Displacement of contact points

Overbites

= MOCDO

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Recording the DHC

Examine the subject using the MOCDO

scale

As soon as a definite treatment need

threshold is reached, then theexamination is stopped

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MOCDO

Missing teeth

Overjets Crossbites


Overbites

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Missing Teeth (teeth not visible)

Congenital absence/traumatic loss

Ectopic teeth

Impacted teeth

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Missing Teeth

Palatally ectopic canines

Is the canine palpable in the buccalsulcus?

If not, it is ectopic = Need for

Treatment

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Missing Teeth

IMPACTED if 4mm or less space

is available between adjacentteeth

Impacted = Need for Treatment

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Missing Teeth

(Congenital absence/traumatic

loss)

In your opinion, is orthodontictreatment required to open or

close the space?

If yes = Need for Treatment

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MOCDO

Missing teeth

Overjets Crossbites


Overbites

Original Slide No.15

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Measuring Overjets

Increased overjets (Class II) and

reverse overjets (Class III) aremeasured using the metal ruler

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Positive overjets

Second line (red)6mm

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Measuring Overjets

Measure to the labial aspect of the most

prominentincisor

Only record Need for Treatment if the

overjet extends beyond the 6mm line

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Measuring Reverse Overjets

All four incisors must be in lingual

occlusion

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Measuring Reverse Overjets

If the reverse overjet falls

exactly on the 4mm (white line)record in the Definite Need for

Treatment category

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First line (white)4mm

Crowding

Reverse overjets

Open bites

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MOCDO

Missing teeth

Overjets Crossbites


Overbites

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Crossbites

Can be anterior or posterior, but

mostly posterior.

Check for displacement on closure. If displacement on closure = Need for

Treatment

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MOCDO

Missing teeth

Overjets

Crossbites


(crowding)

Overbites

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Crowding

Only applies to crowdingbetween permanent teeth

Measure between the contactpoints of the two mostcrowded teeth

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First line (white)4mm

Crowding

Reverse overjets

Open bites

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MOCDO

Missing teeth

Overjets Crossbites


Overbites

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Overbite

Deep overbite

Open bite

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Deep Overbite

Deep overbite causing

gingival or palatal traumaticinjury

= Definite Need for Treatment

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Other Points of the Modified IOTN

Generalised spacing is notrecorded in the Dental Health

Component

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