General Dental Practitioners, Ministry of Health, Kuwait City, Kuwait.
University of Leeds, Leeds, UK.
Eur J Dent Educ. 2023 Aug;27(3):489-496. doi: 10.1111/eje.12832. Epub 2022 Jul 12.
The aim was to assess the ability and confidence of UK undergraduate dental students in applying the Index of Orthodontic Treatment Need (IOTN) and determining appropriate orthodontic referral.
This was a cross-sectional survey using a case-based online questionnaire. Fourth and fifth year undergraduate dental students were recruited from UK dental schools through their university and social media. Six cases were presented and participants were asked to provide an IOTN score and judgement about referral. Participants were asked about their confidence, experience and orthodontic teaching.
Sixty-nine responses were returned. A quarter of participants reported having used IOTN before in a clinical setting. Clinical experience with IOTN influenced confidence. Familiarity with making orthodontic referrals was low and only one participant reported having made an orthodontic referral. Correct IOTN scores were given by 68% of participants for a large 14 mm overjet (5a) case, 43% of participants for an impacted canine (5i) case and 26% of participants for an impacted premolar (5i) case. Incorrect IOTN was most common in hypodontia cases with only 19% correctly identifying mild hypodontia (4h) and 28% identifying severe hypodontia (5h). For the majority of cases, incorrect answers about referral were due to confusion between specialist practitioner and orthodontic consultant pathways.
Dental students' ability and confidence in correctly applying the IOTN Dental Health Component and selecting the appropriate referral pathway was inadequate. Responses suggest a lack of clinical experience in assessing patients, applying the IOTN and making referrals. The low response rate is disappointing and limits the scope for making recommendations.
本研究旨在评估英国本科牙科学生应用正畸治疗需求指数（IOTN）的能力和信心，并确定合适的正畸转诊。
这是一项基于案例的横断面调查，采用在线问卷调查。通过大学和社交媒体招募来自英国牙科学校的四年级和五年级本科生。共呈现了 6 个案例，并要求参与者提供 IOTN 评分和转诊判断。参与者被问及他们的信心、经验和正畸教学情况。
共收到 69 份回复。四分之一的参与者报告在临床环境中使用过 IOTN。临床使用 IOTN 的经验影响信心。熟悉制作正畸转诊的情况较低，只有一名参与者报告过进行过正畸转诊。68%的参与者正确给出了一个 14mm 以上的深覆颌（5a）病例的 IOTN 评分，43%的参与者正确给出了一个埋伏牙（5i）病例的 IOTN 评分，26%的参与者正确给出了一个埋伏前磨牙（5i）病例的 IOTN 评分。在缺牙病例中，IOTN 错误最为常见，只有 19%的参与者正确识别轻度缺牙（4h），28%的参与者正确识别重度缺牙（5h）。对于大多数病例，转诊的错误答案是由于混淆了专科医生和正畸顾问的途径。
牙科学生正确应用 IOTN 牙科健康成分和选择合适转诊途径的能力和信心不足。调查结果表明，学生在评估患者、应用 IOTN 和转诊方面缺乏临床经验。低回应率令人失望，限制了提出建议的范围。
