PubMed · 4501687
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1972-02-01. Asking questions.. https://doi.org/10.1038/sj.bdj.4802807
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UNLABELLED: An Oral Health Index (OHX) has been designed to provide a numerical measure of the overall state of a patient's oral health by means of a series of simple clinical examinations. This has been amended to produce the Oral Health Score (OHS). OBJECTIVE: To assess, by means of a questionnaire, the ease of use and understanding of the OHS by general dental practitioners. METHODS: 350 GDPs were asked to participate in the project, of whom 329 agreed. These dentists were given a lecture of 2 hours' duration on the OHS. The participating dentists were requested to use the OHS for a period of 1 year. At the end of this period, a questionnaire was delivered to them by post, with an explanatory letter and reply-paid envelope. RESULTS: Completed, usable questionnaires were received from 239 GDPs, a 77% response rate. Ninety three percent of respondents considered the OHS instructions to be satisfactory. The respondents' views on the criteria on which the OHS component assessments are based indicated that over 90% of respondents agreed with the criteria for caries, adequacy of restorations, periodontal assessment, mucosal assessment and assessment of dentures. A majority of respondents agreed that the OHS provided a valid representation of oral health. CONCLUSION: The results of the present study indicate that the OHS is considered to be an easy-to-use measure of a patient's oral health and that it provides a valid representation of a patient's oral health.
Occlusal indexes objectively quantify malocclusions. The index of complexity, outcome and treatment need (ICON) is a new index developed to measure several aspects of occlusion and treatment outcome. The purpose of this study was to test the validity of the ICON in measuring orthodontic complexity, outcome, and degree of improvement. Fifteen orthodontists evaluated 100 pairs of pretreatment and posttreatment study models for complexity, outcome, and degree of improvement. A calibrated examiner used ICON to score the casts. One month later, a random subset of 40 study casts was rescored by raters and the examiner for reliability testing. A simple kappa statistic was used to assess agreement between the scores from the expert panel and from the ICON examiner. Interrater agreement was moderate for complexity (kappa =.50), slight for outcome (kappa =.18), and poor for degree of improvement (kappa =.04). Reliability of the calibrated examiner was kappa =.90 for pretreatment and kappa =.83 for posttreatment casts. Agreement between the raters and the ICON scores was moderate for complexity (kappa =.52) and outcome (kappa =.50) and fair for degree of improvement (kappa =.27). ICON is valid for assessing cases for complexity and outcome. However, lack of agreement among the raters for degree of improvement and between the ICON-based evaluations and the orthodontists' evaluation of degree of improvement suggests that this component should be reexamined.
The difficulty of achieving an ideal or normal occlusion might lie in the pretreatment occlusion, patient-associated factors, and the treatment. The purpose of this study was to identify factors that were related to the treating orthodontist's posttreatment categorization of a case as difficult or easy. Ten orthodontists each identified 10 easy cases and 10 difficult cases that they had treated. The initial malocclusion was measured with the peer assessment rating (PAR) index and the index of orthodontic treatment need (IOTN). Patient and treatment information was obtained from the treatment records. Statistical analysis with parametric or nonparametric testing was performed. Difficult cases had greater severity and need before treatment and greater residual malocclusion and need after treatment. Difficult cases had more chart entries for problems with hygiene and compliance. They were more likely to have had extractions and changes in treatment plan. Difficult cases also required more appointments and a longer treatment duration. Three logistic regression models were developed based on malocclusion severity, patient characteristics, and treatment characteristics. The models support a correlation between greater pretreatment malocclusion severity, 1-phase treatment, and the designation as a difficult case. This study supports a model in which malocclusion severity and factors associated with the patient and the treatment contribute to an orthodontist's categorization of a case as easy or difficult.