Orthodontic Treatment Eligibility among New Patients Referred to National Dental Centre, Brunei Darussalam

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Taqtyuddin Tahir
Uday Kumar Umesan
Jagjit Singh Dhaliwal
Hanif Abdul Rahman


Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referrals made by the general dental practitioners (GDPs) to the Specialist Orthodontic Unit, National Dental Centre (NDC) for orthodontic assessment from government dental clinics in Brunei-Muara district using Index of Orthodontic Treatment Need (IOTN) as an objective measure.

Material and Methods: Patients’ data were collected from Brunei Health Information Management Systems (Bru-HIMS) for one-year period from 1st January 2018 to 31st December 2018. From this patient pool, a total of 147 patients who underwent orthodontic assessment were identified. The data collected were imported to RStudio to perform appropriate statistical analyses.

Results: Of 147 new patient referrals, 72.1% were female and 27.9% were male, with a mean age of 18.3 years (SD ± 5.8 years). Patients with age range of 9 to 39 years were evaluated. A total of 87.8% of new patient referrals were eligible under IOTN. The predominant incisor relationship referred was class II division 1 (33.3%) and the prevalence of class III was high at 30.6%. The most common malocclusion trait referred was a severe dental contact point displacements >4 mm, grade 4d (53.1%).

Conclusion: A total of 87.8% of new patient referrals were deemed eligible by specialist orthodontists utilizing IOTN. A total of 83.7% of new patient referrals were in a definite need for orthodontic treatment. It is highly recommended for general dental practitioners to have training in utilizing IOTN and necessitate establishment of proper referral guidelines.

Malocclusion, orthodontic treatment eligibility, waiting list, index of orthodontic treatment need, general dental practitioner

Article Details

How to Cite
Tahir, T., Umesan, U. K., Dhaliwal, J. S., & Rahman, H. A. (2020). Orthodontic Treatment Eligibility among New Patients Referred to National Dental Centre, Brunei Darussalam. Asian Journal of Dental Sciences, 3(3), 31-41. Retrieved from https://journalajds.com/index.php/AJDS/article/view/30120
Original Research Article


Tak M, Nagarajappa R, Sharda AJ, Asawa K, Tak A, Jalihal S, et al. Prevalence of malocclusion and orthodontic treatment needs among 12-15 years old school children of Udaipur, India. Eur J Dent. 2013;7(5 SUPPL.):45–53.

Bayat JT, Huggare J, Mohlin B, Akrami N. Determinants of orthodontic treatment need and demand: A cross-sectional path model study. Eur J Orthod. 2016;39(1):85–91.

Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod; 1989.

Jamilian A, Kiaee B, Sanayei S, Khosravi S, Perillo L. Orthodontic treatment of malocclusion and its impact on oral health-related quality of life. Open Dent J. 2016;10(1):236–41.

Bhatia R, Winnier JJ, Mehta N. Impact of malocclusion on oral health-related quality of life in 10-14-year-old children of Mumbai, India. Contemp Clin Dent. 2016;7(4):445–50.

Izadi M, Gill DS, Naini FB. Retrospective study to determine the change in referral pattern to St George’s Hospital Orthodontic Department before and after the 2006 NHS dental contract changes. Prim Dent Care. 2010;17(3):111–4.

Ireland AJ, Cunningham SJ, Petrie A, Cobourne MT, Acharya P, Sandy JR, et al. An index of Orthognathic Functional Treatment Need (IOFTN). J Orthod. 2014;41(2):77–83.

British Standards Institute (BSI). Glossary of Dental Terms (BS4492). London: BSI; 1983.

AlZaben JM. A pilot study of appropriateness of orthodontic referrals in Jordanian Ministry of Health. Smile Dent J. 2013;8(3):28–31.

Meade MJ, Millett DT. An audit of orthodontic treatment eligibility among new patients referred to a Health Service Executive orthodontic referral centre. J Ir Dent Assoc. 2013;59(5):246–51.

Ministry of Health Brunei Darussalam; 2017.

(Revised as of 11 December 2018)

Gazit-Rappaport T, Haisraeli-Shalish M, Gazit E. Psychosocial reward of orthodontic treatment in adult patients. Eur J. Orthod. 2010;32(4):441–6.

Rasool G, Nausheen A, Hassan N, Bashir S. Orthodontic treatment and patient’s expectations. 2012;4(2):44–7.

McSwiney TP, Millett DT. North Cork HSE orthodontic treatment waiting list 2009-2010: Retrospective audit of patient records. Journal of the Irish Dental Association. 2013;59:87–90.

Loke ST, Tan SY. Competency of primary care officers in referring patients for orthodontic treatment using IOTN (Index of Orthodontic Treatment Need). Malays Dent J. 2017;2:1–29.

Ministry of Health Brunei Darussalam. Oral Health Information Booklet 2014. 2014;1–74.

Seehra J, Fleming PS, Newton T, DiBiase AT. Bullying in orthodontic patients and its relationship to malocclusion, selfesteem and oral health-related quality of life. J Orthod. 2011;38(4):247–56.

Thickett E, Hogkins J, Power S, Short M, Reed R, Weeks L, et al. An audit to examine the appropriateness of new patient referrals. Br. Orthod Soc Clin Effect Bull. 2006;19:19-20.

Fleming PS, Proczek K, DiBiase AT. I want braces: Factors motivating patients and their parents to seek orthodontic treatment. Community Dent Health. 2008;25(3): 1669.