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Perception vs. Reality? The Importance
of the Orthodontic Screening
AL-KHOURY N, CERONE M, RETROUVEY JM, LIGHT N
INTRODUCTION
Potential Orthodontic patients are screened before being accepted for complete
examination records in the Undergraduate Dental Clinic at McGill University. The
screening process relies on an experienced orthodontist’s perception of a patient's dental
malocclusion as well as other clinical parameters to categorize the patient as: “accepted
for treatment by a dental student”, “placed on a re-evaluation list”, “patient is not an ideal
candidate and may be called if needed” and “patient has been referred to a private
practice”. The accepted patients then undergo complete orthodontic examination, which
include: intraoral examination, radiographs, and acquisition of study models. Each
patient’s case presentation (CP) is discussed with the Director of Orthodontics who
makes the final decision if the patient is accepted or rejected for orthodontic treatments.
OBJECTIVE AND HYPOTHESIS
The goal of this project is to evaluate what percentage of screened patients at McGill’s
Undergraduate Dental Clinic were accepted for acquisition of orthodontic records, and of
those accepted, what percentage were ultimately accepted for orthodontic treatment after
records were taken.
MATERIALS AND METHODS
A sample of all booked patients from Fall 2009 to Winter 2010 was collected (n=479).
Within this sample, we identified the patients that were accepted or rejected for complete
orthodontic examination after screening.
A list from the clinic secretary was received, thereby identifying those acceptably
screened patients that were ultimately accepted or rejected for orthodontic treatment.
Of those patients that were rejected, further investigation of the reason for their rejection
was carried out and noted.
The accepted patients’ age and gender were obtained by analyzing the case presentation.
RESULTS
Table 1. Screenings
Table 2. Case Presentations
Table 3. Main Reasons for Rejection post-CP
Figure 1. Age-Sex Distribution of accepted cases from CP
Figure 2. Age Distribution of the Number of accepted cases vs Age
DISCUSSION
The overall percentage of booked patients that were accepted following screening was
22%, with a no-show rate of 19%. Of the 388 screened patients, 27% (116 patients)
were accepted for complete orthodontic records. 15% of these patients were rejected
after performing complete orthodontic examination, which demonstrated a complex
malocclusion (see table 3).
From the overall number of accepted patients post-CP, an additional 12% never began
treatment either because of the loss of interest or the lack of money.
In addition, the majority of the patients accepted are between the ages of 10 to 14, thus
Interceptive Orthodontic Treatments were required. These are the patients that
undergraduate dental students should be treating.
CONCLUSION
It would seem that the McGill’s Undergraduate Dental Clinic orthodontic screening
procedure is quite effective due to the fact that only 15% of the patients are rejected after
CP. However, teaching Orthodontics to undergraduate dental students in a supervised
program is an extremely difficult task since finding the perfect interceptive patient is rare.
Out of 479 patients that were called, 400 were dismissed and only 79 patients were
accepted and began treatment (16%).