The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
권호 표지
DOI QR코드

DOI QR Code

Development and validation of a novel screening instrument to prioritize the orthodontic referral of developing malocclusion in children: The index for interceptive orthodontics referral

  • Saraswathy Devi Sinniah (Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus) ;
  • Annapurny Venkiteswaran (Centre of Paediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus) ;
  • Najiyatu Nazihah Zakaria (Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus)
  • Received : 2022.10.26
  • Accepted : 2023.01.31
  • Published : 2023.03.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

Keywords

Acknowledgement

This study was funded by the Faculty of Dentistry Universiti Teknologi MARA postgraduate fund.

References

  1. King GJ, Brudvik P. Effectiveness of interceptive orthodontic treatment in reducing malocclusions. Am J Orthod Dentofacial Orthop 2010;137:18-25. https://doi.org/10.1016/j.ajodo.2008.02.023
  2. Zakaria NN, Sinniah SD, Venkiteswaran A. Characteristics and association of gender to dental and occlusal anomalies in Malaysian primary school children. Compend Oral Sci 2021;8:77-88. https://doi.org/10.24191/cos.v8i0.17485
  3. Fleming PS. Timing orthodontic treatment: early or late? Aust Dent J 2017;62 Suppl 1:11-9. https://doi.org/10.1111/adj.12474
  4. Ellis PE, Benson PE. Potential hazards of orthodontic treatment--what your patient should know. Dent Update 2002;29:492-6.
  5. Ackerman JL, Proffit WR. Preventive and interceptive orthodontics: a strong theory proves weak in practice. Angle Orthod 1980;50:75-87.
  6. Loke ST. Training dental officers and nurses in the index of orthodontic treatment need (IOTN) as a screening tool in public health facilities. Malays J Public Health Med 2006;6:49-55.
  7. Lim N, Bennani F, Mei L, Thomson WM, Farella M, Antoun JS. Orthodontic screening and referral practices of dental therapists in New Zealand. Aust Orthod J 2017;33:158-69. https://doi.org/10.21307/aoj-2020-094
  8. Masood Y, Masood M, Zainul NN, Araby NB, Hussain SF, Newton T. Impact of malocclusion on oral health related quality of life in young people. Health Qual Life Outcomes 2013;11:25.
  9. Ministry of Health Malaysia. Annual report Oral Health Division 2013 [Internet]. Putrajaya: Ministry of Health Malaysia; 2013 [cited 2022 Feb 9]. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwinuPOJxH1AhWv4zgGHbnICWsQFnoECAIQAQ&url=http%3A%2F%2Fohd.moh.gov.my%2Fimages%2Fpdf%2Fannual_rpt%2Fannual_rpt13.pdf&usg=AOvVaw0Hx5kyIyl-4NZOQad71oqP
  10. Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod 1989;11:309-20. https://doi.org/10.1093/oxfordjournals.ejo.a035999
  11. Cousley R. IOTN as an assessment of patient eligibility for consultant orthodontic care. J Orthod 2013;40:271-2. https://doi.org/10.1179/1465312513Z.000000000123
  12. Reddy S, Derringer KA, Rennie L. Orthodontic referrals: why do GDPs get it wrong? Br Dent J 2016;221:583-7. https://doi.org/10.1038/sj.bdj.2016.826
  13. de Oliveira CM. The planning, contracting and monitoring of orthodontic services, and the use of the IOTN index: a survey of consultants in dental public health in the United Kingdom. Br Dent J 2003;195:704-6; discussion 696. https://doi.org/10.1038/sj.bdj.4810833
  14. Zreaqat M, Hassan R, Ismail AR, Ismail NM, Aziz FA. Orthodontic treatment need and demand among 12- and 16 year-old school children in Malaysia. Oral Health Dent Manag 2013;12:217-21.
  15. Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics. 5th ed. St. Louis: Elsevier/Mosby; 2013.
  16. British Standards Institution. British standard glossary of dental terms. London: British Standards Institution; 1983.
  17. Arraj GP, Rossi-Fedele G, Dogramaci EJ. The association of overjet size and traumatic dental injuries- a systematic review and meta-analysis. Dent Traumatol 2019;35:217-32. https://doi.org/10.1111/edt.12481
  18. Mohamed AM, Mohd Ariffin WF, Rosli TI, Mahyuddin A. The feasibility of Index of Orthodontic Treatment Need (IOTN) in labial segment malocclusion among 8-10 years old. Arch Orofac Sci 2014;9:76-84.
  19. Lynn MR. Determination and quantification of content validity. Nurs Res 1986;35:382-5. https://doi.org/10.1097/00006199-198611000-00017
  20. Holden RR. Face validity. In: Weiner IB, Craighead WE, eds. The Corsini encyclopedia of psychology. 4th ed. Hoboken: John Wiley & Sons, Inc.; 2010.
  21. Cook DA, Beckman TJ. Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 2006;119:166.e7-16. https://doi.org/10.1016/j.amjmed.2005.10.036
  22. Yusoff MSB. ABC of content validation and content validity index calculation. Educ Med J 2019;11:49-54. https://doi.org/10.21315/eimj2019.11.2.6
  23. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health 2006;29:489-97. https://doi.org/10.1002/nur.20147
  24. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007;30:459-67. https://doi.org/10.1002/nur.20199
  25. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960;20:37-46. https://doi.org/10.1177/001316446002000104
  26. Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull 1971;76:378-82. https://doi.org/10.1037/h0031619
  27. Oluwatayo JA. Validity and reliability issues in educational research. J Educ Soc Res 2012;2:391-400.
  28. Williams A. How to...write and analyse a questionnaire. J Orthod 2003;30:245-52. https://doi.org/10.1093/ortho/30.3.245