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IOTN
Background
The Index of Orthodontic Treatment Need (IOTN) was developed by Shaw,
Richmond and O'Brien at Manchester Dental School in the 1990's. They were
based on a number of existing orthodontic indices. Since then the UK NHS has
introduced their use to limit access to orthodontic care
IOTN has two components - Dental Health Component (DHC) and Aesthetic
Component (AC). In the NHS patients must score IOTN 4 or 5 for treatment. In
patients with IOTN 3 the aesthetic component is applied, those patients with an
IOTN DC score of 3 AND an IOTN AC score of 6 or greater, qualify for
treatment
Only the worst feature of the occlusion is scored (ie you do not add a number of
minor feature scores together.
The aide memoir to it's use is MOCDO : Missing Overjet Crossbite Displacement
Overbite, Look for the worst first, ie those features that score IOTN 5, then IOTN
4, 3 etc
The table below allows quick reference to IOTN DHC with the most common
features.
M O C D O
Cleft lip & Palate > 9mm
Impacted / Ectopic Overjet
IOTN
teeth > - 3.5mm
5
Hypodontia >4 reverse
missing teeth Overjet
>6mm Overjet Crossbite with Deep Overbite
Supernumaries -2mm to - >2mm > 4mm contact + Trauma
IOTN
Hypodontia <4 3.5mm displacement point >4mm
4
missing teeth reverse between RCP displacement Anterior Open
Overjet and ICP Bite
Crossbite with Deep Overbite
>4mm Overjet
>1mm <4mm contact (no trauma)
IOTN <-2mm
displacement point <4mm
3 reverse
between RCP displacement Anterior Open
Overjet
and ICP Bite
<2mm contact
IOTN
>2mm Overjet point
2
displacement
IOTN Minimal
1 irregularity
2 7
3 8
4 9
5 10