A summary of the HSE guidelines for eligibility for orthodontic treatment so that dentists have a visual guide to which cases should be referred to a specialist.

Throughout our professional lives, we will be asked the question: “will I need braces?” A self-conscious teenager might ask, but what a worried parent may really be wondering is: “will my child be eligible for treatment within the HSE?”
The modified Index of Treatment Need (IOTN) guidelines for eligibility were introduced in the HSE in 2007 as a way to assess orthodontic need objectively rather than subjectively. This article aims to offer a visual guide to simplify the IOTN guidelines on eligibility for referral to the HSE and aid general practitioners to offer advice to their patients and refer appropriately.
A healthy smile starts at home with good habits regarding diet, snacks, drinks and brushing, which are key to a healthy dental future. Only patients with good oral hygiene and dental health are eligible for orthodontic treatment.

blueCircleAges 8/9:
Keep the child’s age in mind when assessing dentition or looking at OPGs (see normal eruption dates). Dental age and chronological age are not always the same so be alert to an abnormal sequence or asymmetric eruption patterns. Contralateral teeth should erupt within six months of each other.
Refer if interceptive treatment is appropriate.

orangeCircleAges 10-12:
Check family history for anomalies such as impacted canines. Palpate for canines and monitor dental development. A median diastema can be normal before the canines erupt. Check for severe skeletal problems, an overjet >9mm, impacted teeth, missing teeth and crossbites with displacements, and refer for orthodontic assessment if appropriate.

greenCircleAges 12+:
Check aesthetic component once the canines have erupted. Refer 4d cases with AC 8-10 or other eligible patients.

Please download full article/guide here.

Ciara Scott

Dr Ciara Scott is a specialist orthodontist with the HSE in Dublin Mid-Leinster.
Ciara wishes to acknowledge the assistance of Dr Marielle Blake of the HSE and Dr Sinéad O’Hanrahan of the OSI in the preparation of this material.