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Audit of the Health Service Executive orthodontic referral pathway between 2009 and 2011 in the Dublin Mid-Leinster region.
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An
audit
was
undertaken
in
2009
to
determine
the
success
of
the
new
national
orthodontic
referral
protocol
introduced
to
the
Health
Service
Executive
(
HSE
)
in
2007
and
operated
in
the
Dublin
Mid-
Leinster
HSE
region
.
It
was
repeated
in
2011
to
determine
if
the
HSE
austerity
measures
have
had
a
bearing
on
the
orthodontic
service
performance
in
the
Dublin
Mid-
Leinster
HSE
region
.
The
audit
also
measured
the
success
of
referring
practitioners
in
identifying
the
correct
Index
of
Orthodontic
Treatment
Need
(
IOTN
)
classification
of
the
patient
.
In
the
2011
audit
,
the
figures
were
broken
down
to
identify
the
occlusal
variables
that
caused
dental
practitioners
most
difficulties
in
identification
.
The
audit
demonstrates
a
good
referral
to
assessment
timeframe
in
2009
(
85
-
80
%
compliance
for
IOTN
5
and
4
within
three
to
six
months
,
respectively
)
,
which
deteriorates
significantly
in
2011
(
26
-
4
%
for
IOTN
5
and
4
within
three
to
six
months
,
respectively
)
.
The
ability
of
dentists
to
identify
the
correct
IOTN
classification
was
better
in
2009
(
60
%
correct
)
compared
to
2011
(
51
%
correct
)
,
but
both
figures
fell
below
the
audit
standard
of
75
%
of
referrals
with
correct
IOTN
classifications
.
The
IOTN
occlusal
dental
health
components
most
readily
identified
by
referring
practitioners
and
meeting
audit
standards
were
5
a
(
overjet
>
9
mm
)
,
5
i
(
impacted
teeth
)
and
5
h
(
extensive
hypodontia
)
.
The
remaining
occlusal
dental
health
components
in
the
HSE
IOTN
fell
below
the
audit
standard
.
The
audit
clearly
identifies
a
requirement
for
a
continued
educational
effort
to
maintain
the
HSE
IOTN
skill
base
in
primary
care
,
and
a
need
for
additional
resources
to
manage
the
demand
for
orthodontic
assessments
.
