Orthodontics

This specialist department corrects teeth and jaw alignment problems using devices such as braces. The department also provides advice to referring practitioners for treatments they can provide, such as extractions.

Clinical Criteria:

Adult patients are only accepted if there is a major improvement in oral health anticipated as a result of the treatment.

The Index of Orthodontic Treatment Need (IOTN) is used as a guide for screening patient treatment needs in this clinic. Only patients with IOTN grade 4 or 5 will be considered as follows:

Grade 5 – Very Great Priority

  • Overjet > 12mm
  • Reverse overjet > 4mm
  • Impeded eruption of teeth (except third molars) due to crowding, displacement, presence of supernumerary teeth, or retained deciduous teeth (These cases may not require appliances)

Grade 4 – Great Priority

  • Overjet 9-12mm
  • Reverse overjet 2-4mm
  • Anterior crossbite > 1mm mandibular displacement
  • Posterior crossbite > 2mm mandibular displacement
  • Crowding > 10mm in one arch
  • Anterior or posterior open bite > 4mm
  • Rotation of anterior tooth > 30°
  • Increased, complete/overbite causing recession of upper lingual or lower labial gingivae

Patients with missing upper anterior teeth requiring pre-prosthetic orthodontics or orthodontic space closure to obviate the need for a prosthesis may also be accepted.

Exclusions:

  • Patients with cleft defects of lip and/or palate. These patients are covered by the Medicare Cleft Palate Scheme and can attend a private orthodontist or The Royal Children's Hospital
  • Gingival bleeding on probing
  • Plaque index >20%
  • Patients who have active periodontal disease. These patients can only be treated once the periodontal problems are in a maintenance phase

Prerequisite for referral

If accepted for specialist care, patients must be prepared to attend The Royal Dental Hospital of Melbourne for multiple visits, often over many years.