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Orthodontic referrals: why do GDPs get it wrong?

S Reddy1, K A Derringer2, L Rennie3

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Most orthodontic referrals are inappropriate, with only a third meeting standards. Improving referral quality requires solutions beyond guidelines, such as proformas and enhanced professional education.

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Area of Science:

  • Dentistry
  • Orthodontics
  • Healthcare Management

Background:

  • Clinical audits are essential for assessing and improving healthcare services.
  • Orthodontic referrals require careful assessment to ensure appropriate patient selection for treatment.

Purpose of the Study:

  • To audit the suitability of orthodontic referrals at King's College Hospital Orthodontic Department.
  • To identify reasons for inappropriate orthodontic referrals and propose solutions.

Main Methods:

  • Prospective audit of 228 new patient referrals over 5 months.
  • Data collection via questionnaires completed by dental students and checked by clinical teachers.
  • Second audit cycle conducted after implementing referral guidelines and pathways.

Main Results:

  • Only 37.2% of initial referrals met standards, decreasing to 33.3% in the second cycle.
  • Common issues included incorrect Index of Orthodontic Treatment Need (IOTN) scores, poor oral hygiene, early referrals, and adult patients.
  • Referral guidelines and targeted education proved ineffective in improving referral quality.

Conclusions:

  • High rates of inappropriate orthodontic referrals persist despite interventions.
  • Effective solutions may require proformas and enhanced professional education to improve referral quality.
  • Further strategies are needed to optimize the orthodontic referral pathway.