National British Orthodontic Society (BOS) Orthognathic Audit 2017–2018

Abstract

Objective: To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients before treatment. Design: National clinical audit. Setting: Data collected using Bristol Online Surveys. Participants: Sixty-nine UK hospital orthodontic departments submitted data. Methods: Data were collected at two time points using Bristol Online Surveys over a period of 12 months. These were before treatment at the first multidisciplinary clinic (MDT) and immediately after surgery. The data collected included: Index of Orthognathic Functional Treatment Need (IOFTN); Index of Orthodontic Treatment Need (IOTN); age; previous orthodontic treatment; attendance at an MDT; treatment times; and information provision. Results: Eighty-five units agreed to take part in the audit with 69 submitting data, giving a response rate of 81%. The data from 3404 patients were uploaded, 2263 before treatment and 1141 immediately after surgery. Of patients, 91.07% had an IOFTN score of 4 or 5 and 88.73% had an IOTN score of 4 or 5. The mean age at the first MDT was 22 years in the first cohort and 21 years and 4 months in the second immediate post-surgery cohort. Of patients, 37.93% had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment; 96.93% had an MDT confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2 years and 6 months. With respect to information provision, patients received information from a number of sources, principally the British Orthodontic Society (BOS) patient information leaflets and the BOS website Your Jaw Surgery. Conclusions: In the UK, the majority of orthognathic cases fulfil the criteria for acceptance for NHS-funded orthognathic treatment, as outlined by the Chief Dental Officer’s interim guidance on orthognathic treatment. This suggests any prior approval process would not be a good use of NHS resources in the commissioning of orthognathic treatment.

Characteristics of orthognathic multidisciplinary team clinics in England. Part 2: A qualitative study

“…The national orthognathic audit 2017–2018 reported a broad range of waiting time (range <1 month to 4 years) from immediate preoperative MDT to surgery ( Ireland et al, 2019 ). Consistent with this, a longer waiting list/waiting time was a weakness of some of the orthognathic MDT clinics in this study.…”

“…A marked variation in the orthognathic care pathway has been reported ( Morris, 2006 ; Parbatani et al, 2010 ) and confirmed via a questionnaire study preceding this study by the same team. Further, Ireland et al (2019) analysed the acceptance criteria, information provision and attendance of MDT clinics by orthognathic patients in an audit. This audit reported that 3.07% of patients had not been through the pre-treatment MDT.…”

Establishing a clinical psychology team within the orthognathic service: A triad model of orthodontic, maxillofacial and psychological care

“…A national orthognathic audit was undertaken during 2017-2018 of acceptance criteria for treatment and information provided to patients before their treatment (Ireland et al, 2019). A total of 69 hospitals submitted evidence, including Whipps Cross.…”