Adding an orthodontic screening to your evaluation process can be a quick improvement to your care. In just 7 minutes, you gain a great diagnostic tool, provide an excellent service for your patients, and build credibility with your patients. Whether or not you provide orthodontics, orthodontic screenings are a must for all general dentists who want to better understand their patients’ oral health and motivations.
Screenings are an important first step in the orthodontic process, helping you to choose the right cases to treat (or refer), and set up your patient so you are profitable and stress-free.
Before you begin orthodontic treatment, you should understand the factors that are essential in an orthodontic screening. We put together this Ultimate Orthodontic Screening Checklist to help you with this important process.
The Ultimate Orthodontic Screening Checklist
Patient History (1 minute)
Patients fill out a written form prior so this is a small portion of your screening. You can quickly clarify any areas from your questionnaire in your discussion.
1. Medical History
Check to see if they have any previous medical issues or sensitivities to medication.
Total Time: 0.5 minute
2. Dental History
This will help you to better understand their dental situation, parental orthodontic background, and growth. For example, you can inquire if the patient has consulted with an orthodontist prior or note if the patient has speech problems. You can also see if he/she plays a musical instrument, which may affect jaw development.
Total Time: 0.5 minute
Classification (3 minutes)
This portion of the screening is where the “meat” of the orthodontics come in. You should be working with a dental assistant to document your classification. This enables you to get highest efficiency.
3. Dental Classification
You will determine their orthodontic classification and what division they are. You will also look at aspects of their dentition like their crowding, arch shape, curve of spee, and periodontal condition.
Total Time: 1 minute
4. Temporomandibular Joints
This evaluation will help you determine if they have any preexisting TMJ or TMD symptoms. Do they have any headaches? If so, how often and what type of pain do they experience? How wide can they open their mouth? Do you feel any clicks? From this, you can determine more about their jaw function, and if orthodontics may be helpful to correct these issues.
Total Time: 1 minute
5. Facial Survey
There are a couple reasons why you want to take a facial survey. You want to understand how their musculature may affect your orthodontic treatment. Understanding these features can help you choose the most suitable treatment type, as some facial types have faster treatment with extraction, while others see better results with non-extraction. This portion of the screening can also help you to better understand how orthodontics may affect their facial esthetics and balance.
Tell a joke! Not only is it a nice touch to your screening, but you get to see how they smile naturally. Viewing a natural smile can give you vital information, like posturing or how many millimeters of gingival display they may have. Knowing if they have a gummy smile can help you to discuss potential treatment for this, whether it’s using orthodontics, or other methods.
Total Time: 0.5 minute
6. Myofunctional
Looking at your patient’s function allows you to plan a more effective treatment. Sometimes myofunctional habits can cause certain orthodontic treatments to stall, so fixing certain habits early can give you a faster treatment with much better retention. You’ll be looking at their lip tonicity and competency, any open bite or overjet, and other aspects like how they breathe. Understanding the patient’s myofunctional situation not only helps any orthodontic treatment and patient expectations, but it can also improve your restorative success.
Total Time: 0.5 minute
Patient Motivation (3 minutes)
This is a key area to understanding what your patient wants. You can sometimes ask “What brings you to my practice today?” before you start screening. There are various motivation questions you can use, such as “Is there anything that bothers you when you look in the mirror?” or "Have you ever thought about getting braces?" If they’re coming in for a toothache, you may want to focus on fixing that first. On the other hand, if they have dental/facial comments or have mentioned wanting braces, this part of the orthodontic screening can help you.
Face the patient when you talk with them. Although this is a simple tip, you may be surprised with how often we see patients speaking to the back of a dentist’s head, who may be looking at a form or computer. This is a great opportunity to get to know your patient and understand their greatest dental concerns, so you can best help them. If you do this right, they will trust that you have their best interest at heart.
7. Chief Complaint
If your patient decides that they want orthodontic treatment from you or the specialist, you should make sure you know what they want fixed. Their chief complaint should always be addressed by the treatment, in addition to helping them with the other benefits from braces.
Total Time: 1 minute
8. Patient’s Perception of Protrusion
This is a common aspect of the screening that gets missed, but it’s important. This can help you determine what type of treatment would be best for the patient. Your perception of their protrusion could be very different than theirs. You want to avoid situations where you treat the patient and she looks beautiful (by esthetic norms and your standards), but the patient thinks she looks too full or sunken in. You not only want a great finish, but also for your patient to be happy. Just ask before and you save yourself the hassle.
Don’t ask them “What is your perception of protrusion?” Instead, use words they can better understand. You can ask instead, “Do you like where your lips rest?” or “Would you prefer your lips to be fuller, or move back?”
Total Time: 1 minute
9. Treatment Preferences
Understand if they have any preferences. Are they OK with extracting teeth if they can have a better result? Or are they adamant on a non-extraction treatment plan?
Do what’s right for the patient. This may not always be what the patient wants. Sometimes the patient does not want to take out teeth no matter how much you discuss what’s best for them. If a non-extraction treatment plan would hurt their occlusion and facial balance, you may need to walk away from treating this patient. They may get their braces elsewhere. We find that it’s better for your reputation and profitability to do better treatment that you are comfortable with than to accept all cases where some turn out bad. If you don’t yet know what your limits are, don’t worry, you will have these discussions at a later point of the process. Education and practice will help you get the confidence and knowledge to be quick at this.
Total Time: 1 minute
Bonus Tip: Introducing the Ortho Screening
First time providing an orthodontic evaluation? Here is a sample script to help you get ideas to introduce the orthodontic screening:
“As part of our full oral health evaluation, we are also providing a free orthodontic exam. With this quick screening, we can let you know about your teeth and jaw alignment to better understand your dental health."
Total Time: 0.5 minute
Download this checklist in a printable format
Diagnosis is the key to success in orthodontics, so we wanted to share the key factors that we look at in our orthodontic evaluation. For the best success, you should diagnose before starting any treatment and putting on any brackets or fitting removable appliances. Once you understand orthodontic diagnosis, a good orthodontic screening can provide you valuable information, in as quick as 7 minutes!
Our graduates usually find that with this screening, 80% of patients could be good orthodontic patients. After you do a thorough orthodontic evaluation, you will know if your patient is a good orthodontic candidate or not. If your patients tell you that they are interested in getting orthodontic care, you can refer them out, or you can help them yourself with the next step: the first consultation and getting records. Want to have a confident first ortho consultation? Read these sample scripts.
Want to take your orthodontics to the next level?
Providing orthodontic treatment can change your patients’ lives and be very rewarding and profitable when done right. This quick checklist should help you start this direction.
If you want more knowledge in orthodontic diagnosis or are interested to treat orthodontic patients, it's extremely helpful to enroll into an extensive program like our Comprehensive Orthodontic Series. Here, you would be able to understand the screening in greater depth, gain diagnosis and communication tips, and practice with sample cases. As a student, you’ll also get to work with SmileStream, a robust orthodontic software that has an interactive orthodontic screening form. This form has 52 easy-to-use questions help to keep you and your team on track and documented. Working with an orthodontic diagnostic software can give you peace of mind, guidance, and efficiency within orthodontics.
