CATEGORY AUSTRALASIAN DENTIST59 CLINICAL of GDPs towards orthodontic diagnosis and treatment, and found that GDPs who were providing orthodontic treatment mostly applied clear aligner therapy (75.6%) and GDPs stated that they mostly refer complex cases and growing patients to orthodontists, with 95.1% of GDPs referred patients to an orthodontist, mostly (95.5%) of skeletal anomalies. Their study concluded that GDPs should benefit more from orthodontic diagnosis and diagnosis methods for the early diagnosis and correct guidance of such skeletal anomalies. All the literature studies are based on variations on age groups, gender, working experience (years), experience in attending orthodontic courses and seminars, personal studies in the field of orthodontics, referral of patients in need of complex orthodontic treatments and regional specific. Benefits of Diagnostic Skills In orthodontic treatments, proper timing and treatment planning are the key factors in achieving favourable outcomes and preventing unnecessary cost. Since general dentist are usually the first referral source of orthodontic treatments, acquiring knowledge of accurate diagnosis and proper timing of orthodontic treatments would be necessary for them. American Association of Orthodontists states that graduated dentists should be able to design and adjust a space maintainer device; they should also have the ability to diagnose and manage space-related problems, as well as being familiar with single tooth movement or moving part of the dental arch by using functional orthodontic appliances. It is also stated that in orthodontic treatments, understanding the proper timing of the treatment is a key factor in achieving the optimum results and reducing the time and cost of postponed treatments. General diagnosis a GDP should know about the identification of proper timing of orthodontic treatments are: X Ideal timing for the first orthodontic examination X Proper timing of the extraction of primary canine tooth in case of absence of eruption of the permanent canine tooth X Ideal timing of treatment of class III skeletal problem deficient maxilla X Ideal timing of treatment of class II skeletal problem excess maxilla X Ideal timing of treatment of class II skeletal problem deficient mandible X Ideal timing of treatment of class III skeletal problem excess mandible with the increased mandibular plane inclination X Ideal timing of treatment of supernumerary teeth X Possibility of compensation of the vertical changes of the face caused by maxillary excess by providing treatment in older ages. Benefits of Referral Referral to the orthodontist by a general dentist usually occurs when diagnosis and treatments are out of their ability or when during the orthodontic treatment, for various reasons including the complexity of the treatment or prolongation of treatment time. Based on various studies of the orthodontic referral behaviour of dentists, it was reported that only a small number of them were able to correctly identify the appropriate timing of referral. The majority of orthodontic treatments are traditionally provided by specialists; however, a substantial number of general dentists (GDs) appear to provide some type of orthodontic service. GDs usually act as the primary referral source for the patients in need of orthodontic treatments; therefore, having the proper knowledge and understanding regarding the accurate diagnosis of clinical situations requiring timely treatment, as well as necessary referral to specialists, can be of paramount importance. Aldrees et al (2015), based on their study, most of the participants (58.1%) reported that they referred 1-4 patients to an orthodontist per month, 19.4% referred 5-10 patients, 9.7% referred more than 10 patients, and 12.9% did not refer any patient to an orthodontist. Studies have also reported that besides having the knowledge of referral to orthodontists in a specific orthodontic problem, having access to orthodontists also plays an important role in making a decision for referring the patient to the specialist. Conclusion General practitioners as well as nonorthodontic specialists should be equipped with the ability to identify at the early stages of orthodontic issues and advise patients to obtain a thorough orthodontic examination by the field specialist only. It is strongly advised that general practitioners or non-orthodontic experts should advise patients to visit orthodontic experts for critical orthodontic issues. GPDs who have not received clinical training in orthodontics are expected to act within the framework of preventive and interceptive treatments. Thus, indicating the necessity of developing more educational courses and referral guidelines that could briefly demonstrate when and which cases should be referred to a specialist and when and in which cases, GDs are capable of providing orthodontic treatments. Continuing Dental Education (CDE) programs can be helpful for general dentists and non-orthodontic specialists to upgrade their knowledge of orthodontic treatment which in turn will result in proper counselling and referral. A study done by Zarif Najafi et al (2014), showed that most of the participants considered university education the most important source of learning orthodontic skills. Further, Lee et al (AJODO 2022), confirmed the results of the previous study. Therefore, allocating more hours of education in the dental school’s curriculum can be beneficial for improving the GDs knowledge of the orthodontic treatments. Although the gold standard for evaluating the need for orthodontic treatment is to be evaluated by an Orthodontist, it is important to understand the perceptions of GDPs; because they can directly and indirectly affect the provision and success of orthodontic treatment. X geoff@orthoed.com.au Tel +613 91080475 Email gapmagagazines@gmail.com for a complete list of references. Percentage of answers to the questions based on the diagnosis of the orthodontic problem by GDPs
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