National BOS Orthognathic Audit 2017-2018

Objective; To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients prior to treatment. Design; National clinical auditSetting; Data collected using Bristol Online Surveys (BOS)Participants; 69 UK hospital orthodontic departments submitted data. Methods; Data was collected at two time points using BOS over a period of 12 months. These were prior to treatment at the first multidisciplinary clinic (MDT), and immediately post-surgery. The data collected included: IOFTN, IOTN, age, previous orthodontic treatment, attendance at an MDT, treatment times and information provision.Results; 85 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 prior to treatment and 1141 immediately post-surgery. 91.07% of patients 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 22yr in the first cohort, and 21yr and 4mo in the second immediate post-surgery cohort. 37.93% of patients had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment. 96.93% had a multidisciplinary team confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2yr and 6mo. With respect to information provision, patients received information from a number of sources, principally the 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