Abstract : Orthodontic studies over several decades have found generally inconsistent agreement among dentists when evaluating orthodontic treatment need. There have also been recent reports that undergraduate dental education does not sufficiently prepare dentists to diagnose and make appropriate referrals of potential orthodontic patients. This highlights an opportunity to improve dental education in the area of orthodontic needs assessment. The Index of Orthodontic Treatment Need (IOTN) is an occlusal index that has been found to be both reliable and valid in studies both in Europe and in the United States. The IOTN's use as an educational tool has not been evaluated. The purpose of this study was to investigate the efficacy of IOTN as a tool to improve dental students' ability to assess orthodontic treatment need. Fourth-year dental students were divided into three groups of twenty (control, sham-control, experimental). The subjects evaluated thirty orthodontic study models with a 'gold standard' previously established by an expert panel of fifteen orthodontists for orthodontic treatment need. The control group evaluated the models on two separate occasions for orthodontic treatment need and the sham control group evaluated the models a second time after training in posterior-anterior cephalometrics. The experimental group evaluated the models after IOTN instruction. Kappa, sensitivity and specificity were calculated for each subject. For kappa, the ANCOVA result reveals a significant group effect (p = 0.0001), a significant gender effect (p = 0.0289), but no significant group by gender interaction (p = 0.1762). For sensitivity, there was no significant group effect (p = 0.1007), gender effect (p = 0.6997), or group by gender interaction (p = 0.8644). For specificity, there was a significant group effect (p < 0.0001), significant gender effect (p = 0.0377), but no significant group by gender interaction (p = 0.4315).
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