Quality and Pattern of Orthodontic Referrals to an Orthodontic Clinic in a Nigerian Tertiary Hospital

Abstract

Background This study aims to evaluate the quality and pattern of referral letters received in a Nigerian orthodontic clinic.
Method Referral letters of patients attending the orthodontic unit of the University College Hospital, Ibadan over a 6-month period were retrieved and analysed for information including date, age, sex, patient name, clinic name, name of referring doctor, history of complaint, diagnosis, management already instituted and reasons for referral. Each were scored 1 when present and 0 when absent. Inclusions such as radiographs and study models were scored the same. Thus, a maximum of 12 points were recorded when all items were present. Referral letters were then grouped into grades according to their scores: grade A maximum score (12); grade B (9-11); grade C (6-8); and grade D (<6).
Results A total of 160 referral letters were received, including no grade A letters (0%), 74 (46%) grade B letters, 81 (51%) were grade C letters and 5 (3%) were grade D letters. The teaching hospital's oral diagnostic clinic provided most of the letters (109), accounting for 68%, while the remaining 32% were from other sources. All 74 (46%) grade B letters were from the same oral diagnostic clinic; however, there was no statistically-significant difference between source of referral and grade of letter (p>0.05).
Conclusion There were no grade A letters, while the majority was grades B and C; signifying that none were of the highest quality. In addition, some vital information was missing from the letters and no inclusion (radiographs or study models) was recorded. Therefore, the style of writing orthodontic referrals needs to be improved. There may be a need to design standard orthodontic referral forms for of uniformity in referring patients for orthodontic treatment.