Whenever orthodontic treatment is to be considered, it is essential to carry out a complete patient assessment to get a clear picture of the patient's medical and dental condition before any irreversible treatment (such as extractions) are carried out or the orthodontic treatment causes more harm than benefit. The assessment is also key in establishing the correct diagnosis and likely cause of the malocclusion. This assessment should include the following: *Medical History *Patient's Complaint *History of Trauma *Habits *Extra-Oral Examination *Intra-Oral Examination *Radiograph *Indication of Orthodontic Treatment Need Scoring *Justification for Treatment *Treatment Aims *Treatment Plan The Extra Oral Examination Should Include: *Skeletal Pattern *Anterior-Posterior *Vertical Dimension *Transverse *Soft Tissues *Temporomandibular Joint Examination The Intra Oral Examination Should Include: *Dental health *Lower arch *Upper arch *Teeth in occlusion *Radiographs The presence of dental disease precludes any active orthodontic treatment, even if the malocclusion is severe. This is because orthodontic appliances accumulate plaque and combining this with a high carbohydrate diet and poor oral hygiene can result in extensive decalcification of the teeth and accelerated bone loss if you try to move the teeth when there is active gingivitis and periodontal disease.<unk>  is measured from the labial surface of the most prominent incisor to the labial surface of the mandibular incisor. Normally, this measurement is . If the lower incisor is anterior to the upper incisors, the<unk>  is given a negative value. In the UK, an<unk>  is generally described as increased if it is >. The Index of Orthodontic Treatment Need rates<unk>  highly on its weighting system, second behind missing teeth. It then grades severity of<unk>  as: *Grade 3, Borderline need for treatment = increased<unk>  . Radiographs can aid your diagnosis. Any radiographs taken must be clinically justified in accordance with the IRMER Regulations 2000. Radiographs may help by giving you more information on: *Presence or absence of teeth *Stage of development of adult dentition *Root morphology of teeth *Presence of ectopic or supernumerary teeth *Presence of dental disease *Relationship of the teeth to the skeletal dental bases and their relationship to the cranial base. *Radiographs commonly used in orthodontics assessment include: *Dental panoramic tomography *Cephalometric lateral skull radiograph *Upper standard occlusal radiographs *Periapical Radiographs *Bitewing Radiographs
Overjet
Isochronic tones
Skull bossing
Triangular face
Stunt 
Dichotic pitch
Calcaneal pitch
Oak wilt