FEASIBILITY OF THE NEWLY DEVELOPED INDEX FOR INTERCEPTIVE ORTHODONTICS REFERRAL (IIOR) AND THE USER'S PERCEPTION: A PILOT STUDY Introduction: The Index for Interceptive Orthodontics Referral (IIOR), a tool designed to guide the timely referral of developing malocclusion was recently developed and validated. The IIOR may facilitate the timely identification and referral of cases that may benefit from interceptive orthodontics. This pilot study aimed to assess the feasibility of the IIOR and perception among its users. Objectives: (1) To assess the feasibility of using IIOR among dental frontliners. (2) To investigate the perception of IIOR usage among dental frontliners. Methodology: Thirteen participants (6 dental officers, 3 orthodontic postgraduate students, and 4 dental therapists) were briefed about the IIOR through a pre-recorded video presentation. Subsequently, the participants were asked to grade 10 study models with a case summary of each, using the IIOR. The participants' responses were compared to the grading by experts on the 10 study models of various malocclusion using IIOR, which was established before this pilot study. After grading, they were asked to complete a questionnaire that assessed their perception towards the IIOR, in an interactive method. The questionnaire had undergone content and face validation. Results: The Fleiss Kappa scoring by the participants resulted in moderate agreement of 0.5. A total of 79.23% of participants matched the gold standard scoring. Additionally, 92.3% of the participants were happy to have a screening tool such as the IIOR to guide and assist them during patient screening. They found IIOR to be very useful, efficient, and easy to understand. Conclusions: In this pilot study, the IIOR was found to be feasible to use and was highly accepted by the dental frontliners. The IIOR was found to be simple and convenient to use by the dental frontliners during dental screening.

Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.