Protocol - Malocclusion
Angles Classification is a set of criteria that categorizes the three different types of malocclusion. The interviewer-administered questions are used to determine if the participant has ever had orthodontic treatment.
Note from PhenX Oral Health Working Group (WG): There are laptop programs that can be used with this protocol, and the Oral Health WG recommends such a system as it does notify the recorder of correctable errors. An example of a paper data recording form is included as part of this protocol so that the user can see the format of such a data entry system. It also is good to have paper forms on hand in case of an electrical failure or some other problem that prohibits use of the electronic data entry system.
To determine what class the subject falls under, the following should be considered:
Relative position of the dental arches, mesio-distally, normal, with malocclusions usually confined to the anterior teeth. First molars usually in normal occlusion, although one or more may be in lingual or buccal occlusion. Cases belonging to this class far exceed in number those of all other classes combined.
Retrusion of the lower jaw, with distal occlusion of the lower teeth.
a. Narrow upper arch, with lengthened and prominent upper incisors; lack of nasal and lip function. Mouth-breathers.
b. Same as a., but with only one lateral half of the arch involved, the other being normal. Mouth-breathers.
a. Slight narrowing of the upper arch; bunching of the upper incisors, with overlapping and lingual inclinations; normal lip and nasal function.
b. Same as a., but with only one lateral half of the arch involved, the other being normal; normal lip and mouth function.
a. Protrusion of the lower jaw, with mesial occlusion of the lower teeth; lower incisors and cuspids inclined lingually.
b. Same as a., but with only one lateral half of the arch involved, the other being normal.
Examiner visually assesses and determines whether the subject has Class I (orthognathic), II (convex), or III (concave) malocclusion. Conclusions are recorded on a standardized examination form.
1. Have you ever had any orthodontic treatment?
1[ ]Yes (Go to question 2)
2. How long did you wear fixed braces on your teeth?
0[ ]Not Applicable
1[ ]1 year or less
2[ ]1-2 years
3[ ]>2 years
Protocol Name from Source:
Personnel and Training Required
Orthodontists, dentists, or dental hygienists participate in training sessions to review the screening forms and examination procedures and, in two calibration sessions, to gather data describing reliability of the measures collected. During the calibration sessions, orthodontists examine subjects; results are tabulated and then discussed.
For the interviewer-administered questions, the interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews.* The interviewer should be trained to prompt respondents further if a "dont know" response is provided.
*There are multiple modes to administer this question (e.g., paper-and-pencil and computer-assisted interviews).
Hand- or head-held light, a millimeter ruler, gloves, and tongue depressor for cheek retraction.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Child, Adolescent, Adult
Participants ≥8 years of age.
A clinical examination by a trained dental professional such as an orthodontist, dentist, or dental hygienist is necessary to determine the class of malocclusion.
|Common Data Elements (CDE)||Person Malocclusion Indicator||2966477||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Oral malocclusion proto||62590-5||LOINC|
Process and Review
National Institutes of Health (NIH), National Institute of Dental and Craniofacial Research (NIDCR), Archive of Procedures and Methods Used in Oral Health Surveys. Angles Classification of Malocclusion.
National Institutes of Health (NIH), National Institute on Aging (NIA), Baltimore Longitudinal Study on Aging (BLSA). Dental Examination. Questions 27 (question 1) and 28 (question 2).
National Institutes of Health (NIH), National Institute of Dental and Craniofacial Research (NIDCR), Archive of Procedures and Methods Used in Oral Health Surveys. Timing of Treatment for Class II Malocclusion in Children.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX080701030000||Angle's Classification is a set of criteria more||N/A|
|PX080701010000||Have you ever had any orthodontic treatment?||Variable Mapping|
|PX080701020000||How long did you wear fixed braces on your teeth?||N/A|
December 30, 2009
A measure to categorize the misalignment of teeth and/or incorrect relation between the teeth of the two dental arches.
To determine through a clinical examination the extent to which a person has malocclusion, a misalignment of the teeth and/or incorrect relation between the teeth of the two dental arches.
Oral health, Malocclusion, Angle's Classification, Teeth misalignment, Jaw misalignment, Orthodontic treatment, Clinical examination