What is Salzmann score for orthodontics?

Answer 1

The Salzmann Index (also known as the Handicapping Malocclusion Assessment Record) was proposed by J. A. Salzmann in 1968 as a method for prioritizing orthodontic treamtent needs for children. It assigns points to specific problems. If the points add up to, or more than a threshhold, then according to the form, you need treatment.

It is a woefully inadequate method of describing the full nature of an orthodontic problem. However, it's easy for the insurance industry to understand, and since they get to set the threshhold to whatever number they want, they can use it as a means to deny treatment as being "unnecessary." It has therefore been accepted as the standard.

Here are some of the many problems with it:

1) Teeth are scored as being crowded or rotated with no ability to indicate by how much. There is no way to indicate severity.

2) Front to back discrepancies are only scored if they are a full tooth width off. Any orthdontist understands that someone can have major bite problems (like tooth wear, breakage) without it being off that much.

3) It was approved in 1968. I think we have improved a little bit since then in our understanding about how the teeth function, and what needs to be treated and what doesn't.

4) It was developed as an assessment for children. Adult orthodontic patients require additional considerations.

5) It doesn't take into account, for the most part, the periodontal consequences of teeth being out of position. It has 1 assessment of this: overjet and overbite.

6) It doesn't take in to account, at all, the psychosocial aspects of poorly aligned teeth, which according to the Surgeon General's report in 2000, can negatively affect the quality of life.

7) It doesn't take into account, at all, the newly discovered association between periodontal disease and Diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes. Malocclusion has been shown to be a contributing factor to periodontal disease.

Etc.