IOTN Grade 5 (Very Great)

 

This grade indicates a severe need for treatment and can be classified as follows:

5i Impeded eruption of teeth (except for third molars) due to crowding, displacement, the presence of supernumerary teeth, retained deciduous teeth and any pathological cause.
5h Extensive hypodontia with restorative implications (more than 1 tooth missing in any quadrant) requiring pre-restorative orthodontics.
5a Increased overjet greater than 9mm.
5m Reverse overjet greater than 3.5mm with reported masticatory and speech difficulties.
5p Defects of cleft lip and palate and other craniofacial anomalies.
5s Submerged deciduous teeth.  CONVENTION: Not recorded unless only two cusps remain visible and/or adjacent teeth are severely tipped towards each other and closely approximated.