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Orthodontics

Ortho Cases: Clean Problem List

A clean, repeatable framework for building orthodontic problem lists in exams.

Quick Answers

What is an orthodontic problem list?

A structured summary of all relevant skeletal, dental, soft-tissue, and functional problems in one place.

Why is it important in exams?

Examiners use it to see if you recognised the key issues before you start talking about treatment options.

How many headings do I really need?

Most exams are happy if you cover: complaint, skeletal, dental, soft tissue, functional, and other factors.

How does it link to the treatment plan?

Good plans simply address each problem list item with one or more clear treatment objectives.

1. Why a clean problem list changes your ortho answers

In orthodontic cases, it is easy to jump straight into appliances or mechanics. Examiners, however, first want to know if you actually see the full picture.

A clean problem list turns a messy ceph, crowded arch, and long story into a short, organised snapshot of the whole case.

2. Universal structure for any ortho problem list

Use these six headings every time

1. Chief complaint – what the patient actually wants changed (e.g. “protruding upper teeth”).
2. Skeletal pattern – anteroposterior, vertical, and transverse (e.g. Class II, average FMPA, mild asymmetry).
3. Dental relationships – molar/canine relationships, overjet, overbite, crossbites, crowding/spacing.
4. Soft-tissue / facial – profile, lip competence, smile line, incisor display.
5. Functional / habits – CO–CR shift, habits, mouth breathing, speech, TMD symptoms.
6. Other factors – caries, restorations, missing teeth, periodontal status, growth potential, compliance.

For exams, just write 2–4 sharp points under each heading. This alone already looks like a high-level orthodontic answer.

3. Example: Class II division 1 crowded case

Here is how the same structure looks for a typical board-style case:

  • Chief complaint: “My upper teeth stick out and I don’t like my smile.”
  • Skeletal: Skeletal Class II, average vertical pattern, mild mandibular retrusion.
  • Dental: Half-unit Class II molars, increased overjet (8 mm), deep overbite, mild upper and lower crowding.
  • Soft tissue: Convex profile, mild lip incompetence, increased incisor display on smiling.
  • Functional: No CO–CR shift, no reported TMD, mouth breathing at night.
  • Other: Good OH, no active caries, still growing, likely to cooperate with fixed appliances.

From this, it becomes straightforward to set objectives and choose between extraction / non-extraction mechanics.

4. Common mistakes with ortho problem lists

Most candidates lose marks in the same few ways:

  • Mixing problems with treatment (e.g. “needs extraction of premolars”).
  • Ignoring vertical or transverse dimension and only talking about Class I/II/III.
  • Forgetting soft-tissue and smile considerations completely.
  • Writing long paragraphs instead of short, classified points.

A problem list is “what is wrong now”, not “what I want to do”. Keep it descriptive, not prescriptive.

5. Fast practice routine for problem lists

5-minute drill for any exam case

1. Look at one case (photos, models, or a written vignette).
2. Write the six headings: complaint, skeletal, dental, soft tissue, functional, other.
3. Under each, add 2–3 bullet points only.
4. Say the list aloud as if explaining to an examiner.
5. Repeat with a new case tomorrow — same headings, new findings.

With repetition, you will automatically think in this structure every time you see an ortho case, both in clinic and in exams.

6. How DentAIstudy helps

DentAIstudy can take an orthodontic scenario and convert it into a clean, exam-ready problem list in seconds.

  • Organises findings into skeletal, dental, soft-tissue, and functional headings.
  • Generates sample problem lists from written cases, radiographs, or typical exam vignettes.
  • Suggests clear objectives that link directly from each problem item.
  • Helps you rehearse multiple variations of similar Class I, II, and III cases quickly.

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References

  • Proffit WR, Fields HW, Larson B. Contemporary Orthodontics. 6th ed. Elsevier; 2018.
  • Graber LW, Vanarsdall RL, Vig KWL, Huang GJ. Orthodontics: Current Principles and Techniques. 6th ed. Elsevier; 2016.
  • British Orthodontic Society. Clinical guidelines for orthodontic treatment planning and assessment.
  • American Board of Orthodontics. Case evaluation and grading system for dental casts and radiographs.