Comparing the Salzmann Index to automatic qualifying conditions when selecting medically necessary orthodontic patients

INTRODUCTIONThis study compared the Salzmann Index (SI) to the American Association of Orthodontists-proposed Automatic Qualifying Conditions (AQC) list in determining eligibility for medically necessary orthodontic care (MNOC). In Pennsylvania, The SI must reflect a score of ≥25, whereas the AQCs are considered binary indicators of a treatment need-the presence of any AQC qualifies a patient for treatment under Medicaid. This study was designed to determine whether the same patients are selected as eligible for MNOC regardless of which selection method is used.METHODSThe orthodontic records of 139 participants aged 10-17 years were used to calculate SI scores and identify any AQCs present. McNemar's test of agreement was used to compare patients selected for treatment needs on the basis of SI to those selected on the basis of the presence of an AQC.RESULTSThe mean SI score was 14.7. Twelve patients (8.6%) were selected for treatment needs because of an SI of ≥25, whereas 44 patients (31.7%) were deemed to have at least 1 AQC present. Of the 44 patients with AQCs, only 11 had SI scores of ≥25. McNemar's test of agreement found that SI score and AQC presence did not select patients similarly (P