Objectives: The absence of a guideline to refer developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity.
Methods: A cross-sectional study involving schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. A clinical assessment was carried out on 413 schoolchildren. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index was tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics.
Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were concluded. The SCVI/Ave value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores.
Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

Keywords: orthodontic index, early treatment, diagnosis and treatment planning, paediatric dentistry