Diagnostic Approach of Dental Professionals Toward Malocclusion Types in Pakistan: A Cross-Sectional Study

Abstract

Background: Malocclusion assessment by dental practitioners is important for recognizing dental and skeletal discrepancies and facilitating appropriate orthodontic referral. Evidence regarding diagnostic practices and perceived barriers among practitioners in Pakistan remains limited. Objective: To describe dental practitioners’ self-reported malocclusion-classification approaches, diagnostic practices, confidence, barriers, training needs, and referral practices. Methods: This descriptive analytical cross-sectional online survey included 200 clinically active dental practitioners recruited through convenience sampling in Pakistan from September 2025 to January 2026. Data were collected using an investigator-developed, expert-reviewed questionnaire and analyzed using frequencies, percentages, Wilson 95% confidence intervals, Pearson chi-square tests, and conditional Monte Carlo exact tests. Results: Angle’s dental classification was the principal approach for 43.5% of respondents, while 38.0% combined dental and skeletal classification. Combined clinical examination and diagnostic records were reported by 47.5%, and 68.5% recorded overjet and overbite. Awareness of functional and esthetic implications was reported by 90.0%, but diagnostic confidence by 50.0%. Lack of radiographic facilities was the most frequent barrier (28.0%). Early referral was supported by 92.0%, and 75.0% favored national diagnostic guidelines. Barrier distributions and training needs differed by gender (p=0.022 and p=0.001, respectively). Conclusion: Respondents reported high awareness but variable diagnostic practices, limited confidence, and resource and training needs. These findings describe perceived practice gaps but do not establish diagnostic competence or nationally representative patterns.