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Certification of maxillofacial disability and impairment
[To cite: Shamim T. Certification of maxillofacial disability and impairment [Correspondence]. Natl Med J India 2023;36:67. DOI: 10.25259/NMJI_600_22]
Dental professionals are included in the medical board of health institutions in India to give expert opinion on evaluation and procedure for certification of maxillofacial disability and impairment. The Extraordinary Gazette of India had issued guidelines for the purpose of assessing the extent of specified disability in a person under the Rights of Persons with Disabilities Act, 2016 (49 of 2016) as annexure II on 5 January 2018, but had omitted maxillofacial disability and impairment in the reported guidelines.1 We attempt to detail maxillofacial disability and impairment that should be added in the revised guidelines of Rights of Persons with Disabilities Act, 2016 (49 of 2016). The maxillofacial disability and impairment may be measured in terms of loss of motion, loss of muscle strength and loss of coordination.2
The McBride method introduced by the American orthopedic surgeon McBride in 1936 is still used for evaluation and certification of maxillofacial disability and impairment in India.3 Evaluation of facial impairment and tooth loss is graduated as per the McBride method (Table I).3 Tooth loss is graduated for natural as well as artificial teeth and the maximum percentage admissible under the McBride method is 15%.
| Maxillofacial disability and impairment | Impairment whole percentage |
|---|---|
| Evaluation criteria for impairment of face | |
| I. Fracture of the jaws including disfigurement | |
| A. Maxilla united with malocclusion | 8 |
| B. Mandibular: malocclusion | 8 |
| C. Condyloid process: painful occlusion | 8 |
| II. Ankylosis temporomandibular joint (motion | 1 0 |
| limited 1/4 to 1/2 inch) | |
| III. Loss of all teeth replaceable with prosthesis | 1 5 |
| IV. Loss of tongue: one-third | 5 |
| V. Loss of ear auricle | 5 |
| VI. Nose injury interfering with breathing | 7 |
| Evaluation criteria of tooth loss | |
| I. Tooth loss | |
| A. Anterior teeth (incisor) | 0.3 |
| B. Canine | 0.45 |
| C. Premolar | 0.45 |
| D. Molar | 0.9 |
| II. Implant crown | |
| A. Anterior teeth (incisor) | 0.06 |
| B. Canine | 0.09 |
| C. Premolar | 0.09 |
| D. Molar | 0.18 |
| III. Denture | |
| A. Pontic site | 0.06–0.18 |
| B. Removable denture site | 0.09–0.27 |
| C. Full denture | 0.15–0.45 |
| IV. Complete tooth loss | 15 |
Conflict of interest
None declared
References
- The Gazette of India Extraordinary Part II—Section 3—Sub-section (ii) Section 56 of the Rights of Persons with Disabilities Act, 2016 (49 of 2016) Available at www.swavlambancard.gov.in/public/files/ProceduresGuidelines.pdf (accessed on 8 Jul 2022)
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