TMPPM 2008 > Texas Medicaid Services > Dental > How to Score the Handicapping Labiolingual Deviation (HLD) Index
This sheet and a Boley Gauge are required to score.
Procedure:
•Occlude client or models in centric position.
•Record all measurements rounded-off to the nearest millimeter.
•Enter score 0 if the condition is absent.
•Overjet is measured from the most protrusive incisor.
•Overbite is measured from the labio-incisal edge of overlapped anterior tooth or teeth to point of maximum coverage.
•Ectopic eruption and anterior crowding: Do not double-score. Record the more serious condition.
PLEASE PRINT CLEARLY:
Client Name:
Date of birth:
Medicaid ID:
Address: (Street/City/County/State/Zip Code)
CONDITIONS OBSERVED
HLD SCORE
Cleft Palate
Score 15
Severe Traumatic Deviations Trauma/Accident related only
Overjet in mm. Minus 2 mm. Example: 8 mm. - 2 mm. = 6 points
=
Overbite in mm. Minus 3 mm. Example: 5 mm. - 3 mm. = 2 points
Mandibular Protrusion in mm. See definitions/instructions to score (previous page)
x5
Open Bite in mm. See definitions/instructions to score (previous page)
x4
Ectopic Eruption (Anteriors Only) Reminder: Points cannot be awarded on the same arch for Ectopic Eruption and Crowding
Each tooth x3
Anterior Crowding10 point maximum total for both arches combined
Max.
Mand.
= 5 pts. each arch
Labiolingual Spread in mm.
TOTAL
Diagnosis
For TMHP use only
Authorization Number
Examiner:
Recorder:
Provider's Signature
Please submit this score sheet with records
Occlude client or models in centric position.