Examination forms in different  languages are available here (PDF). Just click on the appropriate flag.

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The picture manual can be ordered here.
Instructions for translating into another language can be downloaded here.
Guidance to NOT-S can be downloaded here.

Development and evaluation of a comprehensive screening for orofacial dysfunction 

Bakke M, Bergendal B, McAllister A, Sjögreen L, Åsten P. Development and evaluation of a comprehensive screening for orofacial dysfunction. Swed Dent J 2007;31:75-84.


The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test - Screening (NOT-S), consisting of a structured interview and clinical examination, was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated into the other Nordic languages, and into English, and then into an increasing number of languages. 
     The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more 'yes' for impairment in a domain resulted in one point (maximum NOT-S score 12 points).
     The mean NOT-S score (±SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1±2.6, and 0.4±0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 20 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.

Here you can find the full article (in English) as a PDF-document (approx. 7 MB).


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