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# Silness-Löe Index

- Silness-Löe Index (Silness and Löe, 1964)
Guest editor: Kaban Moslehzadeh The measurement of the state of oral hygiene by Silness-Löe plaque index is based on recording both soft debris and mineralized deposits on the following teeth. Missing teeth are not substituted.

Each of the four surfaces of the teeth (buccal, lingual, mesial and distal) is given a score from 0-3. The scores from the four areas of the tooth are added and divided by four in order to give the plaque index for the tooth with the following scores and criteria:

Abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin. Moderate accumulation of soft deposit s within the gingival pocket. Assuming a tooth with the following scores on the four surfaces Surface Buccal Lingual Mesial Distal Scores 2 1 1 2 . 2 3 CALCULATION EXAMPLE: The following example shows how to calculate the scores for the index. or the tooth and gingival margin which can be seen with the naked eye. The plaque may be seen in situ only after application of disclosing solution or by using the probe on the tooth surface.The Plaque Index System Scores 0 1 No plaque Criteria A film of plaque adhering to the free gingival margin and adjacent area of the tooth.

4 . 24.5 + 1. according to the plaque index system this means the plaque index for the tooth is moderate accumulation of soft deposit within the gingival pocket.3) / 6 = 1. The index for the patient is obtained by summing the indices for all six teeth and dividing by six.Plaque Index = (2+1+1+2) / 4 = 1. if you have the following indices for the teeth : Tooth Maxillary right first molar (16) Maxillary right lateral incisor (12) Maxillary left first bicuspid (24) Mandibular left first molar (36) Mandibular left lateral incisor (32) Mandibular right first bicuspid (44) Then the index for the patient will be Index 1.2 1 1.2 + 1 + 1.3 +1.3 The index for patient = (1. 32.5 1.5. For instance.6 + 1.3 1. or the tooth and gingival margin which can be seen with the naked eye. The indices for the following six teeth may be grouped to designate the index for the group of teeth: 16. 36. 12. 44.6 1.

1960) Oral Hygiene Index (Greene and Vermillion. . The segment distal to the right cuspid (see picture). each of these index is in turn based on 12 numerical determinations representing the amount of debris or calculus found on the buccal and lingual surfaces of each of three segments of each dental arch. The segment distal to the left cuspid. 1960) Guest editor: Kaban Moslehzadeh The Oral Hygiene Index is composed of the combined Debris Indexand Calculus index. The segment mesial to the right and left first bicuspids. namely 1. 3.Oral Hygiene Index (Greene and Vermilion. 2.

Criteria for classifying debris Scores 0 1 No debris or stain present Criteria Soft debris covering not more than one third of the tooth surface.The Maxillary and the Mandibular arches are each composed of three segments (these are illustrated above). of the exposed tooth surface. From each segment one tooth is used for calculating the individual index. for that particular segment. but not more than two thirds. but additional provisions are made for recording subgingival deposits. 2 3 . The tooth used for the calculation must have the greatest area covered by either debris or calculus. The method for scoring calculus is the same as that applied to debris. or presence of extrinsic stains without other debris regardless of surface area covered Soft debris covering more than one third. Each segment is examined for debris or calculus. Soft debris covering more than two thirds of the exposed tooth surface.

Debris Right Buccal Upper Lower Total 3 2 5 Lingual 1 2 3 Anterior Labial 2 1 3 Lingual 2 1 3 Left Buccal 3 1 4 Lingual 1 2 3 Total Buccal/Labial 8 4 12 Lingual 4 5 9 .Criteria for classifying calculus Scores 0 1 2 No calculus present Criteria Supragingival calculus covering not more than third of the exposed tooth surface. the debris scores are totaled and divided by the number of segments scored. the Index values are calculated. but in the same manner. Supragingival calculus covering more than two third of the exposed tooth surface or a continuos heavy band of subgingival calculus around the cervical portion of the tooth or both. 3 CALCULATION EXAMPLE: After the scores for debris and calculus are recorded. The same method is used to obtain the calculus index scores. For each individual. Supragingival calculus covering more than one third but not more than two thirds of the exposed tooth surface or the presence of individual flecks of subgingival calculus around the cervical portion of the tooth or both. The following example shows how to calculate the indices. The scores for debris and calculus should be tabulated separately and indexes for each calculated independently.

. Oral Hygiene Index = Debris Index + Calculus Index 3.66 A simplified version exists. 1964). the OHI-S (Greene and Vermilion.16 = 4. Debris Index = (12+9) / 6= 3.Debris Index = (The total of the upper and lower buccal-scores) +(The total of the upper and lower lingual-scores) /(The number of segments scored).5 Calculus Right Buccal Upper Lower Total 1 0 1 Lingual 0 1 1 Anterior Labial 0 0 0 Lingual 0 2 2 Left Buccal 1 0 1 Lingual 0 2 2 Totals Buccal/Labial 2 0 2 Lingual 0 5 5 Calculus Index = (The total of the upper and lower buccal-scores) +(The total of the upper and lower lingual-scores) / (The number of segments scored). as follows.5 + 1.16 The average individual or group debris and calculus scores are combined to obtain Oral Hygiene Index. Calculus Index = (2+5) / 6= 1.

1964) Guest editor: Kaban Moslehzadeh The Simplified Oral Hygiene Index (OHI-S) differs from the original OHI (The Oral Hygiene Index) in the number of the tooth surfaces scored (6 rather than 12). the central incisor (21 or 41 respectively) on the opposite side of the midline is substitted. the Debris Index and the Calculus Index. the first fully erupted tooth distal to the second bicuspid (15). the method of selecting the surfaces to be scored. The buccal surfaces of the selected upper molars and the lingual surfaces of the selected lower molars are inspected. the labial surfaces of the upper right (11) and the lower left central incisors (31) are scored. in turn. The criteria used for assigning scores to the tooth surfaces are the same as those use for the OHI (The Oral Hygiene Index).OHI-S (Simplified) (Greene and Vermillion. is examined. In the absence of either of this anterior teeth. usually the first molar (16) but sometimes the second (17) or third molar (18). is based on numerical determinations representing the amount of debris or calculus found on the preselected tooth surfaces. SELECTION OF TOOTH SURFACES The six surfaces examined for the OHI-S are selected from four posterior and two anterior teeth. has two components. which can be obtained.  In the posterior portion of the dentition. Each of these indexes.Simplified Oral Hygiene Index | OHI-S . . and the scores. The OHI-S.  In the anterior portion of the mouth. like the OHI.

but not more than two thirds. or presence of extrinsic stains without other debris regardless of surface area covered Soft debris covering more than one third. of the exposed tooth surface. 2 3 . Soft debris covering more than two thirds of the exposed tooth surface.Criteria for classifying debris Scores 0 1 No debris or stain present Criteria Soft debris covering not more than one third of the tooth surface.

Supragingival calculus covering more than two third of the exposed tooth surface or a continuos heavy band of subgingival calculus around the cervical portion of the tooth or both. Supragingival calculus covering more than one third but not more than two thirds of the exposed tooth surface or the presence of individual flecks of subgingival calculus around the cervical portion of the tooth or both. The average individual or group score is known as the Simplified Debris Index (DI-S). At least two of the six possible surfaces must have been examined for an individual score to be calculated.Criteria for classifying calculus Scores 0 1 2 No calculus present Criteria Supragingival calculus covering not more than third of the exposed tooth surface. the debris scores are totaled and divided by the number of surfaces scored. The same methods are used to obtain the calculus scores or the Simplified Calculus Index (CI-S). 3 CALCULATION EXAMPLE: After the scores for debris and calculus are recorded. the Index values are calculated. After score for a group of individual is obtained by computing the average of the individual scores. For each individual. .

The scores for debris and calculus should be tabulated separately and index for each calculated independently. . The CI-S and DI-S values may range from 0 to 3. Debris Right molar Buccal Upper Lower 3 Lingual 2 Anterior Labial 2 Labial 1 Left molar Buccal 3 Lingual 2 Total Buccal 8 1 Lingual 4 Debris Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined buccal and lingual surfaces). The following example shows how to calculate the index.The average individual or group debris and calculus scores are combined to obtain the Simplified Oral Hygiene Index. These values are just half the score magnitude possible with the OHI (Oral Hygiene Index). but in the same manner. the OHI-S values from 0 to 6.2 Calculus Right molar Buccal Upper Lower 1 Lingual 1 Anterior Labial 0 Labial 2 Left molar Buccal 1 Lingual 2 Total Buccal 2 2 Lingual 3 Calculus Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined buccal and lingual surfaces). Debris Index = (9+4) / 6 = 2.

Oral Hygiene Index = Debris Index + Calculus Index 2.Calculus Index = (4+3) / 6= 1. a score of 0 to 5 is assigned to each facial and lingual nonrestored surface of all the teeth except third molars. 1970) Guest editor: Kaban Moslehzadeh This index is the same as the Quigley Hein Index except the criteria has been modified.2 + 1. as follows The Plaque Index System Scores 0 1 2 3 4 No plaque Criteria Separate flecks of plaque at the cervical margin of the tooth A thin continuos band of plaque (up to one mm) at the cervical margin of the tooth A band of plaque wider than one mm but covering less than one-third of the crown of the tooth Plaque covering at least one-third but less than two-thirds of the crown of the tooth .2 The average individual or group debris and calculus scores are combined to obtain simplified Oral Hygiene Index. As Quigley Hein Index.2 = 3.4 Quigely Hein Index (modified) . as follows.Quigley Hein Index (Modified by Turesky et al.

CALCULATION EXAMPLE: Assuming nonrestored upper jaw and lower jaw surfaces are examined and the scores are stored in the following two tables: Upper jaw 25 22 21 11 12 13 14 Buccal surface score 2 1 3 0 0 1 1 Lingual surface score 2 3 2 1 0 2 3 .5 Plaque covering two-thirds or more of the crown of the tooth An index for the entire mouth is determined by dividing the total score by the number surfaces ( a maximum of 2 x 2 x 14 = 56 surfaces) examined.

.15 17 Total 2 5 15 2 3 18 Lower jaw 47 44 43 42 41 31 32 33 34 Total Buccal surface score 4 3 2 2 2 2 0 0 0 15 Lingual surface score 5 5 3 3 4 3 2 2 0 27 Index = Total score / The number surfaces examined ((15 + 18) + (15 + 27)) / 36 = 2.1 The index for the entire mouth is 2.1.