Oral hygiene indices

Krisztina Árendás
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 Oral hygiene – caries prevention
৩ poor oral hygiene  plaque accumulation 
 gingivitis, periodontal diseases

৩ prevention  less carological or periodontolal problems

৩ instruation and motivation of the patient

 Dental plaque - biofilms
•soft adherent structured deposits, which forms on the
tooth surface

•consists of a mixed bacterial flora, sometimes with

desquamated epithelial cells and migrated
polymorphonuclear leukocytes
 Examination of dental plaque
 inspection
 palpation
- dental probe
 disclosing agents
Differential diagnosis
৩ food debris toothbrush, rinsing

৩ pellicula immediately after

brushing (proteins,
immunoglobulins
from saliva)
৩ materia alba food debris + bacteria

৩ calculus
 Why dying?

৩ improving technics (education)

৩ checking results
৩ making it visible for the patient
Disclosing agents – expectations
☞ not toxic (either locally or systematically)
☞ not allergene
☞ properly visible
☞ selective plaque dying (don’t dye fillings and other restorations,
sof tissues etc.)
☞ their taste is OK
☞ removable
 Types of disclosing agents
– to dye the dental plaque
solutions or tablets

erythrosin (I!)
fuchsin (carcinogene)
neutral red
Na-fluorescein
methilen blue

one tone and two tones dyes to differentiate fresh (red) &
matured plaque (blue)
 How to use?
৩anamnesis – iodine allergy?
৩rinsing – removing food and materia alba
৩vaseline on lips
৩solution: cotton ball, apply on the teeth
৩tablets: chewing
৩rinse
৩evaluation – plaque indices
৩brushing by the patient – remove most of the dye
৩scaling, polishing (professional cleaning) – remove the rest of the
dye
How to use?
 Oral hygiene indices
without using disclosing agents
evaluation of the extension of plaque
o Green Vermillon’s Oral Hygiene Index – Simplified
o Oral Debris Index
o Silness-Löe plaque index

after using disclosing agents

o Quigley-Hein Plaque Index
o Cohen Plaque Index
 Oral Hygiene Index - Simplified (OHI-S)
(Greene–Vermillion index, 1964)
a simplified oral hygiene index with a debris (plaque) and calculus component
simplified = only on 6 tooth surfaces

☞ 6 tooth surfaces are scored (4 posterior and 2

anterior)
☞ debris (plaque) is scored on a scale of 0-3
☞ calculus deposits are scored for the same surfaces
on a scale of 0-3
☞ the index values are calculated from the recordings
of the calculus and debris scores
☞ scores are added together and divided by the
number of surfaces scored

debris index (DI) + calculus index (CI) !

OHI-S= DI-S+CI-S
 Criteria for classifying OHI-S
debris
0 no debris or stain present
1 soft debris covering not more than one third of
the tooth surface, or presence of extrinsic stains
without other debris regardless of surface area
covered
2 soft debris covering more than one third, but not
more than two thirds of the exposed tooth
surface.
3 soft debris covering more than two thirds of the
exposed tooth surface.
calculus
0 no calculus present
1 supragingival calculus covering not more
than thirds of the exposed tooth surface
2 supragingival calculus covering more than
one third but less than two thirds of the
clinical crown or presence of individual
flecks of subgingival cervical calculus
3 supragingival calculus covering more than
two thirds of the exposed tooth surface or
a heavy band of subgingival calculus
 Silness-Löe Plaque Index (Pl I; 1964)
measures the thickness of the plaque
records both soft debris and mineralized deposits on the following teeth on 4
surfaces  average is calculated
sc. criteria
0 no plaque
1 a film of plaque adhering to the free gingival margin and
adjacent area of the tooth
the plaque might be seen in situ only after application of
disclosing solution or by using the probe on the tooth
surface
2 moderate accumulation of soft deposits within the gingival
sulcus or on thegingival margin of the tooth (can be seen
with the naked eye)
3 abundance of soft matter within the sulcus and/or on the tooth
in the gingival margin
 Quigley-Hein Index – after dying the teeth
(Modified by Turesky, 1970)
scores criteria
0 no plaque

1 separate flecks of plaque at the cervical margin of the tooth

2 a thin continuos band of plaque (<1 mm) at the cervical margin of the tooth
3 a band of plaque wider than one mm but covering less than one third of the crown

4 plaque covering at least one third but less than two thirds of the crown

5 plaque covering two thirds or more of the crown

on every teeth, 6 surfaces

 Cohen Index
similar to QH
registered on buccal and oral surfaces of all the teeth  maths average
 Brushing & professional cleaning
☞ corrections - fillings, prosthetic works with
overhanging parts: finishing & polishing
☞ supragingival scaling
☞ subgingival scaling
☞ polishing
☞ education, recalling