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The Department of Nidhi sharma


Pedodontics and Roll no. 42
Preventive Dentistry BDS IVth prof
CONTENTS
DMFT INDEX
DMFS INDEX
deft/s INDEX
DEFINITION OF AN INDEX
A NUMERICAL VALUE DESCRIBING THE
RELATIVE STATUS OF A POPULATION ON A
GRADUATED SCALE WITH DEFINITE UPPER
AND LOWER LIMITS, WHICH IS DESIGNED
TO PERMIT AND FACILITATE COMPARISON
WITH OTHER POPULATIONS CLASSIFIED BY
THE SAME CRITERIA AND METHODS

- RUSSELL A.L.
1.) DECAYED-MISSING-
FILLED TEETH INDEX (DMFT
INDEX)
Introduction:
The DMFT INDEX was
developed by Henry T. Klein, Carrole E.
Palmer and Knutson J.W. in 1938 to
determine the prevalence of coronal
caries.
ADVANTAGES:
Simple
Rapid
Versatile
Universally accepted and applicable
measurement that has been used widely
for several decades

FEATURES OF DMFT INDEX

This INDEX is based on the fact that dental
hard tissues are not self healing and
established caries leaves a scar of some sort.
The tooth either remains decayed or if
treated, it is extracted or filled.
It is an irreversible INDEX measuring the life
time caries experience.
It is a cumulative INDEX that measures all
the evidence of a condition past and present.
It is applied only to permanent teeth.
PROCEDURE
It is composed of 3 components:
D used to describe decayed teeth
M used to describe missing teeth due
to caries
F used to describe caries that have
been previously filled due to caries
All the 28 permanent teeth are examined.

The teeth not included are :
I. The third molars
II. Unerupted teeth
III. Congenitally missing and supernumerary teeth
IV. Teeth removed for reasons other than dental caries
such as for orthodontic treatment or impaction
V. Teeth restored for reasons other than dental caries
such as trauma, cosmetic purposes or for use as a
bridge abutment.
VI. Primary tooth retained with the permanent successor
erupted.
The following teeth should not be counted
as missing :

Unerupted teeth
Missing due to accident
Congenitally missing teeth
Teeth that have been extracted for orthodontic
reasons

INSTRUMENTS USED
Mouth mirror
Explorer

CRITERIA FOR
IDENTIFICATION OF DENTAL
CARIES
The lesion is clinically visible and obvious.
Explorer tip can penetrate deep into soft
yielding material
There is discoloration or loss of translucency
typical of undermined or demineralized
enamel
The explorer tip in a pit or fissure catches or
resists removal after moderate to firm
pressure on insertion and when there is
softness at the base of the area.
PRINCIPLES AND RULES IN
RECORDING DMFT
No tooth must be counted more than once. It is either
decayed, missing, filled or sound.
Decayed, missing and filled teeth should be recorded
separately since the components of DMF are of great
interest .
When counting the number of decayed teeth, also
include those teeth, which have restorations with
recurrent decay.
Care must be taken to list as missing only those teeth,
which have been lost due to decay . Also included
should be those teeth which are so badly decayed
that they are indicated for extraction.
The following teeth should not be counted as
missing :
Unerupted teeth
Missing due to accident
Congenitally missing teeth
Teeth that have been extracted for orthodontic
reasons
A tooth may have several restorations but it is
counted as one tooth
Deciduous teeth are not included in DMF
count



A tooth is considered to be erupted when the
occlusal surface or incisal edge is totally
exposed .
A tooth is considered to be present even though
the crown has been destroyed and only the
roots are left.

EXAMINATION METHOD FOR
DMFT
D- Decayed
Indicates the number of permanent teeth that
are decayed.
In counting the number of decayed permanent
teeth,a tooth can only be counted once.it cant
be counted as decayed and filled.
If it has been restored and caries can be
detected, count it as decayed.

M MISSING
Indicates the number of missing permanent teeth
due to decay.
Those teeth which are so badly decayed that
they are indicated for extraction are counted as
missing.

F- FILLED
Indicates the number of permanent teeth that
have been attacked by caries, but which have
been restored.
A tooth may have several fillings but it is counted
as one tooth.

CALCULATION OF THE
INDEX
The maximum number for an individual DMFT
score is 28 or 32, if third molars are included.

A. Individual DMFT
Total each component that is D,M and F
separately , then, total D+M+F=DMF.
For eg. A DMFT score of 3+2+5=10 for an
individual means that 3 teeth are decayed , 2
teeth are missing and 5 teeth have fillings. It also
means that 18 teeth are intact.

Recording Format for DMFT Index


17 16 15 14 13 12 11 21 22 23 24 25 26 27




47 46 45 44 43 42 41 31 32 33 34 35 36 37

DT= MT= FT= DMFT SCORE=

B. Group average:
Total DMF

Total number of the subjects examined
LIMITATIONS OF DMFT
INDEX
DMFT values are not related to the number of teeth at
risk.
DMFT INDEX can be invalid in older adults because
teeth can become lost for reasons other than caries.
DMFT INDEX can be misleading in children whose
teeth have been lost due to orthodontic reasons.
DMFT INDEX can over estimate caries experience in
teeth in which preventive fillings have been placed.
DMFT INDEX equates a disease state with a healthy
state by assigning the same score for decayed tooth
as well as for a filled healthy tooth.
DMFT INDEX is of little use in studies of root caries.
WHO MODIFICATION OF DMF
INDEX (1987)
All third molars are included
Temporary restorations are considered as D.
Only carious cavities are considered as D, the
initial lesions are not considered as D.
WHO MODIFICATION OF DMFT
INDEX (1997)
For individuals 30 years and older, the M-
component should comprise teeth missing due to
caries or for any other reason.
For subjects under 30 years of age, the M-
component should only include teeth missing due
to caries.

2.) DECAYED MISSING
FILLED TOOTH SURFACES
INDEX (DMFS)

DMFS Index was developed by Henry T.Klein,
Carrole. E.Palmer and Knutson J. W. in 1938
along with the DMFT Index to assess the
prevalence of coronal caries.
PROCEDURE
The DMFS Index is applied only to permanent
teeth surfaces. It is composed of three
components:
D- used to describe decayed teeth surfaces.
M- used to describe missing teeth surfaces due
to caries.
F- used to describe teeth surfaces that have
been previously filled due to caries.
ADVANTAGES

The DMF Index is more sensitive and is usually
the Index of choice in a clinical trial of a caries
preventive agent .
LIMITATIONS
A DMFS examination takes longer ,
Is more likely to produce in consistencies in
diagnosis.
May require the use of radiographs to be fully
accurate.
THE SURFACES EXAMINED
ARE-

A. For posterior teeth:
Five surfaces: facial, lingual, mesial, distal and
occlusal
B. For anterior teeth
Four surfaces: facial, lingual, mesial and distal

RECORDING FORMAT FOR DMFS INDEX



17 16 15 14 13 12 11 21 22 23 24 25 26 27



47 46 45 44 43 42 41 31 32 33 34 35 36 37

DS= MS= FS= DMFS SCORE=
CALCULATION OF DMFS
INDEX
A.) If 28 teeth are examined- . 16 posterior teeth (16x5) =80
surfaces
. 12 anterior teeth (12x4)=48
surfaces
. TOTAL = 128 surfaces
B.) If third molars are included-

. For third molars (4x5) = 20
surfaces
. TOTAL = 128 + 20
= 148 surfaces
CARIES INDICES FOR
PRIMARY DENTITION
def index
The def index was described by Gruebbel A. O. in
1944.
The caries index used for primary dentition are
deft index and defs index equivalent to the
DMFT and DMFS indices used for permanent
dentition
EXAMINATION METHOD FOR
def index
d- decayed teeth
e- extracted teeth
Indicates those deciduous teeth which have been
extracted due to caries or which are so badly
decayed that they are indicated for extraction
f- filled teeth
Indicates the number of deciduous teeth that have
been attacked by caries but which have been
restored without any recurrent decay present.
If a tooth has a filling but shows evidence of
recurrent decay it is counted as a decayed tooth.
CALCULATION OF def
index
Maximum deft score for an individual would be
20.
Maximum score for the defs will be

Maximum score for defs - For 8 posterior teeth
(8x5) = 40 surfaces
-For 12 anterior teeth
(12x4) =48 surfaces
- Total = 88 surfaces
MODIFICATIONS OF def
index
dmf index
dmf index is used in children before the age of
exfoliation.
df index
df index is a method of getting around the
exfoliation problem in which missing teeth are
ignored.
df index can be applied to the whole tooth as
the dft index or to the individual surfaces as dfs
index.
MIXED DENTITION
In this the caries indices for the permanent
and the deciduous teeth have to be done
separately and calculated separately .
A DMFT / DMFS and a deft /defs are
never added together.
Each child is given a separate index for
permanent teeth and another for primary
teeth.
The index for the permanent teeth is
usually determined first and then the index
for the primary teeth separately.