Dental Indices

SriramP
final yr B.D.S
SYNOPSIS
• INTRODUCTION
• DEFINITION
• OBJECTIVES
• TYPES OF INDICES
• ORAL HYGIENE INDICES
• GINGIVAL AND PERIODONTAL INDICES
• CARIES INDEX
• FLOUROSIS INDEX
• CONCLUSION
 WHAT IS AN INDEX ?
• Index is a graduated scale having definite upper and lower limits ,
with scores on the scale corresponding to the specific criteria which is
designed to permit and facilitate comparison with other populations
classified by same criteria and methods
RUSSEL AL
OBJECTIVES
• Simplicity
• Objectivity
• Validity
• sensitivity
• specificity
• reliability
• Acceptability
• Quantifiability
TYPES OF INDICES
BASED ON THE DIRECTION IN WHICH THE
SCORES CAN FLUCTUATE
• REVERSIBLE INDEX
• Eg.Oral hygiene index.

• IRREVERSIBLE INDEX
• Eg.Caries index
BASED ON THE ASSESMENT OF
CONDITION
TYPES INDICES

ORAL HYGIENE INDEX  ORAL HYGIENE INDEX

 ORAL HYGIENE INDEX - SIMPLIFIED
 PLAQUE INDEX
PERIODONTAL INDEX  GINGIVAL INDEX
 RUSSEL'S PERIODONTAL INDEX
 COMMUNITY PRIODONTAL INDEX
 COMMUNITY PERIODONTAL INDEX FOR TREATMENT NEEDS
CARIES INDEX  DMFT,DMFS

FLOUROSIS INDEX  DEAN'S FLOUROSIS INDEX

 ORAL HYGIENE INDEX
• SIMPLE AND SENSITIVE METHOD FOR ASSESSING ORAL HYGIENE OF A GROUP OR INDIVIDUAL
QUANTITATIVELY.
• Devoleped in 1960 by John.C.Green and Jack.R.Vermillion
• TYPE: Reversible index
• Aim : To classify and assess the oral hygiene status
INSTRUMENTS USED : Mouth Mirror and NO.23 sheperd crook explorer.
SURFACES EXAMINED : BUCCAL AND LINGUAL
It is composed of two components
DEBRIS INDEX,
CALCULUS INDEX
RULES OF OHI
• 1. ONLY FULLY ERUPTED TOOTH ARE SCORED
• 2.THIRD MOLARS AND PARTIALLY ERUPTED TOOTH ARE NOT
INCLUDED IN THE SCORING CRITERIA
• 3.BUCCAL AND LINGUAL SCORES OF THE TOOTH IN A SEGMENT
HAVING GREATEST SURFACE AREA COVERED BY DEBRIS OR CALCULUS
IS TAKEN.
ADVANTAGES LIMITATIONS
• SIMPLE,SENSITIVE,RAPID REQUIRES MORE TIME
METHOD CANNOT BE USED FOR PRIMARY
• BEST INDEX FOR DEBRIS AND DENTITION
CALCULUS
• USEFUL TOOL IN ASSESSING THE
ORAL HYGIENE OF THE
INDIVUDIAL
 ORAL HYGIENE INDEX-SIMPLIFIED

• BY JOHN.C.GREENE AND JACK.R.VERMILLION IN 1964

• TYPE:SIMPLIFIED REVERSIBLE INDEX
PICKING A REPRESENTATIVE TOOTH FROM EACH SEGMENT ,
IF THE INDEX TOOTH HAS FULL CROWN RESTORATIONS OR ANY
SURFACE REDUCED DUE TO CARIES OR TRAUMA , ARE NOT SCORED
AND ALTERNATE TOOTH IS EXAMINED.
 Buccal surfaces in segment 1,2,3,5 and lingual surfaces in 4,6.

SEGMENT 1 2 3 4 5 6

PRIMARY 16 11 26 36 31 46

ALTERNATE 17,18 21 27,28 37,38 41 47,48

ADVANTAGES DISADVANTAGES
• EASY TO USE • LESS SENSITIVE THAN ORIGINAL
VERSION
• LESS TIME FOR RECORDING
UNDERESTIMATION OR
OVERESTIMATION OF DEBRIS AND
CALCULUS
 PLAQUE INDEX

• BY SILLNESS AND LOE .H IN 1964

• AIM : TO ASSESS THE THICKNES OF GINGIVA AT THE GINGIVAL
MARGIN OF THE TOOTH
• TYPE:REVERSIBLE,FULL MOUTH INDEX
• I.USED: MOUTH MIRROR ,
• NO.23 SHEPERD CROOK EXPLORER
• SURFACES EXAMINED : BUCCAL,LINGUAL,MESIAL,DISTAL
Disadvantages Advantages
Individual variation while
recording . • RELIABLE TECHNIQUE FOR
Single examiner is recommended. EVALUATING BOTH MECHANICAL
RATING SCORES
AND CHEMICAL ANTIPLAQUE
AGENTS
EXCELLENT 0 • USED IN LONGITUDINAL STUDIES
GOOD 0.1-0.9 AND CLINIC TRIALS
FAIR 1.0-1.9

POOR 2.0-3.0
GINGIVAL AND PERIODONTAL INDICES
GINGIVAL INDEX
• BY LOE.H and SILNESS.J IN 1963.
• AIM : TO ASSESS THE SEVERITY OF GINGIVITIS
• TYPE:REVERSIBLE, FULL MOUTH INDEX
• I.USED : MOUTH MIRROR , STRAIGHT PROBE
• SURFACES EXAMINED: BUCCAL, LINGUAL, MESIAL, DISTAL
ALL THE TEETH ARE EXAMINED OR SELECTED TEETH ARE SCORED
THE INDEX TEETH ARE 16,12,24,36,32,44
• INTERPRETATION
SCORE DISEASE
PROGRESS
0.1-1.0 MILD
GINGIVITIS
1.1-2.0 MODERATE
GINGIVITIS
2.1-3.0 SEVERE
GINGIVITIS
ADVANTAGES DISADVANTAGES

Easy of use . • No sufficient sensitivity.

Rapid method of estimation of • No substitution for index tooth.
gingival status.
RUSELL'S PERIODONTAL INDEX
• DEVOLEPED BY RUSELL AL IN 1956
• AIM:TO ASSESS THE PERIODONTAL DISEASE,PRESENCE / ABSENCE OF
GINGIVAL INFLAMMATION AND ITS SEVERITY.
• TYPE:REVERSIBLE,FULL MOUTH INDEX
• I.USED : MOUTH MIRROR , STRAIGHT PROBE
 • INTRPRETATION
CONDITION SCORES

NORMAL SUPPORTIVE 0.0-0.2

TISSURE
SIMPLE GINGIVITIS 0.3-0.9

BEGINNING DESTRUCTIVE 1.0-1.9

PERIODONTAL DISEASE
ESTABLISHED 2.0-4.9
DESTRUCTIVE
PERIODONTAL DISEASE
TERMINAL DISEASE 5.0-8.0
ADVANTAGES
• EASY AND QUICKLY LEARNED
• IT MEASURES REVERSIBLE AND
IRREVERSIBLE ASPECTS OF
PERIODONTAL DISEASES
DISADVANTAGES
• IN FIELDSURVEYS ,
RADIOGRAPHIC ESTIMATION IS
NOT POSSIBLE
• NO STANDARDIZED PROBES
USED
• MORE TIME CONSUMING
COMMUNITY PRIODONTAL INDEX OF
TREATMENT NEEDS (CPITN)
• BY Jukka Ainamo , David Barnes , George Beagrie , Terry cutress ,
James Martin , Jennifer Sardo Infirri in 1982
• AIM:TO SURVEY AND EVALUATE PERIODOTNAL TREATMENT NEEDS
RATHER THAN DETERMINING PAST AND PRESENT PERIODONTAL
STATUS
I.USED: CPITN PROBE
TREATMENT
NEEDS

TN 0

TN 1

TN 2A

TN 2B

TN 3
ADVANTAGES DISADVANTAGES
• SIMPLE AND MORE OBJECTIVE • DOES NOT PROVIDE PREVIOUS
• RAPID APPRECIATION OF DISEASE EXPERIENCE
PERIODONTAL CONDITION , • DOESNOT RECORD POSITION OF
THEIR TREATMENT NEEDS AND MARGINAL GINGIVA
PERSONNEL REQUIRED • EXCLUSION OF IMPORTANT
• INTERNATIONAL UNIFORMITY SIGNS OF DISEASE , SUCH AS
ATTACHMENT LOSS AND
MOBILITY
COMMUNITY PERIODONTAL INDEX
• BY W.H.O IN 1994
• AIM:TO ASSESS THE PERIODONTAL STATUS OF THE INDIVIDUAL
• TYPE:COMPOSITE, SIMPLIFIED INDEX
• I.used : Mouth mirror , CPITN probe
ADVANTAGES DISADVANTAGES
• SEVERITY OF DISEASE CAN BE • TIMECONSUMING.
MEASURED. • CALIBRATION AS PER CPI
• TREATMENT NEEDS CAN BE CRITERIA IS DIFFICULT.
RECORDED.
CARIES INDEX
DMFT/S INDEX
• BY HENRY KLEIN , CARROLE E PALMER AND JW KNUTSON IN 1938
• AIM:TO ASSESS THE CUMULATIVE CARIES EXPERIENCE OF THE
INDIVIDUAL
• TYPE:CUMULATIVE, IRREVERSIBLE INDEX
RULES TO FOLLOW WHILE
RECORDING DMFT/S INDEX
• THIRDMOLAR SHOULD BE EXCLUDED
• TEETH EXTRACTED FOR ORTHO PURPOSE , ETC.SHOULD BE EXCLUDED
• SECONDARY CARIES IN RESTORED TOOTH MUST BE MARKED D
• Teeth restored for cosmetic reason ( maybe following a trauma) and
supernumerary tooth should be excluded
DISADVANTAGES
• NOT RELATED TO NO.OF TOOTH
AT RISK
• INVALID IN OLDER PATIENTS ,
TEETH MAY BE LOST DUE TO
VARIOUS REASONS
• MISLEADING IN CHILDREN DUE
TO ORTHO EXTRACTION
• NO USE IN ROOT CARIES
• NO INFORMATION REGARDING
TREATMENT NEEDS
ADVANTAGES
• by assessing the caries index
,CARIES EXPERIENCE
• prevalence of caries in the
individual level and the
community level.
• DMFS IS MORE SENSITIVE AND
PRECISE THAN DMFT
FLUOROSIS INDEX
• FLUOROSIS IS A HYPOPLASIA OR HYPO MINERALIZATION OF TOOTH
ENAMELOR DENTINE PRODUCED BY CHRONIC INGESTION
OFEXCESSIVE AMOUNTS OF FLUORIDE DURING THE PERIOD WHEN
TEETH ARE DEVOLEPING.
DEAN'S FLUOROSIS INDEX
• IN 1934, DR.TRENDLEY.H.DEAN DEVISED AN INDEX TO ASSESS THE
PRESENCE AND SEVERITY OF MOTTLED ENAMEL.
THIS SCALE HAS NO NUMBERS , AND IS SCORED BASED ON THE
CLINICAL APPEARENCE OF TWO MOST AFFECTED TOOTH.
ADVANTAGES DISADVANTAGES
• PREFERRED INDEX FOR • NOT MUCH SUUFICIENT
MEASURING DENTAL FLUORSIS INFORMATION OF DENTITION
• HELPS TO IDICATE THE • ISOLATED DEFECTS ARE NOT
PREVALENCE IN THE REGION RECORDED
• THE CRITERIA IS UNCLEAR, AND
LACKING SENSITIVITY
•
REFERENCES
• ESSENTIALS OF PREVENTIVE AND COMMUNITY DENTISTRY , SOBEN
PETER 3ED