Dental Indices and Scoring Methods

Index

-expression of clinical observation in numeric value

-describes status of ind. or group with respect to condition being measured

Index score that is more CONSISTENT and LESS SUBJECTIVE than word descriptions of condition

Use of Numeric Score results in-

Simple Index

measure presence or absence of condition

Cumulative Index

measures all the evidence of the condition (past and present)

Irreversible

measure conditions that will not change

Reversible

measure conditions that can be changed

Clear, Reliable, Evaluative, Valid, Acceptable, Sensitive, Simple *quantifiable, objective

Properties of a Good Index (CREVASS)

Caries Indices

-determine total caries experience PAST and PRESENT

-DMFT & DMFS

-deft

-RCI

**IRREVERSIBLE

DMFT

-decayed, missing, filled teeth

-tooth counted IF decayed, filled, or removed **because of decay

-3rd molars don't count

-each tooth counted ONLY once (recurrent counted as decayed)

**not counted if removed or restored for reasons other than decay

-There is a need for treatment

-no access to care

-not educated

What can it mean if there is an increases incidence in decay?

(DMFT)

-utilizing care

-are receiving care

-need preventive care

-education

What can it mean if there is an increased incidence in fillings? (DMFT)

28

Maximum DMFT?

D,M,F recorded separately then totaled.

How are DMFT scores recorded/totaled?

DMFS

Decayed, Missing, Filled **SURFACES

-x-rays required

5

How many surfaces on posterior? (DMFS)

4

How many surfaces on anterior? (DMFS)

128

Max score for DMFS?

deft

-measures observable caries in **primary teeth

-20 teeth evaluated

-missing teeth ignored

represents tooth indicated for extraction due to caries

What does "e" represent in deft?

RCI

-Root Caries Index

-**RECESSION must be present

-score reported as %

all decayed and filled root surfaces

What is the numerator in RCI score?

all M,D,B, & L surfaces with **recession

What is the denominator in RCI score?

Indices that measure Oral Hygiene Status

-Biofilm, Debris, Calculus

-Clinical Setting

-Community Setting

Community Setting

findings help determine how daily oral care is being provided and monitor the results of ______ programs (nursing homes)

Clinical Setting

-patient education, motivation

Plaque Index (PL I)

-assess biofilm thickness along cervical 1/3 of tooth

-eval entire dentition or selected teeth

-4 areas, M,D,F,L

-Scale of 0-3

-Excellent= 0

-Good= .1-.9

-Fair= 1-1.9

-Poor= 2-3

What are the ratings for (PL I)? (4)

Plaque Control Record

-records presence of biofilm on individual tooth surfaces so pt can **SEE progress while learning biofilm control

-M,D,L,B surfaces evaluated

0% is goal, 10% realistic

What is goal of Plaque Control Record?

Plaque Free Score

-all B,L,M,D surfaces evaluated

-disclose and count number of surfaces without stained plaque

-calculate percent of surfaces without plaque (100% goal)

Patient Hygiene Performance (PHP)

-Teeth (3,8,14,19,24,30)

-2nd molar is used if 1st is missing

-divide into 5 sections

-facial surfaces of incisors and max molars, lingual surfaces of mand molars examined

-5 surfaces/tooth, 6 teeth = Max of 30

-should decrease as OHI improves

Simplified Oral Hygiene Index (OHI-S)

-assess oral cleanliness by estimating tooth surface covered with debris and calculus.

-2 Components:

-Simplified Debris Index (DI-S)

-Simplified Calculus Index (DI-C)

How to calculate (OHI-S)

-6 teeth, (max molars facial, mand molars lingual, incisors labial) + proximal

-3,8,14,19,24,30

-record 6 debris scores

-record 6 calc scores

OHI-S Scores

-0,1,2,3

-2 scores may be used ind.(DI-S, CI-S) **OR combined for the OHI-S

-0= excellent

-3.1-6 = poor

Indices that measure Gingival and Periodontal Health

*Gingival- GI, SBI

*Periodontal- PSR,CPITN, PI, PDI

Sulcular Bleeding Index (SBI)

-reversible

-designed to detect early symptoms of gingivitis

-useful in short-term clinical trials

-B,L,M,D surfaces of max and mand *anterior teeth only!!

-sulcus gently probed then observed after 30 seconds

-Scale of 0-5

-0= no bleeding, up to 5= spontaneous bleeding

Examiner calibration critical

How do you measure SBI?

Gingival Bleeding Index (GBI)

-determine presence/absence gingival inflammation

*observe bleeding in interprox sulci

-floss all interprox areas

-visualize 30 secs

Eastman Interdental Bleeding Index

-wooden interdental cleaner inserted into interprox space

-presence/absence of bleeding noted within quad 15 sec after final insertion

-can report as percent or # bleeding sites

Gingival Index

-subjective measure of amt of gingivitis

-B,L,M,D of all or selected teeth evaluated

0-none

1-slight redness, no spontaneous bleeding

2-moderate redness, some bleeding

3-spontaneous bleeding, ulceration, deep red

Gingival Index Score

Community Periodontal Index of Treatment Needs (CPITN)

-developed by WHO

-requires use of specially designed probe -WHO probe (color coded band btwn 3.5mm-5.5mm)

-5 codes, 0,1,2,3,4,(*)

-detection of calc, overhangs, root surfaces, irregularities

What else does the WHO probe aid in?

Periodontal Screening and Recording (PSR)

-modified version of CPITN index

-adopted by ADA and AAP in 1992

-used in clinical as screening procedure to **determine need for CPE

-WHO probe

-eval by sextant

-5 codes=0-4, (*)

-Periodontal Index (PI) and Periodontal Disease Index (PDI)

-Neither recognize gingivitis as a separate disease

What are other periodontal indices, which aren't used much today?

Fluorosis Index

-developed by Dean to measure amt of fluorosis in communities

-smooth surface enamel of all teeth examined

**Numerical score= 0-normal, up to 5=severe

Community Needs Assessment (Exam Methods)

**Type I-Complete Exam

-mirror, explorer, lighting, x-rays, study models, diagnostic tests, etc.

Community Needs Assessment (Exam Methods)

**Type II-Limited Exam

-mirror explorer, lighting, posterior BWX, and select PA

Community Needs Assessment (Exam Methods)

**Type III-Inspection

-mirror, explorer, light

Community Needs Assessment (Exam Methods)

**Type IV-Screening

-tongue depressor, light