Oral hygiene indices. Oral hygiene indices for determining dental plaque Oral hygiene index according to Kuzmina

06.07.2020

Oral hygiene is one of the most accessible and at the same time one of the leading methods of preventing oral diseases. Regular and competent oral care is an integral part of all preventive measures. Mass population surveys conducted in all countries of the world have convincingly shown that systematic oral care has an undoubted preventive value. It is possible to objectively assess the level of oral hygiene only using hygiene indices.

To identify dental plaque in assessing oral hygiene in modern dentistry, objective indicators (indices) are used that characterize the quality and quantity of dental plaque. However, the number of assessment methods, which are based on different numbers of teeth from different functional groups, up to staining all teeth on both sides or collecting and weighing plaque around individual teeth, indicates the relevance of the problem under consideration and the imperfection of existing methods.

Oral hygiene indices.

Method for determining the Fedorov-Volodkina hygienic index//E.M.Melnichenko “Prevention of dental diseases”, Minsk, “Higher School”., 1990, pp. 3-17.

It is determined by the intensity of the color of the vestibular surface of the six lower frontal teeth by applying an iodine-iodide-potassium solution (Schiller-Pisarev liquid).

The calculation is carried out according to the formula:

Ksr (hygiene index) = Kn (total hygiene index for each of the six teeth) / n (number of teeth).

Coloring the entire surface of the crown is scored 5 points, 3/4 of the surface - 4, 1/2 of the surface - 3, 1/4 of the surface - 2 points. If there is no staining, 1 point is given. The indicator is assessed as follows: good index, satisfactory, unsatisfactory, bad, very bad.

However, the proposed method has a number of disadvantages:

Determination of the quality and quantity of dental plaque and assessment of the hygiene index were carried out only on one’s own teeth;
- the use of known dyes is impossible when determining the amount of dental plaque on bridges, since these solutions are difficult to wash off from the surface of the dentures.

Name

Facilities

diagnostics

Self-control criteria

Lugol's solution

1.1-1.5 is good

1.6-2.0 - satisfactory

2.1-2.5 - unsatisfactory

2.6-3.4 - bad

3.5-5.0 - very bad

The vestibular surface of the six front teeth of the lower jaw - incisors and canines - is stained with Lugol's solution. Rating on a 5-point system:

5 points - the entire surface of the teeth is stained,

4 points - 3/4 of the tooth surface,

3 points - 1/2 of the tooth surface,

2 points - 1/4 of the tooth surface,

1 point - no staining

Then find the arithmetic mean by dividing the sum of the color of all teeth by their number: K av = Kp: p.

Good level of hygiene: Ksr=1.0-1.3 b

IG = sum of six teeth points
6.

Schiller-Pisarev solution or Lugol's solution

0-0.6 good

0.7-1.6 satisfactory

1.7-2.5 unsatisfactory

2.6-3 - bad

Determine the presence of plaque and tartar on the buccal surface of the first upper molars, the lingual surface of the lower molars, and the vestibular surface 1| and lower |1

6 1| 6
6 | 1 6.
On all surfaces, plaque is first determined, then tartar.

0 - no plaque (stone)

1 - plaque covers up to 1/3 of the tooth surface

2 - plaque covers from 1/3 to 2/3 of the tooth surface

3 - plaque covers more than 2/3 of the tooth surface

Tartar assessment:

0 - absence of tartar

1 - supragingival tartar covers no more than 1/3 of the tooth crown

2 - supragingival tartar covers from 1/3 to 2/3 of the tooth crown, or single formations of subgingival tartar are detected

3 - supragingival tartar covers more than 2/3 of the tooth crown, or significant deposits of subgingival tartar are detected along the entire circumference of the tooth.

IZN = sum of indicators of 6 teeth
6

The assessment of the tartar index is carried out similarly to UIG = IZN + IZK

Schiller-Pisarev solution

0-no staining

1- staining up to 1/3 of the crown,

2- staining up to 2/3 of the crown

3- more than 2/3 of the tooth crown

Staining of the vestibular and lingual surfaces

6 1 | 6
6 | 1 6

The plaque index and stone index are summed up and the average is obtained.

RHP Index - Oral Hygiene Performance Index (Podshadley, Haley - 1968)

Color 6 teeth:

16, 26, 11, 31 - vestibular surfaces.

36, 46 - lingual surfaces

The examined surface is divided into 5 sections: 1-medial, 2-distal, 3-mid-occlusal, 4-central, 5-mid-cervical.

Plaque is assessed at each site:

0 - no staining

1 - staining detected

For each tooth, the site codes are summed up. Then the values of all examined teeth are summed up and the resulting sum is divided by the number of teeth.

Index values:

0 - excellent

0.1-0.6 - good

0.7-1.6 - satisfactory

1.7 or more - unsatisfactory

Index of need for treatment of periodontal diseases - CPITN

To assess the prevalence and intensity of periodontal diseases, almost all countries use the index of need for the treatment of periodontal diseases - CPITN. This index was proposed by specialists of the WHO working group to assess the condition of periodontal tissues during epidemiological surveys of the population.

Currently, the scope of the index has expanded, and it is used to plan and evaluate the effectiveness of prevention programs, as well as calculate the required number of dental personnel. In addition, the CPITN index is currently used in clinical practice to examine and monitor the periodontal condition of individual patients.

This index registers only those clinical signs that may undergo reverse development: inflammatory changes in the gums, which are judged by bleeding, tartar. The index does not record irreversible changes (gingival recession, tooth mobility, loss of epithelial attachment), does not indicate the activity of the process and cannot be used to plan specific clinical treatment in patients with developed periodontitis.

The main advantages of the CPITN index are the simplicity and speed of its determination, information content and the ability to compare results.

To determine the CPITN index, the dentition is conventionally divided into 6 parts (sextants), including the following teeth: 17/16, 11, 26/27, 36/37, 31, 46/47.

The periodontium is examined in each sextant, and for epidemiological purposes only in the area of the so-called “index” teeth. When using the index for clinical practice, the periodontium is examined in the area of all teeth and the most severe lesion is identified.

It should be remembered that a sextant is examined if it contains two or more teeth that cannot be removed. If only one tooth remains in the sextant, it is included in the adjacent sextant, and this sextant is excluded from the examination.

In the adult population, starting from 20 years of age and older, 10 index teeth are examined, which are identified as the most informative:

When examining each pair of molars, only one code characterizing the worst condition is taken into account and recorded.

For persons under 20 years of age, 6 index teeth are examined during the epidemiological survey: 16, 11, 26, 36, 31, 46.

CODE 1: bleeding observed during or after probing.

Note: bleeding may appear immediately or after 10-30 seconds. after probing.

CODE 2: tartar or other plaque-retaining factors (overhanging edges of fillings, etc.) are visible or felt during probing.

CODE 3: pathological pocket 4 or 5 mm (the edge of the gum is in the black area of the probe or the 3.5 mm mark is hidden).

CODE 4: pathological pocket 6 mm deep or more (with the 5.5 mm mark or black area of the probe hidden in the pocket).

CODE X: When only one or no teeth are present in the sextant (third molars are excluded unless they are in place of second molars).

To determine the need for periodontal disease treatment, population groups or individual patients can be categorized based on the following criteria.

0: CODE 0 (healthy) or X (excluded) for all 6 sextants means that there is no need for treatment for this patient.

1: A CODE of 1 or higher indicates that this patient needs to improve his oral hygiene status.

2: a) CODE 2 or higher indicates the need for professional hygiene and the elimination of factors that contribute to plaque retention. In addition, the patient needs training in oral hygiene.

b) CODE 3 indicates the need for oral hygiene and curettage, which usually reduces inflammation and reduces pocket depth to values equal to or less than 3 mm.

3: Sextant with CODE 4 can sometimes be successfully treated with deep curettage and adequate oral hygiene. In other cases, this treatment does not help, and then complex treatment is required, which includes deep curettage.

The prevalence and intensity of periodontal disease in the population is assessed based on the results of a survey of 15-year-old adolescents.

Prevalence of signs of periodontal damage (adolescents 15 years old)

Prevalence Bleeding gums Tartar

low 0 - 50% 0 - 20%

average 51 - 80% 21 - 50%

high 81 - 100% 51 - 100%

Level of intensity of signs of periodontal damage (adolescents 15 years old)

INTENSITY LEVEL BLEEDING GUMS CALCULUS

LOW 0.0 - 0.5 sextants 0.0 - 1.5 sextants

AVERAGE 0.6 - 1.5 sextants 1.6 - 2.5 sextants

HIGH< 1,6 секстантов < 2,6 секстантов

Gingivitis index PMA (Schour, Massler) modified by Parma

Gingivitis index PMA (Schour, Massler) as modified by Parma (determination of risk factors) - papillary-marginal-alveolar index is calculated by adding the assessments of the gum condition of each tooth in % using the formula:

RMA = sum of indicators x 100%

3 x number of teeth

0 - no inflammation,

1 - inflammation of the interdental papilla (P)

2 - inflammation of the marginal gum (M)

3 - inflammation of the alveolar gum (A)

At the age of 6-7 years, the number of teeth is normally 24, at 12-14 years - 28, and at 15 years and older - 28 or 30.

The PMA index is very sensitive to the slightest changes in the clinical picture, and its value can be influenced by random influences.

COMPLEX PERIODONTAL INDEX, KPI(P.A.Leus, 1988)

Methodology. The condition of periodontal tissue is determined using a conventional dental probe and a dental mirror; dental tweezers can be used to determine mobility. In adults, 17/16, 11, 26/27, 37/36, 31, 46/47 are examined. If several signs are present, a more severe condition is recorded (higher score).

Criteria

0 - healthy - dental plaque and signs of periodontal damage are not detected;

1- dental plaque - any amount of dental plaque;

2- bleeding - bleeding visible to the naked eye upon slight probing of the periodontal groove;

3 - tartar - any amount of tartar in the subgingival area of the tooth;

4 - pathological pocket - pathological periodontal pocket determined by the probe;

5 - tooth mobility - mobility 2-3 degrees

The KPI of an individual is calculated using the formula:

KPI = Sum of codes / number of sextants (usually 6)

Interpretation:

Values Intensity level

0.1-1.0 Risk of disease

1.1-2.0 Light

2.1-3.5 Average

3.6-5.0 Heavy

Index CP.I.- communal periodontal index.

Designed to determine the condition of periodontal tissues during epidemiological studies. The condition of periodontal tissues is assessed by:

Presence of subgingival calculus

Bleeding gums after gentle probing

By the presence and depth of pockets

A special button probe is used for the study:

Weight 25 grams

Button diameter 0.5 mm

Marking 3-5-8-11 mm

Distance between 3 and 5mm black

In persons from 15 to 20 years old, teeth 11, 16, 26, 31, 36, 46 are examined. In persons over 20 years old, teeth are examined: 11, 16, 17, 26, 27, 31, 36, 37, 46, 47.

Research is carried out from the vestibular and oral surfaces, in the distal and medial areas

Research methodology:

1. The working part of the probe is placed parallel to the long axis of the tooth

2. The button of the probe is inserted with minimal pressure into the space between the tooth and soft tissues until an obstacle is felt

3. Mark the immersion depth of the probe

4. When extracting, the probe is pressed against the tooth to determine whether there is subgingival calculus on it

5. At the end of the study, the gums are observed after 30-40 seconds to determine bleeding

Data logging:

0 - healthy gums

1 - bleeding after 30-40 seconds, with a pocket depth of less than 3 mm

2 - subgingival calculus

3 - pathological pocket 4-5 mm

4 - pathological pocket 6 mm or more

If several symptoms are present, the most severe one is recorded.

In each sextant, the periodontal condition of only one tooth is recorded, recording the tooth with the most severe clinical periodontal condition

To evaluate the index, the proportion of people who have a particular number of sextants with a particular code is calculated.

Iodine index of enamel remineralization.

The active permeability of iodine in tooth tissue is known. Remineralization index (RI), which characterizes the effectiveness of the remineralization therapy used. It is assessed using a four-point system:

1 point – no staining of the tooth area;

2 points - light yellow coloration of the tooth area;

3 points - light brown or yellow staining of the tooth area;

4 points - dark brown staining of the tooth area.

The calculation is carried out according to the formula:

IR = IRNP x number of teeth with hypersensitivity / n,

where IR is the remineralization index;

RRI—remineralization index of one non-carious lesion;

P - number of teeth examined.

Dark brown and light brown staining indicates demineralization of the tooth area with non-carious lesions; light yellow - indicates a certain level of remineralization processes in this area of the tooth, and the absence of staining or its slightly yellow color demonstrates a good level of the remineralization process of a particular non-carious tooth lesion.

Prevalence and severity of hyperesthesia of hard dental tissues

(Fedorov Yu.A., Shtorina G.B., 1988; Fedorov Yu.A. et al., 1989).

The index is calculated using the formula and expressed as a percentage:

Number of teeth with increased = sensitivity / Number of teeth in a given patient x 100%.

Depending on the number of teeth with sensitivity to various irritants, the index varies from 3.1% to 100.0%.

3.1—25% are diagnosed with a limited form of hyperesthesia

26-100% - generalized form of dental hyperesthesia.

Dental hyperesthesia intensity index (DHI)

calculated by the formula:

IIGZ = Sum of index values of each tooth / Number of teeth with increased sensitivity

The index is calculated in points, which are determined based on the following indicators:

0 - no reaction to temperature, chemical and tactile stimuli;

1 point—sensitivity to temperature stimuli;

2 points - sensitivity to temperature and chemical stimuli;

3 points - sensitivity to temperature, chemical and tactile stimuli.

Values of the intensity index of hyperesthesia of hard dental tissues

1.0 - 1.5 points, degree I hyperesthesia;

1.6 - 2.2 points - II degree;

2.3 - 3.0 points - III degree.

The listed indices correlate with each other in 85.2-93.8% of cases and allow adequate and objective monitoring of the intensity and severity of the pathological process, and monitoring the dynamics of changes during treatment.

Indices used during dental examination. Indexes in dentistry

One of the main indices (KPU) reflects the intensity of dental caries damage. K means the number of carious teeth, P - the number of filled teeth, Y - the number of teeth removed or to be removed. The sum of these indicators gives an idea of the intensity of the caries process in a particular person.

There are three types of KPU index:

KPU of teeth (KPUz) - the number of carious and filled teeth of the subject;
KPU surfaces (KPUpov) - the number of tooth surfaces affected by caries;
KPUpol - the absolute number of carious cavities and fillings in the teeth.

For temporary teeth, the following indicators are used:

kp - the number of carious and filled teeth in the temporary occlusion;
kp - number of affected surfaces;
checkpoint - the number of carious cavities and fillings.

Teeth removed or lost as a result of physiological change are not taken into account in the temporary dentition. In children, when changing teeth, two indices are used at once: KP and KPU. To determine the overall intensity of the disease, both indicators are summed up. KPU from 6 to 10 indicates a high intensity of carious lesions, 3-5 - moderate, 1-2 - low.

These indices do not provide a sufficiently objective picture, as they have the following disadvantages:

both treated and extracted teeth are taken into account;
can only increase over time and with age begin to reflect the previous incidence of caries;
do not allow taking into account the very initial carious lesions.

Serious disadvantages of the KPUz and KPUp indices include their unreliability when tooth damage increases due to the formation of new cavities in treated teeth, the occurrence of secondary caries, loss of fillings, and the like.

The prevalence of caries is expressed as a percentage. To do this, the number of people who were found to have certain manifestations of dental caries (except for focal demineralization) is divided by the total number of people examined in this group and multiplied by 100.
In order to assess the prevalence of dental caries in a particular region or compare the value of this indicator in different regions, the following assessment criteria for the level of prevalence among 12-year-old children are used:
INTENSITY LEVEL
LOW - 0-30%
AVERAGE - 31 - 80%
HIGH - 81 - 100%
To assess the intensity of dental caries, the following indices are used:
a) intensity of caries of temporary (baby) teeth:
index kp (z) - the sum of teeth affected by untreated caries
and filled in one individual;
index kp (n) - the sum of surfaces affected by untreated
caries and fillings in one individual;
In order to calculate the average value of the indices kp(z) and kp(p) in a group of subjects, one should determine the index for each person examined, add up all the values and divide the resulting amount by the number of people in the group.
b) intensity of caries of permanent teeth:
index KPU(z) - the sum of carious, filled and removed
teeth in one individual;
index KPU (n) - the sum of all surfaces of the teeth on which
caries or filling was diagnosed in one individual. (If
the tooth is removed, then in this index it is considered to be 5 surfaces).
When determining these indices, early forms of dental caries in the form of white and pigmented spots are not taken into account.
In order to calculate the average value of indices for a group, you should find the sum of individual indices and divide it by the number of people examined in this group.
c) assessment of the intensity of dental caries among the population.
To compare the intensity of dental caries between different regions or countries, the average values of the KPU index are used.

The CPITN index is used in clinical practice to examine and monitor periodontal condition.. This index records only those clinical signs that may undergo reverse development (inflammatory changes in the gums, judged by bleeding, tartar), and does not take into account irreversible changes (gingival recession, tooth mobility, loss of epithelial attachment). CPITN "does not tell" about the activity of the process and cannot be used for treatment planning.

The main advantage of the CPITN index is its simplicity, speed of determination, information content and the ability to compare results. The need for treatment is determined based on the following criteria.

CODE 0 or X means that there is no need to treat this patient.
CODE 1 indicates that this patient needs to improve his oral hygiene.
CODE 2 indicates the need for professional hygiene and the elimination of factors that contribute to plaque retention.
CODE 3 indicates the need for oral hygiene and curettage, which usually reduces inflammation and reduces pocket depth to values equal to or less than 3 mm.
CODE 4 can sometimes be successfully treated with deep curettage and adequate oral hygiene. Complex treatment is required.

Papillary-marginal-alveolar index (PMA) used to assess the severity of gingivitis. There are several types of this index, but the most widespread is the PMA index in the Parma modification. The number of teeth (while maintaining the integrity of the dentition) is taken into account depending on age: 6 - 11 years - 24 teeth, 12 - 14 years - 28 teeth, 15 years and older - 30 teeth. Normally, the PMA index is zero.

How well a patient monitors oral hygiene is determined by the Fedorov-Volodkina Hygienic Index. The index is recommended to be used to assess the hygienic state of the oral cavity in children under 5-6 years of age. To determine the index, the labial surface of six teeth is examined. Teeth are stained using special solutions and the presence of plaque is assessed. Determination of supra- and subgingival tartar is carried out using a dental probe. The calculation of the index consists of the values obtained for each component of the index, divided by the number of surfaces surveyed, followed by the summation of both values.

Also common Oral Hygiene Performance Index (OHP). To quantify plaque, 6 teeth are stained. The index is calculated by determining the code for each tooth by adding the codes for each section. Then the codes for all examined teeth are summed up and the resulting sum is divided by the number of teeth:

To assess the state of occlusion it is used dental aesthetic index, which determines the position of the teeth and the state of the bite in the sagittal, vertical and transversal directions. It is used from the age of 12.

The examination is carried out visually and using a button probe. The index includes definitions of the following components:

lack of teeth;
crowding in the incisal segments;
gap in incisal segments;
diastema;
deviations in the anterior region of the upper jaw;
deviations in the anterior region of the lower jaw;
anterior maxillary overlap;
anterior mandibular overlap;
vertical anterior slit;
anterior-posterior relationship of molars.

The dental aesthetic index allows you to analyze each of the components of the index or group them by anomalies of the dentition and bite.

In order to assess the prevalence of dental caries in a particular region or compare the value of this indicator in different regions, the following assessment criteria for the level of prevalence among 12-year-old children are used:

Intensity level

LOW - 0-30% MEDIUM - 31 - 80% HIGH - 81 - 100%

To assess the intensity of dental caries, the following indices are used:

a) intensity of caries of temporary (baby) teeth:
index kp (z) - the sum of teeth affected by untreated caries and filled in one individual;

kp index (n) - the sum of surfaces affected by untreated caries and filled in one individual;

In order to calculate the average value of the indices bullpen) And kp(p) in a group of subjects, you should determine the index for each person examined, add up all the values and divide the resulting amount by the number of people in the group.

b) intensity of caries of permanent teeth:

index KPU(z) - the sum of carious, filled and extracted teeth in one individual;

KPU index (p) - the sum of all tooth surfaces on which caries or fillings are diagnosed in one individual. (If a tooth is removed, then in this index it is considered 5 surfaces).

When determining these indices, early forms of dental caries in the form of white and pigmented spots are not taken into account.
In order to calculate the average value of indices for a group, you should find the sum of individual indices and divide it by the number of people examined in this group.

c) assessment of the intensity of dental caries among the population.
To compare the intensity of dental caries between different regions or countries, the average values of the KPU index are used.

Methods for assessing oral hygiene. Oral Health Indices

Methods for assessing dental plaque

Fedorov-Volodkina Index(1968) was widely used in our country until recently.

The hygienic index is determined by the intensity of coloring of the labial surface of the six lower frontal teeth with an iodine-iodide-potassium solution, assessed using a five-point system and calculated using the formula: By Wed=(∑To u)/n

Where By Wed. - general hygienic cleaning index; To u- hygienic index of cleaning one tooth; n- number of teeth.

Staining the entire surface of the crown means 5 points; 3/4 - 4 points; 1/2 - 3 points; 1/4 - 2 points; absence of staining - 1 point. Normally, the hygiene index should not exceed 1.=

Green-Vermillion Index(Green, Vermillion, 1964). The Oral Hygiene Index Simplified (OHI-S) evaluates the area of tooth surface covered by plaque and/or tartar and does not require the use of special dyes. To determine OHI-S, examine the buccal surface 16 and 26, the labial surface 11 and 31, and the lingual surface 36 and 46, moving the tip of the probe from the cutting edge towards the gum.

The absence of dental plaque is indicated as 0 , dental plaque up to 1/3 of the tooth surface - 1 , dental plaque from 1/3 to 2/3 - 2 , dental plaque covers more than 2/3 of the enamel surface - 3 . Then tartar is determined according to the same principle.

Formula for calculating the index.OHI - S=∑(ZN/n)+∑(ZK/n)

Where n- number of teeth, ZN- plaque, ZK- tartar.

Silnes-Lowe Index(Silness, Loe, 1967) takes into account the thickness of plaque in the gingival region in 4 areas of the tooth surface: vestibular, lingual, distal and mesial. After drying the enamel, the tip of the probe is passed along its surface at the gingival sulcus. If a soft substance does not adhere to the tip of the probe, the plaque index on the tooth area is indicated as - 0. If the plaque is not visually determined, but becomes visible after moving the probe, the index is 1. A plaque with a thin to moderate layer thickness, visible to the naked eye, is assessed as 2 Intensive deposition of dental plaque in the area of the gingival sulcus and interdental space is designated as 3. For each tooth, the index is calculated by dividing the sum of the points of 4 surfaces by 4.

The general index is equal to the sum of the indicators of all examined teeth, divided by their number.

Tartar index(CSI)(ENNEVER et al., 1961). Supra- and subgingival tartar is determined on the incisors and canines of the lower jaw. The vestibular, distal-lingual, central-lingual and medial-lingual surfaces are examined differentially.

To determine the intensity of tartar, a scale from 0 to 3 is used for each surface examined:

0 - no tartar

1 - tartar is determined to be less than 0.5mm in width and/or thickness

2 - width and/or thickness of tartar from 0.5 to 1 mm

3 - width and/or thickness of tartar more than 1 mm.

Formula for calculating the index: ZK intensity = (∑codes_of_all_surfaces)/n_teeth

where n is the number of teeth.

Ramfjord index(S. Ramfjord, 1956) as part of the periodontal index involves the determination of dental plaque on the vestibular, lingual and palatal surfaces, as well as the proximal surfaces of the 11, 14, 26, 31, 34, 46 teeth. The method requires preliminary staining with a Bismarck brown solution. Scoring is done as follows:

0 - absence of dental plaque

1 - dental plaque is present on some tooth surfaces

2 - dental plaque is present on all surfaces, but covers more than half of the tooth

3 - dental plaque is present on all surfaces, but covers more than half.

The index is calculated by dividing the total score by the number of teeth examined.

Navi Index(I.M.Navy, E.Quiglty, I.Hein, 1962).Tissue color indices in the oral cavity limited by the labial surfaces of the front teeth are calculated. Before the examination, the mouth is rinsed with a 0.75% solution of basic fuchsin. The calculation is carried out as follows:

0 - no plaque

1 - the plaque was stained only at the gingival border

2 - pronounced plaque line at the gingival border

3 - the gingival third of the surface is covered with plaque

4 - 2/3 of the surface is covered with plaque

5 - more than 2/3 of the surface is covered with plaque.

The index was calculated in terms of the average number per tooth per subject.

Turesky index(S. Turesky, 1970). The authors used the Quigley-Hein counting system on the labial and lingual surfaces of the entire row of teeth.

0 - no plaque

1 - individual spots of plaque in the cervical area of the tooth

2 - a thin continuous strip of plaque (up to 1 mm) in the cervical part of the tooth

3 - plaque strip is wider than 1 mm, but covers less than 1/3 of the tooth crown

4 - plaque covers more than 1/3, but less than 2/3 of the tooth crown

5 - plaque covers 2/3 of the tooth crown or more.

Arnim index(S. Arnim, 1963) when assessing the effectiveness of various oral hygiene procedures, determined the amount of plaque present on the labial surfaces of the four upper and lower incisors, stained with erythrosine. This area is photographed and developed at 4x magnification. The outlines of the corresponding teeth and colored masses are transferred to paper and these areas are determined with a planimer. The percentage of surface area covered by plaque is then calculated.

Hygiene Performance Index(Podshadley, Haby, 1968) requires the use of dye. Then a visual assessment of the buccal surfaces of 16 and 26, labial - 11 and 31, lingual - 36 and 46 teeth is carried out. The surveyed surface is conventionally divided into 5 sections: 1 - medial, 2 - distal 3 - mid-occlusal, 4 - central, 5 - mid-cervical.

0 - no staining

1 - staining of any intensity is available

The index is calculated using the formula:PHP=(∑codes)/n

Clinical methods for assessing gum health

PMA Index(Schour, Massler ). Inflammation of the gingival papilla (P) is assessed as 1, inflammation of the gingival margin (M) - 2, inflammation of the mucous membrane of the alveolar process of the jaw (A) - 3.

By summing up the gum condition assessments for each tooth, the PMA index is obtained. At the same time, the number of examined teeth of patients aged 6 to 11 years is 24, from 12 to 14 years old - 28, and from 15 years old - 30.

The PMA index is calculated as a percentage as follows:

RMA = (sum of indicators x 100): (3 x number of teeth)

In absolute numbers, PMA = sum of indicators: (number of teeth x 3).

Gingival index GI(Loe, Silence ) . For each tooth, four areas are differentially examined: vestibular-distal gingival papilla, vestibular marginal gingiva, vestibular-medial gingival papilla, lingual (or palatal) marginal gingiva.

0 - normal gum;

1 - mild inflammation, slight discoloration of the gum mucosa, slight swelling, no bleeding on palpation;

2 - moderate inflammation, redness, swelling, bleeding on palpation;

3 - pronounced inflammation with noticeable redness and swelling, ulceration, and a tendency to spontaneous bleeding.

Key teeth whose gums are examined: 16, 21, 24, 36, 41, 44.

To evaluate the examination results, the sum of points is divided by 4 and the number of teeth.

0.1 - 1.0 - mild gingivitis

1.1 - 2.0 - moderate gingivitis

2.1 - 3.0 - severe gingivitis.

IN periodontal index P.I. (Russell) the condition of the gums and alveolar bone is calculated individually for each tooth. For calculation, a scale is used in which a relatively low index is assigned to gum inflammation, and a relatively higher index to alveolar bone resorption. The indices of each tooth are summed up, and the result is divided by the number of teeth in the oral cavity. The result shows the patient's periodontal index, which reflects the relative status of periodontal disease in a given oral cavity without taking into account the type and causes of the disease. The arithmetic mean of the individual indices of the examined patients characterizes the group or population indicator.

Periodontal Disease Index - PDI (Ramfjord, 1959) includes an assessment of the condition of the gums and periodontium. The vestibular and oral surfaces of the 16th, 21st, 24th, 36th, 41st, and 44th teeth are examined. Plaque and tartar are taken into account. The depth of the periodontal pocket is measured with a graduated probe from the enamel-cement junction to the bottom of the pocket.

GINGIVITIS INDEX

0 - no signs of inflammation

1 - mild or moderate inflammation of the gums, not spreading around the tooth

2 - moderate inflammation of the gums, spreading around the tooth

3 - severe gingivitis, characterized by severe redness, swelling, bleeding and ulceration.

INDEX OF PERIODONTAL DISEASE

0-3 - the gingival groove is determined no deeper than the cemento-enamel junction

4 - gum pocket depth up to 3 mm

5 - gum pocket depth from 3 mm to 6 mm

6 - gum pocket depth more than 6 mm.

CPITN (WHO) - comprehensive periodontal index of treatment need used to assess the periodontal condition of the adult population, to plan prevention and treatment, determine the need for dental personnel, analyze and improve treatment and preventive programs.

To determine the indicator, a specially designed periodontal probe is used, which has a ball with a diameter of 0.5 mm at the end and a black stripe at a distance of 3.5 mm from the tip of the probe.

In persons over 20 years of age, the periodontium is examined in the area of six groups of teeth (17/16, 11, 26/27, 37/36, 31, 46/47) in the lower and upper jaws. If there is not a single index tooth in the named sextant, then all remaining teeth in that sextant are examined.

In young people under the age of 19, teeth 16, 11, 26, 36, 31, 46 are examined.

Registration of research results is carried out according to the following codes:

0 - healthy gums, no signs of pathology

1 - bleeding of the gums is observed after probing

2 - subgingival tartar is determined with a probe; the black strip of the probe does not sink into the gingival pocket

3 - a pocket of 4-5mm is determined; the black strip of the probe is partially immersed in the periodontal pocket

4 - a pocket of more than 6 mm is determined; the black strip of the probe is completely immersed in the gingival pocket.

Complex periodontal index - KPI (P.A. Leus). In adolescents and adults, teeth 17/16, 11, 26/27, 31, 36/37, 46/47 are examined.

The patient is examined in a dental chair under adequate artificial lighting. A standard set of dental instruments is used.

If several signs are present, a more severe lesion is recorded (higher score). In case of doubt, preference is given to underdiagnosis.

An individual’s KPI is calculated using the formula: KPI=(∑codes)/n

where n is the number of teeth examined.

Index for assessing dental plaque in young children (E.M. Kuzmina, 2000)

To assess the amount of plaque in a young child (from the eruption of primary teeth to 3 years), all teeth present in the oral cavity are examined. The assessment is carried out visually or using a dental probe.

The amount of plaque must be determined even if there are only 2-3 teeth in the child’s mouth.

Codes and evaluation criteria:

0 - no plaque
1 - plaque present

The individual index value is calculated using the formula:

Plaque = number of teeth with plaque / number of teeth in the mouth

Index interpretation

HYGIENIC INDEX according to Fedorov-Volodkina (1971)

To determine the index, the labial surface of six teeth is examined: 43, 42, 41, 31, 32, 33

The indicated teeth are stained using special solutions (Schiller-Pisarev, fuchsin, erythrosine, and the presence of plaque is assessed using the following codes:

1 - no dental plaque was detected;

2 - staining one quarter of the surface of the tooth crown;

3 - staining half the surface of the tooth crown;

4 - staining three quarters of the surface of the tooth crown;

5 - staining the entire surface of the tooth crown.

To assess the plaque present in a given patient, add up the codes obtained from examining each of the stained teeth and divide the sum by 6.

To obtain the average value of the hygiene index in a group of children, add up the individual index values for each child and divide the sum by the number of children in the group.

ORAL HYGIENE INDEX SIMPLIFIED (IGR-U), (OHI-S), J.C. Green, J.R. Vermillion (1964)

The index allows you to separately assess the amount of plaque and tartar.

To determine the index, 6 teeth are examined:

16, 11, 26, 31 - vestibular surfaces

36, 46 - lingual surfaces

Assessment of dental plaque can be carried out visually or using staining solutions (Schiller-Pisarev, fuchsin, erythrosine).

0 - no dental plaque was detected;

1 - soft plaque covering no more than 1/3 of the tooth surface, or the presence of any amount of colored deposits (green, brown, etc.);

2 - soft plaque covering more than 1/3, but less than 2/3 of the tooth surface;

3 - soft plaque covering more than 2/3 of the tooth surface.

CODES AND CRITERIA FOR EVALUATING DENTAL CALCULUS

Determination of supra- and subgingival tartar is carried out using a dental probe.

0 - no tartar was detected;

1 - supragingival tartar, covering no more than 1/3 of the tooth surface;

2 - supragingival tartar, covering more than 1/3, but less than 2/3 of the tooth surface, or the presence of individual deposits of subgingival tartar in the cervical area of the tooth;

3 - supragingival calculus covering more than 2/3 of the tooth surface, or significant deposits of subgingival calculus around the cervical area of the tooth.

The calculation of the index consists of the values obtained for each component of the index, divided by the number of surfaces surveyed, and summing both values.

Formula for calculation:

IGR-U= SUM OF PLAQUE VALUES / NUMBER OF SURFACES + SUM OF STONE VALUES / NUMBER OF SURFACES

Index interpretation

Oral Hygiene Performance Index (OHP) Podshadley, Haley (1968)

To quantify dental plaque, 6 teeth are stained:

16, 26, 11, 31 - vestibular surfaces;

36, 46 - lingual surfaces.

If there is no index tooth, you can examine the adjacent one, but within the group of teeth of the same name. Artificial crowns and parts of fixed dentures are examined in the same way as teeth.

Examined surface of each tooth
conditionally divided into 5 sections

medial
distal
midocclusal
central
midcervical

CODES AND CRITERIA FOR ASSESSING DENTAL PLAQUE

0 - no staining

1 - staining detected

The index is calculated by determining the code for each tooth by adding the codes for each section. Then the codes for all examined teeth are summed up and the resulting sum is divided by the number of teeth.

The index is calculated using the following formula:

RNR = SUM OF ALL TEETH CODES / NUMBER OF TEETH EXAMINED

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Target setting. Learn to determine the state of oral hygiene by the amount of plaque and tartar; methods, technical and organizational techniques, rules and manipulations necessary for the practical implementation of preventive measures.

One of the most important criteria for the condition of the oral organs when determining the level of health is the assessment of the state of oral hygiene. The main indicator of hygiene is the determination of the amount of soft plaque, tartar and pellicle that appears on the surface of the tooth after its eruption. The process of their accumulation depends on self-cleaning - the most important physiological function of the oral cavity. Quantitative accounting of dental plaque, a component of the oral cavity that depends on many factors, is most often used as an indicator of hygiene.

Soft plaque in the oral cavity is located on the surface of the tooth, most often in the gingival area, at the border of the neck of the tooth and the edge of the gum. It has a gray or yellow-gray color and is invisible in small quantities on the teeth. However, it can be easily detected by scraping the enamel surface in the cervical area with a trowel or excavator. When accumulated, it takes on the appearance of a soft amorphous grayish-white or grayish-yellow mass; The thickest layer of plaque is noted in the area of the gingival margin. At the point where the gums come into contact with plaque, signs of inflammation are often observed. When brushing your teeth or eating food, especially hard and dense food, part of the plaque from the surface of the tooth is constantly removed, but quickly forms again. Despite its softness and friability, dental plaque is firmly bound to the surface of the tooth.

Detection of soft dental plaque and its quantitative assessment are based on a chemical reaction or sorption of dyes by extracellular plaque polysaccharides. Usually Lugol's solution is used for this purpose (Kalii jodati 2.0; Jodi crist. 1.0; Aq. destill. 40.0), the iodine of which colors the polysaccharides in yellowish-pink tones (Fig. 16). Basic fuchsin (Fucsini bas. 1.5; Spiritus aet. 70% 25.0) is also used for staining dental plaque, 15 drops per 1/4 cup of water for rinsing, Bismarck brown, erythrosine in tablets. To detect plaque, Lugol's solution is used in the form of applications with small cotton swabs soaked in Lugol's solution and applied to the surface of the teeth. Fuchsin basic stains soft dental plaque a dirty red color by vigorously rinsing the mouth with the solution for 30 seconds, after which excess dye is removed by rinsing with plain water.

The amount of dental plaque in the oral cavity is assessed intravitally using various semi-quantitative methods that determine the area of colored plaque on the surface of the teeth. This allows you to individually objectively assess the state of oral hygiene. In our country, the Fedorov-Volodkina index is most widely used for this purpose. It is based on a semi-quantitative (score) assessment of the area of the vestibular surfaces stained with Lugol's solution of the six anterior teeth of the lower jaw - incisors and canines. In this case, staining of the entire surface of the tooth crown is assessed as 5 points, 3/4 of the surface - 4 points, V2 - 3 points, 1/4 - 2 points, absence of staining - 1 point. Then the arithmetic mean is found by dividing the sum of the color of all teeth by their number using the formula: [Ksr = EKn/n], where Ksr is the hygiene index; EKn - the sum of the assessment of the examined teeth; n is the number of teeth examined. A good level of hygiene is characterized by an index of 1.0-1.3 points. The higher the index value, the lower the level of oral hygiene. Other methods for assessing oral health are similar in principle to the one described and differ in some details.

Tartar is also an acquired structure of the oral cavity. It accumulates in small quantities on the lingual surfaces of the anterior teeth of the lower jaw, which is explained by the close location of the excretory ducts of the sublingual and submandibular salivary glands. It is a mineralized structure of varying degrees of looseness and strength, firmly welded to the surface of the teeth. Its color varies from yellowish-white to gray-black depending on the state of oral hygiene, smoking, diet and other factors.
There are supra- and subgingival tartar. Supragingival calculus is clearly visible upon visual inspection. It accumulates on the teeth located near the mouths of the excretory ducts of the salivary glands in all people; Tartar formation increases with age. Subgingival tartar is usually invisible, as it is located under the gum, in the depths of the formed pathological gum pocket. It is hard, dense, firmly connected to the root of the tooth, and therefore is removed with great difficulty.
Quantitative assessment of supragingival calculus is based on the same principles as the oral hygiene index, but is used less frequently. It can be painted, for example, with basic fuchsin.
Diagnostic dyes are also convenient to use as a test to assess the effectiveness of dental plaque removal. To do this, use 6% basic fuchsin for applications or 0.75% for rinsing for 20 seconds, as well as Lugol’s solution and other dyes.
Soft plaque and tartar form the main part of dental acquired structures, collectively called “dental deposits”. They are infected and can support and promote the development of foci of infection.
To maintain a healthy mouth, removing plaque is important. The method of removing plaque is described in detail in the section on oral hygiene. Tartar removal is usually done mechanically using excavators or tools specially designed for this purpose - hooks, enamel knives, curettage spoons, etc. When removing tartar, the following rules must be observed:
1) all instruments must be sterile;
2) before removing tartar, it is necessary to antiseptically treat the surgical field with a 3% solution of hydrogen peroxide and iodine. To isolate from saliva, use cotton swabs or gauze pads;
3) the hand holding an excavator or other tool for removing dental plaque should be fixed on the patient’s chin or adjacent teeth, which prevents damage to soft tissues;
4) mobile teeth are fixed with the fingers of the left hand;
5) after removing deposits, treat the oral cavity with antiseptic solutions (iodine, 2-3% hydrogen peroxide solution). When working as a doctor removing dental plaque, you need to protect your eyes with special glasses.
For thorough removal of tartar from all teeth, the correct position of the patient is important: the level of the chair and the position of the head vary depending on the group of teeth being treated.
It is recommended to complete the removal of tartar by polishing the root surface. This procedure is performed using special rubber cups, polishers, and wooden sticks. For polishing, use paste (10 g of pumice, 10 g of glycerin and 5 drops of iodine) or chalk mixed with hydrogen peroxide.
When removing a stone, a certain sequence is usually followed. For example, stone is first removed from the cheeks, then from the lingual surfaces, then from the interdental spaces. It is recommended to remove subgingival stone and granulation from no more than 5-6 teeth at a time, based on the rule that the quality of removal plays a paramount role. The removal of subgingival calculus is controlled by a probe. If roughness is felt when sliding along the surface of the root, this indicates incomplete removal and the manipulation should be repeated.

Fedorov-Volodkina Index (1968) was widely used in our country until recently.

Where TO Wed. – general hygienic cleaning index; TO u– hygienic index of cleaning one tooth; n– number of teeth.

Staining the entire surface of the crown means 5 points; 3/4 – 4 points; 1/2 – 3 points; 1/4 – 2 points; absence of staining – 1 point.

Normally, the hygiene index should not exceed 1.

Green-Vermillion index (Green, Vermillion, 1964) . The Oral Health Index Simplified (OHI-S) evaluates the area of tooth surface covered by plaque and/or tartar and does not require the use of special stains. To determine OHI-S, examine the buccal surface 16 and 26, the labial surface 11 and 31, and the lingual surface 36 and 46, moving the tip of the probe from the cutting edge towards the gum.

The absence of dental plaque is indicated as 0 , dental plaque up to 1/3 of the tooth surface – 1 , dental plaque from 1/3 to 2/3 – 2 , dental plaque covers more than 2/3 of the enamel surface – 3 . Then tartar is determined according to the same principle.

Formula for calculating the index.

Where n– number of teeth, ZN- plaque, ZK– tartar.

Plaque:		Stone:

	1/3 crown		supragingival stone on 1/3 of the crown
	for 2/3 crowns		supragingival stone on 2/3 of the crown
	> 2/3 crowns		supragingival calculus > 2/3 of the crown or subgingival calculus surrounding the cervical portion of the tooth

Silnes-Lowe Index (Silness, Loe, 1967) takes into account the thickness of plaque in the gingival region in 4 areas of the tooth surface: vestibular, lingual, distal and mesial. After drying the enamel, the tip of the probe is passed along its surface at the gingival sulcus. If no soft substance adheres to the tip of the probe, the plaque index on the tooth area is indicated as - 0 . If the plaque is not visually detected, but becomes visible after moving the probe, the index is equal to 1 . A plaque with a thin to moderate thickness, visible to the naked eye, is assessed by 2 . Intensive deposition of dental plaque in the area of the gingival sulcus and interdental space is designated as 3 . For each tooth, the index is calculated by dividing the sum of the points of 4 surfaces by 4.

The general index is equal to the sum of the indicators of all examined teeth, divided by their number.

Tartar index (CSI) (ENNEVER" et al., 1961). Supra- and subgingival tartar is determined on the incisors and canines of the lower jaw. The vestibular, distal-lingual, central-lingual and medial-lingual surfaces are differentially examined.

To determine the intensity of tartar, a scale from 0 to 3 is used for each surface examined:

0 - no tartar

1 - tartar is determined to be less than 0.5mm in width and/or thickness

2 - width and/or thickness of tartar from 0.5 to 1 mm

3 - width and/or thickness of tartar more than 1 mm.

Formula for calculating the index:

Ramfjord index (S. Ramfjord, 1956) as part of the periodontal index involves the determination of dental plaque on the vestibular, lingual and palatal surfaces, as well as the proximal surfaces of the 11, 14, 26, 31, 34, 46 teeth. The method requires preliminary staining with a Bismarck brown solution. Scoring is done as follows:

0 - absence of dental plaque

1 - dental plaque is present on some tooth surfaces

2 - dental plaque is present on all surfaces, but covers more than half of the tooth

3 - dental plaque is present on all surfaces, but covers more than half.

The index is calculated by dividing the total score by the number of teeth examined.

Navy index (I.M.Navy, E.Quiglty, I.Hein, 1962). The color indices of tissues in the oral cavity limited by the labial surfaces of the front teeth are calculated. Before the examination, the mouth is rinsed with a 0.75% solution of basic fuchsin. The calculation is carried out as follows:

0 - no plaque

1 - the plaque was stained only at the gingival border

2 - pronounced plaque line at the gingival border

3 - the gingival third of the surface is covered with plaque

4 - 2/3 of the surface is covered with plaque

5 - more than 2/3 of the surface is covered with plaque.

The index was calculated in terms of the average number per tooth per subject.

Turesky index (S.Turesky, 1970). The authors used the Quigley-Hein scoring system on the labial and lingual surfaces of the entire row of teeth.

0 - no plaque

1 - individual spots of plaque in the cervical area of the tooth

2 - a thin continuous strip of plaque (up to 1 mm) in the cervical part of the tooth

3 - plaque strip is wider than 1 mm, but covers less than 1/3 of the tooth crown

4 - plaque covers more than 1/3, but less than 2/3 of the tooth crown

5 - plaque covers 2/3 of the tooth crown or more.

Index Arnim (S. Arnim, 1963) in assessing the effectiveness of various oral hygiene procedures, determined the amount of plaque present on the labial surfaces of four upper and lower incisors stained with erythrosine. This area is photographed and developed at 4x magnification. The outlines of the corresponding teeth and colored masses are transferred to paper and these areas are determined with a planimer. The percentage of surface area covered by plaque is then calculated.

Hygiene Performance Index (Podshadley, Haby, 1968) requires the use of dye. Then a visual assessment of the buccal surfaces of 16 and 26 teeth, labial surfaces of 11 and 31 teeth, and lingual surfaces of 36 and 46 teeth is carried out. The surveyed surface is conventionally divided into 5 sections: 1 – medial, 2 - distal 3 - mid-occlusal, 4 – central, 5 - mid-cervical.

0 - no staining

1 - staining of any intensity is available

The index is calculated using the formula:

G
den is the number of teeth examined.

Dental health affects the entire body. Ways to prevent problems are regular hygiene and periodic visits to the doctor. The dentist will analyze the health of the mucous membranes, gums, and crowns using hygiene indices that quantitatively show the degree of the disease and help control the degree of its development.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from Crimean Medical University. Institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry including implantology and implant prosthetics.

Ask a question to an expert

I believe that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then treatment may indeed not come to the point - it won’t be necessary. Microcracks and small caries on teeth can be removed with regular toothpaste. How? The so-called filling paste. For myself, I highlight Denta Seal. Try it too.

Hygiene indices are data that evaluate enamel contamination, the presence of bacteria, hard plaque, show the number of healthy crowns, and also the number of crowns partially or affected by carious lesions. Based on the final figures, the doctor will determine the stage of destruction of the teeth, the thoroughness of cleaning, tissue and bite problems, and the effectiveness of the prescribed treatment.

For each type of damage to the jaw and gums, there are special assessment parameters, which will be discussed below.

Types of CPU

The basic indicator taken into account by the dentist is PU. He talks about the intensity of dental caries. The following data is assessed:

K – foci of identified areas of caries;
P – fillings;
U – extracted teeth.

In total, the information shows how intensively caries spreads:

KPU cavities - the number of cavities as a result of filling, caries;
KPU of existing surfaces – number of external areas damaged by caries;
KPU of teeth – number of affected, filled teeth.

KP is used for baby teeth, where the letter K stands for caries, P stands for filled teeth. In children, fallen out or extracted milk teeth are not taken into account.

KPU assessment

To determine the level of caries developing in the mouth, 3 indicators are used, obtaining a percentage. For calculations, take the number of patients with caries, divide by the total number of subjects, then multiply by 100. Comparing the health of people regionally, they examine 12-year-old patients. The obtained data on the prevalence of caries are interpreted as follows:

less than 30% – low;
30-80% - average;
80-100% - high.

The strength of infection is determined by the number of teeth affected by caries. Receive 5 degrees. In 12-year-old patients, the degree is:

less than 2.6 – very low;
2.6-4.4 – moderate;
4.4-6.4 – high;
more than 6.5 - very high.

In 35-year-old patients, the degree is:

less than 1.5 – very low;
1.5-6.2 – low;
6.2-12.7 – moderate;
12.7-16.2 – high;
more than 16.3 – very high.

An increase is a change in values during subsequent examinations of the patient for the worse. Thanks to this assessment, the level of current health is studied and an individual treatment regimen is prescribed.

Disadvantages of the CPU

In addition to the obvious benefits, the CPU has disadvantages. They are as follows:

the summarized picture is influenced by the past dynamics of caries distribution, which increases with age;
calculations take into account both treated and extracted teeth;
the initial stages of caries are not taken into account.

Taking into account the nuances of the assessment above, the results of the CPA do not give the doctor a reliable picture of the health of the oral cavity, since over time, fillings fall out, further pockets of caries appear, and when the data is summarized with past examinations, the final picture becomes less/highly distorted.

Periodontal indices

Information about the condition of the periodontium visualizes the dynamics of gum infection - the spread of existing pathology, the depth of the lesion, and monitors the success of treatment. Data are presented that allow us to obtain a picture of the condition of the periodontium. During one visit to the dentist, you can undergo examination using several methods, which will give a complete picture.

Papillary-marginal-alveolar index (pma)

This is one of the main tests. Reveals gingivitis, its duration, depth. The doctor will note problematic points in the patient’s mouth, fill out the sheet with points, noting the identified location of the lesion:

1 - papilla affected;
2 - marginal gum inflamed;
3 - problem with the alveolar gum.

Based on the final calculations, the average number is derived, identifying the stage of gingivitis:

up to 30% - light;
30-60% - average;
more than 60% - severe.

Periodontal index (PI)

Signs of gingivitis, as well as its degree. The dentist assesses the presence of mobility, destruction of bone tissue, periodontal pockets, giving points:

0 – no lesions;
1 – unilateral mild inflammation;
2 – the tooth holds well, but is surrounded by inflammation;
4 – x-ray reveals resorption of the apices of the septa;
6 – if there is a pocket, the tooth does not hurt, it holds firmly;
8 – tissues are destroyed, the tooth is shaky and moves.

less than 1.5 – first;
1.5 - 4 - second;
4 - 8 - third.

The indicator signals the need to treat periodontal diseases. The mucous membranes around the teeth of both jaws are subject to examination. The specialist examines with a probe, identifying hard plaque, pockets, and bleeding. The results are displayed in numbers:

0 – no problem;
1 – due to the action of the instruments used during the test - blood;
2 – there is a stone;
3 – presence of a periodontal pocket of 5 mm;
4—presence of a periodontal pocket larger than 6 mm.

For each checked unit, the points are summed up, after which the entire amount will be divided by 6, obtaining the numbers:

0 – no need to treat;
1 – cleaning and regular visits to the dentist are required;
2-3 – professional cleaning is required;
4 – the need for complex therapy.

Measuring pocket depth

The presence of pockets is a clear symptom of periodontitis. Not only are they inconvenient to eat, but they also become a source of unpleasant odors as food remains rot inside. The severity of inflammation is indicated by the depth of the pockets. The measurement is carried out with a probe, lowered into a pocket and observing the scale. A depth of up to 2 mm is considered normal. With initial gingivitis - 3.5 mm, average - more than 4 mm, and if more than 5 mm - significant inflammation and deformation are diagnosed.

It is an average number indicating periodontal damage in the subjects. Tests are carried out in groups - in children 3-4 years old, adolescents 7-14 years old, patients over 18 years old. You will need tweezers and a probe to determine the dimensions of the clusters and pockets, the mobility of the fangs, incisors, and molars. Average CPI is an assessment of the overall values for all examined patients. The data obtained show the intensity of the spread of periodontitis:

less than 1 – low prospect of periodontitis;
1-2 – tissues are barely affected;
2-3.5 – average degree of damage;
3.5-6 – serious severity.

Gingivitis index

The IG number indicates the location and extent of spread of the disease. Numbers 12, 16, 24, 32, 36, 44 are examined. For each unit, the dentist makes assessments on four sides - distal, as well as the nucleus, medial and lingual sections. A visual assessment is sufficient; when necessary, a probe is used. The scores will be as follows:

0 – no inflammation;
1 – the structure and color of the gum tissue have changed slightly, there is no bleeding;
2 – the gums are swollen, changed color, and bleed a little;
3 – severe swelling and inflammation of the gums were detected, and the slightest damage causes bleeding.

After the examination, the doctor sums up the points, divides the number by the number of teeth examined, obtaining:

up to 1 – mild form of gingivitis;
1-2 – middle stage;
2-3 – heavy.

Ramfiord index

Periodontal diseases are indicated. Checking the lingual, vestibular edge, identifying the accumulation of soft, hard deposits. The gingivitis indicator is displayed:

0 – normal;
1 – inflamed area;
2 – significant gum disease;
3 – severe condition.

Indicators of periodontitis will be as follows:

0-3 – the dimensions of the studied pocket are considered acceptable;
4 – depth of the studied pocket is less than 3 mm;
5 – depth 3-6 mm;
6 – pocket more than 6 mm deep.

There are signs of gingivitis and possible periodontitis. Test according to Muhlemann and Son. When the gums are healthy in appearance, but may bleed due to some minor lesion. The dentist, barely pressing, traces a line near the tooth with a probe and evaluates the reaction:

0 – no reaction;
1 – blood appears after 30 seconds;
2 – blood will come out immediately or up to 30 seconds;
3 – bleeding is provoked by brushing teeth and eating.

Simplified bleeding index

Testing is an assessment of the responses of the subject. The dentist asks whether gum bleeding occurs, what situations provoke it, and then suggests the degree of inflammation (approximately).

PBI by Saxer and Miihiemann

Using a probe, the doctor makes a furrow along the papillae between the teeth, assessing the severity of inflammation:

0 – no reaction;
1 – pinpoint hemorrhages;
2 – a lot of hemorrhages;
3 – bleeding fills the groove.

Hygienic indices

Enamel contamination is assessed - accumulations of deposits are assessed qualitatively and quantitatively. Below are the main indices.

Fedorova-Volodkina

The test is common among dentists; it boils down to staining the lower incisors with a solution of iodine. The reaction is assessed next:

1 – no coloring;
2 – color ¼ surface;
3 – color of ½ tooth;
4 – color ¾ of the surface;
5 – the entire tooth is stained.

The doctor will divide the points received by 6, obtaining the following decoding:

less than 1.5 – excellent;
1.5-2 – good level of hygienic care;
2-2.5 – insufficient cleaning;
2.5-3.4 – poor care;
3.4-5 – hygiene is practically unnoticeable.

Green Vermilion

Loose plaque and hardened plaque are assessed. The doctor examines the numbers: 46, 11, 26, 16, 31, 36. The assessment of the upper molars and incisors is carried out from the vestibular part, and the lower ones - from the lingual part. Based on the results, the final scores are displayed:

0 – clean;
1 – 1/3 of the surface with deposits;
2 – 2/3 parts with deposits;
3 – contamination of more than 2/3 of the tooth.

For the inspected unit, a separate assessment of contamination and stone is given, the results are divided by 6, resulting in:

less than 0.6 – excellent;
0.6-1.6 – decent level of cleanliness;
1.6-2.5 – not clean enough;
2.5-3 – dirty.

Silnes Low

An analysis of the jaw is performed. No painting required, a probe is used. Points:

0 – clean;
1 – thin layer of dirt;
2 – plaques;
3 – surface coating.

Contamination is detected on the incisors and canines at the junction with the gums:

0 – clean;
1 – deposits up to 0.5 mm;
2 – stone up to 1 mm;
3 – stone width exceeds 1 mm.

Plaque index according to Quigley and Hein

Assessment of accumulations of deposits of both jaws by numbers: 43, 11, 12, 21, 22, 23,13, 31, 32, 33, 41, 42. The surface is painted with magenta, after which the doctor checks the vestibular edges:

0 – no color;
1 – coloring in the cervical area;
2 – color 1 mm;
3 – accumulation of more than 1 mm, but less than 1/3 of the surface;
4 – deposits cover up to 2/3 of the tooth;
5 – contamination covers more than 2/3 of the surface.

Lange API

It is important to provide proper care to the proximal surfaces; their cleanliness will show the doctor how well the patient maintains dental hygiene. The mucous membrane is painted with a special solution, contamination is detected from the oral and vestibular sides, depending on the quadrants. The score is displayed as a percentage:

up to 25% is a good indicator;
up to 40% - fairly acceptable hygiene;
up to 70% - satisfactory care;
over 70% - insufficient hygiene.

Ramfiord index

Plaque from the palatal, lingual, and vestibular sides is assessed using numbers 46, 14, 26, 11, 31, 34. The surface is first painted with Bismarck's solution. Taking into account the nature of the clusters, the following is derived:

0 – clean;
1 – partially there are deposits;
2 – deposits cover the faces, but less than ½;
3 – deposit covers more than ½ of the faces.

Navi

Assessment of the anterior incisors from the lips. First, the mouth is rinsed with a fuchsin solution, then the staining is assessed:

0 – clean;
1 – coloring of the border with the gums;
2 – wide strip of plaque near the gums;
3 – 1/3 of the tooth from the gum is covered with dirt;
4 – plaque covered up to 2/3;
5 – sediment covers more than 2/3.

Tureski

The oral cavity is rinsed with a fuchsin dye solution, then the accumulation of plaque is assessed on the entire dentition:

0 – clean;
1 – a little plaque at the cervix;
2 – deposits 1 mm;
3 – deposits more than 1 mm, but less than 1/3;
4 – pollution up to 2/3;
5 – more than 2/3 flying time.

Arnim

The area of contamination is measured. The assessment is labor-intensive and is used in scientific research, but not for routine examinations. The anterior incisors of both jaws, pre-stained with erythrosine, are assessed. A vestibular photograph is taken, enlarged 4 times, and printed. Next, the outline of the incisors and painted surfaces is transferred to the paper, and the dimensions of the plaque area are determined with a planimer.

PFRI according to Axelsson

First, the oral cavity undergoes professional cleaning, then you cannot brush your teeth for 24 hours. Next, the doctor stains the mucous membranes, assesses the amount of plaque, identifying the number of dirty teeth among the existing ones:

up to 10% - very low rate of plaque formation;
10-20% - low speed;
30% - average;
30-40% - high;
over 40% is very high.

Hygiene efficiency

The thoroughness of cleaning is checked. RHP evaluates numbers 46, 11, 16, 31, 36, 26; first, the mouth is rinsed with a dye solution to evaluate the intensity of staining of each of the 5 parts (distal, as well as medial, central, with them occlusal, cervical). The sector result is displayed in points:

0 – clean;
1 – painted.

Do you feel nervous before visiting the dentist?

YesNo

0 – excellent hygiene;
0.6 – good cleaning;
up to 1.6 – satisfactory level;
over 1.7 – poor hygiene.

Stages of epidemiological testing

Epidemiologists study the spread of disease among people from different walks of life. A dental examination is carried out in three stages:

Preparation. Drawing up plans, deadlines, methods, research objectives. Preparing the site and equipment for research. Formation of a group of 2 doctors, 1 nurse. The selection of representatives from different population groups and patients of different sexes should be equally distributed.
Examination. The data is entered into the registration card without corrections or additions. The information is entered with codes indicating the presence or absence of symptoms.
Grade. The results are calculated according to criteria (prevalence of caries, quantitative indicator of periodontal disease, etc.). The results are displayed as a percentage and allow you to form a picture of the dental health of people in the region, taking into account a list of different factors. Next, preventive and treatment measures are prescribed.

The listed hygiene indices assess the condition of the oral cavity and represent a safe method of obtaining information for forecasts.

Oral hygiene indices. Oral hygiene indices for determining dental plaque Oral hygiene index according to Kuzmina