Dental caries index

Dental caries indexSubmitted to: Submitted by:The Department of Nidhi sharmaPedodontics and Roll no. 42Preventive Dentistry BDS IVth prof

CONTENTSDMFT INDEX DMFS INDEXdeft/s INDEXDEFINITION 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 RapidVersatileUniversally 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.PROCEDUREIt is composed of 3 components:D used to describe decayed teethM used to describe missing teeth due to cariesF used to describe caries that have been previously filled due to cariesAll the 28 permanent teeth are examined.

The teeth not included are :The third molarsUnerupted teethCongenitally missing and supernumerary teethTeeth removed for reasons other than dental caries such as for orthodontic treatment or impactionTeeth restored for reasons other than dental caries such as trauma, cosmetic purposes or for use as a bridge abutment.Primary tooth retained with the permanent successor erupted.The following teeth should not be counted as missing :

Unerupted teeth Missing due to accidentCongenitally missing teethTeeth that have been extracted for orthodontic reasons

INSTRUMENTS USEDMouth mirrorExplorer

CRITERIA FOR IDENTIFICATION OF DENTAL CARIESThe lesion is clinically visible and obvious.Explorer tip can penetrate deep into soft yielding materialThere is discoloration or loss of translucency typical of undermined or demineralized enamelThe 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 DMFTNo 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 accidentCongenitally missing teethTeeth that have been extracted for orthodontic reasonsA tooth may have several restorations but it is counted as one toothDeciduous 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 DMFTD- 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 MISSINGIndicates 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- FILLEDIndicates 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 INDEXThe maximum number for an individual DMFT score is 28 or 32, if third molars are included.

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 examinedLIMITATIONS OF DMFT INDEXDMFT 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 includedTemporary 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. PROCEDUREThe 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.ADVANTAGESThe DMF Index is more sensitive and is usually the Index of choice in a clinical trial of a caries preventive agent . LIMITATIONSA 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-

For posterior teeth: Five surfaces: facial, lingual, mesial, distal and occlusalB. For anterior teethFour 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 INDEXA.) If 28 teeth are examined-. 16 posterior teeth (16x5) =80 surfaces. 12 anterior teeth (12x4)=48 surfaces. TOTAL = 128 surfacesB.) If third molars are included-

. For third molars (4x5) = 20 surfaces . TOTAL = 128 + 20 = 148 surfacesCARIES INDICES FOR PRIMARY DENTITIONdef indexThe 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 dentitionEXAMINATION METHOD FOR def indexd- decayed teethe- extracted teethIndicates those deciduous teeth which have been extracted due to caries or which are so badly decayed that they are indicated for extractionf- 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 indexMaximum 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 surfacesFor 12 anterior teeth (12x4) =48 surfaces- Total = 88 surfacesMODIFICATIONS OF def index dmf indexdmf index is used in children before the age of exfoliation.df indexdf 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 DENTITIONIn 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.THANK YOU