Green-Vermilion index. Oral hygiene index. Medical examination at the dentist

Hygienic index

The Green-Vermilion hygienic index allows you to evaluate the amount of tartar and plaque separately. To determine it, six teeth are studied: 31, 11, 16, 26 - vestibular planes, and 36, 46 - lingual. Plaque can be assessed using dye solutions (Fuchsin, Schiller-Pisarev, Erythrosin) or visually.

The following codes and criteria for dental plaque exist:

• 0 – no layers;
• 1 - soft plaque covering no more than 1/3 of the tooth plane, or the presence of any number of colored deposits (brown, green and others).
• 2 – thin layer located on less than 2/3, but more than 1/3 of the surface of the molar;
• 3 – soft plaque, occupying more than 2/3 of the tooth plane.

Determination of sub- and supragingival molar stone is carried out using a dental probe.

What else is good about the Green-Vermilion index? Assessment of dental calculus (criteria and codes) is as follows:

• 0 – no stones present;
• 1 – supragingival deposit covering no more than 1/3 of the tooth plane;
• 2 – formation located above the gum, covering less than 2/3, but more than 1/3 of the plane of the tooth, or the presence of individual growths in its cervical region;
• 3 – supragingival layer covering more than 2/3 of the tooth plane, or large deposits of stone located near its neck.

The Green-Vermilion index is calculated by adding the values ​​​​produced for each of its elements, dividing by the number of planes studied and adding both values.

Assessment of tooth mobility using the Miller scale as modified by Flesar;

Determination of tooth mobility according to D.A. Entinu.

Algorithm for determining tooth mobility.

Algorithm for determining the dental plaque index according to Silness-Loey.

Algorithms for determining indexes.

The index evaluates the amount of soft plaque in the gingival area. The assessment is carried out visually and with a probe without staining, 4 surfaces are examined, for better diagnosis, the area of ​​the tooth neck is pre-dried with an air jet.

Plaque intensity, evaluation criteria:

0 – there is no plaque on the tip of the probe;

1 - a small amount of plaque;

2 – a thin layer of plaque near the neck, a significant amount at the tip of the probe;

3 – a significant amount of plaque in the gingival area and in the interdental spaces.

The index is calculated using the formula:

General index = (sum of points) / (number of teeth examined).

Mullemann bleeding index (modified by Cowell).

Determines the degree of bleeding of the gingival sulcus during probing or pressure on the gingival papilla.

In the area of ​​“Ramfjord's teeth” (16,21,24,36,41,44) from the buccal and lingual (palatal) surfaces, the tip of the periodontal probe, without pressure, is guided from the medial to the distal surface of the tooth.

0 — after the study there is no bleeding;

1 - bleeding appears no earlier than after 30s;

2 — bleeding occurs either immediately after the test or within 30 s;

3 - bleeding occurs when eating or brushing teeth.

Index value = (sum of indicators of all teeth) / (number of teeth).

The generally accepted classification of pathological tooth mobility according to D.A. is based on Entin (Entin D.A. 1954) is the direction of the visually determined displacement of the tooth relative to its axis.

I degree – tooth displacement only in the vestibulo-oral direction;

II degree – visible displacement of the tooth both in the vestibulo-oral and medio-distal

III degree – tooth displacement in the vestibulo-oral, medio-distal and vertical

directions: when pressing, the tooth is immersed in the hole, and then

it returns to its original position again.

The method used to assess pathological mobility according to the Miller scale (Miller SC 1938) modified by Fleszar (Flezar et al., 1980):

0 - stable tooth, there is only physiological mobility;

1 - tooth displacement relative to the vertical axis is slightly greater, but does not exceed 1 mm;

2 - the tooth moves 1-2 mm in the buccal-lingual direction, the function is not impaired;

3 - mobility is pronounced, while the tooth moves not only in the buccal-lingual direction, but also vertically, its function is impaired.

Algorithm for determining the class of furcation defect.

Furcation defect of the alveolar bone is a defect in the bone tissue of the interradicular septum in the area of ​​furcation of multi-rooted teeth. To determine the state of the furcation defect, a furcation probe is used. Probing of the furcation is carried out in the horizontal direction. Based on the magnitude of the horizontal spread of the process, the class of furcation lesions is distinguished. There are several classifications of furcation defects.

Classification by I. Glickman (1958):

Class I - alveolar bone resorption, which exposes the root furcation area, but is not accompanied by destruction of the interradicular bone.

Class II—interradicular bone is partially lost, but there is no through defect.

Class III - a through defect in the furcation area is detected during probing, but is hidden by the gum.

Class IV - a through defect of the interradicular septum, the furcation area can be examined in the oral cavity and is not hidden by the gum.

Classification by PJ Heins, SP Canter (1968):

Class I - the apex of the alveolar ridge exposes the arch of the root furcation; horizontal probing of the bone defect can be accompanied by immersion of a graduated probe up to 2 mm in the direction of the interradicular septum.

Class II - in addition to signs of a class I furcation defect, a horizontal immersion of a graduated probe in the direction of the interradicular septum by more than 2 mm is possible, but the instrument does not penetrate to the opposite side.

Class III - corresponds to the free penetration of a graduated probe to the opposite side when it moves in the horizontal direction.

Classification by J. Lindhe (1983):

Initial (grade 1) destruction of the interradicular septum by 1/3 of its cross section or less.

Partial (class 2) destruction of the interradicular septum exceeds 1/3 of its cross section, but does not form a through defect.

Total (grade 3) destruction of the interradicular bone in the horizontal direction with the formation of a through defect.

Cliche

The calculation formula is attached as follows:

IGR-u = sum of plaque values/number of planes + sum of stone values/number of surfaces.

The interpretation of the index (the IGR value at the level of medicine) is proposed as follows:

• 0.0-1.2 - flawless;
• 1.3-3.0 – acceptable;
• 3.1-6.0 – low.

The Green-Vermilion index has the following values ​​for dental plaque standards:

• 0.0-0.6 – impeccable;
• 0.7-1.8 – tolerable;
• 1.9-3.0 – bad.

KPU indices

What do oral hygiene indices express? One of the basic dental coefficients (BDC) demonstrates the intensity of decay. The letter “K” means the number of damaged teeth, “P” - the number of filled teeth, “U” - the number of teeth to be removed or liquidated. The sum of these values ​​gives an idea of ​​the development of the decay process in a particular person.

There are three types of KPU coefficient:

• KPUz – the number of carious and treated teeth in the subject;
• KPU of planes (KPUpov) – the number of destroyed faces;
• KPUpol – the sum of fillings and carious cavities.

For non-permanent teeth, the following indicators are used:

• KP – the number of damaged and healed teeth of short-term occlusion;
• KP – sum of rotten planes;
• CPR – number of carious cavities and fillings.

Teeth lost as a result of physical change or extracted are not taken into account in an unstable dentition. In children, when changing teeth, two coefficients are used simultaneously: KPU and KP. To identify the overall intensity of the disease, both degrees are summed up. KPI from 6 to 10 confirms a high intensity of decay, 3-5 – moderate, 1-2 – low.

These standards do not show the real picture, as they have the following shortcomings:

• both extracted and cured teeth are taken into account;
• can only increase over time and begin to reproduce past carious damage with age;
• do not allow for initial damage to be taken into account.

Other indexes

There are other hygienic indices in modern dentistry.
They also allow you to assess the patient’s oral hygiene and understand whether he needs treatment and prevention. The PMA index in modern dentistry stands for: papillary-marginal-alveolar. It is used by dentists to evaluate gum disease. In this formula, the number of teeth directly depends on age characteristics:

• 6-11 years – 24 teeth;
• 12-14 – 28;
• 15 and more – 30.

Under normal conditions, PMA should be equal.

The Fedorov-Volodkina index allows you to determine how well a person monitors the condition of the oral cavity. It is most often used for children under 7 years of age. To correctly calculate this indicator, it is necessary to examine the surface of 6 teeth, stain them with calcium iodine solution and measure the amount of plaque. The stone is detected using a small probe. The index is calculated from all the values ​​for the components divided by the surfaces examined, and finally both values ​​are summed.

The RHR (Oral Hygiene Index) is popular among dentists. To correctly calculate it, you should stain 6 teeth to detect plaque. The calculation is carried out with the definition of codes. They are then summed and divided (in this case) by 6.

To assess the bite, an aesthetic dental index is needed, which determines the location of the teeth in three anatomical directions. It can only be used when the patient reaches the age of 12 years. Examination of the oral cavity is carried out visually and using a probe. To determine the index, you need to determine components such as missing teeth, crowding and spaces between incisors, deviations, overlaps, diastemas, etc.

This index is good because it analyzes each of the components separately and allows you to identify various anomalies.

Each of these indices is important, as it makes it possible to detect developmental abnormalities, identify the level of hygiene in each individual person, and begin treatment on time.

To keep your mouth healthy, you need to carefully and constantly get rid of dental plaque. Residues of food and plaque can be removed at home using basic brushing and toothpaste. Mineralized deposits should be removed at the dentist's office every six months to prevent the development of tartar. At the same time, you should conduct a full examination of the oral cavity for the presence of caries and other unpleasant diseases. Don't forget about regular visits to the dentist and enjoy well-groomed teeth.

Serious shortcomings

Significant flaws in the indicators of KPUz and KPUpov include their uncertainty with increasing decay due to the formation of new depressions in healed teeth, loss of fillings, the occurrence of secondary caries and similar factors.

The multiplicity of caries is shown as a percentage. To do this, the composition of people in whom this disease was found (except for focal demineralization) is divided by the number of those studied in this team and multiplied by one hundred.

In order to assess the prevalence of tooth decay in a particular region, the following estimated conditions for the level of prevalence among twelve-year-old children are used:

• low intensity level – 0-30%;
• relative – 31-80%
• large – 81-100%.

Evaluation of indicators

There are three main directions for assessing caries lesion indicators;

1. Extent of caries spread. This indicator is the percentage of the number of patients diagnosed with caries to the total number of people examined.
   This technique is often used to compare oral health status in different regions of the country.

   The levels of caries prevalence among 12-year-old patients are used as assessment criteria: a low level corresponds to an indicator from 0 to 30%, an average level from 31 to 80%, and a high level from 81 to 100%.

2. The intensity of spread is an indicator that determines the degree of caries damage to the elements of the jaw row of a particular patient. For children under 12 years of age, the following assessment criteria apply:

• very low intensity – up to 1.1;
• low – up to 2.6;
• moderate – from 2.7 to 4.4;
• high – from 4.5 to 6.5;
• very high – more than 6.5.

For adults, this breakdown changes slightly and looks like this:

• very low – up to 1.5;
• low – from 1.6 to 6.2;
• moderate – from 6.2 to 12.7;
• high – 12.8-16.2;
• very high – more than 16.2.

1. Increase in caries infection. This indicator allows you to assess the dynamics of the development of the carious process in an individual patient.
   To determine it, the intensity of caries over a certain period of time is revealed.

   A change in the value of the indicator up or down indicates the effectiveness or ineffectiveness of the therapeutic process.

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CPITN Index

The hygienic state of the oral cavity is assessed using different indices. Let's consider the CPITN coefficient. It is used in clinical practice to monitor and examine periodontal health. Using this index, only those signs that can begin to develop in the opposite direction are recorded (tartar, gum inflammation, which is judged by bleeding), and does not take into account irreversible changes (tooth mobility, gum recession, loss of epithelial attachment).

CPITN does not record process activity. This coefficient is not used for treatment planning. Its most important advantage is the speed of identification, information content, simplicity and the ability to compare results. The need for treatment is determined based on the following signs:

• code X or 0 means that there is no need to treat the patient;
• 1 indicates that a person should take better care of his or her mouth;
• 2 means that it is necessary to eliminate the factors influencing the retention of plaque and carry out professional hygiene;
• Code 3 indicates constant oral hygiene and curettage, which usually reduces inflammation and reduces pocket depth to less than or equal to 3 mm;
• 4 means that adequate hygiene of the oral mucosa is necessary, as well as deep curettage. In this case, combined treatment is required.

Dental indices, oral hygiene index 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 those examined in a given group and multiplied by 100. In order to estimate the prevalence of dental caries in a particular region or compare the magnitude of this indicator in different regions, use the following assessment criteria for the level of prevalence among 12-year-old children: 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 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 filled 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 extracted teeth in one individual; index KPU (n) - the sum of all surfaces of the teeth on which caries or a filling is 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. 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 for treatment for 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 the retention of dental plaque.
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. The papillary marginal alveolar index (PMA)
is 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. The Oral Hygiene Performance Index (OHP)
is also common .
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 the bite, a 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.

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% 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;

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

index KPU (n) - the sum of all surfaces of the teeth on which caries or a filling is 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

The 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: Ksr = (∑Ku)/n

where is Ksr. – general hygienic cleaning index; Ku – 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 simplified oral hygiene index (OHI-S) is an assessment of the area of ​​the tooth surface covered with plaque and/or tartar, 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 plaque is designated as 0 , plaque up to 1/3 of the tooth surface is 1 , plaque from 1/3 to 2/3 is 2 , 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 is the number of teeth, ZN is dental plaque, ZK is tartar.

The Silness-Loe 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.

Calculus 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.

The 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 (IMNavy, 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 - 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.

The 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.

The Hygiene Performance Index (Podshadley and Haby, 1968) requires the use of a 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 examined surface is conventionally divided into 5 sections: 1 – medial, 2 – distal, 3 – mid-occlusal, 4 – central, 5 – mid-cervical.

0 - no staining

1 - there is staining of any intensity

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

where n is the number of teeth examined.

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, Silness) . 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 – severe 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 the periodontal index PI (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 indicator is assigned to gum inflammation, and a relatively higher indicator 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.

The 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 to 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) - a comprehensive periodontal index of need for treatment is 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 – gum bleeding 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 larger than 6 mm is determined; the black strip of the probe is completely immersed in the gingival pocket.

Complex periodontal index - CPI (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)

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: 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 — dental plaque was not 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), JC Green, JR 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

CODES AND CRITERIA FOR ASSESSING DENTAL PLAQUE

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

0 — dental plaque was not 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 dental calculus 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.

The examined surface of each tooth is conventionally divided into 5 sections

1. medial
2. distal
3. midocclusal
4. central
5. 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

Children's hygiene

What is the Fedorov-Volodkina index? It can be used to determine whether the patient takes good care of his teeth. This indicator should be used to assess the oral health of children under 5-6 years of age. To establish it, the labial edge of six teeth is studied.

Using special solutions, teeth are stained and the presence of plaque on them is assessed. Determination of sub- and supragingival calculus is carried out using a dental probe. The calculation of the coefficient consists of the numbers obtained for each of its elements, divided by the number of planes studied, followed by the addition of both values.

conclusions

Hygienic indices used in dentistry allow specialists to effectively assess various aspects of the patient’s oral cavity.

This allows not only to demonstrate to a person the quality of care for teeth and gums, but also to identify existing pathologies of the elements of the jaw row, as well as evaluate the effectiveness of the treatment.

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Norm

The Fedorov-Volodkina index (1968) is still used in our country today.

First, the labial surface of the six front lower teeth is stained with a potassium-iodine-iodide solution. The hygienic index is determined by the intensity of the resulting color, then it is assessed using the five-point method and calculated using the formula Kcp=(∑Ku)/n, where:

• Ksr – general hygienic cleaning coefficient;
• Ku – healthy indicator of cleaning one tooth;
• n – number of teeth.

Coloring the entire plane of the crown means 5 points; 3/4 – 4; 1/2 – 3; 1/4 – 2 points; lack of color – 1. Normally, a healthy indicator should not exceed 1.

Php Index

Scientists Podszadlej and Haley developed an oral hygiene performance index. First, a dye solution is applied to the teeth, then the patient rinses his mouth with water, and 6 teeth are examined. In this case, their surface is divided into 5 sections: medial, distal, mid-occlusal, central, mid-cervical. The absence of staining is determined by zero, and the presence - by one.

When calculating, use the formula: IG = ZN/n, where ZN is the sum of codes for all teeth; n – number of teeth examined. With a value of 0, the condition of the oral cavity is considered excellent, and with a value of 1.7 or more, it is considered unsatisfactory.

Inspection

What are the indicators for assessing the results of medical examination by a dentist? It is known that a comprehensive examination of residents involves a method of protecting their health, consisting of providing conditions for their impeccable physical development, preventing illnesses through the implementation of proper sanitary, hygienic, preventive, therapeutic and social measures.

The purpose of medical examination is to strengthen and preserve people's health and increase their life length.

A medical examination is designed to solve the following problems:

• annual analysis of a person’s well-being;
• comprehensive monitoring of patients;
• combating bad habits, identifying and eliminating the causes of tooth decay;
• active and timely implementation of health-improving and therapeutic measures;
• increasing the efficiency and quality of medical care to the population through the successive and interconnected work of all types of institutions, large-scale participation of doctors of various professions, the introduction of technical support, new unifying forms, the creation of mechanical systems for examinations of the electorate with the development of special programs.

Examination according to the WHO method

The purpose of conducting an epidemiological survey using the WHO method is to compare data obtained in different regions and regions of the country, which makes it possible to assess the spread of dental diseases among different categories of the population.

For this purpose, there is a unified examination methodology consisting of three stages:

1. Preparatory. A plan for carrying out the procedure is drawn up, which formulates the goals and objectives of the upcoming work.
   The personnel to carry out the manipulations is determined, consisting of two doctors and a nurse, as well as a group of subjects taking into account age, social status, standard of living, and gender.

   The level of accuracy of the analysis will depend on the number of patients examined.

2. Examination of patients. A thorough examination of the condition of the patient’s oral cavity is performed: his teeth, gums, mucous membranes, structural features of the jaw apparatus and the formation of the bite.
   All results are entered into a special registration card using standard codes in compliance with the accepted algorithm for filling it out.
3. Summarizing. The final stage is the assessment of the results obtained as a result of the examination with the calculation of the required hygienic indices and the prevalence of certain dental diseases.

Based on the results of the survey, specialists have the opportunity to study the dental health of patients of different age groups, social conditions and areas of residence. This allows you to take timely measures to prevent and treat certain pathologies.

Observation of children

By calculating the Green-Vermilion index, doctors can create dispensary groups for monitoring children:

• Group 1 – children who have no pathologies;
• Group 2 – actually healthy babies with a history of any chronic or acute disease that does not affect the function of the most important organs;
• Group 3 – children with chronic illnesses with a balanced, sub- and decompensated course.

There are three phases in the dental examination of children:

• In the first phase of the examination, each child is individually recorded, an additional examination is carried out in the hospital, then an outpatient observation group is determined, the endurance of each child is assessed and the order of examinations is determined.
• In the second, a contingent is formed according to supervision groups, uniform conditions for phasing and continuity of study are assigned, dispensary patients are proportionally divided between doctors, and the needs of the examined contingents in inpatient and outpatient treatment are met.
• In the third, doctors determine the frequency and nature of active supervision of each child, adjust diagnostic and treatment measures in accordance with changes in health status, and evaluate the effectiveness of supervision.

Of great importance is the organization of educational work to prevent dental diseases in children and create motivation to care for newly emerging teeth.

Examination of pregnant women

In order to achieve maximum effect in the prevention of dental diseases, it is necessary to coordinate the work of the dentist and gynecologist, as well as medical examination of women throughout pregnancy. In the dental office, doctors carry out:

• sanitation of the oral cavity;
• assistance in the selection of basic and additional hygiene products, training in rational oral care;
• professional hygiene;
• remineralizing therapy, which increases the resistance of tooth enamel.

The formula will help determine the condition of the mouth

To determine the condition of the oral cavity in medicine, there are about 80 different hygiene indices, based on the principle of staining the enamel with a special solution and identifying dental plaque.

According to the parameters they define, indices can be classified into 4 groups, assessing:

• area affected by plaque;
• thickness of plaque on teeth;
• mass of plaque;
• other parameters of dental plaque (chemical, physical and microbiological).

Prevention of caries

Determining the Green-Vermilion index plays a vital role in the prevention of dental diseases in expectant mothers, which is designed to solve two problems: preventing the development of intrauterine caries in babies and improving the dental status of women.

It is known that the health of the mother affects the process of developing the child’s teeth, which begins at 6-7 weeks of pregnancy. Doctors have determined that with various pathologies in the fetus, the mineralization of tooth enamel slows down, and sometimes stops at the stage of primary calcification. In the postpartum period, it may resume, but will not reach the standard level.

In a woman, already in the early stages of pregnancy, the condition of hard dental tissues and periodontal tissues worsens due to the unsatisfactory hygienic condition of the oral cavity. That is why she must carry out preventive measures until the baby is born. Doctors advise women to adhere to the correct work and rest regime, take vitamin therapy and eat well.

Tartar

The tooth surface is sensitive to various influences. Stones form on it due to the following reasons:

• violation of the chewing process;
• habit of snacking and consumption of an impressive amount of carbonated drinks and carbohydrates;
• eating mostly soft foods;
• diseases of internal organs;
• smoking and alcohol abuse.

The composition of supra- and subgingival stones is somewhat different from each other. The first is dominated by calcium carbonate, magnesium and calcium phosphate. In addition, it is very hard. The second is formed from dental plaque, which contains a large amount of food debris, epithelial cells, mucus, bacteria, bound by viscous saliva.

Why do you need to clean your mouth? It helps prevent the formation of stones. Doctors recommend visiting the dentist regularly and using dental floss, flawless toothpastes and high-quality brushes. You can also use toothpicks and mouth rinses.

Language

Now let’s figure out how to clean your tongue. If there is no plaque on this organ, your digestive system is healthy. Since the time of Hippocrates, doctors have asked the patient to stick out his tongue. It is known that an impressive amount of toxins is expelled from the body through its surface. If bacteria accumulate on the tongue, they become toxic.

This organ contains numerous papillae, bumps and pits, among which tiny particles of food are stuck. This is why the tongue is a breeding ground for bacteria. They are transferred with saliva to the teeth, and then a disgusting smell from the mouth appears - halitosis.

If a person regularly cleans his tongue, the access of infection to his body becomes more difficult, the sensitivity of taste buds increases, and gingivitis, digestive tract disorders, periodontal disease, and caries are prevented.

Everyone needs to scrape this organ, especially smokers and those who have a “geographical” tongue, on the surface of which there are deep folds and grooves.

Tongue care is carried out after the teeth are cleaned and the mouth is rinsed. Bacteria are first removed in sweeping steps (from base to tip) on one half of the organ and then on the other. Then we brush across the tongue 3-4 times, apply the paste to it and carefully scrape the organ from root to edge. Next, you need to rinse your mouth, apply the gel again and leave it on for 2 minutes. After these manipulations, you can wash everything off with water.

Cleaning your tongue is a necessary part of hygiene. It is better to eliminate plaque, mucus, food debris that negatively affects the surface of the tooth with a special scraper or brush (can be soft). A disinfecting gel applied to the scraper fills the gaps between the filamentous papillae. During liquefaction, it actively releases oxygen, which has a powerful antibacterial effect on the anaerobic microflora of the oral cavity. If you periodically perform this procedure, the formation of dental plaque will decrease by 33%.

General overview

The term hygiene index in dental practice is understood as a digital indicator that can be used to evaluate a specific diagnostic criterion for the quality of care for teeth and gums.

In total, there are about 80 different indices that reflect the presence of pathogenic microflora in the oral cavity, the presence of carious cavities, mineralized deposits and other factors indicating the occurrence of pathological processes on the surface of the teeth and gums.

Today, dental indices are divided into 4 large groups, which take into account the following indicators in research:

• plaque area;
• thickness of deposits;
• mass of plaque;
• microbiological, chemical and physical parameters.

Most often, index systems are used in practice, which make it possible to determine the area of ​​damage to the elements of the jaw row by plaque, as well as to determine its thickness.

By clarifying these points, the dentist performs a quantitative assessment of the following indicators:

• the degree of destruction of the elements of the jaw arch;
• the ratio of the number of healthy teeth to those that are damaged and cannot be restored, or have been removed;
• stage of damage to hard and soft tissues;
• the effectiveness of the implemented therapeutic measures.

Mouth rinse

Many patients ask: “What should I rinse my mouth with?” If your gums are inflamed, you can use antimicrobial (antiseptic) and anti-inflammatory agents. Antiseptic drugs act on pathogenic bacteria that cause suppuration. Anti-inflammatory drugs have virtually no effect on viruses, but they can slow down the development of the disease.

So what should you rinse your mouth with if your gums are inflamed? Doctors recommend:

• For periodontitis or gingivitis, use both types of products, although antimicrobial ones will be more effective.
• When the socket of an extracted tooth becomes inflamed, antiseptic agents, for example, Chlorhexidine, should be used.

If you always wash your hands before eating and brush your teeth and tongue afterward, you will have a sparkling smile for many years to come.

PMA – papillary-alveolar-marginal index

When calculating the PMA index, a solution of iodine or Lugol is used, which is applied to the gums and the degree of tissue inflammation is determined by the reaction to the irritant.

The evaluation criteria are:

• 1 – if the papilla (P) is inflamed;
• 2 – in case of inflammation of the marginal edge (M);
• 3 – inflammation of the alveolar part of the gum (A).

Formula RMA = Sum of points/n*3 (in percentage), where n is the number of teeth (up to 6 years – 20 teeth; 6–12 years – 24 teeth; 12-14 years – 28 teeth; over 15 years – 30 teeth) .

If the value is less than 30%, then the degree of damage is mild, 31-60% is moderate, 61% or more is severe.