Community Health Test 2

Front 1

___ is an expression of clinical observation in numeric value. It is a status that can be used for an individual or a group with respect to a condition being measured.

Back 1

INDICES
- an expression of clinical observation in numeric value. It is a status that can be used for an individual or a group with respect to a condition being measured.

Front 2

What are the uses for
indices (index)?

Back 2

Uses for indices
- for individual assessment to motivate as well as educate
- for oral research
- to assess the needs of a target population

Front 3

what is the selection criteria for indices?
A useful and effective index...(8)

Back 3

Selection criteria for indices/ index...
1. simple to use & calculate
2. requires minimal equipment & expense
3. uses a minimal amt of time to complete
4. does not cause the patient discomfort nor is otherwise unacceptable to a patient
5. has a clear- cut criteria that are readily understandable
6. Is as free as possible from subjective interpretation- need to calibrate
7. It is reproducible by same or different examiners
8. It is amenable to statistical analysis; has validity and reliability

Front 4

What are the 2 general categories of indices & explain?

Back 4

Categories of indices...
*****Simple Index- one that measures the presence or absence of a condition. Ex: measurement of dental biofilm w/o evaluating its effect on gingiva.
Measures presence& absence of disease
****Cummulative Index: One that measures all evidence of a condition- past & present. Ex: DMFT index for caries

Front 5

What are the types of simple and cummulative indices??

Back 5

Types of simple& cummulative indices...
~ Irreversible: one that measures conditions that will not change. Ex: one that measures dental caries or DMF
~ Reversible: one that measures conditions that can be changed. Ex: one that measures dental biofilm or plaque free scores

Front 6

Dental Caries Indices- determine total caries experience. These can be __ or ___.Characteristics include:
- teeth which exhibit caries
- measures coronal caries only
- caries indices are irreversible and cummulative
- upper case for permanent lower case for primary dentition
-Examiners must be calibrated

Back 6

Dental Caries Indices
~~can be DMFS or DMFT
Characteristics of dental caries indices include...
- teeth which exhibit caries
- measures coronal caries only
- caries indices are irreversible and cummulative
- upper case for permanent lower case for primary dentition
-Examiners must be calibrated

Front 7

The examination of the dental caries indices examines each tooth in a systematic sequence use an explorer w/ a standarized dimension of working. What are the 4 criteria that a tooth must be to be considered carious??

Back 7

Toth is considered carious if...
- if lesions is clinically visible and obvious
- if the explorer tip can penetrate it
- is demineralization is apparent
- if the explorer tip once placed in pit& fissure resist removal

Front 8

Scoring of DMFS/ DMFT?
D=
M=
F=

Back 8

Scoring of Caries Indices...
D= decayed, visible caries present or both dental caries& restoration are present.
M= Teeth (or surfaces) missing or indicated for extraction due to caries only
F= restored teeth or surfaces or a defective restoration w/o evidence of caries present

Front 9

Scoring dental caries Indices..
-scoring based on 28 teeth
- what are the reasons & teeth that are not counted??

Back 9

teeth not counted in caries indices....
- 3rd molars
- unerupted teeth
- congenitally missing or supernumerary teeth
- teeth removed for reasons other than dental caries such as impaction or ortho treatment
- primary tooth retained w/ permanent successor erupted.
- teeth removed due to trauma,cosmetic or preventive
- teeth used as bridge abutment

Front 10

DMFS
- not counted same as DMFT because you look at surfaces
- # of surfaces posterior __ anterior ___ total # of surfaces in the mouth= 128 surfaces
- missing posterior teeth are counted as 5 surfaces
- procedure is same as DMFT

Back 10

DMFS
- not counted same as DMFT because you look at surfaces
- # of surfaces posterior: 5 anterior :4 total # of surfaces in the mouth= 128 surfaces
- missing posterior teeth are counted as 5 surfaces
- procedure is same as DMFT

Front 11

DMFS vs. DMFT
__ : only 1 letter assigned per tooth, teeth are counted as "d " if it has restoration & caries, the further caries are not scored if it is already decayed, w/ this you can't determine the extent of disease, this one is used for prevalance surveys (% of population)

Back 11

DMFT
- only 1 letter assigned per tooth
- teeth are counted as "d " if it has restoration & caries
- the further caries are not scored if it is already decayed
- w/ this you can't determine the extent of disease
- this indice is used for prevalance surveys (% of population)

Front 12

DMFS vs. DMFT
___: it is more sensitive because the total caries and sensivity of it
- used for incidence studies (new decay)

Back 12

DMFS
- more sensitive because the total caries and sensivity of it
- used for incidence studies (new decay)

Front 13

Primary teeth caries indices...
deft or dft: 20 teeth are evaluated
- 88 surfaces evaluated
...Scoring...
d=
e=
f=

Back 13

scoring for primary teeth caries indices...
d= decayed
f= filled or restored
e= extraction due to caries

Front 14

In the caries indices for primary teeth which teeth are not counted??

Back 14

primary teeth Not Counted in caries indices...
- missing teeth
- supernumery teeth
- teeth restored for other reasons other than caries

Front 15

Primary teeth dental caries indices...
- exam is the same as DMFT
- the missing primary teeth are ignored
~With Mixed Dentition....
do you perform the same indices or seperate ones??

Back 15

With mixed dentition seperate indices are used for permanent and primary teeth these are also reported seperately

Front 16

__ index is used to determine total root caries experience for individuals& groups& provide a direct, simple method for recording& making comparisons.

Back 16

RCI = Root Caries Index
this one can be done 2 ways...
~ by simple count: provides prevalence data
~ by surfaces: provides incidence

Front 17

Criteria for scoring RCI...
1. well- defined, discolored soft area
2. explorer enters ___, resistances to withdrawal
3. root caries only- located at __ or ____
4.restored lesions scored- entire restoration on root surface

Back 17

Criteria for scoring RCI...
1. well- defined, discolored soft area
2. explorer enters easily, resistances to withdrawal
3. root caries only- located at CEJ or wholly on root surface
4.restored lesions scored- entire restoration on root surface

Front 18

RCI rating & criteria
R= ___
R-D= root surfaces w/ recession present and root caries present. D= ___
R- F= Root surface w/ recession present and the surface is restored. F= ___
R- N= Root surface w/ recession but no caries or restorations are present. N=__
M= the tooth is missing

Back 18

R= recession
D= decayed
F= filled
N=root surfaces that are sound
R-D= root surfaces w/ recession present and root caries present.
R- F= Root surface w/ recession present and the surface is restored.
R- N= Root surface w/ recession but no caries or restorations are present.
M= the tooth is missing

Front 19

Purpose of ___ index is to assess the thickness of biofilm at the gingival area(the margin or gingival 3rd).This indices measures oral hygiene status can be used in a clinical setting to educate & motivate an individual patient.

Back 19

PLI- PLAQUE INDEX
is used to assess the thickness of biofilm at the gingival area(the margin or gingival 3rd).This indices measures oral hygiene status can be used in a clinical setting to educate & motivate an individual patient.

Front 20

With the PLI (plaque index) what areas are examined??
when scoring the higher the # the worse the amt of plaque there is present.
0= no biofilm
1= film is adhering
2= moderate accumulation of soft deposits can be seen w/ naked eye
3= abundance of soft matter

Back 20

PLI- 4 gingival areas - distal, facial, mesial and lingual are examined for each tooth.
when scoring the higher the # the worse the amt of plaque

Front 21

The purpose of ___ indices is to record the presence of dental biofilm on individual tooth surfaces to permit the patient to visualize progress while learning biofilm control.

Back 21

Plaque Control Record
- purpose is to record the presence of dental biofilm on individual tooth surfaces to permit the patient to visualize progress while learning biofilm control.

Front 22

Plaque control record
- all teeth are included
- __ surfaces are recorded
- Scoring= take # of teeth present multiply by 4 or 6 to obtain # of available surfaces. Count the # of surfaces w/ biofilm. Multiply the # of biofilm stained surfaces by 100 & divide by total number of available surfaces to get percentage of surfaces w/ biofilm.

Back 22

PLAQUE CONTROL RECORD
- all teeth are included
- 4-6 surfaces are recorded
- Scoring= take # of teeth present multiply by 4 or 6 to obtain # of available surfaces. Count the # of surfaces w/ biofilm. Multiply the # of biofilm stained surfaces by 100 & divide by total number of available surfaces to get percentage of surfaces w/ biofilm. 0%=ideal
10%= good- suggested as guidelines in perio therapy

Front 23

Purpose of ___ indices is to determine the location, number, and percentage of biofilm- free surfaces for individual motivation and instruction. All erupted teeth are included. 4 surfaces are recorded for each tooth: facial, lingual, mesial or distal. Procedure: dry surface & apply disclosing solution, record in red surfaces w/ biofilm

Back 23

Plaque Free Score
-present goal for plaque free
- under 85% is poor
- dry surface & use disclosing solution
- purpose is to determine the location, number, and percentage of biofilm- free surfaces for individual motivation and instruction. All erupted teeth are included. 4 surfaces are recorded for each tooth: facial, lingual, mesial or distal.

Front 24

How do you get the percentage of biofilm free surfaces??

Back 24

Plaque free score index
(Number of biofilm free surfaces x 100) / # of available surfaces= % of biofilm free surfaces
- multiply # of teeth by 4 to determine # of available surfaces
- subtract # of surfaces w/ biofilm from total available surfaces to find # of biofilm free surfaces

Front 25

Purpose of ___ index is to assess the extent of biofilm over a tooth surface.
The teeth that are examined include # 3,8,14,19,23,30
- Lack sensitivity because you only look at 6 teeth and not the entire surface of the 6 teeth
 Debris assessed by dividing tooth into 5 subdivision

Back 25

PHP- patient hygiene performance
- purpose is to assess the extent of biofilm over a tooth surface.
The teeth that are examined include # 3,8,14,19,23,30
- Lack sensitivity because you only look at 6 teeth and not the entire surface of the 6 teeth
Debris assessed by dividing tooth into 5 subdivision

Front 26

Purpose of ___ index is to assess oral cleanliness by estimating the tooth surface covered with debris and/or calculus.
- broken into DI-S (debris index) & CI-S (calculus index)
- lacks sensitivity bc you only look at 6 teeth

Back 26

OHI-S= Simplified Oral Hygiene Index
- broken into DI-S (debris index) & CI-S (calculus index)
- purpose is to assess oral cleanliness by estimating the tooth surface covered with debris and/or calculus.
- lacks sensitivity bc you only look at 6 teeth

Front 27

OHI- S scoring
0=
1=
2=
3=

Back 27

OHI- S scoring
0= no debris
1= soft debris covers no more than 1/3
2= soft debris covers no more than 1/3 but not more than 2/3 of the exposed tooth surface
3= soft debris covers no more than 2/3 of exoposed tooth surface

Front 28

Purpose of ___ indices is to determine the location, number, and percentage of biofilm- free surfaces for individual motivation and instruction. All erupted teeth are included. 4 surfaces are recorded for each tooth: facial, lingual, mesial or distal. Procedure: dry surface & apply disclosing solution, record in red surfaces w/ biofilm

Back 28

Plaque Free Score
-present goal for plaque free
- under 85% is poor
- dry surface & use disclosing solution
- purpose is to determine the location, number, and percentage of biofilm- free surfaces for individual motivation and instruction. All erupted teeth are included. 4 surfaces are recorded for each tooth: facial, lingual, mesial or distal.

Front 29

How do you get the percentage of biofilm free surfaces??

Back 29

Plaque free score index
(Number of biofilm free surfaces x 100) / # of available surfaces= % of biofilm free surfaces
- multiply # of teeth by 4 to determine # of available surfaces
- subtract # of surfaces w/ biofilm from total available surfaces to find # of biofilm free surfaces

Front 30

Purpose of ___ index is to assess the extent of biofilm over a tooth surface.
The teeth that are examined include # 3,8,14,19,23,30
- Lack sensitivity because you only look at 6 teeth and not the entire surface of the 6 teeth
 Debris assessed by dividing tooth into 5 subdivision

Back 30

PHP- patient hygiene performance
- purpose is to assess the extent of biofilm over a tooth surface.
The teeth that are examined include # 3,8,14,19,23,30
- Lack sensitivity because you only look at 6 teeth and not the entire surface of the 6 teeth
Debris assessed by dividing tooth into 5 subdivision

Front 31

Purpose of ___ index is to assess oral cleanliness by estimating the tooth surface covered with debris and/or calculus.
- broken into DI-S (debris index) & CI-S (calculus index)
- lacks sensitivity bc you only look at 6 teeth

Back 31

OHI-S= Simplified Oral Hygiene Index
- broken into DI-S (debris index) & CI-S (calculus index)
- purpose is to assess oral cleanliness by estimating the tooth surface covered with debris and/or calculus.
- lacks sensitivity bc you only look at 6 teeth

Front 32

OHI- S scoring
0=
1=
2=
3=

Back 32

OHI- S scoring
0= no debris
1= soft debris covers no more than 1/3
2= soft debris covers no more than 1/3 but not more than 2/3 of the exposed tooth surface
3= soft debris covers no more than 2/3 of exoposed tooth surface

Front 33

___ indices
considered "current method"
 Measurement supra gingival calculus ONLY
 Lingual mand ant teeth are only teeth measured (6 teeth total canine to canine)
 Measurement plane 1 vertical
 Measurement plane 2 diagonal (mesial&distal)
 Measurement plane 3 (diagonal)
 Measurement in increments of 5mm (0.5-5.0)

Back 33

VMI - Volpe Manhold Calculus Index
considered "current method"
 Measurement supra gingival calculus ONLY
 Lingual mand ant teeth are only teeth measured (6 teeth total canine to canine)
 Measurement plane 1 vertical
 Measurement plane 2 diagonal (mesial&distal)
 Measurement plane 3 (diagonal)
 Measurement in increments of 5mm (0.5-5.0)

Front 34

Purpose of __ indices is to locate areas of gingival suluc bleeding and color changes in order to recognize and record the presence of early(initial) inflammatory gingival disease.
o 4 area scored per tooth ( F, L, M, D)
o use Probe to measure
o Wait 30 sec before scoring
o scoring= total for the 4 units then divide total score by 4

Back 34

SBI - sulcus Bleeding Index
Purpose is to locate areas of gingival suluc bleeding and color changes in order to recognize and record the presence of early(initial) inflammatory gingival disease.
o 4 area scored per tooth ( F, L, M, D)
o use Probe to measure
o Wait 30 sec before scoring
o scoring= total for the 4 units then divide total score by 4

Front 35

The purpose of __ indices is to record the presence or absence of gingival inflammation as determined by bleeding from interproximal gingival sulci.
o Determined by Interproximal gingival sulci
o use unwaxed floss wait 30 seconds to determine
o Scoring= # bleeding areas/ # scorable units total areas

Back 35

GBI - Gingival Bleeding Index
- purpose is to record the presence or absence of gingival inflammation as determined by bleeding from interproximal gingival sulci.
o Determined by Interproximal gingival sulci
o use unwaxed floss wait 30 seconds to determine
o Scoring= # bleeding areas/ # scorable units total areas

Front 36

Purpose of __ indices is to assess the presence of inflammation in the interdental area as indicated by the presence or absence of bleeding.
- indices most commonly used
- use a triangular wooden interdental cleaner
-scoring= ( #of bleeding areas/ # of total areas) x100

Back 36

EiBi -Eastman Interdental Index
~ Purpose is to assess the presence of inflammation in the interdental area as indicated by the presence or absence of bleeding.
- indices most commonly used
- use a triangular wooden interdental cleaner
-scoring= ( #of bleeding areas/ # of total areas) x100

Front 37

Periodontal Indices
- the loss of attachment is measured
~ ___ Consider gingival index
 measures extent of inflammation in these areas mainly in large groups
~ ___  No longer used
 Invalid because it does not measure “loss of attachment” it accounts for both gingical and perio changes

Back 37

Periodontal Indices
*Loss if attachment is the key to measuring periodontal status*
~ P-M-A (Papillary- Marginal- Attached)- measures extenet of inflammation in area
~ PI (Periodontal Index)- not used anymore, doesn't measure loss of attachment

Front 38

The purpose of __ indice is to assess the severity of gingivitis based on color, consistency, and bleeding on probing.
~ measures 4 areas
-Criteria: o0= normal
o 1= mild inflammation, slight change in color, slight edema, no BOP
o 2= moderate inflammation, redness, edema, glozing
o 3= severe inflammation, marked redness, edema ulceration, spontaneous bleeding

Back 38

GINGIVAL INDEX
- purpose is to assess the severity of gingivitis based on color, consistency, and bleeding on probing.
~ measures 4 areas
~ Criteria: o 0= normal
o 1= mild inflammation, slight change in color, slight edema, no BOP
o 2= moderate inflammation, redness, edema, glozing
o 3= severe inflammation, marked redness, edema ulceration, spontaneous bleeding

Front 39

___ Index
 No longer used
 Because use only 6 teeth and score only 2 measurements per tooth
 measures Ramfjord teeth: 3, 21, 24, 25, 28, 19
 Consider invalid

Back 39

PDI -Periodontal disease Index
 No longer used
 Because use only 6 teeth and score only 2 measurements per tooth (m&f)
 Ramfjord teeth: 3, 21, 24, 25, 28, 19- uses 1 tooth per sextant
 Consider invalid

Front 40

___ are teeth used for epidemiologic studies of periodontal disease: teeth include 3, 19, 12, 28, 9, 25

Back 40

Ramfjord index teeth
- used for epidemoiologic studies of perio disease
- teeth include 3,19,12,28,9,25
- maxillary right & mand left 1st molars, maxillary left and mand right 1st premolars, and maxillary left and mand right central incisors

Front 41

The purpose of __ index is to screen and monitor the periodontal state of the population.  Develop by “WHO” international Index
 Used to score treatment needs rather than perio status
 Current PSR based on this index
Periodontal treatment needs:
o Code 0- no need for treatment
o Code 1- oral hygiene instruction
o Code 2- OHI, scaling root planning, elimination of plaque restoration margins
o Code 3- all treatment of above codes, plus complex perio therapy; may include surgical intervention and or
o Code 4- scaling/ root planning with anesthesia

Back 41

CPITN - Community Perio index at Treatment Needs
 Used to score treatment needs rather than perio status
 Current PSR based on this index
Periodontal treatment needs:
o Code 0- no need for treatment
o Code 1- oral hygiene instruction
o Code 2- OHI, scaling root planning, elimination of plaque restoration margins
o Code 3- all treatment of above codes, plus complex perio therapy; may include surgical intervention and or
o Code 4- scaling/ root planning with anesthesia

Front 42

Caries exams used in public health
**Type __ = screening used w/ a tongue depressor and available light
- the least valid used one
*** Type __ is a complete exam using a mirror, explorer, lighting, xrays, study model, this one is the least commonly used

Back 42

Caries exams used in public health
**TYPE 4 = screening used w/ a tongue depressor and available light
- the least valid used one
*** TYPE 1= is a complete exam using a mirror, explorer, lighting, xrays, study model, this one is the least commonly used

Front 43

Caries exams used in public health
**Type __= is limited exam that uses mirror, explorer, lighting, bitewings, most commonly used when caries treatment program is planned, this is used if it is planned to follow through w/ treatment
**Type __= uses mouth mirror, explorer, lighting, this one is the most commonly used in public health

Back 43

Caries exams used in public health
**TYPE 2 = is limited exam that uses mirror, explorer, lighting, bitewings, most commonly used when caries treatment program is planned, this is used if it is planned to follow through w/ treatment
**TYPE 3 = uses mouth mirror, explorer, lighting, this one is the most commonly used in public health

Front 44

The purpose of __ indices is to provide case definitions that determine the caries status of children 5 years of age or younger.
- Scoring of this relates the age of the child w/ the status of decayed, missing, and filled tooth surfaces observed.

Back 44

ECC & S-ECC ( Early Childhood Caries)
-Purpose is to provide case definitions that determine the caries status of children 5 years of age or younger.
- Scoring of this relates the age of the child w/ the status of decayed, missing, and filled tooth surfaces observed.

Front 45

PSR Codes
- colored area of probe is completely visible in deepest depth
- no calculus, no defective margins, no bleeding

Back 45

PSR codes
code 0
- colored area of probe is completely visible in deepest depth
- no calculus, no defective margins, no bleeding

Front 46

PSR codes
- colored area of probe is completely visible in deepest depth
- has smooth surfaces, no calculus, no defective margins
- bleeding present

Back 46

PSR codes
Code 1
- colored area of probe is completely visible in deepest depth
- has smooth surfaces, no calculus, no defective margins
- bleeding present

Front 47

PSR codes
- colored area of probe is ocmpletely visible at deepest depth
- rough surface felt may be supragingival and/or subgingival calculus
- defective margins of restorations

Back 47

PSR codes
CODE 2
- colored area of probe is ocmpletely visible at deepest depth
- rough surface felt may be supragingival and/or subgingival calculus
- defective margins of restorations

Front 48

PSR codes
- colored area of probe is only partly visible in deepest depth
- rough surfaces or sub or supra calculus may be present
- BOP
- defective margins of restorations

Back 48

PSR CODES
CODE 3
- colored area of probe is only partly visible in deepest depth
- rough surfaces or sub or supra calculus may be present
- BOP
- defective margins of restorations

Front 49

PSR codes
- colored area of probe completely disappears
- probing depth is greater than 5.5 mm

Back 49

PSR codes
code 4
- colored area of probe completely disappears
- probing depth is greater than 5.5 mm

Front 50

PSR code
- any noteable feature such as furcation involvement
- mobility present
- mucogingival problems
- marked recession area present

Back 50

PSR code:
CODE * asterick
- any noteable feature such as furcation involvement
- mobility present
- mucogingival problems
- marked recession area present

Front 51

The purpose of __ index is to measure the prevalence and severity of dental fluorosis. This is considered less sensitive than some other measures of fluorosis, but still recommended for use in community studies.
Scoring- is assigned using the highest numerical score recorded for 2 or more teeth, and community levels of fluorosis are indicated by the percentage of individuals in sample or population that receive scores in each category.

Back 51

DEAN's FLUOROSIS INDEX
- purpose is to measure the prevalence and severity of dental fluorosis. This is considered less sensitive than some other measures of fluorosis, but still recommended for use in community studies.
Scoring- is assigned using the highest numerical score recorded for 2 or more teeth, and community levels of fluorosis are indicated by the percentage of individuals in sample or population that receive scores in each category.

Front 52

The purpose of __ index is to measure the prevalence and severity of dental fluorosis. This index is more sensitive than Dean's index in indentifying the mildest signs of fluorosis.

Back 52

TSIF - Tooth surface index of fluorosis
- The purpose is to measure the prevalence and severity of dental fluorosis. This index is more sensitive than Dean's index in indentifying the mildest signs of fluorosis.