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Methods of Measuring Oral

Diseases

Counts

Number of cases of disease occurrence.


Most useful with unusual condition of low

prevalence.
Less useful as prevalence increases.

Proportions

By adding a denominator to count

Example :
Prevalence = count of caries of population grp.
divided by the total group popn
e.g. 50 cases of aged 50 to 60
500 total age group
= 10 or 10 %

Rates

A proportion using standardized denominator and includes


a time dimension.
(e.g. infant mortality rate , crude birth rate )
Little use in oral disease measure :
- in caries incidence over a period of time
in clinical trials
- annual rate of loss of periodontal attachment in
longitudinal studies

Indices

A graduated numerical scale having upper and lower limits with scores
on the scale corresponding to specific criteria.
1. Ordinal scale lists of conditions in some order of severity without
attempting to define any mathematical relation between categories.
2. Nominal scale simply gives names to different conditions.
3. Interval or ratio scale one in which the number used in the
measuring
scale have a mathematical relation to each other.

Indices

Example : If 1 is used to describe a degree of gingivitis


Then 2 is twice as bad
3 is three times as bad
Until the upper limit of the scale is reached.
Note : Difference between Interval and Ratio Scales
Ratio has true zero point (e.g. height and weight )
Interval no zero point (e.g. Fahrenheit , Celsius )

Properties of Indices
Clarity simplicity and objectivity for ease of

application , and memorization.

Validity must measure what it intended

to
measure . It should correlate with clinical stages
of disease under study.

Reliability

should be able to measure


consistently at different times and under a variety
of conditions.

Properties of Indices

Quantifiability must be amenable to statistical


analysis so that the status of the group can be
expressed by a distribution ( e.g. mean, median , or
other statistical measures.

Sensitivity should be able to detect reasonably


small shifts in either direction in the condition.

Acceptability

Reversible / Irreversible

Measuring Dental Caries

DMF D , decayed

M , missing due to caries


F , filled
def - d- decayed

e- indicated for extraction


f - filled

Measuring Periodontal
Diseases
Gingivitis

- PMA ( Papillary , Marginal , Attached )


- GI ( Gingival Index)
- SBI ( Sulcus Bleeding index)
- EIBI ( Eastman Interdental Bleeding
Index)
- MGI ( Modified Gingival Index )

Periodontitis
- PI ( Periodontal Index ) described by
Russell ( 1956) , scored both gingivitis
and periodontitis
- PDI ( Periodontal Disease Index )
suggested by Ramfjord ( 1959) , an indirect
method of measuring loss of periodontal
attatchment.

GPI Gingival Periodontal Index , an adaptation of PDI

( OLeary ) , both gingivitis and pocket depth .

The Periodontal Treatment Need System (PTNS)

- gave rise to CPITN , presently being used by


WHO ( 1982) surveys.
- categorized patients into levels of treatment need
and assigned times for type of treatment required.

Plaque and Calculus


OHI-S ( Simplified Oral Hygiene Index) scores

calculus and plaque together, both supra and


subgingivally .

PHPI ( Patient Hygiene Performance Index ) is

intended for monitoring of oral health performance


by patients . It requires a disclosing stain.

Plaque and Calculus


PlI (Plaque Index) suggested by Silness and Loe

(1964), is designed to be used along with GI.

VMI (Volphe-Manhold Index) is widely used in USA,

in trials to test agents for plaque control and


calculus inhibition. It is intended to score new
deposits of supra-gingival calculus , following a
prophylaxis to remove all calculus , in clinical trials.