Oral health directly affects the condition of the entire human body as a whole. Hygiene is the simplest and most accessible, as well as the main way to prevent diseases of teeth and gums. Following the rules of hygiene for caring for the mucous membrane will help you maintain your health and avoid many serious problems.

The dentist performs a thorough examination of all teeth and tissues. Doctors use hygiene indices to assess cavity health. With their help, they quantify the extent of the disease and track its progression. There are a large number of hygiene indicators in dentistry, each of which allows us to assess the health of the oral cavity in a different way.

What is the hygiene index in dentistry

In dentistry, health status is measured in the form of special indices. The hygiene index is data that can be used to assess the hygienic state of the oral cavity. The degree of contamination of the enamel surface is assessed, and the presence of bacteria and their quantitative expression, the ratio of healthy and carious ones are detected.

Thanks to these hygiene data, during periodic examinations, the doctor can identify the causes of tooth and gum decay, and also take preventive measures to prevent many serious diseases of the oral mucosa.

Using hygiene data, the dentist finds out:

• oral health;
• stage of destruction;
• deleted units and those that cannot be recovered;
• how thoroughly the cleaning is carried out;
• stage of tissue destruction;
• curvature in bite;
• assessment of treatment effectiveness.

The dentist observes this and many other useful information about the health of the mucous membrane thanks to hygiene indicators. For the analysis of each type of destruction and damage to teeth and tissues, there is its own specialized data.

Types of KPU index

KPU is considered the main indicator in dentistry. It reveals how intense the caries process is. It is used to analyze both temporary and permanent teeth.

Basic data:

• K – number of foci;
• P – number of delivered;
• Y is the number of units that were removed.

The total expression of these data provides information about the intensity with which caries is developing in the patient.

KPU classification:

• KPU of teeth - the number of caries-affected and filled units in the patient;
• KPU of surfaces – the number of enamel surfaces infected with caries;
• KPU of cavities - the number of cavities from caries and fillings.

It is used during treatment to check the results. Based on such a survey, only a rough assessment of the situation is possible.

Papillary bleeding (PBI) according to Saxer and Miihiemann

PBI also determines the degree of gum inflammation and is carried out by drawing a groove with a special probe along the interdental papillae.

Severity of gum disease:

• 0 – no blood;
• 1 – pinpoint hemorrhages occur;
• 2 – there are many pinpoint hemorrhages or blood along the line of the furrow;
• 3 – blood flows or fills the entire groove.

All periodontal indicators allow us to assess the degree of development of gum inflammation. Gingivitis and periodontitis are very serious diseases that lead to tooth loss. The sooner treatment is started, the greater the likelihood of maintaining chewing abilities.

Hygienic indices

Hygienic indicators are used in dentistry to determine the degree of contamination. Various data characterize clusters by their quality and quantity. They differ in the way they evaluate the teeth that are taken for examination.

Each of the hygienic methods approaches the problem of cleanliness from its own side.

Fedorova-Volodkina

The hygiene index according to Fedorov-Volodkina is the most popular and simple. This method of assessing cleanliness involves staining the lower frontal incisors with an iodide solution. After staining, observe the reaction.

Reaction analysis:

• 1 – no color appeared;
• 2 – color appeared on ¼ of the surface;
• 3 – color appeared on ½ part;
• 4 – color appeared on ¾ of the part;
• 5 – the entire surface is completely painted.

Calculated by dividing all points by 6.

Meaning:

• up to 1.5 – cleaning is carried out perfectly;
• from 1.5-2.0 – good level of hygiene;
• up to 2.5 – insufficient purity;
• from 2.5-3.4 – poor level of hygiene;
• up to 5.0 – practically no cleaning is carried out.

This method allows you to identify the presence of soft and stone without the use of dyes. To do this, 6 numbers are examined - 16, 26, 11, 31, 36 and 46. The incisors and upper molars are examined from the vestibular part, lower molars- from the lingual part. The inspection is carried out visually or using a special probe.

Based on the results of the inspection of each unit, points are assigned:

• 0 – clean surface;
• 1 – 1/3 of the surface is covered with sediments;
• 2 – 2/3 are occupied by clusters;
• 3 – observed on more than 2/3 of the surface.

The assessment is given separately for the presence of stone and bacterial accumulations. The points are summed up and divided by 6.

Values:

• up to 0.6 – very good condition;
• from 0.6-1.6 – cleanliness is at a good level;
• up to 2.5 – insufficient hygiene;
• from 2.5-3 – poor level of cleanliness.

Silnes Low

This method makes it possible to analyze all the patient’s dental units or only some at his request. The examination is carried out by a doctor using a probe; no staining is used.

Based on the presence of plaque, the following points are assigned:

• 0 – clean;
• 1 – thin strip deposit, which can only be determined with a probe;
• 2 – plaques are clearly visible visually;
• 3 – cover the entire surface.

The indicator is calculated based on the sum of points on all four sides divided by 4. General value for the entire cavity is calculated as the average between the individual data.

Calculus Index (CSI)

This method reveals the accumulation of plaque on the lower incisors and canines at the junction with the gum. All sides of each tooth are examined separately - vestibular, medial and lingual.

Points are assigned for each face:

• 0 – clean;
• 1 – presence of deposits no more than 0.5 mm;
• 2 – width up to 1 mm;
• 3 – more than 1 mm.

The stone's score is calculated by dividing the sum of points for all faces by the number of units examined.

Quigley and Hein Plaque Index

This method examines the accumulations on the 12 frontal numbers of the lower and upper jaws. For inspection, the following numbers are taken: 13, 12, 11, 21, 22, 23, 33, 32, 31, 41, 42 and 43.

The study requires painting the surface with a fuchsin solution. After this, the vestibular edge of each tooth is examined and points are assigned:

• 0 – color does not appear;
• 1 – some parts appeared in the cervical area;
• 2 – color up to 1 mm;
• 3 – deposit more than 1 mm, but does not cover 1/3;
• 4 – close up to 2/3;
• 5 – cover more than 2/3.

The indicator is calculated based on dividing the points by 12.

Simplified Lange Approximal Plaque Index (API)

Aproximal surfaces require careful care. Depending on whether there are accumulations on them, the doctor determines how well the patient cleanses.

For this method, the mucous membrane must be stained with a special solution. Plaque formation on proximal surfaces is then determined using “yes” or “no” answers. The examination is carried out in the first and third quadrants from the oral side and in the second and fourth quadrants from the vestibular side.

Calculated as a percentage of positive responses to all responses.

• less than 25% - cleaning is carried out well;
• up to 40% - sufficient hygiene;
• up to 70% - hygiene at a satisfactory level;
• more than 70% - cleaning is not carried out enough.

Ramfiord index

Identifies plaque deposits; the vestibular, lingual and palatal sides are examined. Several numbers are taken for analysis - 11, 14, 26, 31, 34 and 46.

Before examining your teeth, you need to stain them with a brown Bismarck solution. After the inspection, an assessment is made based on the nature of the accumulations:

• 0 – clean;
• 1 – presence of deposits on individual parts;
• 2 – appeared on all faces, but occupy less than half;
• 3 – visible on all edges and covering more than half.

Navi

In this method, only the anterior incisors from the labial side are examined. Before starting, you need to rinse your mouth with a fuchsin solution. Based on the results of staining, points are assigned:

• 0 – clean;
• 1 – deposits are slightly colored only along the border with the gum;
• 2 – a stripe of accumulations is clearly visible at the border with the gum;
• 3 – up to 1/3 of the tooth near the gum is covered with deposits;
• 4 – close up to 2/3;
• 5 – cover more than 2/3 of the surface.

The value is the average of one tooth.

Tureski

Its creators used the Quigley and Hein method as a basis, only for the study they took edges from the lingual and labial sides of the entire dentition.

The mouth is similarly stained using a fuchsin solution and the manifestation of accumulations is analyzed according to points:

Turesky's data is calculated by dividing all scores by total number teeth.

Arnim

This method provides the opportunity to most accurately study plaque and measure its area. But it is quite labor-intensive and is more suitable for research purposes. Its labor intensity does not allow it to be used during routine examinations of patients.

The upper and lower front incisors are taken for examination. They are stained with erythrosine and a photograph of the surface is taken from the vestibular side. The image is enlarged 4 times and printed. Next, you need to transfer the outline of the teeth and painted surfaces onto paper and identify these areas using a planimer. After this, the size of the surface area on which plaque has formed is obtained.

Plaque formation rates (PFRI) according to Axelsson

Using this method, they study the speed at which plaque forms. To do this, they clean using professional equipment and do not clean the mouth for the next 24 hours. After this, the mucous membrane is stained with a solution and the surfaces with the resulting plaque are examined.

The result is assessed as a percentage of contaminated units to all inspected:

• less than 10% - very low rate of plaque deposition;
• from 10-20% - low
• up to 30% - average;
• from 30-40% - high;
• more than 40% is very high.

Such a study provides an opportunity to analyze the degree of risk of the occurrence and spread of caries and find out the nature of plaque deposition.

Plaque estimates in young children

Used to analyze plaque in children that appears after the appearance of baby teeth. During the examination, all erupted teeth in the child are examined visually or using a special probe.

The condition is assessed as follows:

• 0 – clean;
• 1 – there are deposits.

It is calculated by dividing the number of teeth with deposits by the total number present in the oral cavity.

Values:

• 0 – hygiene is good;
• up to 0.4 – cleaning at a satisfactory level;
• from 0.4-1.0 – hygiene is very poor.

Oral hygiene effectiveness (ORE)

This indicator is used to establish the level of cleaning thoroughness. The following numbers are taken for the study - vestibular parts 16, 26, 11, 31 and lingual parts 36 and 46. The surface is divided into 5 parts - medial, distal, occlusal, central and cervical.

The mouth is rinsed with a special solution and the degree of coloration of each sector is analyzed according to points:

• 0 – clean;
• 1 – color appears.

The indicator of one tooth is obtained by summing all the points based on the results of its examination. The total value is obtained by dividing the sum of individual indicators by their total number.

Hygiene level:

• 0 – hygiene is very well maintained;
• up to 0.6 – cleaning at a good level;
• up to 1.6 – hygiene is satisfactory;
• more than 1.7 - cleaning is carried out poorly.

Hygiene indicators are important for analyzing contamination levels. It is important to comply hygiene rules care and clean your mouth thoroughly daily. Tartar and plaque cause inflammation of the tissue around the teeth and can cause tooth loss.

Stages of epidemiological survey following the WHO methodology

Epidemiology is a way of studying the nature of the spread of diseases in different segments of the population. It is also used for dental purposes.

Epidemiological survey consists of three main stages:

1. Preparatory stage. A plan is drawn up indicating the timing, methods and objectives of the research. The research site is being prepared and necessary equipment. A group of two doctors is formed and nurse who have undergone training. Special population groups are selected to characterize their populations and living conditions ( climatic conditions, social conditions, environment etc.). The number of male and female people should be the same. The size of the groups depends on the required level of rigor of the study.
2. Second stage - examination. A registration card is used to record data. For children under 15 years old it has a simplified form. Additions and corrections to the map are prohibited. All entries are made in the form of codes indicating the specific manifestation of symptoms or their absence. To get a complete picture of the state of health, information is collected on the oral mucosa and the extraoral area.
3. Third stage – evaluation of results. Data is calculated according to the required parameters - the level of caries prevalence, the level of periodontal disease, etc. The results are displayed as a percentage.

Such examinations make it possible to assess the dental situation in a particular region, to identify the dependence of the health of the oral mucosa on others and social conditions life. And also monitor changes in the condition of teeth and gums as the patient ages.

It is important to identify the most common diseases and their intensity in different regions and age groups. Based on the research results, it is planned preventive actions on treatment serious illnesses and hygiene training.

Conclusion

All dental indicators are individual in their own way. They allow you to different sides assess oral health. When examining a patient, the dentist uses one or another method based on individual characteristics body and the condition of the oral mucosa.

All research methods are quite simple to use. They do not deliver to the patient painful sensations and do not require special training. Special solutions for staining plaque are absolutely harmless to the patient.

Thanks to them, the doctor can not only assess the initial condition of the oral cavity, but also predict future deterioration or track changes in teeth and gums after treatment.

Particular attention should be paid to hygienic condition of the oral cavity as a major risk factor for the development of dental diseases. An obligatory stage of the initial examination is to assess the hygienic condition of the oral cavity by determining hygiene indices depending on the age of the child and the pathology with which the patient came in.

Indexes proposed for assessment of the hygienic state of the oral cavity(hygiene index - IG) is conventionally divided into the following groups:

The 1st group of hygienic indices that evaluate the area of ​​dental plaque includes the Fedorov-Volodkina and Green-Vermillion indices.

It is widely used to study the hygienic state of the oral cavity. Fedorov-Volodkina index. The hygienic index is determined by the intensity of coloring of the labial surface of the six lower frontal teeth (43, 42, 41, 31, 32, 33 or 83, 82, 81, 71, 72, 73) with an iodine-potassium iodide solution consisting of 1.0 iodine, 2 .0 potassium iodide, 4.0 distilled water. Evaluated using a five-point system and calculated using the formula:

where K avg is the general hygienic cleaning index;

K and - hygienic index of cleaning one tooth;

n - number of teeth.

Criteria for evaluation:

Coloring the entire surface of the crown - 5 points

Coloring 3/4 of the crown surface - 4 points.

Coloring 1/2 of the crown surface - 3 points.

Coloring 1/4 of the crown surface - 2 points.

Lack of staining - 1 point.

Normally, the hygiene index should not exceed 1.

Interpretation of results:

1.1-1.5 points - good GI;

1.6 - 2.0 - satisfactory;

2.1 - 2.5 - unsatisfactory;

2.6 - 3.4 - bad;

3.5 - 5.0 - very bad.

I.G.Green and I.R.Vermillion(1964) proposed a simplified oral hygiene index OHI-S (Oral Hygiene Indices-Simplified). To determine OHI-S, the following surfaces of teeth are examined: vestibular surfaces of 16,11, 26, 31 and lingual surfaces of 36, 46 teeth. On all surfaces, plaque is determined first, and then tartar.

Criteria for evaluation:

Dental plaque (DI)

0 - no plaque

1 - plaque covers 1/3 of the tooth surface

2 - dental plaque covers 2/3 of the tooth surface

3 - plaque covers >2/3 of the tooth surface

Calculus (CI)

0 - tartar is not detected

1 - supragingival tartar covers 1/3 of the tooth crown

2 - supragingival tartar covers 2/3 of the tooth crown; subgingival tartar in the form of separate conglomerates

3 - supragingival tartar covers 2/3 of the tooth crown and (or) subgingival tartar covers the cervical part of the tooth

Formula for calculation:

Calculation formula:

where S is the sum of values; zn - dental plaque; zk - tartar; n - number of teeth.

Interpretation of results:

Second group of indices.

0 - plaque near the neck of the tooth is not detected by the probe;

1 - plaque is not visually detected, but a lump of plaque is visible on the tip of the probe when passed near the neck of the tooth;

2 - plaque visible to the eye;

3 - intensive plaque deposition on tooth surfaces and in interdental spaces.

J. Silness (1964) and H. Loe (1967)) proposed an original index that takes into account the thickness of the plaque. In the counting system, a value of 2 is given to a thin layer of plaque, and 3 to a thick layer. When determining the index, the thickness of the dental plaque (without staining) is assessed using a dental probe on 4 tooth surfaces: vestibular, lingual and two contact. 6 teeth are examined: 14, 11, 26, 31, 34, 46.

Each of the four gingival regions of the tooth is assigned a value from 0 to 3; this is the plaque index (PII) for a specific area. The values ​​from the four areas of the tooth can be added and divided by 4 to obtain the PII for the tooth. Values ​​for individual teeth(incisors, major and minor molars) can be grouped in order to obtain PII for different groups of teeth. Finally, by adding the indexes for the teeth and dividing by the number of teeth examined, the PII for the individual is obtained.

Criteria for evaluation:

0 is this value when the gingival area of ​​the tooth surface is truly free of plaque. Plaque accumulation is determined by passing the tip of the probe along the surface of the tooth at the gingival sulcus after the tooth has been thoroughly dried; if the soft substance does not stick to the tip of the probe, the area is considered clean;

1 - is prescribed when a plaque in situ cannot be detected with the naked eye, but the plaque becomes visible at the tip of the probe after passing the probe along the surface of the tooth at the gingival sulcus. No detection solution was used in this study;

2 - prescribed when the gingival area is covered with a thin to moderately thick layer of plaque. The plaque is visible to the naked eye;

3 - intensive deposition of a soft substance that fills the niche formed by the gingival border and the surface of the tooth. The interdental area is filled with soft debris.

Thus, the value of the plaque index only indicates the difference in the thickness of soft dental deposits in the gingival region and does not reflect the extent of the plaque on the tooth crown.

Formula for calculation:

a) for one tooth - sum up the values ​​obtained from examining different surfaces of one tooth, divide by 4;

b) for a group of teeth - the index values ​​for individual teeth (incisors, large and small molars) can be summed up to determine the hygienic index for different groups teeth;

c) for an individual - sum up the index values.

Interpretation of results:

PII-0 indicates that the gingival area of ​​the tooth surface is completely free of plaque;

PII-1 reflects a situation where the gingival area is covered with a thin film of plaque that is not visible but is made visible;

PII-2 indicates that the deposit is visible in situ;

PII-3 - about significant (1-2 mm thick) deposits of soft matter.

Tests α=2

1. The doctor stained plaque on the vestibular surface of the lower front teeth. What hygienic index did he define?

A.Green-Vermillion

S. Fedorova-Volodkina

D. Tureski

E. Shika - Asha

2. Which tooth surfaces are stained when determining the Green-Vermillion index?

A. vestibular 16, 11, 26, 31, lingual 36,46

B. lingual 41, 31.46, vestibular 16.41

C. vestibular 14, 11, 26, lingual 31, 34,46

D. vestibular 11, 12, 21, 22, lingual 36, 46

E. vestibular 14, 12, 21, 24, lingual 36, 46

3. When determining the Fedorov-Volodkina index, stain:

A. vestibular surface of 13, 12,11, 21, 22, 23 teeth

B. vestibular surface of 43, 42, 41, 31, 32, 33 teeth

C. lingual surface of teeth 43,42,41, 31, 32, 33

D. oral surface of 13,12, 11, 21, 22, 23 teeth

E. no staining is performed

4. When determining the Silness-Loe index, the teeth are examined:

A. 16,13, 11, 31, 33, 36

B. 16,14, 11, 31, 34, 36

C. 17, 13,11, 31, 31, 33, 37

D. 17, 14, 11, 41,44,47

E. 13,12,11,31,32,33

5. Using the Silness-Loe hygiene index, the following are assessed:

A. plaque area

B. plaque thickness

C. microbial composition of plaque

D. amount of plaque

E. plaque density

6. To assess the hygienic state of the oral cavity in children under 5-6 years old, the following index is used:

B. Green-Vermillion

D. Fedorova-Volodkina

7. To assess dental plaque and tartar, the following index is used:

B. Green-Vermillion

D. Fedorova-Volodkina

8. A solution consisting of 1 g of iodine, 2 g of potassium iodide, 40 ml of distilled water is:

A. Lugol solution

B. fuchsin solution

C. Schiller-Pisarev solution

D. methylene solution blue

E. trioxazine solution

9. According to Fedorov-Volodkina, a good level of oral hygiene corresponds to the following values:

10. Satisfactory level of oral hygiene according to Fedorov-Volodkina

correspond to the values:

11. An unsatisfactory level of oral hygiene according to Fedorov-Volodkina corresponds to the following values:

12. According to Fedorov-Volodkina, a poor level of oral hygiene corresponds to the following values:

13. According to Fedorov-Volodkina, a very poor level of oral hygiene corresponds to the following values:

14. To determine the Fedorov-Volodkina index, stain:

A. vestibular surface of the anterior group of teeth of the upper jaw

B. palatal surface of the anterior group of teeth of the upper jaw

C. vestibular surface of the anterior group of teeth of the lower jaw

D. lingual surface of the anterior group of teeth of the lower jaw

E. approximal surfaces of the anterior group of teeth of the upper jaw

15. During a preventive examination, a 7-year-old child was assessed with a Fedorov-Volodkina hygiene index of 1.8 points. What level of hygiene does this indicator correspond to?

A. good hygiene index

B. poor hygiene index

C. satisfactory hygiene index

D. poor hygiene index

E. very poor hygiene index

Test questions (α=2).

1. Basic hygienic indices.

2. Methodology for determining the Fedorov-Volodkina hygienic index, evaluation criteria, interpretation of results.

3. Methodology for determining the Green-Vermillion hygienic index, evaluation criteria, interpretation of results.

4. Methodology for determining the hygienic index J.Silness - H.Loe, evaluation criteria, interpretation of results.

, ORGAN AND TISSUE TRANSPLANTATION.docx , 6. States of matter. LR No. 5 “Observation of various states of things, PRELIMINARY ASSESSMENT OF THE CONDITION OF TRANSBOUNDARY RIVERS (pdf.io).doc.
Index assessment of the condition of periodontal tissues

There are reversible, irreversible and complex indices. At using invertible indexes evaluate the dynamics of periodontal disease, effectiveness therapeutic measures. These indices characterize the severity of symptoms such as inflammation and bleeding of the gums, tooth mobility, and the depth of gingival and periodontal pockets. The most common of them are the PMA index, the periodontal Russell index, etc. The same group includes hygienic indices (Fedorov-Volodkina, Green-Vermilion, Ramfjord, etc.).

Irreversible Indexes: radiographic index, gingival recession index, etc. – characterize the severity of symptoms of periodontal disease such as resorption bone tissue alveolar process, gum atrophy.

Using complex periodontal indices, they provide a comprehensive assessment of the condition of periodontal tissues. For example, when calculating the Komrke index, the PMA index, the depth of periodontal pockets, the degree of atrophy of the gingival margin, bleeding gums, the degree of tooth mobility, and Svrakov’s iodine number are taken into account.

Oral Hygiene Index

To assess the hygienic condition of the oral cavity, the hygiene index is determined according to the method of Yu.A. Fedorov and V.V. Volodkina. As a test for hygienic cleaning of teeth, coloring of the labial surface of the six lower front teeth with an iodine-iodide-potassium solution (potassium iodide - 2 g; crystalline iodine - 1 g; distilled water - 40 ml) is used.

Quantitative assessment produced according to a five-point system:

staining the entire surface of the tooth crown – 5 points;

staining 3/4 of the surface of the tooth crown – 4 points;

staining 1/2 of the surface of the tooth crown – 3 points;

staining 1/4 of the surface of the tooth crown – 2 points;

absence of staining of the surface of the tooth crown – 1 point.

By dividing the sum of points by the number of teeth examined, an indicator of oral hygiene is obtained (hygiene index - IG).

The calculation is made using the formula:

IG = Ki (sum of ratings for each tooth) / n

where: IG – general purification index; Ki – hygienic index of cleaning one tooth;

n – number of teeth examined [usually 6].

The quality of oral hygiene is assessed as follows:

good IG – 1.1 – 1.5 points;

satisfactory IG – 1.6 – 2.0 points;

unsatisfactory IG – 2.1 – 2.5 points;

poor IG – 2.6 – 3.4 points;

very bad IG – 3.5 – 5.0 points.

With regular and proper care for the oral cavity, the hygiene index is in the range of 1.1–1.6 points; an IG value of 2.6 or more points indicates the absence regular care for teeth.

This index is quite simple and accessible for use in any conditions, including when conducting mass population surveys. It can also serve to illustrate the quality of tooth brushing when teaching hygiene skills. Its calculation is carried out quickly, with sufficient information to draw conclusions about the quality of dental care.

Simplified hygiene index OHI-s [Green, Vermilion, 1969]

6 adjacent teeth or 1–2 from different groups (large and small molars, incisors) of the lower and lower teeth are examined. upper jaw; their vestibular and oral surfaces.

1/3 of the surface of the tooth crown – 1

1/2 of the surface of the tooth crown – 2

2/3 of the surface of the tooth crown – 3

no plaque – 0

If the plaque on the surface of the teeth is uneven, then it is assessed by a larger volume or, for accuracy, the arithmetic average of 2 or 4 surfaces is taken.

OHI-s = Sum of indicators / 6

OHI-s = 1 reflects normal or ideal hygienic condition;

OHI-s > 1 – poor hygienic condition.

Papillary marginal alveolar index (PMA)

The papillary-marginal-alveolar index (PMA) allows one to judge the extent and severity of gingivitis. The index can be expressed in absolute numbers or as a percentage.

Evaluation inflammatory process produced as follows:

inflammation of the papilla – 1 point;

inflammation of the gum edge – 2 points;

inflammation of the alveolar gum – 3 points.

The condition of the gums of each tooth is assessed.

The index is calculated using the following formula:

RMA = Sum of indicators in points x 100 / 3 x number of teeth of the subject

where 3 is the averaging coefficient.

The number of teeth with the integrity of the dentition depends on the age of the subject: 6–11 years – 24 teeth; 12–14 years – 28 teeth; 15 years and older – 30 teeth. When teeth are lost, they are based on their actual presence.

Index value with limited prevalence pathological process reaches 25%; with pronounced prevalence and intensity of the pathological process, the indicators approach 50%, and with further spread of the pathological process and an increase in its severity - from 51% or more.

Determination of the numerical value of the Schiller–Pisarev test

To determine the depth of the inflammatory process, L. Svrakov and Yu. Pisarev proposed lubricating the mucous membrane with an iodine-iodide-potassium solution. Staining occurs in areas of deep lesions connective tissue. This is explained by the accumulation large quantity glycogen in areas of inflammation. The test is quite sensitive and objective. When the inflammatory process subsides or stops, the intensity of the color and its area decrease.

When examining the patient, lubricate the gums with the specified solution. The degree of coloring is determined and areas of intense darkening of the gums are recorded in the examination card; for objectification, they can be expressed in numbers (points): coloring of the gingival papillae - 2 points, coloring of the gingival margin - 4 points, coloring of the alveolar gum - 8 points. The total score is divided by the number of teeth in which the study was carried out (usually 6):

Iodine number = Sum of assessments for each tooth / Number of teeth examined

mild inflammation process – up to 2.3 points;

moderately expressed inflammation process – 2.3-5.0 points;

intense inflammatory process – 5.1-8.0 points.

Schiller–Pisarev test

The Schiller-Pisarev test is based on the detection of glycogen in the gum, the content of which increases sharply during inflammation due to the lack of keratinization of the epithelium. In the epithelium of healthy gums, glycogen is either absent or there are traces of it. Depending on the intensity of inflammation, the color of the gums when lubricated with a modified Schiller-Pisarev solution changes from light brown to dark brown. In the presence of healthy periodontium, there is no difference in the color of the gums. The test can also serve as a criterion for the effectiveness of the treatment, since anti-inflammatory therapy reduces the amount of glycogen in the gums.

To characterize inflammation, the following gradation has been adopted:

– staining of the gums in a straw-yellow color – negative test;

– staining of the mucous membrane in a light brown color – weakly positive test;

– dark brown color – positive test.

IN in some cases the test is applied with the simultaneous use of a stomatoscope (magnification 20 times). The Schiller-Pisarev test is performed for periodontal diseases before and after treatment; it is not specific, however, if it is impossible to use other tests, it can serve as a relative indicator of the dynamics of the inflammatory process during treatment.

Periodontal index

The periodontal index (PI) makes it possible to take into account the presence of gingivitis and other symptoms of periodontal pathology: tooth mobility, clinical pocket depth, etc.

The following estimates are used:

no changes and inflammation – 0;

mild gingivitis (gum inflammation does not cover the tooth

from all sides) – 1;

gingivitis without damage to the attached epithelium (clinical

pocket is not detected) – 2;

gingivitis with the formation of a clinical pocket, dysfunction

no, the tooth is immovable – 6;

pronounced destruction of all periodontal tissues, the tooth is mobile,

can be shifted – 8.

The periodontal condition of each existing tooth is assessed - from 0 to 8, taking into account the degree of gum inflammation, tooth mobility and the depth of the clinical pocket. In doubtful cases, the highest possible rating is given. If an X-ray examination of the periodontium is possible, a score of “4” is entered, in which the leading sign is the condition of the bone tissue, manifested by the disappearance of the closing cortical plates at the apexes of the alveolar process. X-ray examination especially important for diagnosis initial degree development of periodontal pathology.

To calculate the index, the resulting scores are added and divided by the number of teeth available using the formula:

PI = Sum of ratings for each tooth / Number of teeth

The index values ​​are as follows:

0.1–1.0 – initial and mild degree of periodontal pathology;

1.5–4.0 – moderate degree of periodontal pathology;

4.0–4.8 – severe degree of periodontal pathology.

Index of need for treatment of periodontal diseases

To determine the periodontal disease treatment need index (CPITN), it is necessary to examine the surrounding tissues in the area of ​​10 teeth (17, 16, 11, 26, 27 and 37, 36, 31, 46, 47).

17/16	11	26/27
47/46	31	36/37

This group of teeth creates the most complete picture of the condition of the periodontal tissues of both jaws.

The study is carried out using the probing method. Using a special (button) probe, bleeding gums, the presence of supra- and subgingival “tartar”, and a clinical pocket are detected.

The CPITN index is assessed using the following codes:

– no signs of disease;

– gingival bleeding after probing;

– the presence of supra- and subgingival “tartar”;

– clinical pocket 4–5 mm deep;

– clinical pocket with a depth of 6 mm or more.

The condition of only 6 teeth is recorded in the corresponding cells. When examining the periodontium of teeth 17 and 16, 26 and 27, 36 and 37, 46 and 47, codes corresponding to a more severe condition are taken into account. For example, if bleeding is detected in the area of ​​tooth 17, and “tartar” is detected in area 16, then a code indicating “tartar” is entered in the cell, i.e. 2.

If any of these teeth is missing, then examine the tooth next to it in the dentition. In the absence and nearby standing tooth the cell is crossed out diagonally and is not included in the summary results.
From the official website of the Department of Therapeutic Dentistry of St. Petersburg State Medical University

Oral hygiene indices

To assess oral hygiene during epidemiological studies, test the effectiveness of hygiene and preventive measures, as well as to identify the role of hygiene in the etiology and pathogenesis of major dental diseases, a large number of objective indices have currently been proposed. All these indices are based on an assessment of the area of ​​dental plaque, its thickness, mass, and physicochemical parameters.

Hygiene index according to Pakhomov G.N.

The following teeth are stained with Lugol's solution: 6 lower frontal teeth, all 1st molars (16, 26, 36, 46), as well as 11 and 21 (12 teeth in total).

Color rating:

absence of staining – 1 point;

¼ of the tooth surface – 2 points;

½ tooth surface – 3 points;

¾ of the tooth surface – 4 points;

The entire surface of the tooth – 5 points.

The assessment is carried out by finding the arithmetic mean by adding the sum of the color (in points) of all twelve teeth and dividing the resulting sum by twelve.

In our country, its modification is most often used Fedorov-Volodkina. The basis is a semi-quantitative assessment of Lugol's solution staining of six anterior teeth of the lower jaw (incisors and canines). At the same time, staining of the entire surface of the tooth crown is estimated at 5 points, ¾ of the surface - 4 points, ½ of the surface - 3 points, ¼ - 2 points, absence of staining - 1 point (Fig. No. 6).

Rice. No. 6 Codes for assessing the Fedorov-Volodkina index

The assessment is carried out by finding the arithmetic mean by adding the sum of the color (in points) of all six teeth and dividing the resulting sum by six.

where is Ksr. – hygiene index, K – sum of hygiene assessment of all examined teeth, n – number of examined teeth.

Interpretation of indices by Pakhomov G.N. And Fedorov-Volodkina:

1.0 – 1.5 – good level of hygiene;

1.6 – 2.0 – satisfactory level of hygiene;

2.1 – 2.5 – unsatisfactory level of hygiene;

2.6 – 3.4 – poor level of hygiene;

3.5 – 5.0 – very poor level of hygiene.

In some cases, it is more convenient and faster to determine a qualitative assessment of plaque intensity using a 3-point system. In this case, intense staining of plaque with Lugol's solution is taken as 3 points, weak staining - 2.0, absence - 1.0. The calculation is carried out according to the formula:

where Sav. – qualitative hygienic indicator, Sn – sum of index values ​​for all examined teeth, n – number of examined teeth. Normally, the quality index of oral hygiene should be equal to 1.0.

Modified Fedorova index (L.V. Fedorova, 1982)

It differs from the Fedor-Volodkina hygiene index in that the study is carried out in the area of ​​16 teeth (16, 13, 12, 11, 21, 22, 23, 25, 36, 33, 32, 31, 41, 42, 43, 45). This allows you to more objectively assess the level of hygiene of all groups of teeth. The area of ​​dental plaque is assessed similarly to IG Fedorov-Volodkina.

Simplified index of oral hygiene (modified by Leus P.A.) - “IGR-U”(OHJ – S, Green, Wermillion, 1964).

Formula: IGR – U = +

Key: ∑ - sum of values;

ZN – dental plaque;

ZK – dental calculus;

n – number of teeth examined (usually 6).

Methodology: visually, using a dental probe, dental plaque and tartar are determined on the labial surfaces of 11 and 31, buccal surfaces of 16 and 26 and lingual surfaces of 36 and 46 teeth.

Assessment of dental plaque (P) values ​​is carried out using a three-point system: 0 – no plaque detected; 1 – soft plaque covers 1/3 of the tooth surface or dense brown plaque in any quantity; 2 – soft ZN covers 2/3 of the tooth surface; 3 – soft teeth cover more than 2/3 of the tooth surface.

Assessment of tartar values ​​(TC) is also carried out using a three-point system: 0 – TC not detected; 1 – supragingival zone covers 1/3 of the tooth surface; 2 – supragingival GC covers 2/3 of the tooth surface or subgingival GC is present in the form of separate conglomerates; 3 – the supragingival zone covers more than 2/3 of the tooth surface or the subgingival zone surrounds the cervical part of the tooth.

IZK = Sum of indicators 6 teeth / 6

UIG (OHJ-S) = IZN + IZK

The interpretation of the Green-Vermilion index is carried out according to the following scheme:

Ramfier Index (1956) By identifying dental plaque, it is determined on 6 teeth: 14, 11, 26, 46, 31, 34.

The lateral, buccal and lingual surfaces are examined using brown Bismarck solution. The assessment is carried out according to the following criteria:

0 – absence of dental plaque (DB);

1 – ST is present on some, but not all lateral, buccal and lingual surfaces of the tooth;

2 – ZB is present on all lateral, buccal and lingual surfaces, but covers no more than half of the tooth;

3 – ZB is present on all lateral, buccal and lingual surfaces, and covers more than half of the tooth. The index is calculated by dividing the total score by the number of teeth examined.

Schick-Asch Index (1961) according to the definition of ZN at 14, 11, 26, 46, 31, 34.

0 – no ZN;

1 – GN on the lateral or gingival border covers less than 1/3 of the gingival half of the labial or lingual surface;

2 – GL covers more than 1/3, but less than 2/3 of the gingival half of the labial or lingual surface;

3 – ZN covers 2/3 or more than half of the gingival labial or lingual surface of the tooth.