MEASURING DENTAL CARIES Chapter 15

DMF INDEX Def INDEX d=decayed e=extracted f=filled ID = DECAYED M = MISSING F = FILLED Irreversible, simple, versatile Provides a broad picture of caries activity in a specific population Uppercase letters for permanent dentition Score = 0 to 32 Can be applied to whole teeth or surfaces (DMFS) d=decayed e=extracted f=filled Can be applied to whole teeth or surfaces (defs) Applies to primary or mixed dentition Missing teeth for caries are not recorded

DIAGNOSING CORONAL CARIES CLINICALLY RADIOGRAPHICALLY

DIAGNOSING CORONAL CARIES TRUE or FALSE Not all noncavitated lesions progress to become dentinal lesions which require restorative treatment Good proportion of noncavitated lesions remain static or even regress especially smooth surface lesions Noncavitated lesions are irreversible Dentinal lesions are reversible

HIDDEN CARIES A carious lesion seen in dentin on a bitewing radiograph where clinically the occlusal enamel appears sound or only minimally demineralized There has been a rise in the number of clinically sound occlusal surfaces over the past two decades Dentists routinely examining children who are clinically caries-free often discover a large lesion on a radiograph that was missed clinically

DENTAL CARIES INDICES DMFT count = Total DMFT divided by the population examined deft count = Total deft divided by the number of children examined FNM = Total filled teeth divided by total DMFT This indicates treatment received for decay (Filling Needs Met) *

DENTAL CARIES INDICES Decayed Teeth = Total decayed teeth divided by total DMFT This indicates treatment required for unmet filling needs Missing Teeth = Total missing teeth divided by total DMFT This indicates the number of teeth lost by decay

DENTAL CARIES INDICES Average Decayed/Missing/Filled teeth per person = D/M/F teeth divided by number of people examined UTN = Mean number decayed teeth divided by mean number decayed plus filled teeth This indicates the Unmet Treatment Needs This index can also be used to compare the treatment needs of one population with those of another Example: UTN of a community with fluorided water vs a community without fluoridated water

mean average median middle mode often

WHAT IS YOUR ANSWER? 13, 18, 13, 14, 13, 16, 14, 21, 13 WHAT IS THE MEAN FOR THE ABOVE LIST OF VALUES? 13, 13, 13, 13, 14, 14, 16, 18, 21 WHAT IS THE MEDIAN FOR THE ABOVE LIST OF VALUES? WHAT IS THE MODE FOR THE ABOVE LIST OF VALUES? WHAT IS THE RANGE FOR THE ABOVE LIST OF VALUES?

RADIOGRAPHICALLY IS IT ROOT CARIES? IS IT CERVICAL BURNOUT? Will not show a root edge image Will show an ill-defined cupped-out or saucer-shaped radiolucency just below CEJ Will show a diffuse, rounded, inner border IS IT CERVICAL BURNOUT? Will show tissues at the CEJ that are thinner than enamel above it and alveolar bone below it Will show a radiolucent wedge configuration adjacent to the CEJ Will show radiolucent ill-defined margins

ROOT CARIES

CERVICAL BURNOUT This is a phenomenon caused by relative lower x-ray absorption on the mesial or distal aspect of teeth, between the edge of the enamel and the adjacent crest of the alveolar ridge

ROOT CARIES INDEX It evaluates the extent of root caries and client’s risk for root caries disease It includes only those root surfaces exposed to oral environment by gingival recession R = root surface D = decayed root surface F = filled root surface N = intact, sound root surface RCI = (R - D) + (R - F) (R-D) + (R-F) + (R-N)

ROOT CARIES INDEX It can computed for an individual, for a population at large and for specific tooth type It is recommended that RCI be applied to both supra and sub gingival lesions, however, scores for each type of lesion are recorded separately Example: A Root Caries Index (RCI) of 7% indicates that of all the teeth that had gingival recession, only 7% were decayed or filled on root surfaces

CARIES TREATMENT NEEDS PRIVATE PRACTICE (Practitioner) Detects more carious lesions Can overtreat Treatment plans for same clients vary drastically from DDS to DDS Judge if minor lesion in primary tooth will develop into major lesion over time COMMUNITY (Survey) Detects fewer carious lesions Miss early lesions Difficult to determine treatment need by a survey Scores a tooth by how it appears at present time