1. Oral Health Training & Calibration Programme
Tooth Status

2. Tooth Status Coding:
Note 21 is present

3. Tooth Status Assessing Dental Caries
The examination should be conducted with a plane mouth mirror & Williams explorer
The explorer should be used to clean off any food debris
Before scoring the teeth identify which teeth are present and absent
Adopt a systematic approach to the examination:
Proceed from upper right to left & lower left to lower right
Record the crown and the root status separately.
Do not aggressively probe surfaces; visual decay may be confirmed by probing to detect the softened floor of the lesion

4. Assessing dental caries
If in doubt leave it out…score low
Don't second-guess yourself: score tooth and move on
Permanent teeth take precedence over primary teeth occupying the same space - record the status of the permanent tooth
Decay takes precedence over a filling on the same tooth: record the decay not the filling
If a filling or a cavity crosses over the dentinal-enamel junction by more than 1mm then score the condition on both.
Ignore supernumeraries

5. Assessing dental caries
A tooth should be considered present when any part of it is visible
Different fields for primary teeth and 75-85
Each box for each primary and/or permanent tooth must be coded
For 12 year olds and older, usually code ‘6’ for all primary teeth.
Data must be entered in both the crown & root boxes for the same permanent tooth.
Root caries recorded at age 18 years and older

6. Non cavitated dentine caries
Caries Iceberg
Cavitation
Non cavitated dentine caries
Enamel Caries
Easy to diagnose
Harder to diagnose
Good Eyesight
Clean tooth
Good lighting
Aids
The prevalence of caries is like an iceberg. What we see (above the water) is only a fraction of the disease that is present in a patients mouth. The rest has not yet cavitated and may or may not be into dentine. The very large fraction of caries that is confined to enamel is amenable to prevention.

7. Non cavitated dentine caries
Caries Iceberg
We measure a stage of caries progression: “Obvious dentinal decay”
We must all measure at the same level (regardless of eyesight)
Cavitation
Non cavitated dentine caries
Enamel Caries
The prevalence of caries is like an iceberg. What we see (above the water) is only a fraction of the disease that is present in a patients mouth. The rest has not yet cavitated and may or may not be into dentine. The very large fraction of caries that is confined to enamel is amenable to prevention.

8. Often no clear distinction between normal and abnormal
Iceberg
Cavitation
Non cavitated dentine caries
Enamel Caries
Often no clear distinction between normal and abnormal
The prevalence of caries is like an iceberg. What we see (above the water) is only a fraction of the disease that is present in a patients mouth. The rest has not yet cavitated and may or may not be into dentine. The very large fraction of caries that is confined to enamel is amenable to prevention.
There is often no clear distinction between normal and abnormal, for example how do we diagnose gingivitis, at what shade of red or if bleeding on probing, at what pressure. How valid is bleeding on probing

9. Code 1 Sound never decayed or restored
-The tooth shows no evidence of treated or untreated clinical dentinal caries.
-The following conditions are scored as sound
-white or chalky spots
-discoloured or rough spots
-stained pits or fissures in the enamel that catch the explorer but do not have a detectably softened floor
-undermined enamel, or softening of the walls
-dark, shiny, hard, pitted areas of enamel in a tooth showing signs of moderate to severe fluorosis
-All questionable lesions should be coded as sound.

10. Code 2 Sound crown sealed
Never decayed or otherwise restored (crown only) and the tooth has been sealed with an unfilled resin material
Can be difficult to distinguish from preventive resin restorations
Can be difficult to distinguish from composite restorations

11. 65 is code 1, 26 is Code 2, 27 is Code 1

12. Code 1 Sound

13. Code as Sound
Unless see caries or restorations the use next lowest code which is sound.

14. Codes 3-6, 19 Missing tooth 3: Missing – due to orthodontic treatment
4: Missing – due to trauma
5: Missing – due to caries or periodontal disease
6: Unerupted tooth, congenitally missing or unexposed root
teeth that are missing because they are not yet erupted
congenitally missing;
deciduous teeth that have been exfoliated
you are unsure of the reason for the loss
19. Implant: tooth is replaced with an implant

15. 12 is Code 6 Congenitally Missing Tooth
Often difficult to determine if first molars have been extracted. If done at a young age the 12 year molar will be in the 6 position

16. Caries is recorded at the obvious dentinal level of involvement
Caries Codes 7-10 Crown, 11 Root Decayed (includes temporary filling) - Crown and/or Root
Caries is recorded at the obvious dentinal level of involvement
7. Decayed severely (+/- separate filling) lesion extending at least 2/3 of the way through the crown structure or has progressed at least ½ way through the root
8. Decayed – pit and fissure caries (crown only).
9. Decayed – as above smooth surface caries (crown only)
10. Decayed – as above both smooth surface & pit and fissure caries (crown only)
11. Decayed – smooth surface caries (root only)

17. What Code Should You Score?
Score 7 severe

18. Visual Caries 12 Code?
12 has visual caries

19. What Code Should You Score?
Score 10 both smooth and pit and fissure caries

20. Codes 12-14 Filled - Crown and/or Root
12. Filled with amalgam, no other decay
13. Filled with other material (resin, GIC, inlay, crown), no other decay
14. Filled with amalgam and other material (resin, GIC, inlay, crown), no other decay

21. Code 11: Root Caries Code Crown 13 and root 13
If the restoration or caries extends at least 1 mm on to the crown or root record as on both.
Code Crown 13 and root 13

22. Code 13 Filled with resin on 11, 21

23. Codes 15-17: Filled – Defective, no other decay Crown and/or Root
15. Filled with amalgam, no other decay, but filling is defective and needs replacement
16. Filled with other material (resin, GIC, inlay, crown) but filling is defective and needs replacement
17. Filled with amalgam and other material (resin, GIC, inlay, crown) but filling is defective and needs replacement
1 mm defect is threshold to say is a defective restoration

24. Defective Composite

25. Defective Amalgams

26. Codes
18. Bridge abutment, special crown or veneer (crown only): restoration placed for reasons other than caries
20. Fractured due to trauma: Tooth is fractured as a result of trauma. Fracture has been or can be repaired and rehabilitated. (ask respondent)
21. Other : This box allows the examiner to code and specify a condition NOT identified in the above codes. An example may be a vertically fractured tooth
All bridge abutments are coded 18

27. Tooth13- Code 18 Bridge Abutment

28. Code 20

29. Code 20 Restoration not for caries

30. ***Talk to the respondent to assist in your decision
Code Hierarchy
Use the Codes in this order:
Sound or Sound and Sealed
Caries
Restorations for Caries
Restorations for Trauma
Restorations for Aesthetics
e.g. Tooth has restorations for trauma, aesthetics and caries – use caries codes
***Talk to the respondent to assist in your decision
Caries is trump whenever present use the caries codes.
Caries trumps sealants