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Indices Used for Assessment

of Dental Caries

Permanent teeth index


DMF index

Decayed Missing Filled (DMF)


It was developed by Klein, Palmer and
Knutson in 1938 and modefide by WHO in
1987 to determine the prevalence and
control of dental caries
DMF Teeth index (DMFT)
DMF Surface index (DMFS)

ADVANTAGES

Simple
Rapid
Multipurpose
Universally accepted

BASIS OF INDEX
The index is based on the fact that
the dental hard tissues are not self
healing and established caries leaves
a scar of some sort.
The tooth either remains decayed
or if treated, it is extracted or filled.
The DMFT index is therefore an
irreversible index , measuring the life
time experience

PROCEDURE
D

Represent decayed teeth


Includes:
- Carious teeth
- Filled teeth with recurrent decay
-Temporary filling

M Represent missing teeth due to


caries
Excluded cases:
Teeth extracted for reasons other than dental
carie
orthodontic treatment
impaction.
Periodontal disease.

Un-erupted teeth
Congenitally missing and supernumerary teeth
Avulsed tooth due to trauma
Primary tooth retained with permanent successor
erupted.

F Represent filled teeth due to


caries
Excluded cases:
Teeth restored for other than caries:
Trauma
Cosmetic purposes
Use of bridge abutment.
Preventive restoration e.g. fissure
sealant

INSTRUMENT USED
- Mouth mirror
- Periodontal probe
- All permanent teeth should be
examined.

The criteria for identification of dental caries are:

- The lesion is clinically visible and obvious


- There is discoloration and loss of
translucency
typical of undermined or demineralized
enamel
- The explorer tip in a pit or fissure catches or
resists removal after moderate to firm
pressure
on insertion and when there is softness at
the
base of the area

Recording Format for DMFT


index

17 16 15
26 27

14

13

12

11

21

22

23

24

25

47 46 45
37 38

43

42

41

31

32

33

34

35

36

D=
=

M=

F=

DMFT Score

Individual and Average DMFT


Total D + M + F = DMF
For example: DMF score of 3 (D) + 2 (M) +
5 (F) = 10
For an individual means that 3 teeth are
decayed, 2 teeth are missing, and 5
teeth have fillings.
Furthermore we can say that: 32 10 = 22
are sound
Average or mean DMFT =
examined

Total DMF
Total number of subject

Principles and rules in recording DMFT


No tooth must be counted more than once. It is
either decayed, missing, filled or sound.
A tooth may have several restorations but it is
counted as one tooth.
Deciduous tooth are not included in DMF count
A tooth is considered to be erupted when the
occlusal surface or incisal edge is totally exposed
or can be exposed by gently reflecting the
overlying gingival tissue with the mirror or
explorer.
A tooth is considered to be present even though
crown has been destroyed and only the roots are
left

Limitation of Index DMFT


1. Not related to the number of teeth at risk.
2. Can be invalid in older adults because teeth
can become lost for reasons other than caries.
3. Can be misleading in children whose teeth
have been lost due to orthodontic reasons.
4. Can overestimate caries experience in teeth in
which preventive fillings have been placed.
5. Little use in studies of root caries.
6. Equates a disease state with a healthy state by
assigning the same score for a decayed tooth
as well as for a filled healthy tooth

DMFS index
Surfaces examined in DMFS:
1.

For posterior teeth:


5 surfaces: Facial, lingual, mesial, distal and
occlusal

2. For anterior teeth:


4 surfaces: facial, lingual, mesial and distal
D Caries surface of tooth
F Filled surface of tooth due to caries
M Missing tooth surfaces due to caries

Recording Format for DMFS


index

17 16 15 14
25 26 27

13

12

11

21

22

23

24

47 46
36 37

42

41

31

32

33

34

35

45 43
38

D=
M=
Score =

F=

DMFS

Calculation of DMFS index:


32 teeth are examined last molars are
excluded
20 posterior teeth (20 x 5) = 110
surfaces
12 anterior teeth (12 x 4) = 48 surfaces
Total 128 surfaces

Advantages of DMFS Index


DMFS index is more sensitive and is
usually the index of choice in a
clinical trial of a caries preventive
agent.

Limitations of Index DMFS


1. DMFS examination takes longer
2. Is more likely to produce
inconsistencies in diagnosis
3. May require the use of radiographs
to be fully accurate
Instrument used:
Mouth mirror and perio probe

Caries indices for primary teeth


dmft/dmfs-
deft/defs-
The def index was described by
Gruebbel in 1944
d = decayed tooth
e = extracted tooth
f = filled tooth
Basic principles and rules are same like
. DMF index