Gingival and Oral Hygiene

Indices
 Gingival Index (Löe and Silness,
1963)
 The Gingival Index (Löe and
Silness, 1963) was created for the
assessment of the gingival condition
and records qualitative changes in
the gingiva. It scores the marginal
and interproximal tissues separately
on the basis of 0 to 3.
The criteria are:
 0= Normal gingiva;
 1= Mild inflammation – slight change in
color and slight edema but no bleeding on
probing;
 2= Moderate inflammation – redness,
edema and glazing, bleeding on probing;
 3= Severe inflammation – marked
redness and edema, ulceration with
tendency to spontaneous bleeding.
 The bleeding is assessed by probing gently
along the wall of soft tissue of the gingival
sulcus.
 The scores of the four areas of the tooth
can be summed and divided by four to
give the GI for the tooth.
 The GI of the individual can be obtained
by adding the values of each tooth and
dividing by the number of teeth examined.
 The Gingival Index may be scored for all
surfaces of all or selected teeth or for
selected areas of all or selected teeth.
 The GI may be used for the assessment
of prevalence and severity of gingivitis in
populations, groups and individuals. A
score from
 0.1-1.0 = mild inflammation;
 1.1-2.0 = moderate inflammation
 from, and
 2.1-3.0 signifies severe inflammation.
 Sulcus Bleeding Index (SBI)
Muhlemann and Son, 1971
An early sign of gingivitis is bleeding on probing and,
in 1971, Muhlemann and Son described the Sulcus
Bleeding Index (SBI).
The criteria for scoring are as follows:
 Score 0 – health looking papillary and marginal gingiva
no bleeding on probing;
 Score 1 – healthy looking gingiva, bleeding on probing;
 Score 2 – bleeding on probing, change in color, no
edema;
 Score 3 – bleeding on probing, change in color, slight
edema;
 Score 4 –bleeding on probing, change in color, obvious
edema;
 Score 5 –spontaneous bleeding, change in color,
marked edema.
 Four gingival units are scored
systematically for each tooth: the labial
and lingual marginal gingival (M units)
and the mesial and distal papillary
gingival (P units).
 Scores for these units are added and
divided by four.
 Adding the scores of the undivided teeth
and dividing them by the number of teeth
can determine the sulcus bleeding index.
Oral Hygiene Index (Greene and Vermilion, 1960)

 The Oral Hygiene Index is

composed of the combined
Debris Index and
Calculus index, each of
these index is in turn based
on 12 numerical
determinations representing
the amount of debris or
calculus found on the buccal
and lingual surfaces of each
of three segments of each
dental arch, namely
 The segment distal to the
right cuspid (see picture).
 The segment distal to the
left cuspid.
 The segment mesial to the
right and left first bicuspids.
 Each segment is examined for
debris or calculus. From each
segment one tooth is used for
calculating the individual index, for
that particular segment. The tooth
used for the calculation must have
the greatest area covered by either
debris or calculus.
Criteria for classifying debris and
calculus
 Debris Index = (The total of the upper
and lower buccal-scores) + (The total of
the upper and lower lingual-scores) /(The
number of segments scored).
 Calculus Index = (The total of the upper
and lower buccal-scores) + (The total of
the upper and lower lingual-scores) /
(The number of segments scored).
 The average individual or group debris
and calculus scores are combined to
obtain Oral Hygiene Index.
 Simplified Oral Hygiene Index
(Greene and Vermillion, 1964)

 The Simplified Oral Hygiene Index (OHI-

S) differs from the original OHI (The Oral
Hygiene Index) in the number of the
tooth surfaces scored (6 rather than 12),
the method of selecting the surfaces to be
scored, and the scores, which can be
obtained. The criteria used for assigning
scores to the tooth surfaces are the same
as those use for the OHI (The Oral
Hygiene Index).
 The OHI-S, like the OHI, has two
components, the Debris Index and
the Calculus Index. Each of these
indexes, in turn, is based on
numerical determinations
representing the amount of debris
or calculus found on the preselected
tooth surfaces.
 The six surfaces examined for
the OHI-S are selected from
four posterior and two anterior
teeth.
 In the posterior portion of the
dentition, the first fully erupted
tooth distal to the second
bicuspid (15), usually the first
molar (16) but sometimes the
second (17) or third molar
(18), is examined. The buccal
surfaces of the selected upper
molars and the lingual surfaces
of the selected lower molars are
inspected.
 In the anterior portion of the
mouth, the labial surfaces of
the upper right (11) and the
lower left central incisors (31)
are scored. In the absence of
either of this anterior teeth, the
central incisor (21 or 41
respectively) on the opposite
side of the midline is substitted.

 Debris Index = (The buccal-scores) +
(The lingual-scores) / (Total number of
examined buccal and lingual surfaces).
 Calculus Index = (The buccal-scores) +
(The lingual-scores) / (Total number of
examined buccal and lingual surfaces).
 The average individual or group debris
and calculus scores are combined to
obtain simplified Oral Hygiene Index.