Spread of caries. Assessment and registration of the condition of hard dental tissues

To assess the hygienic state of the oral cavity, there are various dental indices. In total, there are about 80 of them. All of them help to evaluate the microflora oral cavity and position of periodontal tissues.

KPU index

KPU index in modern dentistry shows the degree of damage to teeth by carious deposits. K – total number of carious teeth, P – filled, U – removed. In total, this index shows the dynamics of carious processes. There are such types of KPU:

• KPUz - carious and filled;
• KPUpov - dental surfaces affected by the carious process;
• KPUpol – cavities with caries and filling material located in the oral cavity.

These indexes have the following negative sides:

• they take into account the number of cured and deleted ones;
• KPU reflects the past dynamics of caries disease and only increases with the patient’s age;
• the index does not take into account only the beginning manifestations of caries.

The KPU has such a disadvantage as unreliability when the number of affected teeth increases due to caries, fallen fillings and other similar situations.

How common dental caries is is usually determined as a percentage. They take a certain group with carious formations, divide by the number of people in the group and multiply by 100%.

To compare the prevalence of caries by region or region, use the following diagram, built on the basis of indicators of children aged 11 to 13 years:

Intensity level

• low – 0-30%
• average – 31-80%
• high – 81-100%

To determine the dynamics of the development of carious formations, dentists are guided by the following indices:

• dynamics of carious formations on temporary ones:

1. KPU(z) - teeth affected by carious formations + filled;
2. KPU(p) - surfaces affected by carious formations + filled surfaces;

• dynamics of carious formations on permanent ones:

1. KPU(z) - carious, filled and extracted teeth;
2. KPU(p) - surfaces with carious formations + filled.

When determining data, carious lesions that look like a pigmented spot are not taken into account.

• dynamics of carious lesions in the population: in order to compare the intensity of caries development in different regions, areas, average values ​​of the CP should be used.

CPITN Index

The CPITN index in modern dentistry is used in dentistry to track periodontal diseases. This indicator evaluates those factors that can be reversed (gum inflammation, tartar formation, for example). CPITN does not take into account changes that cannot be reversed (tooth mobility, deterioration of gums). CPITN does not help determine the activity of the change and does not help guide treatment.

The most important advantage CPITN - provides a lot of information on the basis of which results are derived. The need for treatment is based on codes such as:

Other indexes

There are others hygienic indices in modern dentistry. They also allow you to assess the patient’s oral hygiene and understand whether he needs treatment and prevention.

The PMA index in modern dentistry stands for: papillary-marginal-alveolar. It is used by dentists to evaluate gum disease. In this formula, the number of teeth directly depends on age characteristics:

• 6-11 years – 24 teeth;
• 12-14 – 28;
• 15 and more – 30.

At normal conditions RMA should be equal.

The Fedorov-Volodkina index allows you to determine how well a person monitors the condition of the oral cavity. It is most often used for children under 7 years of age. To correctly calculate this indicator, it is necessary to examine the surface of 6 teeth, stain them with calcium iodine solution and measure the amount of plaque. The stone is detected using a small probe. The index is calculated from all the values ​​for the components divided by the surfaces examined, and finally both values ​​are summed.

The RHR (Oral Hygiene Index) is popular among dentists. To correctly calculate it, you should stain 6 teeth to detect plaque. The calculation is carried out with the definition of codes. Then they are summed and divided (into in this case) by 6.

To assess the bite, an aesthetic dental index is needed, which determines the location of the teeth in three anatomical directions. It can only be used when the patient reaches the age of 12 years. Examination of the oral cavity is carried out visually and using a probe. To determine the index, you need to determine components such as missing teeth, crowding and spaces between incisors, deviations, overlaps, diastemas, etc.

This index is good because it analyzes each of the components separately and allows you to identify various anomalies.

Each of these indices is important, as it makes it possible to detect developmental abnormalities, identify the level of hygiene in each individual person, and begin treatment on time.

To keep your mouth healthy, you need to carefully and constantly get rid of dental plaque. Residues of food and plaque can be removed at home using basic brushing and toothpaste. Mineralized deposits should be removed at the dentist's office every six months to prevent the development of tartar. At the same time, a full examination of the oral cavity should be carried out for the presence of caries and other unpleasant diseases. Don't forget about regular visits to the dentist and enjoy well-groomed teeth.

The intensity and prevalence of caries are considered the main sources of statistics for this disease. Data are regularly collected on the frequency and speed of progression of the disease for all age groups patients, depending on the influence of external and internal factors on their dental system. Thanks to the quantitative recording of disease outbreaks, scientists can conduct scientific research, and dentists can carry out preventive and therapeutic work in the fight against caries.

For dentistry, caries is considered a pressing problem that has to be dealt with every day. However, working with the disease separately, it is impossible to achieve positive results in the form of a reduction in mass outbreaks of lesions. This is why disease statistics are kept all over the world.

The collected data helps not only to increase the professional level of dentists, but also to implement into practice latest methods diagnosis and treatment. As a result, dental caries statistics help improve the quality of care dental services.

To establish a diagnosis, the dentist interviews the patient and records all information in a medical card– the main document for recording the work of a doctor. When treatment ends, the card remains with the dentist for five years, then is archived for 75 years. Thanks to a well-coordinated storage system, it is possible to track and collect statistical data on the development of caries at any time.

Main tasks of statistics

Dental research relies on statistical data on caries, its prevalence, intensity and duration in different patients. When collecting information, the following tasks are set:

• studying the mechanism of origin and development of the disease in its individual manifestations;
• studying the origin of the disease in general: the conditions and causes of its occurrence;
• division of the population according to the degree of risk of developing the disease;
• drawing up future forecasts of the development of the disease for planning preventive care and adequate provision of dental services to the population;
• assessment of the effectiveness of created preventive and therapeutic methods;
• determining the degree of development of the disease in the examined group of patients in order to correct errors that have appeared and plan new directions in methods of prevention and treatment.

Important indicators when collecting information

When conducting mass examinations, dentists take into account, first of all, the age of the patients. Children have different susceptibility to caries, and they also have two types of teeth: temporary and permanent. It is known that baby teeth are more susceptible to caries. Accordingly, children belong to a separate, pediatric group of patients. In addition to this age group, there is a group of adults, consisting of three subgroups: young (adolescent) age, middle and old.

The next point when collecting information on the spread of caries is external and internal factors influence. This includes the patient’s place of residence: is the climate suitable for his health, is there enough sunlight, is it present in drinking water the required amount of minerals, micro and macroelements.

The patient's diet also plays a role. important role in the appearance of dental damage. An unbalanced diet is the cause of a deficiency of vitamins and minerals in the body. As a result, a person’s immunity weakens, often causing illness. Other causes of the disease can be found in the article.

Prevalence of the disease

According to the list of terms used by WHO - the World Health Organization, four main parameters are used to assess dental damage: the intensity of dental caries, its prevalence, increase and decrease in intensity over a specific period of time.

Disease prevalence is a calculation of a certain ratio, expressed as a percentage. The calculations take the number of patients in whom at least one sign of tooth damage was noticed during examination, and the number of all patients examined. Formula for calculating the required number: ((patients with caries)/(total number of patients examined))×100%.

The incidence of caries depends on the result obtained: up to 30% - low, from 31% to 80% - average, more than 80% - high.

In some cases, a term is used that is more suitable in meaning for the purposes of statistics of the manifestation of the disease - patients without caries. As a result, the inverse prevalence indicator is calculated according to the formula: ((patients without caries)/(total number of examined patients))×100%.

A low level of disease prevalence means that patients without caries make up more than 20% of the total percentage of those examined, medium – from 5% to 20%, high – up to 5%.

Conservative, sedentary parameter

In each region, research results are used to a limited extent, only to improve the level of preventive measures against caries. All obtained indicators of the prevalence of the disease are compared with each other in different regions, aiming at mass eradication of the problem.

This state of affairs is associated with the specifics of the disease - if a person begins to have dental damage, he will forever remain in the group of patients. Even if it was a long time ago, and caries was stopped or cured. Accordingly, disease prevalence is a sedentary, routine parameter. That is why assessing the effectiveness of preventive measures is only possible by comparing large groups patients different ages and with different places of residence.

Disease intensity

To solve statistical problems, it is necessary to take into account not only the fact of the development of the disease. To improve the level of dental services, an assessment of the intensity of caries is needed.

To calculate the degree of intensity of the disease, scientists from WHO came up with a special index of the sum of damaged teeth - SPU, where K - teeth affected by caries, P - filled teeth, U - teeth removed. The intensity of dental caries is calculated according to the formula: ((K+P+U)/(total number of surveyed)).

Children with temporary (baby) teeth are given the index kp, where k is teeth affected by caries, p is filled teeth. For children whose temporary teeth are being replaced by permanent ones, the intensity of the disease is calculated using the KPU+KP index.

In mass studies of the intensity of the disease in children, it begins to be calculated from about 12 years of age, when the replacement of temporary teeth with permanent ones has ended. Such restrictions are considered the most informative, since the level of caries damage to primary teeth is a relative concept and not a constant one. WHO identifies five degrees of disease intensity, which can be found in the table:

Intensity waxing and waning

The increase in caries activity is studied for each patient individually. Dentists are researching how much healthy teeth the disease struck within a certain period of time. Typically, the doctor examines the patient every two to three years, in case of sudden deterioration - every three to six months.

The increase in morbidity is the difference in the indicators of the PCI index between the last examination of the patient and the previous one. Thanks to these studies, the dentist can plan a treatment method and a method of prevention based on the needs of each patient.

Based on this, scientist T.F. Vinogradova identified three types of disease development activity, which can be found in the article.

If prevention and treatment help, the activity of caries lesions begins to weaken - the disease is reduced. This information is measured using the formula: ((Mk-M)/Mk))×100%.

Mk – increase in the disease in patients before preventive and therapeutic work, M – increase in disease after dental procedures.

Degree of provision of dental services to the population

In certain areas serving the population, the following indicators of the provision of dental services are studied:

• the number of people who sought help;
• availability of services;
• providing dentists with jobs;
• the ratio of the number of dentists to the number of people living in a particular area;
• providing the population with dental chairs.

During large-scale studies of the provision of dental services to the population, several groups of patients are simultaneously examined in certain regions, each of which must contain at least 20 people. Formula for identifying the level of dental care (USL): 100%-((k+A)/(KPU))×100, where k is the average number of teeth affected by caries, without treatment, A is the average number of teeth removed without restoration of their functions with the help of dentures. If the indicator is more than 75%, then the USP is good, 50%-74% is satisfactory, 10%-49% is insufficient, and less than 9% is bad.

Tell us in the comments how the quality of dental services is in your city?

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As already noted, caries progresses over life (as a rule). Programs primary prevention pursue the goal of reducing (ideally stopping) the progression of caries (over time). For an objective quantitative assessment of the progression of caries over time, the concept of caries growth (ΔCAI) is used. It is calculated as the difference between the final and initial values ​​of the KPU (kp)

ΔKPU = KPU 2 – KPU 1,

where KPU 2 was registered some time (a year, two or more) after registration of KPU 1.

Typically, ΔCPU is calculated in a group or population.

The effectiveness of two prevention methods can be assessed by comparing ΔCP in two groups:

Example: in group A, over the course of a year, the average value of the LPC changed from 4.0 to 5.5, and in group B (during the same time) from 4.0 to 5.0,

Increase in CPU:

ΔKPU A = 5.5-4.0 = 1.5

ΔKPU B = 5.0-4.0 = 1.0

The prevention program in group B turned out to be more effective: the increase in caries in this group was 1.5 times lower than in group A.

Reduction of caries. This indicator is calculated to compare the increase in caries in various groups, as a relative value and is expressed as a percentage.

Example: in group A, a comprehensive preventive program was carried out and ΔCPA A = 1.0 was obtained.

In group B, they limited themselves to health education work and received ΔKPU B = 2.5 during the same time.

The maximum increase is in group B, and this value is taken as 100%. Next, determine what part of ΔCPB B was the increase in group A:

ΔKPU B = 2.5 100%

ΔKPU A = 1.0 x%

X% = 1.0/2.5 x 100% = 40%

It can be seen that in group A there is an increase of only forty percent of caries from the possible (judging by group B) level of increase.

Reduction – this is the proportion of “prevented”, “failed” increase in caries in the group from the possible maximum:

Reduction = 100% - 40% = 60%

In this case, they say that the program carried out in group A provided a reduction of caries equal to 60%.

Caries prevalence rate and its interpretation

Using Data dental examinations, you can calculate how often in the surveyed group there are persons who have a KPU (kpu, KPU+kp) greater than zero. Prevalence is the proportion of people suffering from caries out of the total number of people surveyed.

Example: there are 100 people in a group, 90 of them have KPU>0.

The prevalence is:

90 people/100 people x 100% = 90%

WHO draws attention to the proportion of people “free” from caries (in this example = 10%) and offers the following interpretation of the caries prevalence rate in 12-year-old children:

The prevalence of dental caries in a group over time may:

1) save

2) increase (due to an increase in caries in the same individuals or due to the renewal of the group by less caries-resistant individuals)

3) decrease (due to the physiological change of teeth in the same individuals or due to the renewal of the group by individuals who do not have caries).

SITUATIONAL TASKS

1) In the 5th grade, a dental examination and treatment was carried out on 20 children. 5 children with KPU-0 were identified. The remaining 15 children were found to have 30 teeth with fillings. 20 teeth with average caries, 5 teeth with pulpitis, 3 teeth with periodontitis and 2 teeth to be removed. Calculate and evaluate the intensity and prevalence of caries in the group.

2) In group A it was carried out preventative work, in group B – no. Before the start of prophylaxis, the CP in groups A and B was 3.5. A year later, in group A, the KPU was 4.0, and in group B – 5.0. Assess the effectiveness of preventive work.

Homework:

1. Create a diary of practical skills.

Literature:

Main

1. Lecture material

2. P.A.Leus. Community dentistry. – Moscow, 2001

3. V.G.Suntsov, V.A.Distel. Dental prophylaxis in children. – Moscow, 2001

Additional

Dental examination. – WHO, Geneva, 1989

Assistants:

Liora A.K.

Kolechkina N.I.

1

The article presents the results of a dental examination of 625 children living in the city of Ufa. The survey used a questionnaire for parents, which included questions about awareness of oral hygiene issues, risk factors for dental diseases, and diet. The results of epidemiological dental surveys indicate a fairly high (according to WHO criteria) prevalence of caries, both temporary and permanent teeth 6, 12 and 15 year old children of the city of Ufa, high prevalence of periodontal diseases and dental anomalies. As a result of the dental examination and questionnaire, a high prevalence of major dental diseases in children was established, low level dental education of parents, which requires improvement of existing preventive measures for this population group.

prevalence

periodontal diseases

dental anomalies

survey

oral hygiene

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The main task of the state and, first of all, its healthcare services is to ensure the health of the nation, organize and implement the most effective programs prevention of the main and most common diseases.

Dental status is one of the main indicators general condition body, and the development of a system of measures aimed at reducing dental morbidity rates should be an integral part of programs for improving the health of the nation.

The dental aspect of public health is characterized by two main indicators - prevalence and intensity, reflecting quantitative signs of diseases of the teeth, gums, level of hygiene, etc.

Currently, dental morbidity in our country among the child population is quite high, and further deterioration should be expected unless the conditions influencing the development of oral diseases are changed in a favorable direction and the quality of dental care, which depends on many objective factors, is not improved. and subjective factors.

One of current problems healthcare are issues of assessing the quality of dental care to the population. This is especially true for the provision of dental therapeutic assistance children, in particular in the treatment of such common diseases as dental caries and periodontal disease. When assessing the quality of dental care, environmental and epidemiological factors must be taken into account.

Identification and elimination of etiological factors, targeted impact on the stages of development of pathology, allows you to obtain the maximum therapeutic and preventive effect, and, therefore, will have a positive impact on the quality of dental care.

At the same time, conducted in various cities of Russia epidemiological studies show an increase in the prevalence and intensity of dental caries depending on age and epidemiological situation.

An epidemiological survey of the child population is the main point in the analysis of dental morbidity, which is necessary to compare morbidity in different regions, determine the quality of dental care, plan preventative treatment programs and evaluate their effectiveness. The main goal of prevention is to eliminate the causes, conditions for the occurrence and development of diseases, as well as increase the body’s resistance to adverse factors. environment.

The purpose of the study was a study of the dental status of children living in the city of Ufa, with the aim of improving the quality of dental care.

Material and methods of examination

To assess the condition of teeth, the indicators recommended by the WHO expert committee were used.

The prevalence of dental caries was determined using the formula:

Number of people with caries

Prevalence = ———————————————— x 100%

Total number of examined

The intensity of dental caries during the period of temporary dentition was determined using the KP index, during the period of mixed dentition using the KP+KPU index, and during the period of permanent dentition - KPU. To assess the prevalence and intensity of dental caries in children aged 12 years, we used the criteria recommended by the WHO Regional Office for Europe (T. Martthaller, D. O'Mullane, D. Metal, 1996).

The condition of periodontal tissues was studied using the periodontal index KPI (Leus P.A., 1988). The hygienic state of the oral cavity in children was assessed using the Fedorov-Volodkina index and the simplified oral hygiene index (IGR-U) (J.C. Green, J.R. Vermillion, 1964). Anomalies of teeth, dentition, jaws and occlusion were considered according to the classification of the Department of Orthodontics and Children's Prosthetics of the Moscow State Medical and Dental University (1990).

The survey used a questionnaire that included questions about children’s awareness of oral hygiene, risk factors for dental diseases, and diet.

Results and discussion

The overall prevalence of caries in primary teeth in 625 children aged 6–15 years was 57.86±1.56%, the intensity of caries in primary teeth was 2.61±0.6. The overall prevalence of caries in permanent teeth in 625 children aged 6 to 15 years was 71.45±1.31 %, and the intensity of caries of permanent teeth is 2.36±0.52. At 6 years of age, the prevalence of caries in primary teeth was 92.19%±2.94. At the age of 12 years, it was 16.4±3.18 %, and at 15 years old it is 4.02±1.92%. A different trend was observed in the prevalence of caries in permanent teeth: from 6 to 15 years of age there was a gradual increase in the process, so if at 6 years the prevalence was 18.64±3.75%, then by 12 years it was 84.28±3.27%, which corresponds to a high prevalence of dental caries. By the age of 15, the prevalence reaches its maximum value - 88.21±3.3%.

Table 1 shows average data on the prevalence and intensity of caries in permanent teeth among key age groups in the city of Ufa.

Table 1

Prevalence and intensity of caries in permanent teeth among key age groups in children in the city of Ufa (according to WHO criteria)

Analysis of the survey results shows that with age there is a tendency for caries of permanent teeth to increase - from 18.64±3.75% among 6-year-olds to 88.21±3.3% among 15-year-olds. In 12-year-old children, the average intensity of caries in permanent teeth is 2.83±1.58. In the structure of the KPU index in 12-year-old children, the “U” component (teeth removed due to caries and its complications) appears, which increases with age; the “K” component (caries) predominated, which was equal to 1.84 ± 0.14, while the “P” component (filling) is only 0.98 ± 0.09. At the age of 15, the “P” component predominates and is equal to - 2.25 ± 0.15, and component “K” - 1.67 ± 0,13. Among the identified dental disorders, periodontal diseases occupy second place. Analysis of the results shows a high prevalence of periodontal diseases, which increases with age. 53.44% of 6-year-old children show signs of periodontal disease. In 12-year-old children, the prevalence of periodontal disease is 80.28%. 19.72% of children are at risk of the disease. The intensity of periodontal lesions in 12-year-old children was 1.56. Among 15-year-old children, the prevalence rises to 85.5%. 14.5% have a risk of developing the disease. The intensity of periodontal diseases increases to 1.74. 65.26% of 12 year old children have mild degree periodontal lesions and need training in the rules of oral hygiene, 15.02% of children have an average degree of periodontal lesions, and these children need professional hygiene oral cavity. Among 15-year-old children, these values ​​are 66.0% and 19.5%, respectively.

The average value of the Fedorov-Volodkina index in the temporary dentition of 6-year-old children was assessed as an unsatisfactory level of oral hygiene.

The average value of the Green-Vermillion index in children in the mixed dentition was 1.48, in the permanent dentition - 1.56. Also for children both in shift work and in permanent dentition increased deposition of tartar was noted.

When examining children in the city of Ufa, the age-specific dynamics of the prevalence of dental anomalies and deformities were studied. At the age of 6 years, the lowest prevalence of 40.05 ± 2.56% of anomalies in the dental system was found. Growth continues up to 12 years, where the maximum prevalence of dentoalveolar anomalies and deformities was found to be 77.20 ± 2.75%. At 15 years of age there is a slight decline to 75.50±3.01%. We compared the prevalence of dental anomalies and deformities between boys and girls. The overall prevalence for girls was 71.63±1.23%, and for boys 68.21±1.42% (P>0.05); there were no significant differences in the prevalence of pathologies in the dental system in boys and girls. When studying age-related dynamics in boys and girls, no significant differences were revealed (Table 2).

table 2

Prevalence of dental anomalies and deformities depending on gender in children living in the city of Ufa

We conducted a survey of 614 parents of schoolchildren living in the city of Ufa in order to determine the level of sanitary and hygienic knowledge, frequency and reasons for applying for dental care, medical activity in the prevention of dental diseases.

When asked at what age it is necessary to brush a child’s teeth, only 18.79% of parents answered that teeth should be brushed from the moment teeth emerge. 39.24% - believe that teeth need to be brushed from 2 summer age, 25.44% - from the age of 3, 20.53% of the parents surveyed answered that teeth should be brushed from the age of 4 and older.

Of the answer options proposed in the questionnaires regarding the hygiene products used by the child, 99.52% of the surveyed parents indicated that they use a toothbrush and toothpaste, of which 45.93%, in addition to basic hygiene products, use additional products (chewing gum, mouthwash, toothpicks, floss). 0.32% of children do not brush their teeth. Oral care is carried out twice a day by 51.14% of children, once a day by 47.55%, after each meal by only 0.98%. 0.33% of children brush their teeth occasionally.

As for the frequency of visits to the dentist by a child, 23.62% visit the dentist once every six months or more often, 2.26% of people answered that they do not visit the dentist at all. The majority of parents, 55.66%, go to the dentist when their child has a toothache. Once a year - 16.69%, once every two years only 1.77% of respondents.

The information we received about preventive measures has a certain theoretical and practical interest. 51.27% of the surveyed parents answered that the dentist did not tell them about the need for preventive measures for the child, the remaining 48.78% of the parents answered that yes, the dentist did.

66.19% of people believe that their child needs measures to prevent dental diseases, 17.7% of parents answered no, and 16.19% do not know. 77.72% of parents are ready to participate in activities to prevent dental diseases, the remaining 22.28% are not. 33.38% of parents always follow the doctor’s recommendations for the prevention of dental diseases, 47.59% do not always fully and not always in a timely manner, 9.05% do not have enough time, 8.84% do not have enough money for effective means oral hygiene, 0.78% of parents believe that the doctor is not competent enough, and 0.35% do not believe in prevention. When asked which methods of health education you trust most, the answers were distributed as follows: an individual conversation with a doctor - 88.76%, television and radio programs - 2.83%, 4.74% - read literature and health bulletins, 3.68% listen to lectures by specialists at the clinic.

Thus, we have identified a low level of sanitary and hygienic knowledge among parents, insufficient medical activity of parents regarding the preservation of dental health in the child, and insufficient work by dental doctors on hygiene education and health education of the population on the prevention of dental diseases. On the other hand, it was revealed high level public trust in information received from dentists. The dentist must know about oral hygiene products and be able to give recommendations on the right choice and the use of products, in accordance with their dental status, is obliged to instill in patients a motivated attitude towards oral hygiene as an integral part of the health of the body.

Thus, the high prevalence of major dental diseases requires the modernization of existing preventive programs for organized groups of the population.

Bibliographic link

Averyanov S.V., Iskhakov I.R., Isaeva A.I., Garayeva K.L. PREVALENCE AND INTENSITY OF DENTAL CARIES, PERIODONTAL DISEASES AND DENTAL ANOMALIES IN CHILDREN OF THE CITY OF UFA // Contemporary issues science and education. – 2016. – No. 2.;
URL: http://site/ru/article/view?id=24341 (access date: 01/05/2020).

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Dental health affects the entire body. Ways to prevent problems are regular hygiene and periodic visits to the doctor. The dentist will analyze the health of the mucous membranes, gums, and crowns using hygiene indices that quantitatively show the degree of the disease and help control the degree of its development.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from Crimean Medical University. Institute in 1991. Specialization: therapeutic, surgical and orthopedic dentistry including implantology and implant prosthetics.

Ask a question to an expert

I believe that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then treatment may indeed not come to the point - it won’t be necessary. Microcracks and small caries on teeth can be removed with regular toothpaste. How? The so-called filling paste. For myself, I highlight Denta Seal. Try it too.

Hygiene indices are data that evaluate enamel contamination, the presence of bacteria, hard plaque, show the number of healthy crowns, and also the number of crowns partially or affected by carious lesions. Based on the final figures, the doctor will determine the stage of destruction of the teeth, the thoroughness of cleaning, tissue and bite problems, and the effectiveness of the prescribed treatment.

For each type of lesion of the jaw and gum units there are special assessment parameters, which we'll talk below.

Types of CPU

The basic indicator taken into account by the dentist is PU. He talks about the intensity of dental caries. The following data is assessed:

• K – foci of identified areas of caries;
• P – fillings;
• U – extracted teeth.

In total, the information shows how intensively caries spreads:

• KPU cavities - the number of cavities as a result of filling, caries;
• KPU of existing surfaces – number of external areas damaged by caries;
• KPU of teeth – number of affected, filled teeth.

KP is used for baby teeth, where the letter K stands for caries, P stands for filled teeth. In children, fallen out or extracted milk teeth are not taken into account.

KPU assessment

To determine the level of caries developing in the mouth, 3 indicators are used, obtaining a percentage. For calculations, take the number of patients with caries, divide by the total number of subjects, then multiply by 100. Comparing the health of people regionally, they examine 12-year-old patients. The obtained data on the prevalence of caries are interpreted as follows:

• less than 30% – low;
• 30-80% - average;
• 80-100% - high.

The strength of infection is determined by the number of teeth affected by caries. Receive 5 degrees. In 12-year-old patients, the degree is:

• less than 2.6 – very low;
• 2.6-4.4 – moderate;
• 4.4-6.4 – high;
• more than 6.5 - very high.

In 35-year-old patients, the degree is:

• less than 1.5 – very low;
• 1.5-6.2 – low;
• 6.2-12.7 – moderate;
• 12.7-16.2 – high;
• more than 16.3 – very high.

An increase is a change in values ​​during subsequent examinations of the patient for the worse. Thanks to this assessment, the level of current health is studied and an individual treatment regimen is prescribed.

Disadvantages of the CPU

In addition to the obvious benefits, the CPU has disadvantages. They are as follows:

• the summarized picture is influenced by the past dynamics of caries distribution, which increases with age;
• calculations take into account both treated and extracted teeth;
• the initial stages of caries are not taken into account.

Taking into account the nuances of the assessment above, the results of the CPA do not give the doctor a reliable picture of the health of the oral cavity, since over time, fillings fall out, further pockets of caries appear, and when the data is summarized with past examinations, the final picture becomes less/highly distorted.

Periodontal indices

Information about the condition of the periodontium visualizes the dynamics of gum infection - the spread of existing pathology, the depth of the lesion, and monitors the success of treatment. Data are presented that allow us to obtain a picture of the condition of the periodontium. During one visit to the dentist, you can undergo examination using several methods, which will give a complete picture.

Papillary-marginal-alveolar index (pma)

This is one of the main tests. Detects gingivitis, its duration, depth. The doctor will note problematic points in the patient’s mouth, fill out the sheet with points, noting the identified location of the lesion:

• 1 - papilla affected;
• 2 - marginal gum inflamed;
• 3 - problem with the alveolar gum.

Based on the final calculations, the average number is derived, identifying the stage of gingivitis:

• up to 30% - light;
• 30-60% - average;
• more than 60% - severe.

Periodontal index (PI)

Signs of gingivitis, as well as its degree. The dentist assesses the presence of mobility, destruction bone tissue, periodontal pockets, giving points:

• 0 – no lesions;
• 1 – unilateral mild inflammation;
• 2 – the tooth holds well, but is surrounded by inflammation;
• 4 – x-ray reveals resorption of the apices of the septa;
• 6 – if there is a pocket, the tooth does not hurt, it holds firmly;
• 8 – tissues are destroyed, the tooth is shaky and moves.

• less than 1.5 – first;
• 1.5 - 4 - second;
• 4 - 8 - third.

The indicator signals the need to treat periodontal diseases. The mucous membranes around the teeth of both jaws are subject to examination. The specialist examines with a probe, identifying hard plaque, pockets, and bleeding. The results are displayed in numbers:

• 0 – no problem;
• 1 – due to the action of the instruments used during the test - blood;
• 2 – there is a stone;
• 3 – presence of a periodontal pocket of 5 mm;
• 4—presence of a periodontal pocket larger than 6 mm.

For each checked unit, the points are summed up, after which the entire amount will be divided by 6, obtaining the numbers:

• 0 – no need to treat;
• 1 – cleaning required, regular visit dentist;
• 2-3 – professional cleaning is required;
• 4 – the need for complex therapy.

Measuring pocket depth

The presence of pockets is a clear symptom of periodontitis. They are not only inconvenient while eating, but become a source of unpleasant odor, because leftover food rots inside. The severity of inflammation is indicated by the depth of the pockets. The measurement is carried out with a probe, lowered into a pocket and observing the scale. A depth of up to 2 mm is considered normal. With initial gingivitis - 3.5 mm, average - more than 4 mm, and if more than 5 mm - significant inflammation and deformation are diagnosed.

It is an average number indicating periodontal damage in the subjects. Tests are carried out in groups - in children 3-4 years old, adolescents 7-14 years old, patients over 18 years old. You will need tweezers and a probe to determine the dimensions of the clusters and pockets, the mobility of the fangs, incisors, and molars. Average KPI - score general values in all examined patients. The data obtained show the intensity of the spread of periodontitis:

• less than 1 – low prospect of periodontitis;
• 1-2 – tissues are barely affected;
• 2-3.5 – average degree of damage;
• 3.5-6 – serious severity.

Gingivitis index

The IG number indicates the location and extent of spread of the disease. Numbers 12, 16, 24, 32, 36, 44 are examined. For each unit, the dentist makes assessments on four sides - distal, as well as the nucleus, medial and lingual sections. A visual assessment is sufficient; when necessary, a probe is used. The scores will be as follows:

• 0 – no inflammation;
• 1 – the structure and color of the gum tissue have changed slightly, there is no bleeding;
• 2 – the gums are swollen, changed color, and bleed a little;
• 3 – identified severe swelling, inflammation of the gums, and the slightest damage causes bleeding.

After the examination, the doctor sums up the points, divides the number by the number of teeth examined, obtaining:

• up to 1 – light form gingivitis;
• 1-2 – middle stage;
• 2-3 – heavy.

Ramfiord index

Periodontal diseases are indicated. Checking the lingual, vestibular edge, identifying the accumulation of soft, hard deposits. The gingivitis indicator is displayed:

• 0 – normal;
• 1 – inflamed area;
• 2 – significant gum disease;
• 3 – severe condition.

Indicators of periodontitis will be as follows:

• 0-3 – the dimensions of the studied pocket are considered acceptable;
• 4 – depth of the studied pocket is less than 3 mm;
• 5 – depth 3-6 mm;
• 6 – pocket more than 6 mm deep.

There are signs of gingivitis and possible periodontitis. Test according to Muhlemann and Son. When the gums are healthy in appearance, but may bleed due to some minor lesion. The dentist, barely pressing, traces a line near the tooth with a probe and evaluates the reaction:

• 0 – no reaction;
• 1 – blood appears after 30 seconds;
• 2 – blood will come out immediately or up to 30 seconds;
• 3 – bleeding is provoked by brushing teeth and eating.

Simplified bleeding index

Testing is an assessment of the responses of the subject. The dentist asks whether gum bleeding occurs, what situations provoke it, and then suggests the degree of inflammation (approximately).

PBI by Saxer and Miihiemann

Using a probe, the doctor makes a furrow along the papillae between the teeth, assessing the severity of inflammation:

• 0 – no reaction;
• 1 – pinpoint hemorrhages;
• 2 – a lot of hemorrhages;
• 3 – bleeding fills the groove.

Hygienic indices

Enamel contamination is assessed - accumulations of deposits are assessed qualitatively and quantitatively. Below are the main indices.

Fedorova-Volodkina

The test is common among dentists; it boils down to staining the lower incisors with a solution of iodine. The reaction is assessed next:

• 1 – no coloring;
• 2 – color ¼ surface;
• 3 – color of ½ tooth;
• 4 – color ¾ of the surface;
• 5 – the entire tooth is stained.

The doctor will divide the points received by 6, obtaining the following decoding:

• less than 1.5 – excellent;
• 1,5-2 – good level hygiene care;
• 2-2.5 – insufficient cleaning;
• 2.5-3.4 – poor care;
• 3.4-5 – hygiene is practically unnoticeable.

Green Vermilion

Loose plaque and hardened plaque are assessed. The doctor examines the numbers: 46, 11, 26, 16, 31, 36. The assessment of the upper molars and incisors is carried out from the vestibular part, and the lower ones - from the lingual part. Based on the results, the final scores are displayed:

• 0 – clean;
• 1 – 1/3 of the surface with deposits;
• 2 – 2/3 parts with deposits;
• 3 – contamination of more than 2/3 of the tooth.

For the inspected unit, a separate assessment of contamination and stone is given, the results are divided by 6, resulting in:

• less than 0.6 – excellent;
• 0.6-1.6 – decent level of cleanliness;
• 1.6-2.5 – not clean enough;
• 2.5-3 – dirty.

Silnes Low

An analysis of the jaw is performed. No painting required, a probe is used. Points:

• 0 – clean;
• 1 – thin layer of dirt;
• 2 – plaques;
• 3 – surface coating.

Contamination is detected on the incisors and canines at the junction with the gums:

• 0 – clean;
• 1 – deposits up to 0.5 mm;
• 2 – stone up to 1 mm;
• 3 – stone width exceeds 1 mm.

Plaque index according to Quigley and Hein

Assessment of accumulations of deposits of both jaws by numbers: 43, 11, 12, 21, 22, 23,13, 31, 32, 33, 41, 42. The surface is painted with magenta, after which the doctor checks the vestibular edges:

• 0 – no color;
• 1 – coloring in the cervical area;
• 2 – color 1 mm;
• 3 – accumulation of more than 1 mm, but less than 1/3 of the surface;
• 4 – deposits cover up to 2/3 of the tooth;
• 5 – contamination covers more than 2/3 of the surface.

Lange API

It is important to provide proper care to the proximal surfaces; their cleanliness will show the doctor how well the patient maintains dental hygiene. The mucous membrane is painted with a special solution, contamination is detected from the oral and vestibular sides, depending on the quadrants. The score is displayed as a percentage:

• up to 25% is a good indicator;
• up to 40% - fairly acceptable hygiene;
• up to 70% - satisfactory care;
• over 70% - insufficient hygiene.

Ramfiord index

Plaque from the palatal, lingual, and vestibular sides is assessed using numbers 46, 14, 26, 11, 31, 34. The surface is first painted with Bismarck's solution. Taking into account the nature of the clusters, the following is derived:

• 0 – clean;
• 1 – partially there are deposits;
• 2 – deposits cover the faces, but less than ½;
• 3 – deposit covers more than ½ of the faces.

Navi

Assessment of the anterior incisors from the lips. First, the mouth is rinsed with a fuchsin solution, then the staining is assessed:

• 0 – clean;
• 1 – coloring of the border with the gums;
• 2 – wide strip of plaque near the gums;
• 3 – 1/3 of the tooth from the gum is covered with dirt;
• 4 – plaque covered up to 2/3;
• 5 – sediment covers more than 2/3.

Tureski

The oral cavity is rinsed with a fuchsin dye solution, then the accumulation of plaque is assessed on the entire dentition:

• 0 – clean;
• 1 – a little plaque at the cervix;
• 2 – deposits 1 mm;
• 3 – deposits more than 1 mm, but less than 1/3;
• 4 – pollution up to 2/3;
• 5 – more than 2/3 flying time.

Arnim

The area of ​​contamination is measured. Assessment is labor-intensive and is used in scientific research, but not for routine inspections. The anterior incisors of both jaws, pre-stained with erythrosine, are assessed. A vestibular photograph is taken, enlarged 4 times, and printed. Next, the outline of the incisors and painted surfaces is transferred to the paper, and the dimensions of the plaque area are determined with a planimer.

PFRI according to Axelsson

First, the oral cavity undergoes professional cleaning, then you cannot brush your teeth for 24 hours. Next, the doctor stains the mucous membranes, assesses the amount of plaque, identifying the number of dirty teeth among the existing ones:

• up to 10% - very low rate of plaque formation;
• 10-20% - low speed;
• 30% - average;
• 30-40% - high;
• over 40% is very high.

Hygiene efficiency

The thoroughness of cleaning is checked. RHP evaluates numbers 46, 11, 16, 31, 36, 26; first, the mouth is rinsed with a dye solution to evaluate the intensity of staining of each of the 5 parts (distal, as well as medial, central, with them occlusal, cervical). The sector result is displayed in points:

• 0 – clean;
• 1 – painted.

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• 0 – excellent hygiene;
• 0.6 – good cleaning;
• up to 1.6 – satisfactory level;
• over 1.7 – poor hygiene.

Stages of epidemiological testing

Epidemiologists study the spread of disease among people from different walks of life. A dental examination is carried out in three stages:

1. Preparation. Drawing up plans, deadlines, methods, research objectives. Preparing the site and equipment for research. Formation of a group of 2 doctors, 1 nurse. Selection of representatives different groups population, patients of different sexes should be equally divided.
2. Examination. The data is entered into the registration card without corrections or additions. The information is entered with codes indicating the presence or absence of symptoms.
3. Grade. The results are calculated according to criteria (prevalence of caries, quantitative indicator of periodontal disease, etc.). The results are displayed as a percentage and allow you to form a picture of the dental health of people in the region, taking into account a list of different factors. Next, preventive and treatment measures are prescribed.

The listed hygiene indices assess the condition of the oral cavity and represent a safe method of obtaining information for forecasts.