6.dmft index a

Preventive and community dentistry II

DMFT Index I and II

D Caroline Mohamed

7 semester

1 D Caroline Mohamed

Objectives

DMFT index

Caries detection

Criteria for caries

Calculation of DMFT

Root caries measurement


Dental caries Caries is a point in a persons life at which the

process of demineralization of tooth structure by acid from bacteria in the tooth biofilm overwhelms the patients ability to remineralize tooth structure.

The end stage of dental caries disease process is cavitation.


How many teeth have caries lesions (incipient caries not included)?

How many teeth have been extracted?

How many teeth have fillings or crowns?


DENTAL INDICES

An index is defined as a numerical value describing the relative status of a population on a graduated scale with a definite upper and lower limits designed to permit and facilitate comparison with other populations classified by the same criteria and methods.

Index

Graduated numerical scale with upper & lower limits, with scores on the scale corresponding to specific criteria

designed to permit and facilitate comparison with other populations classified by the same criteria and methods.

Types of indices:

Reversible (GI)

Complex (PI)

Irreversible (DMF)

Requirements of an ideal index:

1- Validity : measure whats intended to measure

2- Reliability: consistent at different times under a variety

of conditions

3- Clarity, simplicity & objectivity: readily memorized after some practice

4- Quantitability: amenable to statistical analysis

5- Sensitivity: detect small shift

6- Acceptability: not painful

COMMONNLY USED INDICES IN DENTISTRY

DMFT/dmft

OHI-S

CPITN

Plaque index of Silness and Loe

Gingival index of Silness and Loe

Tooth chart positioning


FDI Dental Federation notation system


Dental examination Charts


Indices used for dental caries assessment

1- Indices used for coronal caries.

A- Permanent teeth.

B- Primary teeth.

2- Indices used for root caries.


Permanent teeth index: Decayed-Missing-Filled Index ( DMF )

Klein, Palmer and Knutson,1938 and modified by WHO:

The DMF is an irreversible index, applied only to permanent teeth. And always significant by upper case letters.

1-DMF teeth index (DMFT) measures the prevalence of dental caries/Teeth.

2- DMF surfaces index (DMFS) which measures the severity of dental caries.


DMFT Indices

The Decayed, Missing, Filled (DMF) index has been used for more than 70 years and is well established as the key measure of caries experience in dental epidemiology.


MDF-T components: D component: an irreversible index used to

measure past and present caries experience of a population with permanent teeth.

Decayed teeth which include:

1. Carious tooth.

2. Filled tooth with recurrent decay.

3. Only the root are left.

4. Defect filling with caries.

5. Temporary filling.

6. Filled tooth surface with other surface decayed.


Sound


Decayed Tooth or root with caries.

Definite cavity, undermined enamel, or detectably softened or leathery area of enamel or cementum .

Tooth with temporary filling

Teeth sealed but decayed

Where any doubt exists, the surface is recorded as sound.


D


Decayed D


M component

Missing teeth due to caries. Tooth that were extracted for reasons other

than caries should be excluded, which include: 1. Orthodontic treatment. 2. Impaction. 3. Periodontal disease. 4. Unerupted teeth. 5. Congenitally missing. 6. Avulsion teeth due to trauma or accident. 7. Primary teeth retained in the permanent

dentition.


M I S S E d


Missed


F component: Filled teeth due to caries. Permanent restorations present and no secondary (recurrent) caries or other area of the tooth with primary caries. A tooth with a crown placed because of previous decay. Teeth restored for reason other than dental caries should be excluded, which include: 1. Trauma (fracture). 2. Hypoplasia (cosmatic purposes). 3. Bridge abutment (retention). 4. Sealed root canal due to trauma.


Filled Filled tooth with no decay


Principle and rules in recoding:

1-DMFT:

1- A tooth may have several restorations but it counted as one tooth, F.

2- A tooth may have restoration on one surface and caries on the other, it should be counted as decayed D .

3- No tooth must be counted more than once, D M F or sound.


Note :

1- A tooth is considered to be erupted when the cusp tip of the occlusal surface or incisor edge is exposed.

The excluded teeth in the DMF index are:

1- Supernumerary teeth.

2- The third molar. Klein, Palmer and Knutson only.


The DMF Index is applied to the permanent dentition.

When the index is applied to teeth, it is called the DMFT index, and scores per individual can range from 0 to 28 or 32, depending on whether the third molars are included in the scoring.


Training

D Caroline Mohamed 35

Analyse these images and answer:

The DMF T of this patient is ..( Third molars not included)


Superior teeth D..4 M..2 F..5

Restored

Restored

Restored Restored

Decayed

Restored

Decayed

Missed Missed


Bitewings


D F

Inferior teeth D..0 M..2 F..4

Filled Filled

Filled

Filled

Missed Missed


Primary teeth index: DMF Index variations: 1. dmf index:

Written in lowercase letters, The dmft index expresses the number of affected

teeth in primary dentition, with scores ranging from 0 to 20 for children.

Follow the basic principles and rules for the MDFT


Mixed dentition:

Each child is given a separate index, one for permanent teeth and another for primary teeth.


Analyze the scores by using the following

formula:

Calculation of DMFT :

1- Individual DMFT

Total of each component i.e. D; M; F separately

Then total D + M + F = DMFT


2- For Group of a population

Total DMFT ( SUM ) each individual = DMFT1 + DMFT2 +......

Mean DMFT = Total DMF

Total No. of the subjects examined


Non-cavitated lesion Cavitated lesion


Initial stages of dental caries are reversible.

As long as the lesion is still incipient i.e. with no cavitations remineralization is possible.

The early identification of such early carious lesion is extremely important because it is during this stage that the carious process can be arrested or reversed .


Treatment is by primary preventive practices such as plaque control and topical fluoride applications.


On the other hand, the overt cavitations stage is an irreversible one.

It may be called the point of no return" as it is no longer expected that remineralization can occur.


Traditionally visual-tactile method is used (i.e. explorer as well as vision) .

Mouth mirror

Explorer

Good illumination

Recently, method for diagnosing caries have moved more toward exclusively visual method (i.e. without probing)

Mouth mirror

Good illumination


Explorer should not be used for several reasons:

1-the use of explorer ,even gentle probing with a sharp explorer, is likely to damage the surface zone of non-cavitated lesions.


Even gentle probing

with a sharp explorer

turned non-cavitated

lesion into cavitation. thus turning what could have been a

reversible lesion (non-cavitated) into

one that is irreversible.


The value of early detection

D Caroline Mohamed 53

Is the ability to control the disease process in order to contain, arrest or remineralize lesions, in order to avoid or delay the burden or costs associated with a spiral of restoration and restoration.

If a lesion is left until a filling is needed, the clinical opportunity for effective prevention is LOST!

Identify Tooth decay....


Thanks


6.dmft index a

Documents

d caroline mohamed indices

d caroline mohamed sound

d component

dmf index

dmf teeth index dmft

dental caries assessment

severity of dental caries

irreversible index