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GOOD MORNING

six years old children in a school at Bangalore city


Shankar S, Naveen N Kruthika M

Vinay S
Hidayathulla Shaikh

Indian Journal of Dental Research, 23(2), 2012

DENTAL CARIES
Major public oral health problem Need to reduce the prevalence multifactorial disease Diagnosis complicated for initial lesion If identified at earlier stages prevalence can be substantially reduced

Dental indices
Tool for identifying and measuring disease Various indices for dental caries but need for index that measures initial lesion

LORD KELVIN

Definition
A numerical value describing the relative status of a population on a graduated scale with definite upper and lower limits, which is designed to permit and facilitate comparison with other populations classified by the same criteria and methods. Russel A.L.

Ideal properties of index:

1. 2. 3. 4. 5. 6.

Clarity, simplicity & objectivity Reasonably easy Validity to apply Measure what is intended to Reliability Measure consistently measure Quantifiability Amenable to statistical analysis sensitivity Detect small shifts Acceptability
Not painful & demeaning to the subject

DECAYED,MISSING,FILLED CARIES INDEX (DMF CARIES INDEX)


Henry Klein , Carole E Palmer and Knutson J W 1938. Irreversible index, applied only to permanent teeth D-decayed M-missing F-filled

Can be applied to whole teeth (DMFT) or to surfaces (DMFS)


DMFT: Purpose: To determine total dental caries experience, past & present Based on 28 teeth Third molars excluded Unerupted teeth Congenitally missing & supernumerary teeth Teeth removed for reasons other than dental caries Teeth restored for reasons other than dental caries

Criteria 1) Lesion clinically visible. 2) Catch to the explorer tip. 3) Explorer tip can penetrate deep into the soft yielding tooth material. 4) Discoloration or loss of translucency typical of demineralized or undermined enamel.

RULES OF DMFT: No tooth should be recorded more than once Decayed, missing and filled teeth should be recorded separately. Secondary caries should be counted as decayed. Teeth missing only due to caries should be counted as missing A tooth is considered to be present even though the crown has been destroyed and only the roots are left.

The DMF score for an individual can range from 0 to 28 -whole numbers
A mean DMF score for a group, being the total of individual values divided by the number of subjects examined, can have fractional values

DMFS: Purpose: to determine total dental caries experience, past and present, by recording tooth surfaces involved instead of teeth as in DMFT Principles, rules and regulations are the same as that of DMFT
Surfaces examined Anterior teeth -four surfaces Labial, lingual, mesial, distal Posterior teeth-five surfaces Facial, lingual, mesial, distal & occlusal

W.H.O MODIFICATIONS(1986)
1) 2) All third molars are included. Temporary restorations are considered as D 3) Only carious cavities are considered as D

LIMITATIONS OF DMFT INDEX: 1)DMF values are not related to the number of teeth at risk. 2)DMF can be invalid in older adults because teeth can become lost for reasons other than caries. 3)DMF index can be misleading in children whose teeth have been lost due to orthodontic treatment. 4) DMF index can overestimate caries experience in teeth in which preventive filling have been placed. 5)DMF index is of little use in studies of root caries.

def Index For primary dentition


Grubbel in 1944 d-decayed e-indicated for extraction f-filled

Teeth missing due to caries are not recorded because of the difficulty, in many children, of distinguishing between extracted and naturally exfoliated primary teeth

deft & defs: Purpose: to determine the dental caries experience as shown by the primary teeth present in the oral cavity

Teeth not counted: Missing teeth including unerupted & congenitally missing Supernumerary teeth Teeth restored for reasons other than dental caries are not counted as f

Modifications. dmf: For children over 7 years and upto 11 or 12 the decayed, missing & filled primary molars and canines have been used to determine a dmft or dmfs. A primary molar or canine is presumed missing because of dental caries when it is missing before the normal exfoliation time

NYVADS CRITERIA

PURPOSE
purpose of this study was to compare the def index with Nyvads new diagnostic criteria.

MATERIALS AND METHODS


SAMPLE SIZE 249 AGE GROUP 3 to 6 years Convenient sampling

Children teeth were cleaned and dried with cotton rolls and chip blower. standardized conditions using plane mouth mirrors and explorers with the help of artificial illumination. Examination time:three to five minutes.

RESULTS
The mean value for deft was 2.48

The mean for d, e, and f component of Nyvads new caries diagnostic criteria was 3.18
statistically significant difference with P value of <0.05

The most affected surface according to deft index was occlusal surface, but with Nyvads caries diagnostic criteria, it was facial surface which was similar to a study conducted by M.C.Gonzalez et al

The intra-examiner reliability was 84.5% , 83% , and 85% for different cutoff points like sound versus diseased, active versus inactive, and cavity present versus cavity not present, respectively

The inter-examiner reliability was 86% , 84% and 88% for different cut-off points like sound versus diseased, active versus inactive, and cavity present versus cavity not present, respectively,

CONCLUSION

Nyvads new caries diagnostic criteria can be used to diagnose dental caries at the initial stages, which in turn will reflect exact prevalence of caries

reduce the need of treatment on a long-term basis

cost-benefit relationship.

Shortcomings

results of the study cannot be extrapolated to the general population

NYVADS CRITERIA more difficult to make an exact diagnosis of a precavitated active lesion such as a white spot lesion over the occlusal surface than over the facial surface. These lesions can be underdiagnosed, progressing to frank cavitation. On the other hand, because of the physiologic wear of the occlusal surface during mastication, these lesions can disappear

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