Fundamentals of Clinical Dentistry: Intro to Indices and Charting

Fundamentals of Clinical Dentistry: Intro to Indices and Charting

Specific Objectives:

1) Define the purpose of dental indices, such as DMF-T, DMF-S, Gingival Inflammation Index and Plaque Index.

Dental indices are important tools used in examinations to provide a numeric score that quantifies the magnitude of the disease measured.

DMF-T: The number of teeth that are decayed, missing, or filled, the DMFT index, is a total score of all affected teeth and provides a caries experience score for an individual.

DMF-S: A count of tooth surfaces that are decayed, missing, or filled and provides a greater precision about the caries history of an individual or a population group when mean scores are derived.

Gingival Inflammation Index: Provides an assessment of gingival inflammatory status that can be used in practice to compare gingival health before and after dental visits and or treatments.

Plaque Index: Same as Gingival Inflammation Index but deals with plaque.

2) Differentiate between the terms prevalence and incidence of a disease.

Disease Prevalence: The number of decayed, missing, and filled surfaces that exist in the mouth at any one time. Only one examination is required to determine prevalence.

(Prevalence is what is present at one point in time!)

Disease Incidence: The number of decayed, missing, and filled surfaces that occur over a given period of time. Two different examinations are required to determine incidence- one before, and one at the end of a selected time period.

(Incidence is what happens over a period of time!)

3) Describe the rationale and demonstrate how to chart existing restorations (amalgam, composite, gold, crowns, bridges, other), missing teeth, incipient caries and caries.

Rationale- Well I think this is pretty common sense. Charting the information listed above will give you a record of your patient. This record can be reviewed upon future visits to note and record any changes. If you want me to explain how to wipe the fog off a mirror against the inside of your patient's cheek, let me know. I also think I could get the point of a modified pen grasp across if someone really needs the help.

Code for Dental Charting

Existing Restorations:

Fixed bridge (3 units)- Outline tooth crowns and place an X through tooth root to indicate which tooth is the pontic.

Crown- Outline tooth crown and use diagonal lines to indicate gold.

Non-metallic restoration (e.g. composite)- outline margins of the restoration.

Metallic restoration (e.g. amalgam)- fill in the shape of the restoration with blue pencil.

"Cracked" or "chipped" restorations- use red pencil to outline the existing restoration.

Missing teeth- place an X through crown and root.

Caries- Use red pencil to indicate areas of decay.

4) Describe the rationale and demonstrate how to:

a) Calculate DMF-T and DMF-S from a dental chart: See the example she gave on the chart. I will retype the rules so you have them all on one summary page.

Rules to calculate DMF in Preventative Clinic:

-can be based on 32 or 28 teeth, we ill use 28 teeth (ignore 3rd molars)

-3rd molar extractions will inflate DMF

-For DMF-S, anterior teeth have 4 surfaces (canine to canine) and posterior teeth have 5 surfaces

-each category in DMF is mutually exclusive

(i.e., each tooth can only be counted once)

If a tooth is both filled and decayed, count as decayed

- note: incipient caries are not counted as decayed. They are listed at the bottom of page 1 on the worksheet she handed out to us.

b) Calculate Gingival Inflammation index

0= Absence of all signs of inflammation

1=Mild inflammation, slight change in color and/or slight marginal edema, but no bleeding when probed

2=Moderate inflammation - redness, loss of stippling, edema, and/or bleeding when probed

3=Severe inflammation - marked redness and edema, spontaneous bleeding

The Gingival Index (GI) is computed by using the scores for a certain number of teeth (say #3, 5, 12, and 19) and then dividing