Silness-Le Index

- Silness-Le Index (Silness and Le, 1964)

Guest editor: Kaban Moslehzadeh The measurement of the state of oral hygiene by Silness-Le plaque index is based on recording both soft debris and mineralized deposits on the following teeth. Missing teeth are not substituted.

Each of the four surfaces of the teeth (buccal, lingual, mesial and distal) is given a score from 0-3. The scores from the four areas of the tooth are added and divided by four in order to give the plaque index for the tooth with the following scores and criteria:

The Plaque Index System

Scores 0 1 No plaque

Criteria

A film of plaque adhering to the free gingival margin and adjacent area of the tooth. The plaque may be seen in situ only after application of disclosing solution or by using the probe on the tooth surface. Moderate accumulation of soft deposit s within the gingival pocket, or the tooth and gingival margin which can be seen with the naked eye. Abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin.

CALCULATION EXAMPLE:

The following example shows how to calculate the scores for the index. Assuming a tooth with the following scores on the four surfaces

Surface Buccal Lingual Mesial Distal

Scores 2 1 1 2

Plaque Index = (2+1+1+2) / 4 = 1.5, according to the plaque index system this means the plaque index for the tooth is moderate accumulation of soft deposit within the gingival pocket, or the tooth and gingival margin which can be seen with the naked eye. The indices for the following six teeth may be grouped to designate the index for the group of teeth: 16, 12, 24, 36, 32, 44. The index for the patient is obtained by summing the indices for all six teeth and dividing by six.

For instance, if you have the following indices for the teeth :

Tooth Maxillary right first molar (16) Maxillary right lateral incisor (12) Maxillary left first bicuspid (24) Mandibular left first molar (36) Mandibular left lateral incisor (32) Mandibular right first bicuspid (44)
Then the index for the patient will be

Index 1.5 1.3 1.2 1 1.6 1.3

The index for patient = (1.5 + 1.3 +1.2 + 1 + 1.6 + 1.3) / 6 = 1.4

Oral Hygiene Index (Greene and Vermilion, 1960)

Oral Hygiene Index (Greene and Vermillion, 1960)

Guest editor: Kaban Moslehzadeh The Oral Hygiene Index is composed of the combined Debris Indexand 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 1. The segment distal to the right cuspid (see picture). 2. The segment distal to the left cuspid. 3. The segment mesial to the right and left first bicuspids.

The Maxillary and the Mandibular arches are each composed of three segments (these are illustrated above). 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. The method for scoring calculus is the same as that applied to debris, but additional provisions are made for recording subgingival deposits.

Criteria for classifying debris

Scores 0 1 No debris or stain present

Criteria

Soft debris covering not more than one third of the tooth surface, or presence of extrinsic stains without other debris regardless of surface area covered Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface. Soft debris covering more than two thirds of the exposed tooth surface.

2 3

Criteria for classifying calculus

Scores 0 1 2 No calculus present

Criteria

Supragingival calculus covering not more than third of the exposed tooth surface. Supragingival calculus covering more than one third but not more than two thirds of the exposed tooth surface or the presence of individual flecks of subgingival calculus around the cervical portion of the tooth or both. Supragingival calculus covering more than two third of the exposed tooth surface or a continuos heavy band of subgingival calculus around the cervical portion of the tooth or both.

CALCULATION EXAMPLE:
After the scores for debris and calculus are recorded, the Index values are calculated. For each individual, the debris scores are totaled and divided by the number of segments scored. The same method is used to obtain the calculus index scores. The following example shows how to calculate the indices. The scores for debris and calculus should be tabulated separately and indexes for each calculated independently, but in the same manner.

Debris

Right Buccal Upper Lower Total 3 2 5 Lingual 1 2 3

Anterior Labial 2 1 3 Lingual 2 1 3

Left Buccal 3 1 4 Lingual 1 2 3

Total Buccal/Labial 8 4 12 Lingual 4 5 9

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).

Debris Index = (12+9) / 6= 3.5

Calculus

Right Buccal Upper Lower Total 1 0 1 Lingual 0 1 1

Anterior Labial 0 0 0 Lingual 0 2 2

Left Buccal 1 0 1 Lingual 0 2 2

Totals Buccal/Labial 2 0 2 Lingual 0 5 5

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).

Calculus Index = (2+5) / 6= 1.16

The average individual or group debris and calculus scores are combined to obtain Oral Hygiene Index, as follows.

Oral Hygiene Index

Debris Index + Calculus Index 3.5 + 1.16 = 4.66

A simplified version exists, the OHI-S (Greene and Vermilion, 1964).

Simplified Oral Hygiene Index | OHI-S

- OHI-S (Simplified) (Greene and Vermillion, 1964)
Guest editor: Kaban Moslehzadeh 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.

SELECTION OF 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.

Criteria for classifying debris

Scores 0 1 No debris or stain present

Criteria

Soft debris covering not more than one third of the tooth surface, or presence of extrinsic stains without other debris regardless of surface area covered Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface. Soft debris covering more than two thirds of the exposed tooth surface.

2 3

Criteria for classifying calculus

Scores 0 1 2 No calculus present

Criteria

Supragingival calculus covering not more than third of the exposed tooth surface. Supragingival calculus covering more than one third but not more than two thirds of the exposed tooth surface or the presence of individual flecks of subgingival calculus around the cervical portion of the tooth or both. Supragingival calculus covering more than two third of the exposed tooth surface or a continuos heavy band of subgingival calculus around the cervical portion of the tooth or both.

CALCULATION EXAMPLE:
After the scores for debris and calculus are recorded, the Index values are calculated. For each individual, the debris scores are totaled and divided by the number of surfaces scored. At least two of the six possible surfaces must have been examined for an individual score to be calculated. After score for a group of individual is obtained by computing the average of the individual scores. The average individual or group score is known as the Simplified Debris Index (DI-S). The same methods are used to obtain the calculus scores or the Simplified Calculus Index (CI-S).

The average individual or group debris and calculus scores are combined to obtain the Simplified Oral Hygiene Index. The CI-S and DI-S values may range from 0 to 3; the OHI-S values from 0 to 6. These values are just half the score magnitude possible with the OHI (Oral Hygiene Index). The following example shows how to calculate the index. The scores for debris and calculus should be tabulated separately and index for each calculated independently, but in the same manner.

Debris

Right molar Buccal Upper Lower 3 Lingual 2

Anterior Labial 2 Labial 1

Left molar Buccal 3 Lingual 2

Total Buccal 8 1 Lingual 4

Debris Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined buccal and lingual surfaces).

Debris Index = (9+4) / 6 = 2.2

Calculus

Right molar Buccal Upper Lower 1 Lingual 1

Anterior Labial 0 Labial 2

Left molar Buccal 1 Lingual 2

Total Buccal 2 2 Lingual 3

Calculus Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined buccal and lingual surfaces).

Calculus Index = (4+3) / 6= 1.2

The average individual or group debris and calculus scores are combined to obtain simplified Oral Hygiene Index, as follows.

Oral Hygiene Index

Debris Index + Calculus Index 2.2 + 1.2 = 3.4

Quigely Hein Index (modified)

- Quigley Hein Index (Modified by Turesky et al, 1970)
Guest editor: Kaban Moslehzadeh This index is the same as the Quigley Hein Index except the criteria has been modified. As Quigley Hein Index, a score of 0 to 5 is assigned to each facial and lingual nonrestored surface of all the teeth except third molars, as follows

The Plaque Index System

Scores 0 1 2 3 4 No plaque

Criteria

Separate flecks of plaque at the cervical margin of the tooth A thin continuos band of plaque (up to one mm) at the cervical margin of the tooth A band of plaque wider than one mm but covering less than one-third of the crown of the tooth Plaque covering at least one-third but less than two-thirds of the crown of the tooth

Plaque covering two-thirds or more of the crown of the tooth

An index for the entire mouth is determined by dividing the total score by the number surfaces ( a maximum of 2 x 2 x 14 = 56 surfaces) examined.

CALCULATION EXAMPLE:
Assuming nonrestored upper jaw and lower jaw surfaces are examined and the scores are stored in the following two tables:

Upper jaw 25 22 21 11 12 13 14

Buccal surface score 2 1 3 0 0 1 1

Lingual surface score 2 3 2 1 0 2 3

15 17 Total

2 5 15

2 3 18

Lower jaw 47 44 43 42 41 31 32 33 34 Total

Buccal surface score 4 3 2 2 2 2 0 0 0 15

Lingual surface score 5 5 3 3 4 3 2 2 0 27

Index

Total score / The number surfaces examined ((15 + 18) + (15 + 27)) / 36 = 2.1

The index for the entire mouth is 2.1.