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bases for dmft
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Preventive and community dentistry II
DMFT Index I and II
D Caroline Mohamed
7 semester
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Objectives
DMFT index
Caries detection
Criteria for caries
Calculation of DMFT
Root caries measurement
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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.
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How many teeth have caries lesions (incipient caries not included)?
How many teeth have been extracted?
How many teeth have fillings or crowns?
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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
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FDI Dental Federation notation system
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Dental examination Charts
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Indices used for dental caries assessment
1- Indices used for coronal caries.
A- Permanent teeth.
B- Primary teeth.
2- Indices used for root caries.
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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.
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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.
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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.
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Sound
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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.
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D
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Decayed D
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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.
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M I S S E d
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Missed
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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.
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Filled Filled tooth with no decay
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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.
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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.
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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.
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Training
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Analyse these images and answer:
The DMF T of this patient is ..( Third molars not included)
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Superior teeth D..4 M..2 F..5
Restored
Restored
Restored Restored
Decayed
Restored
Decayed
Missed Missed
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Bitewings
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D F
Inferior teeth D..0 M..2 F..4
Filled Filled
Filled
Filled
Missed Missed
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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
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Mixed dentition:
Each child is given a separate index, one for permanent teeth and another for primary teeth.
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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
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2- For Group of a population
Total DMFT ( SUM ) each individual = DMFT1 + DMFT2 +......
Mean DMFT = Total DMF
Total No. of the subjects examined
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Non-cavitated lesion Cavitated lesion
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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 .
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Treatment is by primary preventive practices such as plaque control and topical fluoride applications.
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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.
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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
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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.
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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.
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The value of early detection
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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....
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Thanks
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