caries

1. What is an index?
○ It is a numerical value.
○ Describing the relative status of a population.
○ On a graduated scale, with a definite upper & lower
limits.

2. Indices for dental caries
○ I- For permanent teeth:
1- DMF ( DMFT)
2- DMFS
○ II- For deciduous teeth
1- def
2- Its modifications: dmf, df
* 2

3. Decayed – Missing – Filled Index
DMF
○ Introduced in 1938.
○ Is the most universally employed index for measuring
dental caries.
○ An irreversible index.
* 3

4. 1- DMF
D Decayed tooth.
M Missing due to caries.
F Filled tooth.
* 4

5. METHOD
○ DMF is only applied for permanent teeth.
○ The teeth not included in the examination are;-
1- Unerupted teeth.
2- Congenitally missing and supernumerary teeth.
3- Teeth removed for other than dental caries
* 5

6. Priciples and Rules when Recording DMF
1- No tooth be counted more than once.
2- Decayed, Filled and Missed teeth due to caries
should be recorded separately.
3- Filled tooth with recurrent caries recorded as
Decayed.
* 6

7. 4- Deciduous teeth are not included in DMF count.
5- A tooth is considered to be erupted when the
occlusal surface or incisal edge is exposed by
reflecting the overlying gingival tissue.
* 7

8. WHO modification of DMF Index (1986)
1- All third molars are included.
2- Temporary restorations are considered as D.
3- Only carious cavities are considered as D.
* 8

9. The DMF INDEX
Expresses the sum of decayed
(D), missing due to caries(M), and
filled (F) teeth per person.
* 9

10. Scoring:
○ Sound tooth 0
○ D 1
○ M 1
○ F 1
○ The total score = D+M+F
○ It ranged from 0 to 32 in a whole number.
* 10
scored
scored
scored
scored

11. An example
○ A person with one decayed tooth, two
missing teeth due to caries , and one
filled tooth
DMF = 1 + 2 + 1= 4
* 11
D M F

12. For a Group of Persons
○ The average number (mean) of DMF =
Sum of DMF of all persons
Number of examined persons
* 12

13. An example:
○ 5 persons with DMFT ;
3,0, 6, 2, 7
3+0+6+2+7
○ Mean DMFT=
5
* 13
= 3.6

14. If a carious tooth (D) has more than
one lesion , still only one score will be
given.
* 14
One
carious
surface
two
carious
surfaces
three
carious
surfaces

15. To overcome this disadvantage
we use
2 - DMFS
○ Tooth Surfaces are counted instead of teeth.
○ It is a sensitive index.
○ Used in clinical trial.
○ DMFS is calculated as for DMFT.
* 15

16. DT = 1
DS = 2
DT = 1
DS = 3
DT = 1
DS = 1
16
*

17. d decayed tooth indicated for
filling.
decayed tooth indicated for
extraction.
filled tooth
17
*
f
e
II- For Deciduous Teeth

18. ○ Missing decidious teeth due
to caries are not recorded.
* 18
m
extracted
Naturally
exfoliated
?
?

19. Modifications of def index
19
*
dmf
index
df
index
Before age of exfoliation.
Only for 1ry molars
= def
Does not allow for 2 grades
of caries.
d + e = d

20. Mixed dentition
○ DMFT or DMFS and deft and defs are never added
together.
○ The index for the permanent teeth is usually determined
first then for primary teeth.
* 20

21. Evaluation Of DMF Index
○ Advantages
1- It is the only comprehensive index to date to measure
dental caries.
2- It is applicable to most age groups.
3- It is very high inter and intraexaminer agreeability.
4- Is the best method to asses treatment need.
* 21

22. 5- Gives an analyses of the following:-
a- Decayed – request for service provider.
b- Missing – tell the negligence of the people.
c- Filled – tell about the services utilized
* 22

23. Limitations of DMF index:
1- DMF score is a simple count. It has no
denominator indicating the number of teeth at
risk.
2- DMF index gives equal scores to missing,
untreated decayed, or well restored teeth.
3- DMF index is invalid when teeth have been
lost for reasons other than caries.
* 23

24. 4- DMF index can overestimate caries
experience by including for ex. Teeth with
“preventive restoration”.
5- DMFS index cannot account for sealed teeth.
To do this ,the DMFS would then become
DMFSS.
6- DMF index is not recommended for measuring
root caries.
* 24

25. Measurements of root caries
Root lesions
characterized by being:
○ Small , disconnected
* 25

26. ○ Lesions occur on exposed roots.
* 26
Teeth with gingival recession

27. Root caries can be measured
by:
1- Simple prevalence (proportion/percentage).
2- Number of carious and restored root lesions per
person.
3- ROOT CARIES INDEX (RCI)
○ Number of missing teeth per an individual should
be recorded in a separate figure with any of the
previous 1,2,or 3.
* 27

28. ○ It is first described in 1980.
○ Scoring is restricted to teeth at risk.
* 28

29. ○ At risk tooth for root caries is that tooth with gingival
recession, i.e. part of cemental surface has exposed to
oral environment.
29
*

30. The is calculated as
follows:
decayed + filled root surface
=
root surface with loss of periodontal attachment:
decayed + filled + sound
* 30
X 100

31. For
example:
○ If we have 100 teeth with gingival recession
(for a group of population) , only 9 teeth were
decayed or filled on root surfaces.
= 9%
* 31

32. References
• Burt AB, Eklund SA. Dentistry, Dental Practice and the Community.
6th Ed 2005, W. B. Saunders Company, Chapter No.15. P.P 194-202
32

33. * 33
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