(9) measuring other conditions in oral epidemiology

7/28/2019 (9) Measuring Other Conditions in Oral Epidemiology

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Most other indexes suffer from the limitation that they recordspecific conditions like:

Overbite: the upper teeth will be 1mm above lower teeth, whenbecome more than 1mm it’s called overbite.

Overjet: the horizontal distance between upper and lower anteriorteeth which will be 1mm, more than 1mm is called overjet.

Crossbite: cusps when meet cusps the upper teeth will be outsidethe fossae of lower teeth so the upper crossing the lower or thereverse.

Openbite: when closes the mouth there is a space between upperand lower.

Midline shifts: central incisor tilted 4mm or more to right or left.

2- Malalignment index: assesses rotation and tooth displacement.

3- Occlusal feature index: records crowding, cuspal interdigitation, andvertical and horizontal overbite.

4- Handicapping Labio-Lingual Deviations (HLD) Index it was applied toassess treatment needs for a public orthodontic program in New YorkState.

5- Treatment Priority Index (TPI): developed by Grainger for assessingtreatment needs, was used once, but only once, in a national studyof orthodontic needs of children in USA.

6- Occlusal Index(OI):it measures 9 characteristics: dental age molar relation overbite overjet. posterior crossbite.

posterior open bite. tooth displacement. midline relations. missing permanent maxillary incisors.



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7- Index of Orthodontic Treatment Need (IOTN): it’s the same as CPITNintroduced in 1989 combines both a functional and an estheticmeasure.

Functional occlusion is categorized into five different grades,whereas the esthetic measure uses a 10-point ordinal scalethat allows the individual to determine his own estheticperception of the dentition.

8- Peer Assessment Rating (PAR) index: is designed to capture all theocclusal anomalies that might be found in malocclusion in a singlescore. It equals occlusal index in reliability.

9- Index of Complexity, Outcome, and Need (ICON): introduced in the

new millennium, it correlates well with patients' perceptions of esthetics, speech, function, and need for treatment.

The Federation Dentaire Internationale(FDI): attempted todevelop an internationally accepted index and simplifiedmethod of determining malocclusion, but it was unsuccessful.

The complexities of malocclusion, and the frustrations thathave grown up with the inadequacies of these indexes, haveled many researchers to believe that functional malocclusionis virtually immeasurable for epidemiologic purposes.

Now the Orthodontic indexes have changed from assessingfunction to assess aesthetic and its effect on the individual'ssocial and psychological well-being. one of those indexes is:

The Denta l Aesthetic Index (DAI): it gives 10 pictures to differentsmiles and orders them from worst to the most beautiful

The IOTN also includes an esthetic component measured on a10-point ordinal scale.

o The World Health Organization, suggests using DAI criteria torecord malocclusion in the following categories:



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Missing incisor, canine, and bicuspid teeth.

Incisal crowding in the maxillary and mandibular anterior segments.

Spacing in the maxillary and mandibular anterior segments.

Diastema(space) between the two maxillary central incisors.

Largest irregularity in the front four maxillary anterior incisors(rotations or displacement from normal alignment).

Largest irregularity in the front four mandibular anterior incisors.

Anterior maxillary and mandibular overjet.

Vertical anterior open bite.

Anteroposterior molar relation.

ORAL CANCER

We said that rare conditions are measured by proportions or rates.

The difference between proportion and rate that in proportion doesn’ t include

time but rate does.

We’ve some indexes to measure oral cancer:

Age-adjusted rate of years of life lost from oral cancer: each age has

specific rate, like if someone is diagnosed today with oral cancer

how many years (s)he will live after this diagnosis, for example

dropped from 23.1 per 100,000 population in 1970 to 19.9 per

100,000 in 1985.



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Five-year survival rates: how many subjects(patients) survive

beyond 5 years, for example a 5-year survival rate of 67%, means

that 67% of persons in whom the condition was diagnosed 5 years

earlier are still alive.

Cleft lip and palate

Since cleft lip and palate are rare conditions we deal with them like

oral cancer so we can use proportion, about 1 infant in 700 births

exhibits this condition.

Any other rare conditions we can use proportion or rate to measure

them.

ORAL HEALTH AND QUALITY OF LIFE

In 2000 they started thinking about quality of life, so oral

health has impact on quality of life so people can function, do

their jobs normally and don’t suffer from pain.



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So they studied the impact of oral health on social,

psychological life of people.

There are ways to measure these problems and attempt to

improve them:

The Oral Health Impact Profile (OHIP) : it’s a questionnaire

was 49 questions now it’s about 14, it asks patients specific

questions these questions are related to the impact of teeth

health on life quality so it measures the social impact of

oral conditions as perceived by the individual and was

derived initially from statements given by dental patients

in interviews.

General Oral Health Assessment Index (GOHAI): originally

used for geriatric so it’s developed from Geriatric Oral

Health Assessment Index this is used with elderly in

nursing home because they’ve the most social distress.

This index is 12 item scale that assesses physical

functions, psychosocial functions, and pain or

discomfort.



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This lecture is lecture 9 with p art from lecture 10 because it’s the same subject in the slides.

THE END

(9) measuring other conditions in oral epidemiology

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