SIMPLIFIED ORAL HYGIENE INDEX

Prepared by:Kristina Corazon L. Robles,Jhoana Camille B. Quilang

Terminology• Dental index -an objective mathematical description of

a disease or condition based on carefully determined criteria under specified circumstances

- A numeric score that quantifies the magnitude of the disease measured.

• Oral Debris –The soft foreign matter loosely attached

to the teeth, It consists of mucin, bacteria and food, and varies in color from greyish white to green or orange.

• Oral calculus – Deposit of inorganic salts composed primarily of calcium carbonate and phosphate mixed with food debris, bacteria and desquamated epithelial cells.

– Supragingival calculus – deposits, usually white to yellowish-brown in color

– Sublingual calculus – deposits apical to the free gingival margin. These deposits usually are light brown to black in color.

Terminology

I. Simplified Oral Hygiene Index (OHIS)

• a reversible index used to measure oral hygiene status.

• a simple method for quantifying the amount of plaque and calculus in its two components, the debris index and the calculus index.

Uses of OHI-S• It has been widely used in studies of the

epidemiology of periodontal disease.

• Useful in evaluation of dental health education programs

• Used to evaluate an individual’s level of oral cleanliness

Uses of OHI-S• Used in evaluating the cleansing

efficiency of tooth brushes.

• It is easy to use because the criteria are objective, the examination may be performed quickly, and a high level of reproducibility is possible with a minimum of training sessions.

HISTORY AND DEVELOPMENT

1964• John C. Greene and Jack R. Vermillion

Developed the original Oral Hygiene Index (OHI)

They Developed OHI-S: – To reduce the number of decisions required on the

part of the examiner

– To reduce time required for the inspection.

Development of OHIS

• Index should not be too time-consuming– For this reason, Greene and

Vermillion simplified their index which was originally OHI.

• The principle of the calculus and debris indices remains the same, as do the criteria of the scores.

III. PROCEDURES and MATERIALS

MATERIALS

• mouth mirror• shepherd’s crook or sickle type dental explorer• no disclosing agent

Method of Measurement

• Each tooth surface is divided horizontally into gingival, middle, and incisal thirds.

• Scoring is done by moving the explorer from the incisal third towards the gingival third of the tooth.

SELECTION OF TOOTH SURFACES:

• ANTERIOR(2 teeth)

– labial surfaces of Maxillary right central incisor (11)Mandibular left central insicor (31)

In the absence of either of these anterior teeth, the central incisor (21 or 41 respectively) on the opposite side of the midline is substituted.

• POSTERIOR (4)

– Buccal surface of:– Maxillary right first molar (16)– Maxillary left first molar (26)

– Lingual surface of:• Mandibular right first molar (46)• Mandibular left first molar (36)

SELECTION OF TOOTH SURFACES:

• Reminders for the OHI-S: Each surface, buccal or lingual, is considered half the

tooth circumference.

Only fully erupted permanent teeth are scored.

A tooth is considered fully erupted when the occlusal or incisal surface has reached the occlusal plane.

Natural teeth with full crown restorations and surfaces reduced in height by caries or trauma are not scored. An alternate tooth is examined instead.

• After the six possible tooth surfaces are selected, then the scores are determined, recorded, and computed for the DI-S and CI-S respectively.

• The OHI-S score per person is the total of the DI-S and CI-S scores per person.

Procedure for OHI-S components:

I. SIMPLIFIED DEBRIS INDEX (DI-S)

• A dental explorer is placed on the incisal third of the tooth and moved toward the gingival third. The occlusal or incisal extent of the debris is noted as it is removed.

Scores Criteria

0 No debris or stain present

1 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

2 Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface.

3 Soft debris covering more than two thirds of the exposed tooth surface.

TABLE 1. CRITERIA FOR CLASSIFYING DEBRIS

Formula for DI-S:

• After the six possible debris scores are recorded, DI-S value is calculated.

Procedure for OHI-S components:

II. SIMPLIFIED CALCULUS INDEX (CI-S)

• The CI-S assessment is performed by gently placing a dental explorer into the distal gingival crevice and drawing it subgingivally from the distal contact area to the mesial contact area.

• The No. 5 explorer is used to estimate the surface area covered by the supragingival calculus and to probe for subgingival calculus

Formula for CI-S:

• The CI-S score per person is obtained by totalling the calculus scores per tooth surface and dividing by the number of surfaces examined.

Scores Criteria

0 No calculus present

1 Supragingival calculus covering not more than third of the exposed tooth surface.

2 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.

3 Supragingival calculus covering more than two third of the exposed tooth surface or a continuous heavy band of subgingival calculus around the cervical portion of the tooth or both.

TABLE 2. CRITERIA FOR CLASSIFYING CALCULUS

CALCULATION

• For each individual:– The debris and calculus scores are totalled and divided by

the number of surfaces scored.• At least two of the six possible surfaces must have been

examined.

• For a certain group of individuals:– Scores are obtained by computing the

average of the individual scores.

• The average individual or group debris and calculus scores are combined to obtain the OHIS

• Interpretation for DI-S and CI-S values:

Good 0.0-0.6

Fair 0.7-1.8

Poor 1.9-3.0

•Interpretation for OHI-S values:Good 0.0-1.2

Fair 1.3-3.0

Poor 3.1-6.0

CALCULATION EXAMPLE

Right molar Anterior Left molar Total

Buccal Lingual Labial Labial Buccal Lingual Buccal/Labial

Lingual

Upper 3 - 2 - 3 - 8 -

Lower - 2 - 1 - 2 1 (Labial)

4

TABLE 3. Debris

(Bu or La-scores) + (lingual-scores)

Total number of examined Bu/La and lingual surfaces

DEBRIS INDEX (DI)-S=

Debris Index = (9+4)

6

= 2.17

Right molar Anterior Left molar Total

Buccal Lingual Labial Labial Buccal Lingual Buccal Lingual

Upper 1 - 0 - 1 - 2 -

Lower - 1 - 2 - 2 2 3

TABLE 4. Calculus

(Bu/La-scores) + (lingual-scores)

(Total number of examined buccal and lingual surfaces).

Calculus Index =

(4 + 3) 6

CI-S=

= 1.17

The DIS and CIS scores are combined to obtain simplified Oral Hygiene Index, as follows:

ORAL HYGIENE INDEX = DEBRIS INDEX +

CALCULUS INDEX

2.17 + 1.17 = 3.34

THANK YOU!!

BIBLIOGRAPHY Wong, A. (1993). Community Dental Health. (3rd ed.). Library of Congress

Catalogue.

Carranza J r., F. (1990). Glickman's Clinical Periodontology. (7th ed.). WB Saunders Company.

Peter, S. Essentials of Preventive and Community Dentistry. (2nd ed.). New Delhi: Arya Publishing House.

Harris, N. O., & Christen, A. G. Primary Preventive Dentistry. (4th ed.). Connecticut: Appleton and Lange.

Darby, M. L., & Walsh, M. M. Dental Hygiene, Theory, and Practice. Toronto: W.B. Saunders Company.