Preventive and community

dentistry II
DMFT Index I and II

D Caroline Mohamed
7 semester
D Caroline Mohamed

Objectives

DMFT index
Caries detection
Criteria for caries
Calculation of DMFT
Root caries measurement

D Caroline Mohamed

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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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

Decayed

Restored

Restored

Restored

Decayed

Restored
Restored
Missed

Missed

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Bitewings

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Inferior teeth D..0 M..2 F..4

Missed

Missed
Filled

Filled

Filled

Filled

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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

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!

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Identify Tooth decay....

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Thanks

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