RU2307593C1 - Index estimation method for estimating oral cavity hygiene quality in young people - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves counting the number of poorly cleaned teeth and examining the whole dental row. Thin coating being detected on a dental surface is assessed with 1 point. Index value is equal to the number of points. The index being equal to zero, oral cavity hygiene is considered to be good. The value being equal to 1-6, oral cavity hygiene is considered to be satisfactory. The value being equal to 7-12, oral cavity hygiene is considered to be unsatisfactory. The value being equal to 13 and higher, oral cavity hygiene is considered to be in critical situation.

EFFECT: high accuracy of prognosis.

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Description

The invention relates to medicine, more specifically to therapeutic dentistry and the prevention of dental diseases, and is intended to determine the level of oral hygiene in young people by a new index assessment.

According to modern concepts, the infectious factor plays a crucial role in the etiology and pathogenesis of major dental diseases, such as caries and periodontal diseases. The pathogenic effect of microorganisms is associated with the formation of dental plaque. Poor oral hygiene in this case is considered as the main factor contributing to the formation and development of dental plaque. The characteristics of the initial clinical situation, the preparation of a treatment plan, the patient’s motivation for proper oral care, and the determination of the effectiveness of treatment and prophylactic measures require objective methods that clearly reflect the patient’s oral hygiene. Currently, there are no specific recommendations for the use of hygiene indices in any age group, in particular for young people. Proper, rational and well-organized oral hygiene in this age period can prevent the development of many dental diseases or suspend them at the initial stage. Therefore, the initial hygiene situation requires special attention and a special approach.

Currently, there are four groups of hygiene indices, taking into account the area, thickness, mass of plaque and physical, chemical and microbiological parameters.

Indices associated with the measurement of mass of dental plaque, proposed T.M. Marthaler et al. (1961), R. Caldwell et al. (1970), are technically complex and time-consuming, which limits their use in a clinical setting.

The J. Silness (1964) and N. Loe (1967) index, based on determining the thickness of the dental plaque in each of the four gingival regions of the tooth, is distinguished by subjectivity of assessment and the difficulty of calculating this index, which also impede its practical application.

The main group of currently known hygiene indices is based on determining the area of dental plaque on the tooth surface. These are indices proposed by S. Ramfjord (1956), R. Shick, M. M. Ash (1961), IMNavy, E. Quiqley, I. Hem (1962), Podshadley, Haley (1968), R. Stallard (1969 ), S. Turesky (1970), Fedorov Yu.A., Volodkina V.V. (1971). The level of oral hygiene using these indices is determined by the formula: hygiene index = the sum of the indicators of each tooth / number of teeth. The disadvantage of these indices is the subjectivity and complexity of determining the score for each surface, calculating the sum of the values of six teeth or the entire dentition, and then dividing this amount by the number of teeth takes a certain amount of time and requires a schematic record, which is not provided by an outpatient card of a dental patient.

The most objective at present is the simplified oral hygiene index OHI-S (Oral Hygien Indices - Simplified) (Green, Wermillion, 1964). It allows you to determine the plaque, tartar index and general index, but more often only the plaque index is used. To determine the index, examine the vestibular surface of 16, 26, 11 and 31 teeth; lingual surface of 36 and 46 teeth. The amount of plaque is estimated by a three-point system. A simplified oral hygiene index is determined by dividing the sum of the values of each tooth by the number of teeth. Evaluation criteria for plaque indicators: 0-0.6 - a good level of oral hygiene; 0.7-1.6 - a satisfactory level of oral hygiene; 1.7-2.5 - unsatisfactory level of oral hygiene; 2.6-3.0 - poor oral hygiene.

Despite the fact that the oral hygiene index OHI-S (Oral Hygien Indices - Simplified) (Green, Wermillion, 1964) is widely used both for scientific research and in everyday dental practice, it has several disadvantages:

- the presence of dental plaque is determined only on six teeth;

- the assessment of the amount of plaque and tartar in relation to the size of the vestibular or oral surface is subjective;

- to calculate the index, additional time and a calculator are necessary, which is not always possible and convenient at the dental appointment;

- assessment criteria, expressed in a four-point gradation by numbers with tenths, are remembered and interpreted with great difficulty;

- there is no practical difference between an “unsatisfactory” and a “poor” level of oral hygiene.

The aim of the invention is to optimize the determination of the level of oral hygiene in young people by using a new method of index assessment.

The goal is achieved by the fact that in the method of index evaluation of the level of oral hygiene according to the invention, an index is determined showing the number of poorly cleaned teeth. Examine the entire dentition. The presence of plaque on any tooth surface is considered as one point. The value of the index is equal to the number of points. For ease of registration and further training in oral hygiene, you can use the dental formula in the outpatient card of a dental patient, noting the fact of the presence of dental deposits with a dot above the tooth.

Evaluation Criteria:

0 - a good level of oral hygiene (a hygienist consultation is not required);

1-6 - a satisfactory level of oral hygiene (correction of teeth brushing);

7-12 - unsatisfactory level of oral hygiene (training in oral hygiene with the selection of means and objects of oral hygiene, hygiene level control);

13 and more - a critical level of oral hygiene (training in oral hygiene, the selection of means and objects of oral hygiene, hygiene control, the use of therapeutic and prophylactic agents that affect hard tooth tissues and periodontal tissues).

Evaluation criteria are calculated as follows. For the average number of teeth, 30 are taken, similar to already existing indices, for example, the PMA Scour E., Massler J. model Parma (1960), designed to determine the degree of gum inflammation, where at the age of 6-11 years the number of teeth in the subject is taken for 24 , aged 12-14 years old for 28 and aged 15 years and older - for 30.

A good level of hygiene is considered, at which all teeth are cleaned qualitatively. 30 teeth are taken as 100%, therefore, an index showing the number of teeth having dental deposits, in this case, should be zero. A condition is considered satisfactory when not more than 20% of the teeth are cleaned poorly, that is, no more than six. An unsatisfactory level of hygiene is determined in the presence of dental plaque by 21-40% of the teeth, which corresponds to an index value of 7 to 12. In addition, the category “critical level of oral hygiene” is distinguished under the condition when more than 40% or 13 or more are covered with microbial plaque teeth.

This index does not imply taking into account the amount of plaque on the tooth surface, since most often this definition is relative and subjective. In addition, a dental plaque covering only the gingival part of the tooth crown is sufficient for a pathogenic effect on periodontal and hard tooth tissues.

The proposed index has slight limitations for use in young people, in the event that there is significant tooth loss. On the other hand, it can be used to determine the level of oral hygiene in older people, provided that the dentition is preserved.

A comparative analysis of the claimed and known (simplified index of oral hygiene (Green, Wermillion, 1964)), selected for the prototype, hygiene indices showed that the difference between the proposed method is a more accurate result of the level of oral hygiene in young people and the simplicity of determining the index.

The presence of distinctive features from the prototype of the signs ensures that the proposed method meets the criterion of "novelty."

The author for the first time proposed a method for index estimation of the level of oral hygiene in young people, which takes into account the presence of dental deposits on all surfaces of the dentition and does not require additional calculations. The proposed index is based not on the area of dental plaque covering the tooth surface, but on the number of teeth having dental plaque. Evaluation criteria, expressed in whole numbers, include the new term - “critical level of oral hygiene”, designed to draw the patient's attention to his condition and motivate him to take good care of the oral cavity.

Significant distinguishing features - examine the entire dentition, the presence of plaque and (or) tartar on any surface of the tooth is taken into account as one point. The value of the index is equal to the number of points.

Evaluation Criteria:

0 - a good level of oral hygiene (a hygienist consultation is not required);

1-6 - a satisfactory level of oral hygiene (correction of teeth brushing);

7-12 - unsatisfactory level of oral hygiene (training in oral hygiene with the selection of means and objects of oral hygiene, hygiene level control);

13 or more - a critical level of oral hygiene (training in oral hygiene, selection of means and objects of oral hygiene, hygiene control, the use of therapeutic and prophylactic agents that affect hard tooth tissues and periodontal tissues) are new and ensure compliance with the claimed technical solutions to the criterion of "significant differences".

The inventive method is as follows.

The presence of plaque and (or) tartar on all teeth of the upper and lower jaw is determined. The vestibular, oral, medial, distal and occlusal surfaces of molars and premolars and the vestibular, oral, medial and distal surfaces of incisors and canines are examined. Research can be carried out both with the help of a dental probe, and with the help of dyes. In the process of inspection, teeth are counted on which there is dental deposit. For ease of registration and further training in oral hygiene, you can use the dental formula in the outpatient card of a dental patient, noting the fact of the presence of dental deposits with a dot above the tooth. Since plaque and (or) tartar on any tooth surface are taken into account for one point, and the index value is equal to the number of points, a simple count of teeth with dental plaque completes the process of determining the index.

The patient’s oral hygiene level is determined by evaluation criteria: 0 - a good level of oral hygiene (hygienist consultation is not required); 1-6 - a satisfactory level of oral hygiene (correction of teeth brushing); 7-12 unsatisfactory level of oral hygiene (training in oral hygiene with the selection of means and objects of oral hygiene, hygiene level control); 13 and more - a critical level of oral hygiene (training in oral hygiene, the selection of means and objects of oral hygiene, hygiene control, the use of therapeutic and prophylactic agents that affect hard tooth tissues and periodontal tissues).

The author has determined the level of oral hygiene in 31 patients aged 17-30 years by the proposed index assessment method.

An excellent level of oral hygiene was determined in 2 patients, satisfactory in 7 patients, unsatisfactory in 13 patients, a critical level of oral hygiene was determined in 8 patients.

The hygiene results of the same patients obtained using the simplified oral hygiene index (Green, Wermillion, 1964) were as follows: a good hygiene level was observed in 10 people, a satisfactory level was observed in 14, an unsatisfactory level of hygiene was found in 2 patients, a poor level hygiene using a simplified oral hygiene index has not been determined in any person.

Comparison of the research results for the two indices showed that the proposed index is more individual, since one value of the Green-Vermilion index corresponded to several values of the new index (table).

Table
Comparative data on the level of oral hygiene Hygiene Level (OHI-S) Matching results (person) Matching Results (%) Hygiene Level (Proposed Index) good 2 6.7 good good 7 23.3 sat. good 5 16.7 unsatisfied. good one 3.3 critical sat. 0 0 sat. sat. 8 26.7 unsatisfied. sat. 6 20,0 critical unsatisfied. 0 0 unsatisfied. unsatisfied. 2 6.7 critical bad 0 0 critical

Thus, the studies showed that the proposed method of index assessment is simple, complete coverage of the dentition, a new more individual system for assessing the level of oral hygiene in young people.

Example 1. The patient M-va, 19 years old, complained of bleeding gums when brushing teeth. When examining the patient’s dentition with a dental probe, plaque was detected on the vestibular, oral and contact surfaces of the upper first and second molars and premolars on the right and left. The plaque covered up to 1/3 of the surface of the crowns. The patient’s upper wisdom teeth were absent. Upper incisors and fangs were free of dental deposits. In the lower molars and premolars, plaque was determined on the vestibular, oral and contact surfaces. On the vestibular side, he covered 2/3 of the surface of the crown, on the lingual up to 1/3 of the surface. In the lower third molars, plaque was also determined on the occlusal surface. Soft dental deposits were determined on the lingual surface of the lower incisors and canines. During the examination, the assistant noted the fact of the presence of dental plaque in the dental formula (a point above the tooth). Thus, the patient's dental deposits were determined on 24 teeth, respectively, the proposed index is 24, which indicates a critical level of oral hygiene.

For a comparative analysis of the results, we determined the level of oral hygiene using the most commonly used simplified oral hygiene index (OHI-S). First, the number of points was calculated on six teeth: on the vestibular surface of 16, 26, 11 and 31 teeth and lingual surface of 36 and 46 teeth. Given that on all these teeth, plaque covers no more than 1/3 of the crown surface, which corresponds to one point, the total score is five. Dividing the amount by the number of teeth received the index value, it is 0.8. This corresponds to a satisfactory level of oral hygiene.

Example 2. The level of oral hygiene in the patient Pnoy, 20 years old, was determined after preliminary use of chewable tablets to detect dental deposits. The patient revealed a soft plaque covering up to 2/3 of the vestibular surface of the upper canines, which was associated with their palatine location. On the oral surface of the lower incisors, a supragingival tartar was determined. No deposits were found on the remaining teeth.

Thus, the patient's dental deposits were determined on 6 teeth, respectively, the proposed index is 6, which indicates a satisfactory level of oral hygiene.

To calculate the simplified oral hygiene index (OHI-S) in this patient, the number of points on six teeth was first determined: on the vestibular surface of 16, 26, 11 and 31 teeth and lingual surface of 36 and 46 teeth. Given that dental deposits were not determined on these surfaces and the total score is zero, the index value is also zero, which corresponds to a good level of oral hygiene.

Example 3. Patient Kev, 26 years old, applied for a routine examination. When examining the dentition with a dental probe, plaque was detected on the vestibular, oral and contact surfaces of 18, 17, 16, 28, 38, 37, 35, 45, 47, 48 covering up to 1/3 of the crown surface. During the examination, the assistant noted the fact of the presence of dental plaque in the dental formula (a point above the tooth). Dental deposits in the patient were determined on 10 teeth, respectively, the proposed index is 10, which indicates an unsatisfactory level of oral hygiene.

To calculate the simplified oral hygiene index (OHI-S) in this patient, the number of points on six teeth was first determined: on the vestibular surface of 16, 26, 11 and 31 teeth and lingual surface of 37 and 47 teeth (36 and 46 teeth were absent). Considering that on all teeth plaque covers no more than 1/3 of the crown surface, which corresponds to one point, the total score is 4. By dividing the amount obtained by the number of teeth we obtain the index value, it is 0.7, which corresponds to a satisfactory level of cavity hygiene the mouth.

Thus, the presented examples clearly demonstrate the effectiveness of the proposed method for determining the level of hygiene, which greatly facilitates the process and improves the quality of the index assessment of oral hygiene in young people.

Tests of the proposed method have confirmed its advantages over the prototype method: in contrast to the prototype method, the hygiene level result is more accurate and individual, which is achieved by examining the entire dentition, in contrast to the six teeth studied in the prototype method, and a new system of evaluation criteria, expressed in whole numbers. The simplicity of the method for determining the index, which does not require additional calculations, greatly facilitates the application of the proposed method in practical dentistry and in scientific research.

Thus, the proposed invention optimizes the determination of the level of oral hygiene in young people by using a new index estimation method.

Literature

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Claims (1)

The method of index estimation of the level of oral hygiene in young people by calculation, characterized in that the number of poorly cleaned teeth is taken into account, the entire dentition is examined, the presence of plaque on any tooth surface is taken into account as one point, the index value is equal to the number of points, with this index value 0 corresponds to a good level of oral hygiene, 1-6 - a satisfactory level of oral hygiene, 7-12 - an unsatisfactory level of oral hygiene, 13 and more - a critical level of cavity hygiene and mouth.