Unit-IV; Professional Sales Representative (PSR).pptx
Survey procedures in dentistry
1. S U R V E Y
PROCEDURES IN
D E N T I S T R Y
B.Deepthi ragasree
BDS (final year)
2. Survey is a non-experimental type of
research that attempts to gather information
about the status quo for a large number of
people by describing present conditions
without directly analyzing their causes.
Definition
4. Monitoring trends in oral
health
and disease:
When national
surveys are repeated
periodically under general
similar conditions, broad oral
health trends over time can
be estimated, provided the
sampling design so
permits.The
WHO's pathfinder survey
protocol when repeated
periodically can assess
trends in health and disease
and it is assumed that the
results are valid enough to
support national policy
decisions.
Policy development:
Survey data can be used to
establish oral
health strategies. Scotland
has successfully
used survey data to develop
its oral health
policy. A number of
American States
switched their primary
preventive focus from
fluoride mouth-rinsing to
sealant application
after statewide surveys
showed most carious
lesions to be in pits and
fissur
Program evaluation:
Survey data are
often used to evaluate
programs though the
principle that
association does not
show cause-and-effect
needs to be
remembered.The success
of particular programs
can only be inferred from
survey data, though the
more localized the survey
and the program, then
the more plausible is the
inference.
5. Assessment of dental
needs:
Although surveys
can be used for assessment
of needs, there is a clear gap
between the criteria used in
surveys and those applied
for individual patient care.
e.g. criteria for caries in
surveys usually are based on
cavitation, but dentists
generally intervene at
an earlier stage in the
carious process.
Providing visibility to
dental issues:
The visibility that oral
health acquires through
the mere existence of
data from a national
survey may be the most
important of all uses of
survey data.
6. METHODS OF DATA COLLECTION
Health interview survey: (face-to-face survey)
It is an invaluable method of measuring
subjective phenomena, such as perceived morbidity, disability and impairment;
opinions, beliefs and attitudes and some behavioral characteristics.
Health examination survey: This survey is carried out by teams consisting of
doctors and auxiliaries.
Disadvantages:
1)It is expensive and cannot be carried out on an extensive scale.
2)The method also requires consideration of providing treatment to people found
suffering from certain disease.
7. METHODS OF DATA COLLECTION
Health records survey : It involves the collection of data from health service
records. This is obviously the most economical method of collecting data.
Disadvantages:
a. The data obtained is not population-based.
b. Reliability is open to question.
c. Lack of uniform procedures and standardization in the recording of data.
Questionnaire survey:
The use of questionnaires and interviews is
a standard method of data collection in
clinical,epidemiological, psychosocial
and demographic research. It is used for
measuring subjective phenomena.
8. METHODS OF DATA COLLECTION - QUESTIONARIE SURVEY
Types:
1) Mailed
questionaries
2) Telephone
questionaries
3)Face-to-face
questionaries
ADVANTAGES:
• Simple
• Economical
• Standardization -
Written instructions
reduce biases from
differences in
administration.
• Anonymity -Privacy
encourages candid
and honest
responses to
sensitive questions.
Disadvantages:
A certain level of
education and skill is
expected from the
respondents.
There is usually a high
rate of nonresponse.
9. Open ended
questions-
Free response
Closed ended
questions- fixed
alternative
The subject answers in his own words. This may produce difficulties when
interpreting the responses, e.g. How many cigarettes do you smoke per day?
They are answered by choosing from a number of fixed alternative
response.
Eg: How many cigarettes do you smoke per
day?
a. Upto -10 b. 10-20
c. 20 -30 d. More than 30
The 2 types of scales most commonly used are :
1)Likert Scale: (Summative)
2)Guttman scale: (Cumulative)(Scalogram)
????
10. Likert Scale: (Summative) Commonly used to quantify
attitudes and behavior. Respondents are asked to select a
response that best represents the rank or degree of their
answer.
E.g. The respondent may be asked to indicate whether he
strongly agrees, agrees, neither, disagrees or strongly
disagrees with the statement. Each response is assigned a
number. The points of each item is added.
Guttman scale: (Cumulative) (Scalogram)
These contain a series of statements that
express increasing intensity of a characteristic.
The respondent is asked to agree or disagree
with each statement. The respondents score is
the total number of items with which he agrees
or disagrees.
12. 1) Establishing the objectives:
The objectives can either be stated in the form of a hypothesis which is to be
tested, or, the objective may be stated by describing what is to be measured.
The starting point of a study is frequently an expression of a null hypothesis, which
states that there is no difference between the groups.
Eg: There is no difference in the periodontal
status of males and females aged 35-44 years in
Mangalore. The objective of the
study is then to test this hypothesis
Eg: To determine the prevalence of dental
caries among 12 year old school children
in Mangalore.
13. 2) Designing the investigation:
Survey protocol: It is important to prepare a written protocol
for the survey, which should contain,
Main objective and purpose of the survey,
A description of the type of information to be collected and
of the methods to be used.
A description of the sampling methods to be used.
Personnel and physical arrangements.
Statistical methods to be used in analyzing the data.
A provisional budget.
A provisional time-table of main activities and responsible
staff.
14. 1 ) Obtaining approval from authorities:
Permission to examine population groups must usually be obtained
from a local, regional or national authority.
E.g. If school populations are to be examined, schoolauthorities and
the parents should be approached for obtaining permission.
2) Emergency care and referral:
All survey teams should be equipped for and
ready to provide emergency care if required.
It is also the responsibility of the examiner to
ensure an appropriate care facility is made.
3 ) Budgeting: A budget for the survey should be prepared
which should include all the resources required to carry out the
survey.
15. 3) Selecting the sample:
Sample
Collect information from these
people to find answers to your
Research questions
Study population:
Sampling units
Make an estimate of their
prevalencein the study
population from sample
findings
Select a few
sampling units from
the study
population
Reference or
parent
population
16. METHODS OF SAMPLING :
1) Simple random sampling
It is a technique whereby each
sampling unit has the same probability
of being selected.
Every item in population has an equal
chance of being included.
Basic procedure:
• Prepare a sampling frame
• Decide on the size ofthe sample
• Select the required number of unit
17. 1) Simple random sampling
LOTTERY METHOD TABLE OF RANDOM
NUMBERS
Here the population units are
numbered on separate slips of paper of
identical size and shape
These slips are then shuffled and blind
fold selection of the number of slips is
made to constitute the desired sample
size
Random numbers are haphazard
collection of certain numbers,
arranged in a cunning manner to
eliminate personal selection or the
unconscious bias in taking out the
sample
18. The first unit is chosen at random and
then, other units are chosen in a
systematic way.
E'.g. Every third patient visiting the
dentist.
(2) Systematic sampling
19. (3) Stratified sampling
The population is first divided into
subgroups or strata according to
certain common characteristics. Then
random or systematic sampling is
performed independently in each
stratum:
Stratified random sampling
Stratified systematic sampling
20. (4) Cluster sampling
A simple random sampling is
selected, not of individual subjects,
but of groups or clusters of
individuals.
The sampling units are clusters and
the sampling frame is a list of these
clusters
21. (5) Multiphase sampling
This is used to take basic data from a large sample
and details from a subsample.
It is a sub-sampling within groups chosen as
cluster samples. The first stage is to select the
groups or clusters.
Then sub-samples are taken in as many
subsequent stages as necessary to obtain the
desired sample size
Eg : Nutritional status of the country
(6)Multistage sampling
22. (7) Panels
They are useful for studying trends. A sample is randomly
selected and then data are collected from the sample on
several occasions.
E.g. Every person is interviewed every 6 months.
A small sample is tested in order to answer certain
questions about the population.
If the questions are not answered, the number of
subjects or units in the sample is increased
gradually until the conclusions may be drawn.
(8) Sequential sampling
23. The examination should be as automatic as
possible to obviate excessive intrusion of
subjective thought. Therefore it should be
performed quickly.
The object of epidemiological surveys is to
examine subjects in fairly large numbers.
Excessive time spent on each individual
necessitates a reduction in the number of
individuals seen.
4.Conducting the Examination : BASIC ORAL HEALTH
EXAMINATION
5 - 10 minutes
15 - 20 minutes
24. • Plane mouth mirrors - 30 per examiner
• Periodontal probes - 30 per examiner
• Several pair of tweezers
• Containers and concentrated sterilizing solution.
• A wash basin
• Cloth or paper hand towels
• Gauze.
Instruments & supplies
Infection control :
Current national recommendations and
standards should be followed for
• Infection control
• Waste disposal
• Disposable masks, gloves, protective eyewear
recommended.
25. CHAIR: Preferable with a head rest. Most comfortable
situation is for the subject to be on a table/bench,
and examiner to sit behind the subject’s head.
ILLUMINATION: A separate unit lamp attached to
head of the examiner fibre optic light source.
CLEANING: Method to remove loose debris where
necessary.
ASSESSMENT FORMS: Adequate supply. Avoidance of
crowding and noise around the examiner.
RECORDER: Live or tape for receiving information
called by the examiner.
ORGANIZING CLERK: To maintain constant flow of
subjects and to enter general descriptive info on
forms.
EXAMINATION AREA :
26. It is used to calculate intra and inter examiner
reproducibility.
It is an index which compares the agreement
against that which might be expected by chance.
Kappa can be thought of as the chance-corrected
proportional agreement, and possible values range
from + 1 (perfect agreement) via 0 (no agreement
above that expected by chance) to -1 (complete
disagreement).
KAPPA STATISTIC:
KAPPA VALUE INTERPRETATION
1 Total agreement
> 0.8 Good
agreement
0.6 - 0.8 Substantial
agreement
0.4 - 0.6 Moderate
agreement
27. CLASSIFICATION OF TYPES OF INSPECTION AND
EXAMINATION :
TYPE 1: Complete examination using mouth mirror
,explorer, good illumination, full mouth radiographs, &
additional diagnostic methods (pulp testing, study models,
transillumination etc.)
TYPE 2: Limited examination, using mouth mirror and
explorer, bitewing radiographs. Periapical radiographs if
indicated.
TYPE 3: Inspection using mouth mirror ,explorer & good
illumination.
TYPE 4: Screening procedure - tongue depressor,
available illumination.
28. (5)ANALYZING DATA :
Once the examination procedures of a survey have been completed,
the work of assembling the material and interpreting it begins.
01
02
The analysis of findings has two
components:
Data processing (statistical analysis)
Interpretation of result
29. (6) Drawing the conclusions and publishing the report:
The conclusions are specifically related to
the investigation that has been carried out
and The final step in a survey procedure should be
the construction of a report with or without a set of
recommendations. Clearness and simplicity should
be sought.
30. 1. Statement of the purposes of the survey.
2. Material and methods.
A) Description of area and population served.
B) Types of information collected
C) Methods of collecting data
D) Sampling method
E) Examiner personnel and equipment
F) Statistical analysis and computational procedure
G) Cost analysis
H) Reliability and reproducibility of results.
3. Results: They should be tabulated and illustrated
appropriately.
4. Discussion and conclusions: The investigations, its
findings and its conclusions are discussed.
5. Summary.
31. ORAL HEALTH SURVEYS
PATH FINDER SURVEYS
The special factors associated with the most
common oral diseases which have enabled a
practical economic survey sampling methodology to
be defined, called the
"pathfinder method".
The "pathfinder method" is a stratified cluster
sampling technique, which aims to include the most
important population subgroups likely to have
differing disease levels.
33. PILOT SURVEY NATIONAL PATH FINDER SURVEY
Only the most important
subgroups in the
population.
One or two index ages
12 years and one other
age group.
Provides the maximum
amount of data needed
to commence planning
Incorporates sufficient
examination sites to cover all
important subgroups of the
population
Atleast three of the index age
groups.
Suitable for collection of data for
planning purposes & monitoring
of oral health programmes in all
countries regardless of the level
of disease, availability of
resources/complexity of care.
35. 5 YEARS INDEX AGE GROUP
Children should be examined between 5th - 6th
birthdays.
• Caries levels in Primary dentition
• Exhibit changes over a short span of time than
in permanent dentition at other index ages
• In some countries, 5 years is also the age at
which children begin primary school.
36. 12 YEARS INDEX AGE GROUP
• Children leave primary school.
• Last age at which a reliable sample may be
obtained easily through school system.
• All permanent teeth (except 3rd molars)
are likely to have erupted.
• Chosen as “global indicator age group
for international comparisons and
surveillance of disease trends”
37. 15 YEARS INDEX AGE GROUP
• Permanent teeth - exposed to oral
environment for 3-9 years.
• Assessment of caries prevalence and
periodontal disease in adolescents. (15-19yrs)
• In countries where it is difficult to obtain a
reliable sample of this
age group, it is customary to examine
individuals in two-three areas
38. 35 - 44 YEARS INDEX AGE GROUP
Standard age group for surveillance of oral
health conditions in adults.
• Planners & decision-makers can assess the full
effect of dental caries, level of severe
periodontal involvement, & general effects of
oral health care provided.
• Samples can be derived from organized
groups - office, factory workers etc.
• Care must be taken to avoid obvious selection
bias.
39. 65 - 74 YEARS INDEX AGE GROUP
• Has become important with the changes in
age distribution of populations and the
worldwide increase in lifespan.
• Estimate the manifestation of oral disease
from a life course perspective.
• Data needed : planning appropriate
interventions for older people and
for assessment of the ultimate effect of oral
health programmes
• Sampling - care should be taken to sample
adequately both house bound & active
members of this age group.
40. NUMBER OF SUBJECTS
The number of subjects in each index age group to
be examined ranges from a minimum of 25 to 50
for each cluster or sampling site, depending on the
expected prevalence and severity of oral diseases.
If this cluster distribution is applied to four index ages in the population
under study, the total sample is 4 x 300 = 1200.
Permits the identification of differences
- between urban and rural group.
- between socioeconomic groups.
- areas where prevalence is much higher or lower.
41. THE WHO ORAL HEALTH ASSESSMENT FORM
(1997)
The WH O Oral Health Assessment Form 1997 is a universally accepted and
used recording methodology for oral health surveys.
STANDARD CODES
If some of the oral health assessments are not carried out, or are not
applicable to the age group being examined, the unused sections of the
form should be canceled with a diagonal line, or by using code 9.
The forms are designed to facilitate computer processing of the result.
The two-digit numbers above or below some of the boxes indicate specific
teeth, according to the system used by the International Dental Federation
(FDI).
42. 1. Survey identification information
2. General information
3. Extra-oral examination
4. Temporomandibular joint assessment
5. Oral mucosa
6. Enamel opacities/hypoplasia
7. Dental fluorosis
8. CPI (periodontal status, formerly called Community Periodontal Index of
Treatment Needs or CPITN)
9. Loss of attachment
10.Dentition status and treatment need
11 .Prosthetic status
12.Prosthetic need
13.Dentofacial anomalies
14.Need for immediate care and referral
15. Notes
ORAL HEALTH ASSESSMENT FORM SHOULD
INCLUDE
47. • During planning - a list of examination sites & of
the examiners involved in the study should be made
& a code assigned to each examiner.
• The coding list should also include the numeric
codes to be used for other relevant information
such as the fluoride content of drinking water or
use of fluoride supplements.
Identification and general
information sections of the form
48. • Country in which the survey is carried out.
• Should not be filled by the investigator.
BOX 1 - 4
WHO code for the country
49. • Should be recorded at the time of examination.
• Enables an investigator to refer back to examinations held
on any particular day which may need to
be reviewed or checked.
BOX 5 - 8
Essential info: year, month, date
50. • Each subject examined should be given an identification number.
• Should always have the same number of digits as the total
number of subjects.
• e.g:1200 subjects . . . first subject - 0001.
• If possible, ID no.s be entered before commencing the
examinations.
BOX 11- 14
Identification number
51. • If more than one examiner is participating in the survey.
• Each examiner should be assigned a specific code.
BOX 15
EXAMINAR
52. • If the subject will be re-examined to assess reproducibility,
original examination is scored “1” & any subsequent examinations
are coded “2”, “3”, “4” etc.
• For all subjects for whom duplicate examinations are made, data
from the 1st examination only are included in
the survey analysis.
BOX 16
Original / Duplicate examination
53. • In Block letters.
• In some countries, identification of survey subjects by name is
not permitted, in such case - space should be left blank.
NAME
54. • Year, month and day of birth
• For cross-checking purposes.
• age at last birthday.
• 6 years is coded as “06”.
• when age is not known - ‘estimated age’: eruption
status, major life events etc.
• Manner of estimation should be reported.
Date of birth (17 - 20)
Age (21 - 22)
SEX - 23
• Must always be recorded, because it is not
always possible to tell a person’s sex from the
name alone.
• 1 = Male, 2 = Female.
55. • In different countries, ethnic groups may be identified in
different ways, by area or country of origin, race, color, language,
religion or tribal membership.
• local health & education authorities should be consulted.
• May be obtained from govt. agencies or school administrative
data at the time of sample selection.
Other Group: To identify different subpopulation groups.
BOX 24 Ethnic group
56. A coding system should be devised according to local usage to identify
different occupations and appropriate code entered.
BOX 25 OCCUPATION
BOX 26 - 27 Geographical location:
• To record the site where examination is being conducted.
• 01 - 98
• ’99’ entered if this information is not recorded.
• Community information is useful for health administrators for planning or
revising programs or strategies.
57. • General information about the local environmental conditions
& availability of services at each site.
1 Urban site
2 Periurban area: areas surrounding major towns with very few
health facilities & limited access.
3 Rural area or small village.
BOX 28
LOCATION
58. • use of tobacco, SES, physical environment, levels of fluoride
etc.
• Frequency of sugar intake.
BOX 29 - 30
OTHER DATA
59. Examiners should use their judgement in matter.
The following codes are used ;
0 - No contraindication
1 - Contraindication
BOX 31
Contraindication to examination
60. In order, to ensure that all conditions are
detected and diagnosed, it is recommended
that the clinical examination follows the order
of the assessment form.
CLINICAL ASSESSMENT
64. Symptoms (box 33).
The following codes and criteria are
used;
0 - No symptoms
1 - Occurrence of clicking, pain or
difficulties in opening or closing the
jaw once or more per week.
9 -Not recorded.
Signs (boxes 34 - 36).
The following codes and criteria are used;
0 - No signs
1 - Occurrence of clicking, tenderness (on
palpation) or reduced jaw mobility (opening
< 30 mm).
9 - Not recorded.
Clicking (box 34) of one or both temporomandibular joints.
Tenderness (on palpation) (box 35) of the anterior temporalis
and/or masseter muscles on one or both sides.
Reduced jaw mobility (box 36) - opening of < 30 mm , taken as the
distance between the incisal tips of the central maxillary and
mandibular incisors
65. Oral mucosa: (boxes 37 - 42)
The examination should be thorough and systematic and be
performed in the following sequence :
a) Labial mucosa and labial sulci (upper and lower)
b) Labial part of the commissures and buccal mucosa (rightand left).
c) Tongue (dorsal and ventral surfaces, margins)
d) Floor of the mouth
e) Hard and soft palate
f) Alveolar ridges/ gingiva (upper and lower).
66. The codes and criteria are :
0 - No abnormal condition
1 - Malignanttumor (oral cancer).
2 - Leukoplakia
3 - Lichenplanus
4 - Ulceration (aphthous, herpetic,
traumatic)
5 - Acute necrotizing gingivitis
6 - Candidiasis
7 - Abscess.
8 - Other condition (specify if
possible)
9 - Not recorded.
The main location of the oral
mucosal lesion(s) should be
recorded in boxes 40 - 42 as
follows;
0 - Vermilion border
1 - Commissures
2 - Lips
3 - Sulci
4 - Buccal mucosa
5 - Floor of the mouth
6 - Tongue
7 - Hard and/or soft palate
8 - Alveolar ridges/gingiva.
9 - Not recorded.
67. Enamel opacities / hypoplasia: boxes ( 43 - 52)
The codes and criteria are as follows:
0 - Normal
1 - Demarcated opacity
2 - Diffuse opacity
3 - Hypoplasia
4 - Otherdefects
5 - Demarcated and diffuse opacities
6 - Demarcated opacities and hypoplasia
7 - Diffuse opacity and hypoplasia
8 - All three conditions
9 - Not recorded
68. Dental fluorosis: (box 53)
Fluorotic lesions are usually B/L symmetrical.Horizontal striated
pattern across the tooth. Premolars > 2nd molars > Maxillary incisors.
• Criteria: Dean’s Index:
0= NORMAL - smooth enamel surface, glossy, pale-creamy white color.
1= QUESTIONABLE - slight aberrations in translucency of enamel, few
white flecks.
2= VERY MILD - small, opaque, paper-white areas scattered irregularly.
3= MILD - white opacities >25% but <50%.
4= MODERATE - marked wear, brown staining.
5= SEVERE - marked hypoplasia. Pitted or worn areas, widespread brown stains.
8= EXCLUDED
9= NOT RECORDED
69. Community Periodontal Index (CPI): (boxes 54 - 59)
The scoring criteria:
0 - Healthy
1 - Bleeding observed directly or by using
mouth mirror after probing
2 - calculus detected during probing but all of
the black band on the probe is visible.
3 - pocket 4- 5 mm (gingival margin within the
black on the probe)
4 - pocket 6mm or more (black band on the
probe not visible)
X- Excluded sextant (less than two teeth
present)
9 Not recorded
Loss of attachment:
0 - Loss of attachment 0-3mm (CEJ not visible
and CPI score 0-3)
1- Loss of attachment 4-5mm (CEJ within the
black band)
2- Loss of attachment 6-8mm (CEJ between the
upped limit of the black band and 8.5mm ring)
3 -Loss of attachment 9-11mm(CEJ between
the 8.5mm & 11.5mm rings)
4 -Loss attachment 12mm /more (CEJ beyond
the 11.5 mm rings)
X-exluded sextant (less than two teeth present)
9 - Not recorded (CEJ neither visible nor
detectable
71. Dentition status and treatment need: (boxes 66-161)
• Examination for dental caries - plane mouth mirror.
• Use of radiography for detection of proximal caries is not
recommended impractical in most filed situations.
• Examiners should adopt a systematic approach.
• Proceed in orderly manner from one tooth to adjacent
tooth or tooth space.
• A tooth should be considered present in the mouth
when any part of it is visible.
• If a permanent & primary tooth occupy the same space,
the status of permanent tooth should be recorded.
72. Dentition status and treatment need: (boxes 66-161)
• An entry must be made in every box pertaining to the coronal & root
status of a tooth.
• In children, root status is not assessed, so the corresponding boxes have
been omitted.
73. Dentition status and treatment need: (boxes 66-161)
0(A) - Sound crown
No evidence of
treated/untreated
caries
Early stages of caries
White /chalky spots
Stained enamel pits
&fissures
Dark, shiny,hard,pitted
areas of enamel
Sound root: when it is
exposed and showed no
evidence of treated
clinical caries.
1(B)Decayed crown
Undermind enamel
Detectable softened
floor
If carious lesion on root,
doesn't involve crown,it
should be recorded as
root caries,temporary
filling.
Decayed root: If the root
caries is discrete from the
crown and will require a
separate treatment, it
should be recorded as root'
caries.
2 (C) Filled crown, with
decay:
A crown that has
one/more permanent
restorations & one/more
ares are decayed
Filled root, with decay:
A root is considered
filled, with decay, when it
has one or more
permanent restorations
and
one or more areas that
are decayed.
74. Dentition status and treatment need: (boxes 66-161)
3(D)Filled crown with no
caries:
A crown that has one/more
permanent restorations are
present & there is no caries
anywhere.
Filled root, with no
decay:
A root is considered filled,
without decay,
when one or more
permanent restorations
are present and there is no
caries anywhere
on the root.
4(E)Missing tooth,due to
caries:
Permanent/primary teeth
extracted because of
caries.Recorded under
coronal status
5(-) Permanent tooth
missing due to any other
reason:
Absent congenitally
extracted for orthodontic
reasons, periodontal
disease,trauma etc
6 (F) Fissure sealant:
A fissure sealant has been
placed on occlusal surface
7(G) Fixed dental
prosthesis
abutment,crown/veneer
8(-) Unerupted tooth:
Teeth scored as Unerupted
are excluded from all
calculations concerning
caries.
Unexposed root - 8
9(-)Not Recorded:
Used for an erupted
permanent tooth that
cannot be examined
For any reason such as
orthodontic bands,severe
Hypoplasia,calculus etc
75. Prosthetic need: (boxes 164 and
165)
0- No prosthesis needed.
1- Need for one-unit prosthesis
(one tooth replacement).
2- Need for multi-unit prosthesis
(more than one tooth
replacement)
3- Need for a combination of one-
and /or multi-unit prosthesis.
4- Need for full
prosthesis(replacement of all
teeth).
5- Not recorded.
Prosthetic status : (boxes 162 and
163)
The presence of prostheses should
be recorded for each jaw (box 162,
upper jaw; box 163, lower jaw).
The following codes are provided for
this:
0- No prosthesis.
1 - Bridge.
2- More than one bridge.
3- Partial denture.
4- Both bridge(s) and partial
denture(s)
5- Full removable denture.
9- Not recorded.
76. Dentofacial anomalies : (boxes 166-176)
The number of missing teeth in the upper and lower arches should be
recorded in boxes 166 and 167 of the assessment form.
Crowding in the incisal segments (box 168)
Crowding in the incisal segments is recorded as follows:
0- No crowding.
1- One segment crowded.
2- Two segments crowded.
Spacing in the incisal segments (box 169)
Spacing in the incisal segments is recorded as follows:
0- No spacing.
1- One segment spaced.
2- Two segments spaced.
77. Dentofacial anomalies : (boxes 166-176)
Diastema (box 170)
Largest anterior maxillary irregularity (box 171)
Largest anterior mandibular irregularity (box 172)
Anterior maxillary overjet (box 173)
Anterior mandibular overjet (box 174)
Vertical anterior openbite (box 175)
Antero-posterior molar relation (box 176)
The right and left sides are assessed with the teeth in occlusion and only the
largest deviation from the normal relation is recorded. The following codes
are used:
0-Normal.
1 -Half cusp. The lower first molar is half a cusp mesial or distal to its normal
relation.
2 -Full cusp. The lower first molar is one cusp or more mesial or distal to its
normal relation.
78. Need for immediate care and referral: (boxes 177-180)
It is the responsibility of the examiner or team leader to ensure that referral to an
appropriate care facility is made, if needed.
Examples of conditions that require immediate attention include
periapical abscess and acute necrotizing ulcerative gingivitis.
Gross caries and chronic alveolar abscesses may also be recorded in box 178.
Three boxes are provided for the recording of the presence (code 1) of the
following condition:
A life threatening condition (oral cancer or precancerous lesion) or other severe
condition with clear oral manifestation (box 177);
pain or infection that needs immediate relief (box l78);
Other conditions, specify (box 179).
If the subject is referred for care, a "1" should be recorded in (box 180)
79. Space is provided at the bottom of the
assessment form for the examiner/recorder to
note, for his or her own reference, any
additional information that might be pertinent
to the subject being examined.
80.
81. Oral Health Surveys, Basic Methods, 4th Edition ,World Health Organization , 1997.
Oral Health Surveys, Basic Methods, 5th Edition , World Health Organization, 2013.
https://apps.who.int/iris/bitstream/handle/10665/97035/9789241548649_eng.pdf?sequence=1
Soben Peter . Essentials of Public Health Dentistry, 5th edition
Hiremath SS, Textbook of Public Health Dentistry, 3rd edition
Marya CM. A textbook of public health dentistry. JP Medical Ltd; 2011 Mar 14.
References
