 Hello everyone, welcome back to a new session on dentistry and more. So, let's start our entire series. So, in this video I will be explaining about the basic definition, classification ideal requisites and the oral debris index that is OHI and OHIS that is oral hygiene indices. So, in the next videos I will be covering more a periodontal indices, caries indices and fluorosis index. So, let's see what is an index. Okay, an index is nothing but numbers which are used to find out the incidence, prevalence and severity of disease based on which preventive programs can be adopted. Or we can say that it is not a definition, we can say that we can express a clinical observation in numerical value. So, the most common definition is given by SLAL. It is a numerical value describing the relative status of a population when graduated scale with definite upper and lower limit which is designed to permit and facilitate comparison with other population classified by the same criterion methods. So, it is nothing but a number which is describing the status of a population. So, what is the status, what is the oral health, what is the caries status, what is the plaque status, what is the ginger status. It is a graduated scale just like a scale with graduation proper markings in between with a definite upper and lower limit. There will be a definite upper limit and lower limit if it is OHIS, upper limit is 6, lower limit is 0 and why we are using this facilitate comparison with other population. So, other population which is classified by the same index we can compare it. So, comparison between the groups is what index is made for. Index should be very clear, the criteria should be very simple and it should be objective. Objective means we have subject and object, the patient is a subject and objective the examiner. So, the rules and criteria can only be decided by the or should be decided by the object. So, if suppose a patient says or the patient has a different opinion about what you finding in his mouth, you cannot trust on the patient's words or patient's judgment. The investigator or the researcher person has to be the final word and it should be acceptable. The index should be acceptable by the patient and there should be sensitivity. Sensitivity means it should be able to detect the very small change in both the direction if it is very bigger or if it is very low, it has to be detect the minute changes. Then, quantifiability, the index should be expressed in numbers and only we can do statistical analysis. So, it should be a number. Anyway, it is a number because the definition itself says it is a number. So, index should be always in a quantity. So, no quality can be measured or compared between each groups or between the different groups. So, it is always should be quantifiable and reliability. We have different types of reliability that is inter-examiner reliability or intra-examiner reliability. So, it can be calculated using capacity statistics. So, it should be more than 0.8 or 80% all the researchers. So, there should be training and calibration should be done before the actual examination. Validity means it should measure what it intends to measure. So, validity we have phase validity, content validity and construct validity. So, if it is a questionnaire based index, we should always check the phase validity, content validity and construct validity before we are playing it. So, these are the ideal requisites of an index that is clarity, simplicity, objectivity, validity, reliability, quantifiability, sensitivity and acceptability. So, it has many uses if it can be used for individual patients in research and community. Community can detect the prevalence and in research we need to do a proper examination to find out baseline data and for individual patient we can check the patients before after oral hygiene status or something like that. So, to motivate the patient after the proper instructions we can compare with indices and produce a result and make him convince that the patient has improved. So, what are the classifications? So, classification is based on the scores fluctuation that is irreversible and reversible. Irreversible indices are oral hygiene indices, plaque indices, ginger indices. So, the scores can be fluctuated. If patient has very poor oral hygiene, the patient score will be very bad but if he is properly cleaning, if properly maintaining the scores will reduce, again it will go back to the older scenario that is reversible index. Irreversible index means tender carries such conditions for periodontal pocket which cannot be reversed depending upon the extent. Full mouth indices are teens, fluorosis index, Russell's periodontal indices, OHI indices, simplified are the shorter versions OHIS that is a simplified indices whereas OHI is a full mouth indices. The next classification is disease index based on the entity, disease, symptom and treatment. Diseases, DMFT, the depotion is disease index. Symptom index is nothing but a ginger index. The presence or absence ginger index or the bleeding index. Treatment index means the T portion of the DMFT. Simple and cumulative index. Simple index means a ginger index. Cumulative index means which records the past condition also that is DMFT index but the past experience carries experiences recorded. So criteria are it should be simple, it should permit examination for many people and require minimum armamentarium and expenditure, should be highly reproducible, should not cause any discomfort, it should be amenable to statistical analysis and there should be a strongly numerically to clinical stages relation should be there. Okay so let's see what is the oral hygiene index. So first we are seeing oral hygiene index given by John C Green and Traca Vermilion in 1960. It is to measure the oral hygiene status of a patient. So we divide the total mouth into six categories, six segments that is we call it as segment or sextant because it is one out of six because we have six segments so we can call it as segment also. So this is the first segment which starts from the third molar on the right side up to premolar. The second segment is canine to canine, here it is premolar to third molar similarly on the lower arch so we have total six arch. So what are the rules of oral hygiene index? The first one is only fully erupted permanent teeth will be recorded, third molars are not commonly recorded, the buckle and lingual score both are taken on a single tooth. So one segment so we will be taking all the buckle scores of here from one four to one eight and whichever tooth is having highest buckle score we will mention that similarly all the lingual score so only one score per segment will be there. So here also all the buckle score will be checked and which tooth is having highest so that score will be mentioned again lingual score so one segment having one buckle score and one lingual score. So what are the debris criteria? So debris is very simple if it is zero means no debris one is one-third of the exposed tooth surface. Two means it is more than one-third but not more than two-third three means it is more than two-third that is debris score. Calculus score also same supra and sub-singeral calculus is there zero means no calculus one is supra-singeral calculus one-third. Two is supra-singeral calculus more than one-third less than two-third but there is addition if there is it is not and it is or either one has to be there or giving score to individual flex okay the score two is for individual flex of sub-singeral calculus or supra-singeral calculus covering more than one-third and less than two-third either this or either this score three is more than two-third supra and there should be a continuous band this is a band this is individual flex okay so for giving three either one should be there either sub-singeral continuous band more than two-third of calculus so this is how we calculate it has two component what is one is debris index one is calculate index so we have buckle score plus lingual score divided by number of segments that is always a denominator will be six so we need to calculate the six segments buckle score and lingual score divided by six again six segments buckle and lingual score of calculus divided by six so finally ojai is equal to da plus ci so usually debris index and calculate index range from zero to six because the maximum score in one segment can be three so let me explain you one segment maximum we get three because out of all these scores the maximum score can be three so all six segments the maximum score will be 18 okay so three three three three similar lingual score so 18 plus 18 36 and denominator is six so maximum score can be six and if there is no calculus no debris it will be it will be zero both buckle and lingual if it is zero means zero by six zero six means maximum score three all the segments buckle score six into three 18 lingual score is six into three 18 so 18 plus 18 36 36 by six six so ojai is addition of da and ci so this can be zero plus six plus zero plus six so this is a formula so we get zero to six plus zero to six that is zero to twelve so this is ojai not ojai s so maximum score for all segment can be 36 for debris or calculus as i mentioned 18 plus 18 so higher the ojai power is oral hygiene patient so in ojai we don't have any special category for based on the score so let's see what is ojai s or simplified oral hygiene index the scores are same zero one two three same for ojai and ojai s but few modifications or changes are here it is developed in 1964 by the same authors john c green and traca vermelion and only fully erupted permanent teeth as good but here instead of checking all the teeth only one teeth per segment is selected it is known as index truth and natural teeth with full crown restoration and surfaces reduced to height will not be considered so we have indexed teeth for all the six segments so the first segment is one six one one two six three six three one and four six so all the molas first molas and central incisor and lower central incisor so suppose one six is missing we can take one seven or one eight because it has a similar surface area one six and one five is a different surface area so we don't take it so one one and two one same surface area not one two similarly two six two seven three eight replacement of second and third molar this is right or left central incisor so here we are checking only six teeth okay there we are checking all the teeth both the buckle and both lingual and we will be taking only one score of one segment that is we check all the teeth we take only one score out of it and here also the difference is for lower three six and four six that is we take lingual surface and both all the rest of the teeth we take buckle or label surface so only six surface we are checking only three six and four six our lingual surfaces and other teeth are buckle surfaces why because there is saliva pulling in all these areas here sub mandible or sublingual gland here parotid glands so it naturally it is all clean areas but if it is not clean we need to know we can assume that patients oral hygiene is not proper so assessing that patient's oral hygiene we check the these teeth because if it is natural cleaning cleansed area is not not even clean it reflects the patient's attitude so this is how we calculate same way h is one simplified question is added up here same formula h i is equal to d is plus c is t i s o c a is total score by number of surfaces here it will be maximum score of six six into three that is eighteen by six so we get only zero to three minimum score is zero maximum score is three because total score is either buckle or lingual total we have six surfaces so maximum six into three so that is eighteen eighteen by number of surfaces a six so eighteen by six six is equal to three so zero to three is a maximum score and h is both debris and calculus will come so zero to three plus zero to three that is six so zero to six will be h is and zero to three will be debris index or catalyst index because it has only buckle score or lingual score not buckle and lingual okay so six teeth has only one measurement there we have both buckle and lingual here only one measurement for four teeth it is buckle and two teeth is lingual that is three six and four six are lingual rest all buckle so archery and archery d i and c a s as three category good fair and poor it is good means zero to zero point six point seven to one point eight is fair four is one point nine to three archery is good means zero to one point two point three to three three to six this is not exactly the double of this there is a change here so this type of category is not there in archery this is only for archery this is a simplified version this is very easy to apply in patients or a large group of people so h s can be used to conduct oral hygiene service because it is very easy compared to archery because it has taken only six surfaces not entire teeth so they're actually in archery as we are taking if it is 32 we are taking entire 32 buckle surface and entire 32 lingual surface so total 64 surface we need to check but only six six scores will be there because only one tooth per segment but both lingual and buckles work but here we are not checking entire teeth only six teeth are checking instead of 64 surfaces and also here there is no buckle lingual on the same tooth on either buckle or lingual so only six surfaces we are checking in archery we are checking actually 64 surfaces so 64 surfaces and six surfaces have huge difference and they have a clear indication of why we are checking these surfaces I told you regarding the saliva pooling and patients hygiene patients attitude so that's all about archery and archery is it is very important in our practical sessions and for the university practical exam this is the compulsory index all students must follow so I'll come up with dmft and dmfs in my next session and then cpi indices cpi tn and resell index and finally pluralsus index so I'll come up with dmft and dmfs okay thank you