Problems and proposals for recording gingivitis and plaque

The origin of indices for recording gingivitis and plaque is reviewed. Each index seems to have been constructed for a special purpose. The development so far has been towards more and more delicately graded indices which are well suited for evaluation of short term clinical trials. The increased sensitively, though advantageous for scientific purpose, is not always practical from a public dental health point of view. It seems that at present there is a need for several different types of index systems. In order to be able to conduct his preventive programs the practicing dentist needs a simple and well defined recording system for oral hygiene and gingival inflammation. Such an index system should be as easy and natural to use as is the scoring of decayed and filled surfaces today. Instead of using individual mean scores of multi-graded plaque and gingival indices, the use of the site prevalence of a single finding is suggested. For recording of gingivitis in daily dental practice the number of gingival margins bleeding on pressure is recommended to be determined as a percentage of the sites examined (Fig. 1,2 and 3). For oral hygiene, correspondingly, the frequency of occurrence of tooth surfaces covered with clearly visible plaque could be used as a clinically relevant parameter (Fig. 4). Keeping visible plaque and gingival bleeding away is also suggested to be a clearly understandable and practical aim in the dental health education of the individual patient.