Methods of assessing gingival and periodontal disease: a review

There has been an effort by the dental profession working in the field of gingival and periodontal disease to find a method of recording the extent and degree of pathological change in tissues leading from gingivitis to periodontitis and to measure reversible as well as irreversible changes. It is obvious that some form of index is required and it should have the following well-defined criteria: (1) Simplicity, (2) Accuracy, (3) Quantitativeness, (4) Reproducibility, (5) Speed, (6) Objectivity, and (7) Amenability to statistical analysis. Indices, as well as determining the prevalence of disease in the group under investigation at a given period in time, must also provide information on incidence of disease, i.e. at different periods of time. Indices must also give data that make it possible to verify the nature, severity and aetiology of the disease process and to evaluate therapeutic measures. Indices yield information about the success or failure of control and prevention of disease, affecting the gingivae and the periodontal tissues. A review of methods of assessing and recording gingival and periodontal disease is presented starting from the early investigations of the century. It is shown that subsequently many variations evolved, often with the same inherent difficulties of interpretation or application. Usually the initial stages of inflammation of the gingivae are more difficult to recognize than established disease. Present methods of recording as objectively and as quickly as possible the gingival state in population groups are discussed with emphasis upon the necessity for providing effective preventive measures based upon assessment of schoolchildren.