Annotation to the seminar №2

Simplified Oral Hygiene Index | OHI-S

Greene and Vermillion, 1964

The Simplified Oral Hygiene Index (OHI-S) differs from the original OHI (The Oral
Hygiene Index) in the number of the tooth surfaces scored (6 rather than 12), the method of
selecting the surfaces to be scored, and the scores, which can be obtained. The criteria used for
assigning scores to the tooth surfaces are the same as those use for the OHI (The Oral Hygiene
Index).

The OHI-S, like the OHI, has two components, the Debris Index and the Calculus Index.
Each of these indexes, in turn, is based on numerical determinations representing the amount of
debris or calculus found on the preselected tooth surfaces.

SELECTION OF TOOTH SURFACES

The six surfaces examined for the OHI-S are selected from four posterior and two
anterior teeth.

In the posterior portion of the dentition, the first fully erupted tooth distal to the second
bicuspid (15), usually the first molar (16) but sometimes the second (17) or third molar (18),
is examined.
 buccal surfaces of the selected upper molars and
 lingual surfaces of the selected lower molars are inspected.

In the anterior portion of the mouth, the labial surfaces of the upper right (11) and the
lower left central incisors (31) are scored. In the absence of either of this anterior teeth, the
central incisor (21 or 41 respectively) on the opposite side of the midline is substitted.
Criteria for classifying debris

Scores Criteria

0 No debris or stain present

1 Soft debris covering not more than one third of the tooth
surface, or presence of extrinsic stains without other debris
regardless of surface area covered

2 Soft debris covering more than one third, but not more
than two thirds, of the exposed tooth surface.

3 Soft debris covering more than two thirds of the exposed

tooth surface.
 Criteria for classifying calculus

Scores Criteria

0 No calculus present

1 Supragingival calculus covering not more than third of

the exposed tooth surface.

2 Supragingival calculus covering more than one third but

not more than two thirds of the exposed tooth surface or the
presence of individual flecks of subgingival calculus
around the cervical portion of the tooth or both.

3 Supragingival calculus covering more than two third of

the exposed tooth surface or a continuos heavy band of
subgingival calculus around the cervical portion of the
tooth or both.

CALCULATION
EXAMPLE:
After the scores for debris and calculus are recorded, the Index values are calculated. For
each individual, the debris scores are totaled and divided by the number of surfaces scored. At
least two of the six possible surfaces must have been examined for an individual score to be
calculated. After score for a group of individual is obtained by computing the average of the
individual scores. The average individual or group score is known as the Simplified Debris
Index (DI-S).

The same methods are used to obtain the calculus scores or the Simplified Calculus
Index (CI-S).

The average individual or group debris and calculus scores are combined to obtain the
Simplified Oral Hygiene Index.

The CI-S and DI-S values may range from 0 to 3; the OHI-S values from 0 to 6. These
values are just half the score magnitude possible with the OHI (Oral Hygiene Index).

The following example shows how to calculate the index. The scores for debris and calculus
should be tabulated separately and index for each calculated independently, but in the same
manner.

Debris

Right molar Anterior Left molar Total

Buccal Lingual Labial Labial Buccal Lingual Buccal Lingual

Upper 3 - 2 - 3 - 8 -

Lower - 2 - 1 - 2 1 4

Debris Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined

buccal and lingual surfaces).

Debris Index = (9+4) / 6 = 2.2

 Calculus

Right molar Anterior Left molar Total

Buccal Lingual Labial Labial Buccal Lingual Buccal Lingual

Upper 1 - 0 - 1 - 2 -

Lower - 1 - 2 - 2 2 3

Calculus Index = (The buccal-scores) + (The lingual-scores) / (Total number of examined

buccal and lingual surfaces).

Calculus Index = (4+3) / 6= 1.2

The average individual or group debris and calculus scores are combined to obtain
simplified Oral Hygiene Index, as follows.

Oral Hygiene Index = Debris Index + Calculus Index

2.2 + 1.2 = 3.4

Value index assessment Evaluation of oral hygiene

0 - 0.6 Low Good

0.7 - 1.6 Average Satisfactory

1.7 - 2.5 High Very high Unsatisfactory Poor

 Oral Hygiene Index (Greene and Vermilion, 1960)

The Oral Hygiene Index is composed of the combined Debris Indexand Calculus index,
each of these index is in turn based on 12 numerical determinations representing the amount of
debris or calculus found on the buccal and lingual surfaces of each of three segments of each
dental arch, namely

1. The segment distal to the right cuspid (see picture).

2. The segment distal to the left cuspid.
3. The segment mesial to the right and left first bicuspids.

The Maxillary and the Mandibular arches are each composed of three segments (these are
illustrated above).

Each segment is examined for debris or calculus. From each segment one tooth is used for
calculating the individual index, for that particular segment. The tooth used for the calculation
must have the greatest area covered by either debris or calculus.
 The method for scoring calculus is the same as that applied to debris, but additional
provisions are made for recording subgingival deposits.

Criteria for classifying debris

Scores Criteria

0 No debris or stain present

1 Soft debris covering not more than one third of the tooth
surface, or presence of extrinsic stains without other debris
regardless of surface area covered

2 Soft debris covering more than one third, but not more than two
thirds, of the exposed tooth surface.

3 Soft debris covering more than two thirds of the exposed tooth
surface.
 Criteria for classifying calculus

Scores Criteria

0 No calculus present

1 Supragingival calculus covering not more than third of the

exposed tooth surface.

2 Supragingival calculus covering more than one third but

not more than two thirds of the exposed tooth surface or the
presence of individual flecks of subgingival calculus around
the cervical portion of the tooth or both.

3 Supragingival calculus covering more than two third of the

exposed tooth surface or a continuos heavy band of
subgingival calculus around the cervical portion of the tooth
or both.

CALCULATION
EXAMPLE:

After the scores for debris and calculus are recorded, the Index values are calculated. For
each individual, the debris scores are totaled and divided by the number of segments scored.

The same method is used to obtain the calculus index scores.

The following example shows how to calculate the indices. The scores for debris and
calculus should be tabulated separately and indexes for each calculated independently, but in
the same manner.

Debris
 Right Anterior Left Total

Bucca Lingu Labial Lingual Bucca Lingu Buccal/La Lingu

l al l al bial al

Upper 3 1 2 2 3 1 8 4

Lower 2 2 1 1 1 2 4 5

Total 5 3 3 3 4 3 12 9
Debris Index = (The total of the upper and lower buccal-scores) +(The total of the
upper and lower lingual-scores) /(The number of segments scored).

Debris Index = (12+9) / 6= 3.5

Calculus

Right Anterior Left Totals

Bucca Lingua Labial Lingu Buccal Lingu Buccal/La Lingua

l l al al bial l

Upper 1 0 0 0 1 0 2 0

Lower 0 1 0 2 0 2 0 5

Total 1 1 0 2 1 2 2 5
Calculus Index = (The total of the upper and lower buccal-scores) +(The total of the upper
and lower lingual-scores) / (The number of segments scored).

Calculus Index = (2+5) / 6= 1,6

 The average individual or group debris and calculus scores are combined to obtain Oral
Hygiene Index, as follows.

Oral Hygiene = Debris Index + Calculus

Index Index

3.5 + 1.16 = 4.66

A simplified version exists, the OHI-S (Greene and Vermilion, 1964).