Decayed, missing and filled teeth (DMFT) index

To assess dental caries in a population, a DMFT index is used. During a systematic examination with a mirror and explorer that includes the crown and exposed root of every primary and permanent tooth, each crown and root are assigned a number based on the result of that exam. The numbers are recorded in boxes corresponding to each tooth to provide a DMFT chart. It is recommended that care be taken to record all tooth-colored fillings, which may be difficult to detect. Number are assigned as follows:

0: A zero indicates a sound crown or root, showing no evidence of either treated or untreated caries. A crown may have defects and still be recorded as 0. Defects that can be disregarded include white or chalky spots; discolored or rough spots that are not soft; stained enamel pits or fissures; dark, shiny, hard, pitted areas of moderate to severe fluorosis; or abraded areas. 1: One indicates a tooth with caries. A tooth or root with a definite cavity, undermined enamel, or detectably softened or leathery area of enamel or cementum can be designated a 1. A tooth with a temporary filling, and teeth that are sealed but decayed, are also termed 1. A 1 is not assigned to any tooth in which caries is only suspected. In cases where the crown of a tooth is entirely decayed, leaving only the root, a 1 is assigned to both crown and root. Where only the root is decayed, only the root is termed a 1. In cases where both the crown and root are involved with decay, whichever site is judged the site of origin is recorded as a 1. These criteria apply to all numbers. 2: Filled teeth, with additional decay, are termed 2. No distinction is made between primary caries which is not associated with a previous filling, and secondary caries, adjacent to an existing restoration. 3: A 3 indicates a filled tooth with no decay. If a tooth has been crowned because of previous decay, that tooth is judged a 3. When a tooth has been crowned for another reason such as aesthetics or for use as a bridge abutment, a 7 is used. 4: A 4 indicates a tooth that is missing as a result of caries. Only crowns are given 4 status. Roots of teeth that have been scored as 4 are recorded as 7 or 9. When primary teeth are missing, the score should be used only if the tooth is missing prematurely. Primary teeth missing because of normal exfoliation need no recording. 5: A permanent tooth missing for any other reason than decay is given a 5. Examples are teeth extracted for orthodontia or because of periodontal disease, teeth that are congenitally missing, or teeth missing because of trauma. The 5 is assigned to the crown, the root is given a 7 or 9. Knowledge of tooth eruption patterns is helpful to determine whether teeth are missing or not yet erupted. Clues to help in the determination include appearance of the alveolar ridge in the area in question, and caries status of other teeth in the mouth. 6: A 6 is assigned to teeth on which sealants have been placed. Teeth on which the occlusal fissure has been enlarged and a composite material placed should also be termed 6. 7: A 7 is used to indicate that the tooth is part of a fixed bridge. When a tooth has been crowned for a reason other than decay, this code is also used. Teeth that have veneers or laminates covering the facial surface are also termed 7 when there is no evidence of caries or restoration. A 7 is also used to indicate a root replaced by an

implant. Teeth that have been replaced by bridge pontics are scored 4 or 5; their roots are scored 9. 8: This code is used for a space with an unerupted permanent tooth where no primary tooth is present. The category does not include missing teeth. Code 8 teeth are excluded from calculations of caries. When applied to a root, an 8 indicates the root surface is not visible in the mouth. 9: Erupted teeth that cannot be examinedbecause of orthodontic bands, for exampleare scored a 9. When applied to a root, a 9 indicates the tooth has been extracted. The crown of that tooth would be scored a 4 or 5. T: Indicating trauma, a T is used when a crown is fractured, with some of its surface missing but with no evidence of decay.

The "D" of DMFT refers to all teeth with codes 1 and 2. The "M" applies to teeth scored 4 in subjects under age 30, and teeth scored 4 or 5 in subjects over age 30. The "F" refers to teeth with code 3. Those teeth coded 6, 7, 8, 9, or T are not included in DMFT calculations. To arrive at a DMFT score for an individual patient's mouth, three values must be determined: the number of teeth with carious lesions, the number of extracted teeth, and the number of teeth with fillings or crowns. A patient who has two areas of decay, six missing teeth and 11 filled or crowned teeth for example, has a DMFT score of19. Teeth that include both decay and fillings or crowns, are only given one point, a D. Thirteen teeth (based on a full dentition of 32) remain intact. It is also possible to determine more detailed DMFS (decayed, missing, or filled surface) scores. As anterior teeth have four surfaces and posterior teeth have five, a full dentition of 32 teeth includes 128 surfaces. A patient with seven decayed surfaces, 20 surfaces from which teeth are missing, and 42 surfaces either filled or included in a crown, the DMFS score is 69. Fifty-nine surfaces are intact. For primary dentition, scoring is referred to as "deft" or "defs" (decayed, extracted, or filled).

Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults.

Sarita PT, Witter DJ, Kreulen CM, Matee MI, van't Hof MA, Creugers NH. Source

Department of Restorative Dentistry, Faculty of Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Abstract PURPOSE:

This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population.
MATERIALS AND METHODS:

The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on 5,532 adults from rural and urban cluster samples. DMFT was related to age, gender, and residence. The pattern of tooth loss within dental arches was mapped, and the prevalence of shortened dental arches was estimated.
RESULTS:

Mean DMFT scores increased gradually from 1.8 (20- to 29-year-olds) to 3.8 (50- to 59-yearolds). A steep increase was observed in the > or = 60-year-olds (DMFT 8.1). "Missing" was the dominant component of DMFT. The mean number of present teeth ranged from 27 in the youngest to 20 in the oldest age group. Under 60 years of age, DMFT was significantly higher for women than for men. No differences were found between residence categories. Molars were more frequently decayed, missing, and mobile than premolars. Of all subjects, 41% had complete dental arches, 44% had interruptions (of these, 73% were in posterior regions only), and 15% had shortened dental arches; 0.5% were edentulous. Of the subjects with shortened dental arches, about 65% had at minimum three pairs of occluding premolars.
CONCLUSION:

An initial low DMFT rate increased after the age of 60 years. Molars had the highest risk of dental decay and were most frequently absent. Shortened dental arches develop as a consequence of the pattern of tooth decay and tooth loss, although interruptions were frequently seen in the posterior regions.

Dental Caries (Tooth Decay) in Adults (Age 20 to 64)

Dental Caries in Permanent (Adult) Teeth

Note: Approximately 5% of adults age 20 to 64 have no teeth. This survey applies only to those adults who have teeth. Dental caries, both treated and untreated, in all adults age 20 to 64 declined from the early 1970s until the most recent (1999-2004) National Health and Nutrition Examination Survey. The decrease was significant in all population subgroups. In spite of this decline, significant disparities are still found in some population groups. Prevalence (Table 1)

92% of adults 20 to 64 have had dental caries in their permanent teeth. White adults and those living in families with higher incomes and more education have had more decay.

Unmet Needs (Table 2)

23% of adults 20 to 64 have untreated decay. Black and Hispanic adults, younger adults, and those with lower incomes and less education have more untreated decay.

Severity (Table 3 and Table 4)

Adults 20 to 64 have an average of 3.28 decayed or missing permanent teeth and 13.65 decayed and missing permanent surfaces. Hispanic subgroups and those with lower incomes have more severe decay in permanent teeth. Black and Hispanic subgroups and those with lower incomes have more untreated permanent teeth.

Tables 1 through 4 present selected caries estimates in permanent teeth for adults aged 20 to 64 years and for selected subgroups. Units of Measure: Dental caries is measured by a dentist examining a persons teeth, and recording the ones with untreated tooth decay and the ones with fillings. This provides three important numbers:

FT (filled teeth): this is the number of decayed teeth that have been treated, which indicates access to dental care; DMT (decayed and missing teeth): this is the number decayed and missing teeth that have not been treated, which measures unmet need; and

DMFT (decayed, missing, and filled teeth): this is the sum of DMT and FT, and is the measure of persons total lifetime tooth decay.

In addition to counting decayed and filled teeth, this same information can be gathered at the tooth surface level. Since every tooth has multiple surfaces, counting the decayed or filled surfaces provides a more accurate measure of the severity of decay. The following tables list both methods of measuring caries.

Table 1: Percent of Adults with Caries in Permanent Teeth

Prevalence of caries in permanent teeth (DMFT) among adults 20 to 64 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 19992004
Characteristic Percent with caries, missing, or filled permanent teeth

Age 20 to 34 years 35 to 49 years 50 to 64 years Sex Male Female Race and Ethnicity White, non-Hispanic Black, non-Hispanic Mexican American 93.49 87.51 82.97 90.57 92.66 85.58 94.30 95.62

Poverty Status (Income compared to Federal Poverty Level) Less than 100% 100% to 199% Greater than 200% Education Less than High School High School More than High School Smoking History Current Smoker Former Smoker Never Smoked Overall 91.48 92.83 91.19 91.63 85.93 92.38 92.91 88.69 88.91 93.05

Data Source: The National Health and Nutrition Examination Survey (NHANES) has been an important source of information on oral health and dental care in the United States since the early 1970s. Tables 1 through 4 present the latest NHANES (collected between 1999 and 2004) data regarding dental caries in adults.

Table 2: Percent of Adults with Untreated Decay in Permanent Teeth

Prevalence of untreated decay in permanent teeth (DT) among adults 20 to 64 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 19992004
Characteristic Percent with untreated decay in

permanent teeth (DT) Age 20 to 34 years 35 to 49 years 50 to 64 years Sex Male Female Race and Ethnicity White, non-Hispanic Black, non-Hispanic Mexican American Poverty Status (Income compared to Federal Poverty Level) Less than 100% 100% to 199% Greater than 200% Education Less than High School High School 45.20 33.03 43.88 39.31 17.97 20.84 40.45 38.35 28.10 22.96 27.88 25.56 22.14

More than High School Smoking History Current Smoker Former Smoker Never Smoked Overall

16.48

39.26 19.67 20.56 25.49

Data Source: The National Health and Nutrition Examination Survey (NHANES) has been an important source of information on oral health and dental care in the United States since the early 1970s. Tables 1 through 4 present the latest NHANES (collected between 1999 and 2004) data regarding dental caries in adults.

Table 3: Adults, Severity of Decay Measured by Number of Permanent Teeth Affected

Mean number of decayed, filled, and decayed or filled permanent teeth among adults 20 to 64 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 19992004
Characteristic Decayed permanent teeth (DT) Missing permanent teeth (MT) Filled permanent teeth (FT) Total decayed, missing, or filled permanent teeth (DMFT)

Age 20 to 34 years 35 to 49 years 50 to 64 years 0.93 0.75 0.55 0.62 2.39 5.30 4.61 7.78 9.20 6.16 10.91 15.05

Sex Male Female Race and Ethnicity White, non-Hispanic Black, non-Hispanic Mexican American 0.68 1.12 0.99 2.17 4.11 2.42 7.82 4.55 4.67 10.67 9.78 8.07 0.87 0.65 2.49 2.56 6.59 7.49 9.95 10.70

Poverty Status (Income compared to Federal Poverty Level) Less than 100% 100% to 199% Greater than 200% Education Less than High School High School More than High School Smoking History Current Smoker Former Smoker Never Smoked Overall 1.42 0.53 0.51 0.76 4.12 2.30 1.83 2.52 5.90 7.73 7.31 7.05 11.44 10.55 9.65 10.33 1.58 1.00 0.41 4.63 3.24 1.65 4.22 6.58 8.04 2.54 10.82 10.10 1.51 1.24 0.48 4.15 3.98 1.95 4.56 5.32 7.87 10.22 10.55 10.30

Data Source: The National Health and Nutrition Examination Survey (NHANES) has been an important source of information on oral health and dental care in the United States since the early 1970s. Tables 1 through 4 present the latest NHANES (collected between 1999 and 2004) data regarding dental caries in adults.

Table 4: Adults, Severity of Decay Measured by Number of Permanent Tooth Surfaces Affected
Mean number of decayed, filled, and decayed or filled permanent tooth surfaces among adults 20 to 64 years of age, by selected characteristics: United States, National Health and Nutrition Examination Survey, 19992004
Characteristic Decayed permanent surfaces (DS) Missing permanent surfaces (MS) Filled permanent surfaces (FS) Total decayed, missing, or filled permanent surfaces (DMFS)

Age 20 to 34 years 35 to 49 years 50 to 64 years Sex Male Female Race and Ethnicity White, non-Hispanic Black, non-Hispanic Mexican American 1.36 2.46 1.83 10.44 19.76 11.63 19.58 9.68 10.68 31.38 31.89 24.14 1.81 1.26 11.91 12.34 16.06 18.52 29.77 32.12 1.73 1.55 1.22 3.04 11.52 25.31 8.62 18.38 27.35 13.39 31.46 53.87

Poverty Status (Income compared to Federal Poverty Level) Less than 100% 100% to 199% Greater than 200% Education Less than High School High School More than High School Smoking History Current Smoker Former Smoker Never Smoked Overall 3.10 0.98 0.93 1.53 19.66 11.06 8.84 12.12 14.47 19.64 17.47 17.31 37.23 31.67 27.24 30.96 3.50 1.94 0.78 22.12 15.56 7.97 9.38 16.04 20.04 35.00 33.53 28.78 3.28 2.56 0.94 19.88 19.09 9.39 10.22 11.94 19.50 33.38 33.59 29.83

Data Source: The National Health and Nutrition Examination Survey (NHANES) has been an important source of information on oral health and dental care in the United States since the early 1970s. Tables 1 through 4 present the latest NHANES (collected between 1999 and 2004) data regarding dental caries in adults.