Sir, measures of oral health are essential for epidemiological and clinical studies in order to provide accurate data for health promotion, prevention and therapy of diseases.
We recently performed an observational study on the oral and dental changes in a group of 12 elderly patients who were suffering from the chronic outcomes of stroke, including hemiplegia, and compared them with a healthy, matched control group.
There was an abundant accumulation of food debris in the mouths of the stroke patients which we were unable to classify with any of the existing indices1,2,3,4 (plaque, oral health assessment and tongue coating). Although the Kaiser-Jones5 Brief Oral Health Status Examination (BOHSE) assesses the oral cavity and surrounding tissues and considers oral cleanliness, the evaluation is limited to the presence of tartar and/or foods on teeth and dentures.
We propose the following index which considers debris accumulation in the left and right vestibular oral arches, as a complementary tool to other indexes of oral cleanliness.
The examination of the oral cavity begins in the upper right quadrant, proceeding clockwise to the lower right quadrant, with a time requirement of all four vestibular arches of less than 30 seconds. Each arch must be rated by assigning a score from 0 to 3 (Table 1).
Using this procedure we calculated the OFDI value for the left and right halves of the mouth and with reference to the whole oral cavity. The index appears to have good specificity and sensitivity: most of the healthy subjects (n = 11) recorded score = 0, with one registering score = 1; in contrast, most of the post-stroke patients recorded positive scores indicative of the inability to remove debris most likely on account of their neurologic disease.
These findings may offer care givers the possibility of quantifying the accumulation of food in their patients' mouth in order to be able to evaluate the positive effects of an educational programme directed at nursing staff.
References
Silness J, Loe H . Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22: 121–135.
Greene J C, Vermillion J R . The simplified oral hygiene index. J Am Dent Assoc 1964; 68: 7–13.
Atchinson K A, Dolan T A . Development of the geriatric oral health assessment index. J Dent Educ 1990; 54: 680–687.
Winkel E G, Roldà n S, Van Winkelhoff A J, Herrera D, Sanz M . Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual center double-blind placebo control study. J Clin Periodontol 2003; 30: 300–306.
Kayser-Jones J, Bird W F, Paul S M, Long L, Schell E S . An instrument to assess the oral health status of nursing home residents. Gerontologist 1995; 356: 814–824.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Migliario, M., Rimondini, L. Food debris index. Br Dent J 211, 581–582 (2011). https://doi.org/10.1038/sj.bdj.2011.1058
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bdj.2011.1058
