Community periodontal index of treatment needs

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Community Periodontal Index of Treatment Needs (CPITN)

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Introduction In the last 70 years, in spite of an improvement in the prevalence of dental caries in many developed countries, in some sections of the population and in some countries a number of factors related to life style and economics are having a detrimental effect on oral health, in general, and periodontal health, in particular(1). Such life style factors include: 1-An increase consumption of refined sugar together with a reduction in consumption of natural, unrefined foods(2). 2-poor or lack of oral hygiene(3). 3-difficulty in accessing oral health care(4).

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Periodontal disease is one of the most widespread diseases in the world and is more prevalent in developing countries, particularly in rural areas. The disease has been reported to appear at an early age in developing countries (as with gingivitis) and progress with age to periodontitis(5).

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In 1977, the World Health Organization(WHO) proposed a new index, “621” method (from its WHO technical series publication number), to evaluate the periodontal treatment needs of populations. In 1983 The index was evaluated by a group of experts and the “621” method evolved into the Community Periodontal Index of Treatment Needs. The CPITN index has developed jointly by the International Dental Federation(IDF) and World Health Organization (WHO) In 1987, the CPITN was incorporated into the WHO manual ‘‘Oral Health Survey, Basic Methods’’. Since then, the CPITN index has been widely used to measure the level of periodontal diseases and treatment needs in populations

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Advantages Its easy use. It permits rapid examination of large population groups. Its world-wide application allows for international comparisons. CPITNis used to determine periodontal conditions as well as periodontal treatment needs(6)

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Limitations First, An overestimation of treatment needs This index is based on a hierarchical concept of progression of periodontal disease. Thus, a sextant presenting a tooth with a periodontal pocket (score 3 or 4) should also present calculus (score 2) and bleeding (score 1).(5) The validity of these assumption has been questioned (Lewis et al. 1994). Grytten et al. (1989) show that close to 30% of teeth with calculus do not present bleeding, and that one fourth of teeth with deep periodontal pockets and bleeding do not present calculus.(6)

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Limitations Second, it does not measure dental mobility and attachment loss important signs of periodontal disease, such as dental mobility attachment loss are not assessed (Cutress et al. 1987, Baelum et al.1988). It is thus important to keep in mind that the CPITN is not a complete measure of periodontal disease(6).

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The use of the community periodontal index of treatment needs (CPITN) provides a picture of the public health requirements in the periodontal field, which is essential for national oral health policy-making and specific interventions.

References : 

References 1. Dumitriu H T, Murea A. Modern and perspective in preventive care of periodontal disease, J Sc Oral Health, 2003; 1:50-56. 2. Soderling E. Nutrition, diet and oral health in the 21st century. Int Dent J 2001; 51: 389-391. 3. Abdellatif HM, Burt BA, An epidemiological investigation into the relative importance of age and oral hygiene status as determinants of periodontitis. J Dent Res 1987; 66: 13-18 4. Hanganu C, Danila I. Community Dentistry, Editura Tehnica Info, 2002, Chisinau

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References 5-Khamrco TY. Assesment of periodontal disease using the CPITN index in a rural population in Ninevah, Iraq. 1999;5:549-555 6-Benigeri M, Brodeur JM, Payette M, Charbonneau A, Ismail AI Community periodontal index of treatment needs and prevalence of periodontal conditions. J Clin Periodontol 2000; 27: 308–312.