The document presents the Community Periodontal Index of Treatment Needs (CPITN), a dental health assessment tool introduced in 1982 that focuses on evaluating periodontal treatment needs rather than past conditions. It outlines the procedures, instruments and criteria used in its application, which includes probing with a specialized CPITN probe and scoring different periodontal conditions. Additionally, it mentions the Community Periodontal Index (CPI) as a modified version of CPITN that includes loss of attachment measurement.

1. DEPARTMENT OF PUBLIC
HEALTH DENTISTRY
T O P I C O F P R E S E N T A T I O N :
CPITN INDEX
(Community Periodontal Index of Treatment Needs)
PRESENTED BY:
JEBAN JYOTI SAHU
ROLL NO.: 1879032

2. CONTENTS
• INTRODUCTION
• SCOPE AND PURPOSE
• PROCEDURE
• SEXTANT
• INDEX TEETH
• INSTRUMENTS USED
• CPITN PROBE
• PROBING PROCEDURE
• EXAMINATION PROCEDURE
• CALCULATION OF CPITN
• COMMUNITY PERIODONTAL INDEX (CPI)
• SUMMARY

3. INTRODUCTION • CPITN was introduced by JUKKA AINAMO , DAVID BARMES ,
GORGE BEAGRIE , TERRY CUTRESS , JEAN MARTIN and
JENNIFER SARDO-INFIRRI for Joint working committee of the
WHO and FDI in 1982 .
• Developed primarily to survey and evaluate periodontal
treatment needs rather than determining past and present
periodontal status i.e. recession of the gingival margin and
alveolar bone .
• Treatment needs imply that CPITN assesses only those
conditions potentially responsive to treatment , but not
nontreatable or irreversible conditions .

4. SCOPE
AND
PURPOSE
• The CPITN procedure is recommended for epidemiological
surveys of periodontal health.
• It provides guidance on planning and monitoring of the
effectiveness of periodontal care programme and dental
personnel required.
• The CPITN records the common treatable conditions namely,
- periodontal pockets
- gingival inflammation
- dental calculus
- other plaque retentive factors
• It doesn’t record irreversible changes such as recession or
other deviations from periodontal health such as tooth
mobility or loss of periodontal attachment.

5. ADVANTAGES:
Major Advantages of CPITN are :
• Simplicity
• Speed
• International Uniformity
LIMITATIONS:
• Does not record the position of gingival margin.
• Does not provide assessment of past periodontal breakdown.

6. PROCEDURE • The dentition is divided into 6 parts
called sextants.
• Each sextant is given a score.
• For epidemiological purposes the
score is identified by examination of
specified index teeth.
• For clinical practise the highest score
in each sextant is identified after
examining all teeth.

7. SEXTANT
• The Mouth is divides into 6 sextants defined by tooth numbers
as shown below-
17-14 13-23 24-27
47-44 43-33 34-37
• The third molars are not included
except where they are functioning in
place of second molars.
• The treatment need in a sextant is
recorded only if there are 2 or more
teeth present and not indicated for
extraction.
• When only one tooth is present in a sextant, it is included in
the adjacent sextant.

8. INDEX
TEETH
• In Epidemiological surveys for adults, aged 20 years or more,
only 10 teeth, known as the Index Teeth are examined.
• The ten specified index Teeth are :-
• The Molars are examined in pairs and
only one score, the highest is
recorded. Only one score is recorded
for each sextant.
17/16 11 26/27
47/46 31 36/37

9. • For young people upto 19 years, only 6 Index teeth are examined. The
second molars are excluded as Index Teeth at these ages because of
the high frequency of false pockets.(non-inflammatory, associated with tooth eruption)
16 11 26
46 31 36
• The six Index teeth selected are :
• When examining children less than 15 years,
Pockets are not recorded although probing
for bleeding and calculus are carried out as a
routine.

10. INSTRUMENTS
USED
CPITN - C PROBE CPITN - E PROBE
• CPITN PROBE
• MOUTH MIRROR

11. CPITN
PROBE
CPITN-E PROBE CPITN-C
PROBE
• Introduced by WHO in 1978.
• Weight: 5gms
• Designed for 2 purposes :
1. Measurement of pocket depth
2. Detection of Sub-gingival calculus
• It has a 0.5mm ball at the tip and mm
markings are at 3.5,5.5,8.5 and 11.5
and colour coding from 3.5 to 5.5.
• Working force: 20-25 gms.

12. • CPITN- C PROBE
• CPITN- E PROBE

13. PROBING
PROCEDURE
• A tooth is probed to determine pocket depth and to detect
subgingival calculus and bleeding response.
PROBING FORCE
WORKING COMPONENT
SENSING COMPONENT
To determine POCKET DEPTH
To detect SUBGINGIVAL CALCULUS
• Working force shouldn’t exceed 20gms- a practical test for
establishing this force is to gently insert the probe point
under the finger nail without causing pain or discomfort.
• Pain to the patient during probing is in
most cases indicative of the use of a
too heavy probing force.

14. • The probe is inserted between the tooth and gingiva ,
and the sulcus depth is noted against the color code or
marking.
• The ball end of the probe should be kept in contact with
root surface.
• Direction of probe during insertion should be whenever
possible in the same plane as the long axis of the tooth.
• ‘Walking’ the probe should be done with short upward & downward
movements.
Recommended sites for Probing:
A tooth should be probed in atleast 6 points.,
MESIO-BUCCAL, MID-BUCCAL, DISTO-BUCCAL, &
THE CORRESPONDING SITES ON THE LINGUAL
SURFACE.

15. EXAMINATION
PROCEDURE
• The aim is to determine the highest score applicable to each
sextant with the least no. of measurements.
• For a sextant to be validly scored, the requirement is that
more than one functional tooth should be present.
NO
YES
SCORE ‘X’, & MOVE
TO NEXT SEXTANT
EXAMINE INDEX
TEETH
(in epidemiological procedure)
EXAMINE ALL TEETH
(in clinical screening procedure)
• Once the highest score has been determined (for each
sextant) there is no need to examine for the presence of
the lower score in that sextant.

16. ‘CODES AND CRITERIA’ & TREATEMENT NEEDS
CODES CRITERIA
TREATMENT
NEEDS
CODE 0
NO SIGNS OF DISEASE (HEALTHY
PERIODONTIUM)
TN 0 NO NEED FOR PERIODONTAL TREATMENT
CODE 1 GINGIVAL BLEEDING AFTER GENTLE PROBING TN 1
NEED FOR IMPROVING THE PERSONAL
ORAL HYGIENE OF THAT INDIVIDUAL
CODE 2
PRESENCE OF SUPRA OR SUBGINGIVAL
CALCULUS
TN 2a
NEED FOR SCALING. NEED FOR IMPROVING
PERSONAL ORAL HYGIENE
CODE 3 PATHOLOGICAL POCKET OF 4-5mm PRESENT, i.e,
when the gingival margin is on the black area of the probe
TN 2b
SCALING AND ROOT PLANING. NEED FOR
IMPROVING PERSONAL ORAL HYGIENE
CODE 4
PATHOLOGICAL POCKET OF 6mm OR MORE
PRESENT, the black area of CPITN probe is not visible
TN 3
COMPLEX TREATMENT WHICH COULD
INVOLVE DEEP SCALING, ROOT PLANING &
MORE COMPLEX SURGICAL PROCEDURES.
CODE X
When only one or no teeth are present in a
sextant (third molars are excluded unless they function in
place of second molars)

17. COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS (CPITN)

18. CALCULATION
OF
CPITN 0 0 0
0 0 0
3 3 3
3 4 3
1 1 0
1 1 1
X 4 4
4 4 X
4 3 1
2 3 1
0 1 0
0 1 0
3 3 3
3 3 3
2 0 2
0 2 0
2 1 3
1 2 3
X X X
X X X
1 2 2
2 2 2
(1) (2) (3) (4) (5) (6)
(7) (8) (9) (10) (11)
EXAMPLE:
The following recordings of a group of 11 adults of age group 35-44yr.
STEP 1:
Count the no. of charts with CODE 0 ONLY.
This identifies no. of subjects with healthy sextants (H)
Count the no. of charts with CODE 1 Recorded as highest score. (0,X,1)
This identifies no. of subjects with gingival bleeding (B)
Count the no. of charts with CODE 2 Recorded as highest score. (0,X,1,2)
This identifies no. of subjects with calculus & other plaque retentive factors (C)
Count the no. of charts with CODE 3 Recorded as highest score. (0,X,1,2,3)
This identifies no. of subjects with pockets of 4-5mm (P1)
Count the no. of charts with CODE 4 Recorded as highest score.
This identifies no. of subjects with pockets of 6mm or more (P2)

19. CALCULATIONS:
The Chart shows:
Greatest Code CODE 0 CODE 1 CODE 2 CODE 3 CODE 4
No. of Subjects
1
(1)
2
(2), (3)
2
(6), (9)
2
(8), (10)
3
(4), (5), (7)
STEP 2:
Calculate the percentages (prevalence):
To obtain prevalence of subjects with CODES
(0,1,2,3,4) as their highest score =
Counts of CODES/No. of subjects respectively.
Total no. of dentate subjects
X 100
CODE 0 =
1
10 X 100 = 10
CODE 1 = 20
CODE 2 = 20
CODE 3 = 20
CODE 4 = 30

20. STEP 3:
Tabulate the data:
Table : Prevalence of persons affected
AGE(yrs) NO. EXAMINED
NO. OF DENTATE
PERSONS
% PERSONS CODED
35-44 11 10 H B C P1 P2
10 20 20 20 30
*NOTE: Total H + B + C + P1 + P2 = (100%)

21. COMMUNITY
PERIODONTAL
INDEX
(CPI)
• This index is modification of CPITN.
• The modification is done by the inclusion of measurement of
‘Loss of Attachment’ and elimination of the ‘Treatment
Needs’ category.
INSTRUMENTS USED:
• MOUTH MIRROR
• The CPITN - C PROBE
PROCEDURE:
Same as that of CPITN.

22. SCORE CRITERIA
0 Healthy
1 Bleeding on probing
2 Calculus detected during probing
3 Pocket 4-5mm
4 Pocket 6mm or more
X Excluded sextant (less than 2 teeth)
9 Not recorded
SCORE CRITERIA
0 Loss of attachment 0-3mm
1 Loss of attachment 4-5mm
2 Loss of attachment 6-8mm
3 Loss of attachment 9-11mm
4 Loss of attachment 12mm or more
X Excluded sextant (less than 2 teeth)
9 Not recorded

23. SUMMARY
• CPITN is a screening procedure for identifying actual and
potential problems posed by periodontal diseases both in the
community and in the individual, introduced in 1982.
• The CPITN records the common treatable conditions namely,
- periodontal pockets
- gingival inflammation
- dental calculus
- other plaque retentive factors
• CPITN PROBE (introduced by WHO in 1978) is used to
measure of pocket depth & detect sub-gingival calculus.
• COMMUNITY PERIODONTAL INDEX (CPI) is the modification of
CPITN which includes measurement of “loss of attachment”

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