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Extracts of the Fourth edition of "Oral Health Surveys - Basic methods", Geneva 1997.
(Please observe that the Fifth edition is available, see Methods and Indices)

This extract concerns: Community Periodontal Index (CPI). Pages 36 - 38.
(Periodontal status, formerly called Community Periodontal Index of Treatment Needs or CPITN)


Community Periodontal Index (CPI)

(boxes 54-59)

Indicators. Three indicators of periodontal status are used for this assessment:

  1. gingival bleeding
  2. calculus
  3. periodontal pockets

A specially designed lightweight CPI probe with a 0.5-mm ball tip is used, with a black band between 3.5 and 5.5 mm and rings at 8.5 and 11.5 mm from the ball tip.

Sextants. The mouth is divided into sextants defined by tooth numbers: 18-14, 13-23, 24-28, 38-34, 33-43, and 44-48. A sextant should be examined only if there are two or more teeth present and not indicated for extration. (Note: This replaces the former instruction to include single remaining teeth in the adjacent sextant.)

Index teeth. For adults aged 20 years and over, the teeth to be examined are:

Teeth to be examined
17 16   11   26 27
47 46   31   36 37

The two molars in each posterior sextant are paired for recording, and if one is missing, there is no replacement. If no index teeth or tooth is present in a sextant qualifying for examination, all the remaining teeth in that sextant are examined and the highest score is recorded as the score for the sextant. In this case, distal surfaces of third molars should not be scored.

For subjects under the the age of 20 years, only six teeth - 16,11, 26, 36, 31 and 46 - are examined. This modification is made in order to avoid scoring the deepened sulci associated with eruption as periodontal pockets. For the same reason, when examining children under the age of 15 are examined, pockets should not be recorded, i.e. only bleeding and calculus should be considered.

Sensing gingival pockets and calculus. An index tooth should be probed, using the probe as a "sensing" instrument to determine pocket depth and to detect subgingival calculus and bleeding response. The sensing force used should be no more than 20 grams. A practical test for establishing this force is to place the probe point under the thumb nail and press until blanching occurs. For sensing subgingival calculus, the lightest possible force that will allow movement of the probe ball tip along the tooth surface should be used.

When the probe is inserted, the ball tip should follow the anatomical configuration of the surface of the tooth root. If the patient feels pain during probing, this is an indicative of the use of too much force.

The probe tip should be inserted gently into the gingival sulcus or pocket and the total extent of the sulcus or pocket explored. For example, the probe is placed in the pocket at the disto-buccal surface of the second molar, as close as possible to the contact point with the third molar, keeping the probe parallel to the long axis of the tooth. The probe is then moved gently, with short upward and downward movements, along the buccal sulcus or pocket to the mesial surface of the second molar, and from the disto-buccal surface of the first molar towards the contact area with the premolar. A similar procedure is carried out for the lingual surfaces, starting distolingually to the second molar.

Examination and recording. The index teeth, all remaining teeth in a sextant where there is no index tooth, should be probed and the highest score recorded in the appropriate box. The codes are:




Bleeding observed, directly or by using mouth mirror, after probing


Calculus detected during probing, but all the black band on the probe visible


Pocket 4 - 5 mm (gingival margin within the black band on the probe)


Pocket 6 mm or more (black band on the probe not visible)


Excluded sextant (less than two teeth present)


Not recorded


Examples of coding are both illustrated and photographed in "Oral Health Surveys".

Last updated by Marie Nordström