Community Periodontal Index for Treatment Needs (CPITN)
Definition and Purpose
- CPITN (Community Periodontal Index for Treatment Needs) is a WHO epidemiological index used to assess:
- Periodontal health status
- Treatment needs of large population groups
- Developed for community screening, not detailed individual diagnosis.
- Main aims:
- Determine prevalence of periodontal disease
- Assess treatment needs
- Compare population groups
- Plan preventive and periodontal programmes
CPITN is the periodontal equivalent of the DMF index used for caries.
Instrument Used
- Examination is performed using a WHO periodontal probe.
- WHO calibrated periodontal probe
- Ball-ended (blunt) tip reduces tissue trauma
- Black band used to assess pocket depth
- Probe is inserted gently into the sulcus without pressure.
Division of the Dentition
- Mouth divided into 6 sextants.
- 2 anterior sextants
- 4 posterior sextants
- Each sextant must contain at least 2 functioning teeth.
- Representative (index) teeth are examined.
- The worst finding in each sextant determines the final code.
Index Teeth
- Posterior sextants
- First and second molars
- Anterior sextants
- Maxillary anterior sextant – right central incisor
- Mandibular anterior sextant – left central incisor
If one tooth has a higher score, the higher score is recorded for the entire sextant.
CPITN Codes
- Code 0 — Healthy Periodontium
- No bleeding
- No calculus
- No periodontal pockets
- Code 1 — Bleeding
- Bleeding after gentle probing
- Code 2 — Calculus Present
- Supra- or subgingival calculus
- Plaque-retentive factors present
- Code 3 — Shallow Periodontal Pocket
- Pocket depth 4–5 mm
- Code 4 — Deep Periodontal Pocket
- Pocket depth >5 mm
- Code X / 5
- Sextant excluded due to insufficient teeth
- Treatment Needs According to CPITN
- Code 0
- No treatment required
- Routine prevention only
- Code 1
- Oral hygiene instruction
- Code 2
- Oral hygiene instruction
- Professional scaling and calculus removal Code 3
- Oral hygiene instruction
- Scaling and root surface treatment
- Basic periodontal therapy
- Code 4
- Complex periodontal treatment
- Curettage
- Periodontal surgery
- Specialist referral
Data Obtained from CPITN
- Average number of sextants per person
- Proportion of healthy individuals
- Proportion with bleeding gums
- Proportion with calculus
- Proportion with shallow pockets
- Proportion with deep pockets
- Helps estimate treatment needs for the entire population.
Advantages
- Simple and fast.
- Standardised by WHO
- Suitable for large epidemiological surveys Allows comparison between populations
- Useful for public health planning
Limitations
- Records only the worst condition in each sextant.
- Clinical detail may be lost
- Not a complete periodontal diagnosis
- Must be interpreted with age, risk factors and clinical findings