Chilton et al evaluated the Columbia Gingival Index (GI) to evaluate patients with gingivitis. This can help diagnose patients with gingivitis and monitor the response to interventions. The authors are from Columbia University in New York City.

The evaluation can be performed on:

(1) a subset of 6 teeth (referred to as the "Ramfjord teeth" since they were used by Ramfjord; these same teeth are used by several of the preceding indices)

(2) all of the teeth in the mouth


The authors demonstrated that the findings from testing 6 teeth was comparable to that of the whole mouth. Testing the subset is usually preferred since it is easier and faster to complete.


Designated Tooth (US Classification)

Location of the "Ramfjord" Teeth


right maxillary first molar


left maxillary medial incisor


left maxillary first premolar (bicuspid)


left mandibular first molar


right mandibular medial incisor


right mandibular first premolar (bicuspid)


6 sites on each tooth is scored (the same sites are used in other indices above):

(1) mesiobuccal

(2) buccal

(3) distobuccal

(4) mesiolingual

(5) lingual

(6) distolingual


Each site is scored based on the gross evidence of gingivitis.






firm, knifelike gingival margin; interdental papilla triangular


no or slight color change

gingival margin slightly swollen and no longer knifelike and firm


discreet areas of redness along the most coronal surfaces of the free gingival margin



obviously red

no bleeding on gentle finger pressure


obviously red

bleeds on gentle finger pressure



The authors did not describe how the final index was derived. Based on other indices (above) and the fact that scores on patients ranged from 4 to 12 (Figure 1, page 40), the following scheme seems likely. I favor this scheme since it would be the only way that a full mouth score would give similar results.


index for each tooth =

= SUM(points for all 6 scoring points)


partial mouth score =

= AVERAGE(indices for all 6 teeth)



• minimum partial mouth score: 0

• maximum partial mouth score: 24

• The higher the score, the greater the severity of gingivitis.

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