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periodontal disease index of Russell

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An assessment tool, named after A. L. Russell, a contemporary American dentist, that estimates the degree of periodontal disease present by measuring gingival inflammation and bone loss. It is used for measuring periodontal disease in population surveys. Each tooth is scored separately according to defined criteria; the higher the score, the more marked the periodontal disease. The population score equals the average for the individual scores in the population examined.

Periodontal disease index of Russell

Criteria for field studies

Additional radiographic criteria


No gingivitis (neither overt inflammation in the investing tissues, nor loss of function due to destruction of supporting tissues).

Normal radiographic appearance.


Mild gingivitis (overt area of inflammation in the free gingivae, but this area does not circumscribe the tooth).


Gingivitis (inflammation completely circumscribes the tooth, but there is no apparent break in the epithelial attachment).


Not used in field study.

Early, notch-like resorption of the alveolar crest.


Gingivitis with pocket formation (the epithelial attachment is broken, and there is a pocket). There is no interference with normal masticatory function, the tooth is firm in its socket, and has not drifted.

Horizontal bone loss involving the entire alveolar crest, up to half of the length of the tooth root (distance from apex to cemento-enamel junction).


Advanced destruction with loss of masticatory function (tooth may be loose; tooth may have drifted; tooth may sound dull on percussion with a metallic instrument; the tooth may be depressible in its socket).

Advanced bone loss, involving more than half of the length of the tooth root, or a definite intrabony pocket with definite widening of the periodontal membranes. There may be root resorption, or rarefaction at the apex.


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