This article provides a conceptual base for population oral health measurement and argues that problems associated with particular indices are subject to the basic issues of knowing what to measure and the level of measurement required to address the object of study and provide clear information about the health of the population as a whole.
Alternative approaches to caries measurement are presented using data from South Australian children attending the school dental services during 2007.
While threshold selection of case definitions depicted different profiles of the same population, the inclusion of non-cavitated lesions did not alter the general disease profile of the population.
The types of measures used depend on the purpose, nature of the data, and conceptualization of the phenomenon, and should continually refer to the population level. In population oral health, controversies surrounding outcome measures, such as caries indices, are moving away from addressing core issues to narrowing mechanistic views. Fundamental deliberations should include the valuation of health states, clearly defining health and disease and distinguishing between disease, determinants and the impacts of disease.