Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Workforce,
Infrastruct
ure,
policies
Oral
Healt
h
Risk
factors
Interventi
on
Strategies
Phipps K, Kuthy R, Marianos D, Isman B. State-based oral health surveillance systems: conceptual
framework and operational definition. Council of State and Territorial Epidemiologists, Atlanta, GA,
Collect
Link to
practice
Dissemina
te
Analyze
Interpret
Phipps K, Kuthy R, Marianos D, Isman B. State-based oral health surveillance systems: conceptual
framework and operational definition. Council of State and Territorial Epidemiologists, Atlanta, GA, 2013.
CDCs Water
Fluoridation reporting
water
System (WFRS)
Behavioral Risk Factor Surveillance System 2014 Codebook Report Land - Line and Cell - Phone data
[Internet]. CDC - BRFSS. 2015 [cited 30 October 2016]. Available from:
BRFSS (Cont)
BRFSS (Cont)
BRFSS (Cont)
BRFSS (Cont)
BRFSS (Cont)
BRFSS (Cont)
The question about, teeth cleaning among adults aged
18 years and above within the past year has been
discontinued as of 2010.
It is unclear when this question will be asked again.
Adults with diabetes who had dental visit in the past
year, was recommended by CSTE in revised Oral Health
Surveillance Indicator measures 2012.
It is unclear when this question will be added under
calculated variable.
Assessment
Monitoring System
(PRAMS)
Developed in 1987 by CDC and participating States
Currently 47 States are participating except California,
Idaho, and Ohio.
Uses mixed-mode methodology; self-administered
through mail, and interviewer administered through
telephone
Same questions are asked by interviewer to facilitate
questionnaire completion
1300 to 3400 women who gave live birth are sampled
each year using states birth certificate file
PRAMS Questionnaires - Pregnancy Risk Assessment Monitoring System - Reproductive Health [Internet].
CDC. 2015 [cited 30 October 2016]. Available from: https://www.cdc.gov/prams/questionnaire.htm
PRAMS (Cont)
The Questionnaire has two parts; Core Questions, and
Standard Questions
Core Questions collect information on; attitude and feelings
about most recent pregnancy, source of prenatal care,
maternal alcohol and tobacco consumption, physical abuse
during pregnancy, pregnancy related morbidity, infant
healthcare, contraceptive use, knowledge of pregnancy related
health issues including adverse effects of tobacco and alcohol
The remaining questions are included in the section of
Standard Questions
Dental questions were added from phase 6 (2009 2011)
Currently, following 6 measures for 1 oral health indicator are
being calculated in phase 7 (2012 Current)
PRAMS (Cont)
PRAMS (Cont)
PRAMS (Cont)
PRAMS (Cont)
PRAMS (Cont)
PRAMS (Cont)
PRAMS (Cont)
Behavioral
Surveillance System
(YRBSS)
School based survey developed in 1990 by CDC to monitor 6
categories of priority health risk behaviors including, tobacco
use, alcohol and drug use, sexual behaviors that contribute to
unintended pregnancy and STDs including HIV, unhealthy dietary
behaviors, physical inactivity, and behaviors that contribute to
unintentional violence or injury
Conducted every 2 years nationally by CDC and locally statewide by department of health and education to provide
representative sample of 9th through 12th grade students
CDC provides representative data for 9 th through 12th grade
students from public and private schools
State level data provides representative sample for 9 th through
12th grade students from public high schools
Youth Risk Behavior Surveillance System (YRBSS) Overview [Internet]. CDC. 2016 [cited 31 October 2016].
Available from: http://www.cdc.gov/healthyyouth/data/yrbs/overview.htm
YRBSS (Cont)
Several methodological changes have been proposed
since 1991
Currently dental visit question is asked under other
topics section in both National (CDC) and Standard (State
and local) questionnaire
Question about last dental visit was included in 1999,
2001, 2003, 2015, and 2017
YRBSS (Cont)
National Survey of
Childrens Health
(NSCH)
National Survey of Childrens Health (NSCH) is nationwide state level survey sponsored by Maternal Child
Health Bureau of the Health Recourses and Services
Administration in partnership with CDC, and Child and
Adolescent Health Initiative
Telephone Survey (landlines only) of households with at
least one resident children aged of 0 17 years
Collects data on physical and mental health, access to
quality healthcare, and childs school, family,
neighborhood, and social context
For 2016, survey will be conducted by Census Bureau,
and integrate two surveys; NSCH, and National Survey of
Children with Special Health Care Needs (NS-CSHCN)
National Survey of Children's Health [Internet]. Data Resource Center for Child and Adolescent Health.
2016 [cited 31 October 2016]. Available from: http://childhealthdata.org/learn/NSCH
NSCH (Cont)
Have been conducted three times since 2003; first in 2003, second
in 2007, and third in 2011/2012
Will be conducted yearly from 2016 with data expected in early
2017
For 2016, following dental questions are included and
recommended by ASTDD as preferred source of data to monitor
these indicators;
- Overall dental health,
- Decay or cavities, bleeding gums, toothache, in the past
12 months
- Dental visit in the past 12 months
NSCH (Cont)
NSCH (Cont)
Basic Screening
Survey (BSS)
Developed by Association of State and Territorial Dental
Directors (ASTDD) in collaboration with the Ohio Department
of Health, and the CDC in 1999
Conducted every 5 years by each state individually*
Two basic components; direct observation of persons mouth,
and questions asked of or about the individual being screened
Direct observation model is required, while questionnaire is
optional
Until 2008, NOHSS encouraged states to obtain information
on at least 3rd grade students but as of 2012 revision of oral
health indicators, states are recommended to collect
information on pre-school (attending head start programs),
kindergarten, and 3rd grade.
The Basic Screening Survey: A tool for Oral Health Surveillance Not Research [Internet]. ASTDD. 2011
[cited 31 October 2016]. Available from: http://www.astdd.org/docs/bss-what-is-oral-health-
BSS (Cont)
All screeners are trained by the State Health Department
before actual screening
Collects data from pre-school (attending head start
programs), school children (kindergarten and 3 rd grade)
on oral health indicators including;
- Caries Experience/treated decay: Percentage of
students with caries experience, including treated and
untreated tooth decay.
- Untreated Tooth Decay. Percentage of students with
untreated tooth decay.
- Dental Sealants. Percentage of students with dental
sealants on at least one permanent molar tooth. (3rd
grade)
BSS (Cont)
Collects data from older adults residing in long-term care or
skilled nursing facilities and those attending congregate meal
sites on oral health indicators including;
- Dentures and Denture use
- Number of natural teeth present
- Untreated tooth decay
- Tooth loss
- Root fragments
- Time Since last dental visit/Frequency of Dental Visits
- Access to Dental Care
- Obvious tooth mobility/need for periodontal care
- Urgency of need for dental care
Basic Screening Surveys: Preschool and School Children [Internet]. ASTDD. 2008 [cited 31 October 2016].
Available from:
Urgent need for dental care Children who need dental care
within 24 to 48 hours because of sign and symptoms
including pain, swelling, or infection
Early dental care Within next several weeks or before their
regular dental appointment, such as untreated decay
without symptoms of pain or swelling
Basic Screening Surveys: Older Adults [Internet]. ASTDD. 2010 [cited 31 October 2016]. Available
from: www.prevmed.org/wp-content/uploads/2013/11/BSS-SeniorsManual.pdf
Urgent need for dental care Dental care within next week because of
sign and symptoms including pain, swelling, or infection; Candidiasis
or suspicious soft tissue lesion is also classified under this category
Early dental care Within next several weeks or before their regular
dental appointment, such as untreated decay without symptoms of
pain or swelling; broken or missing filling and ill fitting denture is also
classified under this category
Water Fluoridation
Reporting System
(WFRS)
Developed by CDC in conjunction with ASTDD
Collected information about;
- Percentage of the population served by public water
systems who receive fluoridated water from 2000
present
Provides data for every state every 2 years
Currently provides county level data for water
fluoridation status for selected states
Proposed to provide data for every county served by one
or more community water systems
Water Fluoridation Reporting System (WFRS) [Internet]. Cdc. 2016 [cited 1 November 2016].
Available from: https://www.cdc.gov/fluoridation/data-tools/reporting-system.html
WRFS (Cont)
State fluoridation managers enter data into WFRS and generate
reports for state program use to improve quality
Data about each water system include facility location,
population served, fluoridation status, natural fluoridation
concentrations, system type. Laboratory testing, dates of facility
inspections, and other relevant information
About 54,000 community water systems included in WRFS. Of
these, about 18,400 systems are listed as either having fluoride
levels that are adjusted, are naturally occurring, or are
consecutively fluoridated (purchased from a neighboring system
that has optimally fluoridated water).
The optimal fluoride level in drinking water to prevent tooth
decay should be 0.7 milligrams of fluoride per liter of water, the
U.S. Department of Health and Human Services (HHS)
References
1) Phipps K, Kuthy R, Marianos D, Isman B. State-based oral health surveillance systems: conceptual framework and
operational definition. Council of State and Territorial Epidemiologists, Atlanta, GA, 2013.
2) Proposed New and Revised Indicators for the National Oral Health Surveillance System [Internet]. CDC. 2013 [cited 25
October 2016]. Available from:
http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/PS/12-CD-01FINALCORRECTEDOCT201.pdf
3) Behavioral Risk Factor Surveillance System 2014 Codebook Report Land - Line and Cell - Phone data [Internet]. CDC BRFSS. 2015 [cited 30 October 2016]. Available from: https://www.cdc.gov/brfss/annual_data/2014/pdf/codebook14_llcp.pdf
4) PRAMS Questionnaires - Pregnancy Risk Assessment Monitoring System - Reproductive Health [Internet]. CDC. 2015 [cited
30 October 2016]. Available from: https://www.cdc.gov/prams/questionnaire.htm
5) Youth Risk Behavior Surveillance System (YRBSS) Overview [Internet]. CDC. 2016 [cited 31 October 2016]. Available from:
http://www.cdc.gov/healthyyouth/data/yrbs/overview.htm
6) National Survey of Children's Health [Internet]. Data Resource Center for Child and Adolescent Health. 2016 [cited 31
October 2016]. Available from: http://childhealthdata.org/learn/NSCH
7) The Basic Screening Survey: A tool for Oral Health Surveillance Not Research [Internet]. ASTDD. 2011 [cited 31 October
2016]. Available from: http://www.astdd.org/docs/bss-what-is-oral-health-surveillance-4-26-2011.pdf
8) Basic Screening Surveys: Preschool and School Children [Internet]. ASTDD. 2008 [cited 31 October 2016]. Available from:
https://dphhs.mt.gov/Portals/85/publichealth/documents/OralHealth/BSSChildrensManual2008.pdf
9) Basic Screening Surveys: Older Adults [Internet]. ASTDD. 2010 [cited 31 October 2016]. Available from:
www.prevmed.org/wp-content/uploads/2013/11/BSS-SeniorsManual.pdf
10) Water Fluoridation Reporting System (WFRS) [Internet]. Cdc. 2016 [cited 1 November 2016]. Available from:
https://www.cdc.gov/fluoridation/data-tools/reporting-system.html
11) http://www.cdc.gov/oralhealth/data_systems/