National Oral Health Surveillance System
Data Sources
Analytic considerations for the surveys
(BRFSS, NHANES, NHIS, YRBSS) Estimates for certain population
subgroups may be based on small numbers and be subject to relatively large
sampling error. When the number of events is small and the probability of
such an event is small, considerable caution must be observed in
interpreting the conditions (cell size < 50). Data from multiple years
may be pooled to obtain adequate sample size.
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BRFSS
The Behavioral Risk Factor
Surveillance System is a state-based, ongoing data collection program
designed to measure behavioral risk factors in the adult,
non-institutionalized population 18 years of age or older. Every month,
states select a random sample of adults for a telephone interview. This
selection process results in a representative sample for each state so
that statistical inferences can be made from the information collected.
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BSS
The Basic Screening Survey (BSS) is a standardized set of surveys designed to
collect information on the observed oral health of participants,
self-report or observed information on age, gender, race and Hispanic
ethnicity, and self-report information on access to care for preschool,
school-age, and adult populations. The surveys are cross-sectional and
descriptive. In the observed oral health survey, gross dental or oral
lesions are recorded by dentists, dental hygienists, or other appropriate
health care workers in accordance with state law. The examiner records
presence of untreated cavities and urgency of need for treatment for all
age groups. In addition, for preschool and school-age children, caries
experience (treated and untreated decay) is also recorded. School-age
children are also examined for presence of sealants on permanent molars. Edentulism (no natural teeth) is recorded for adults. States may use one
or more of the surveys in the BSS to obtain oral health status and dental
care access data for monitoring Healthy People 2010 objectives. Training
materials are provided with the surveys and technical assistance from ASTDD on sampling and analysis
is available to states undertaking these
surveys using the standard protocol. BSS was developed by the Association
of State and Territorial Dental Directors with technical assistance from
CDC.
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CDC Fluoridation Census 1992
The 1992
Fluoridation Census provides information regarding the fluoridation
status for each state. States reported each fluoridated public water
system and the communities each system served; the type of
fluoridation—adjusted or natural (including fluoridated water purchased by
non-fluoridating systems); the number of people receiving fluoridated
water; the date on which fluoridation started; and the chemical used for
fluoridation, if adjusted. CDC. National Center for Prevention Services.
Fluoridation Census 1992. Atlanta, Georgia: U.S. Department of Health and
Human Services, Public Health Service, CDC, 1993. See
Fact
Sheet on the Fluoridation Census 1992.
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CDC Water Fluoridation Reporting System (WFRS)
WFRS provides state oral health program staff a tool for
monitoring the quality of the water fluoridation program in their state. Data
provided by water systems is used by state oral health program staff to
recognize excellent work in water fluoridation and identify opportunities for
continuous improvement in the water fluoridation program. The data are also used
to develop estimates of the percentage of the population that receives
fluoridated water to track Healthy People 2010 Objective 21-9: "Increase the
proportion of the U.S. population served by community water systems with
optimally fluoridated water. Target: 75%." The publication
Populations
Receiving Optimally Fluoridated Public Drinking Water — United States, 2000
(MMWR Vol. 51, No. 7;144-147.) provides the status of water fluoridation by
state for 2000. This Web site is the official source for the 2002 estimates.
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NHANES
Oral health data were collected in the National
Health and Nutrition Examination Survey (NHANES I, NHANES III, and
NHANES 1999-2004).
NHANES I was conducted between 1971 and 1975. This survey was based on a national sample of about
28,000 persons between the ages of 1 and 74. Extensive data on health and
nutrition were collected by interview, physical examination, and
laboratory analyses. The sampling design of NHANES I did not include
persons of Hispanic/Latin origin.
NHANES III, conducted between 1988 and 1994, included about 40,000 people selected from
households in 81 counties across the United States. To obtain reliable
estimates, infants and young children (aged 1 to 5 years), older persons
(aged 60 years and older), Black Americans and Mexican Americans were
sampled at a higher rate. NHANES III also placed an additional emphasis on
the effects of the environment upon health. Data were gathered to measure
the levels of pesticide exposure, the presence of certain trace elements
in the blood, and the amounts of carbon monoxide present in the blood.
NHANES 1999–2004 began in April 1999 and is a continuous survey visiting 15 U.S. locations per
year. Approximately 5,000 people are surveyed annually. Oral health data
from the current NHANES will be added to NOHSS when data from each phase of the survey
become publicly available.
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NHIS The National
Health Interview Survey is a cross-sectional household interview
survey on the health of the civilian noninstitutionalized population of
the United States. The sampling plan follows a multistage area probability
design that permits the representative sampling of households. NHIS data
are collected annually from approximately 43,000 households including
about 106,000 persons.
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PRAMS The
Pregnancy
Risk Assessment Monitoring System collects state-specific,
population-based data on maternal attitudes and experiences prior to,
during, and immediately following pregnancy. The PRAMS sample of women who
have had a recent live birth is drawn from the state's birth certificate
records. Each participating state samples between 1,300 and 3,400 women
per year. Women from some groups are sampled at a higher rate to ensure
adequate data are available in smaller but higher risk populations.
Information is gathered by mail and telephone. Data collection procedures
and instruments are standardized to allow comparisons between states.
PRAMS allows CDC and state health officials to monitor changes in maternal
and child health indicators (e.g., unintended pregnancy, prenatal care,
breastfeeding, smoking, alcohol use, infant health).
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State Oral Health Surveys
Many states conduct periodic oral health surveys. Some states now use
the BSS (Basic Screening Survey) protocol or similar protocols for their
surveys. States can submit results from these surveys for inclusion in
NOHSS. State data that meet criteria for inclusion in NOHSS are published
on the NOHSS Web site. More information on state oral health surveys is
provided at State Oral Health Surveys.
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State Synopses
The Synopses
of State and Territorial Dental Public Health Programs collects oral health program
information provided to the Association of State and Territorial Dental
Directors (ASTDD) annually by each state's dental director or oral health
program manager. ASTDD, in conjunction with CDC's Division of Oral Health,
presents that information with data from standard sources (U.S. Census,
Department of Education, Bureau of Labor Statistics, etc.) on the State
Synopses Web site. Each state has its own synopsis which contains
state-specific information on demographics, oral health infrastructure,
oral health program administration, and oral health program activities. An
interactive national trend table aggregates that information to track
changes over time. Maps display which states conduct each of 12 types of
oral health activities and which states have full-time dental directors.
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YRBSS The
Youth
Risk Behavior Surveillance System is a CDC school-based survey conducted
biennially to assess the prevalence of health risk behaviors among high
school students. YRBSS includes national, state, territorial, and local
school-based surveys of high school students. The school-based surveys
employ a cluster sample design to produce a representative sample of
students in grades 9–12. Survey procedures are designed to protect the
students’ privacy by allowing for anonymous and voluntary participation.
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Page last reviewed: January 23, 2008
Page last modified: December 12, 2006
Content Source: Division of
Oral Health,
National Center for Chronic Disease Prevention and Health Promotion
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