Table of Contents

Component Description

NHANES is critical for monitoring oral health status, risk indicators for disease, and access to preventive and treatment services. This component will address public health significance in areas of surveillance, prevention, treatment, dental care utilization, health policy, evaluation of Federal health programs, standardization of new methods, and oral health disparities.

Oral health data from NHANES will be used for:

Eligible Sample

Participants aged 2 years and older who do not meet any of the exclusion criteria. A positive response to any of the following medical health screening questions asked of participants aged 18 years or older will exclude them from the root caries assessments.

Interview Setting and Mode of Administration

Subcomponents

The following subcomponents are from the oral health examination component and home interview component with the age groups of interest in parentheses:

Survey Staff

One of up to seven trained oral health recorders is paired with a licensed dentist to form a dental examination team. Two teams function independently throughout the data collection period. During the home interview, oral health data are collected by trained interviewers.

Data Collection Forms:

Detailed placement and reading instructions are discussed in the NHANES Oral Health Training and Home Interview Training Manuals (available at https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/default.aspx?BeginYear=2001). Each chapter specifies procedures to be used for each of the oral health subcomponents.

Quality Assurance & Quality Control

The quality of data in this survey is controlled by (1) an intense training period for the dental teams with calibration of dental examiners prior to the beginning of the survey, (2) periodic monitoring and recalibration of dental examiners, and (3) periodic retraining of dental teams. The reference (gold standard) examiner visits each team 3 times per year to observe field operations and to replicate 20 to 25 dental examinations during each visit. The purpose of these “expert replications” is to determine if the field examiners are maintaining the examination standards achieved during training, and to measure the degree of deviation, if any, from those standards. If the inter-rater correlation is not within acceptable limits, retraining is conducted on site and future monitoring of the field examiner intensified. Approximately 10% of examined participants are asked to return for a replicate exam. The purpose of these “repeat exams” is to monitor internal consistency within examiners regarding the data collection process. Each dental examiner participates in an annual retraining session, also conducted by the reference examiner.

Data Processing and Editing

Automated data collection procedures for the survey were introduced in NHANES 1999. In the MECs, data for the oral health component are recorded directly onto a computerized data collection form. The system is centrally integrated and it allows for ongoing monitoring of much of the data.

Analytic Notes

The oral health exam data will be released in the configuration of four “chapters.” These chapters are Dentition, Periodontal, Miscellaneous, and the Home Interview. The oral health chapters and subcomponents in parentheses are matched as follows for this release:

The following oral health chapter with subcomponents will be released at a later date: Periodontal (periodontal pockets, recession, loss of attachment, and bleeding).

A variety of oral health variables can be derived to assist analysts using the oral health exam data. Recommended derivations and a selection of sample code are provided in the Appendices.

Special Notes on Using the Dataset:

The analysis of NHANES 2001-2002 oral health data must be conducted with the key survey design and basic demographic variables. The NHANES 2001-2002 Household Questionnaire Data Files contain demographic data, health indicators, and other related information collected during household interviews. They also contain all survey design variables and sample weights for these age groups. Other household questionnaire and oral questionnaire files may be linked to the oral health examination data file using the unique survey participant identifier SEQN.

Beginning in 2002, there were three additions to the Dentition assessment: (1) residual dental root-tips were assessed for during Tooth Count; (2) the type of replacement for missing teeth (i.e. either removable or fixed) was ascertained in Coronal Caries; and (3) denture questions were added. These items will not be released because they were added in mid-data collection cycle. Consequently, derived variables were created for data collected during 2001-02 to make Year 4 variables comparable to Year 3 variables. This was done for Tooth Count (OHD##TC), Coronal Tooth Condition (OHD##CTC), and Coronal Surface Condition (OHD##CSC).

Additionally, the 1999-2000 OH questions on Xerostomia (OHQ080, -090, -100, -110) are now OHQ085, -095, -105, and -115, respectively, to reflect the age change from 40+ to 18+ years. This change was made in 2001.

In 2002, the medical exclusion question inquiring into a history of needing to take antibiotics prior to dental treatment was slightly modified. With the beginning of the current NHANES (1999), all dental examiners were instructed to probe if a positive response was given to this question. All probes were to include the word “always” needed to take antibiotics prior to dental treatment or dental care. Consequently, “always” was added to question OHQ130 to accurately reflect what respondents were reporting “yes” to. For this data release, a bridge variable (OHD130) was created for the 2001 and 2002 data collection periods.

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:
SEQN
SAS Label:
Respondent sequence number
English Text:
Respondent sequence number.
Target:
Both males and females 2 YEARS - 150 YEARS

OHQ010 - General condition of mouth and teeth

Variable Name:
OHQ010
SAS Label:
General condition of mouth and teeth
English Text:
Now I have some questions about {your/SP's} mouth and teeth. How would you describe the condition of {your/SP's} mouth and teeth? Would you say . . .
English Instructions:
INCLUDE FALSE TEETH AND DENTURES
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Very good, 3115 3115
2 Good, 3875 6990
3 Fair, or 2193 9183
4 Poor? 936 10119
7 Refused 3 10122
9 Don't know 1 10123
. Missing 4 10127

OHQ020 - Limit foods because of teeth problems

Variable Name:
OHQ020
SAS Label:
Limit foods because of teeth problems
English Text:
How often {do you/does SP} limit the kinds or amounts of food {you/s/he} eat{s} because of problems with {your/his/her} teeth or dentures? Would you say . . .
Target:
Both males and females 18 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Always, 91 91
2 Very often, 124 215
3 Often, 133 348
4 Sometimes, 518 866
5 Seldom, or 624 1490
6 Never? 4490 5980
77 Refused 4 5984
99 Don't know 5 5989
. Missing 4138 10127

OHQ030 - When did you last visit a dentist

Variable Name:
OHQ030
SAS Label:
When did you last visit a dentist
English Text:
About how long has it been since {you/SP} last visited a dentist? Include all types of dentists, such as, orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists.
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 6 months or less 4268 4268
2 More than 6 months, but not more than 1 year ago 1657 5925
3 More than 1 year, but not more than 2 years ago 1187 7112
4 More than 2 years, but not more than 3 years ago 603 7715
5 More than 3 years, but not more than 5 years ago 541 8256
6 More than 5 years ago 939 9195
7 Never have been 892 10087 End of Section
77 Refused 4 10091
99 Don't know 32 10123
. Missing 4 10127

OHQ033 - Main reason for last dental visit

Variable Name:
OHQ033
SAS Label:
Main reason for last dental visit
English Text:
What was the main reason {you/SP} last visited the dentist?
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Went in on own for check-up, examination, or cleaning 5206 5206
2 Was called in by the dentist for check-up, examination, or cleaning 449 5655
3 Something was wrong, bothering or hurting {me/SP} 2394 8049
4 Went for treatment of a condition that dentist discovered at earlier checkup or examination 776 8825
5 Other 352 9177
7 Refused 4 9181
9 Don't know 50 9231
. Missing 896 10127

OHQ035 - CHECK ITEM

Variable Name:
OHQ035
English Instructions:
CHECK ITEM OHQ.035: IF OHQ.030 = 5 OR 6, GO TO OHQ.060. OTHERWISE, CONTINUE.
Target:
Both males and females 2 YEARS - 150 YEARS

OHQ037 - CHECK ITEM

Variable Name:
OHQ037
English Instructions:
CHECK ITEM OHQ.037: IF OHQ.033 = 1 OR 2, GO TO OHQ.050. OTHERWISE, CONTINUE.
Target:
Both males and females 2 YEARS - 150 YEARS

OHQ040 - Routine checkups over past 3 yrs

Variable Name:
OHQ040
SAS Label:
Routine checkups over past 3 yrs
English Text:
During the past 3 years, {have/has} {you/SP} been to the dentist for routine check-ups or cleanings?
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 1419 1419
2 No 1155 2574 OHQ060
7 Refused 3 2577 OHQ060
9 Don't know 7 2584 OHQ060
. Missing 7543 10127

OHQ050 - Routine checkups frequency past 3 yrs

Variable Name:
OHQ050
SAS Label:
Routine checkups frequency past 3 yrs
English Text:
During the past 3 years, how often {have you/has SP} gone to the dentist for routine check-ups or cleanings?
English Instructions:
HAND CARD OHQ1
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 2 or more times a year 3286 3286
2 Once a year 1786 5072
3 Less than once a year 479 5551
4 Whenever needed, no regular schedule 1029 6580
7 Refused 0 6580
9 Don't know 6 6586
. Missing 3541 10127

OHQ060 - Regular dentist/lab you visit for care

Variable Name:
OHQ060
SAS Label:
Regular dentist/lab you visit for care
English Text:
Is there a particular dentist or dental clinic that {you/SP} usually {go/goes} to if {you/he/she} need{s} dental care or dental advice?
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 6143 6143
2 No 3067 9210 OHQ075
7 Refused 3 9213 OHQ075
9 Don't know 18 9231 OHQ075
. Missing 896 10127

OHQ070Q - How long use this dentist/lab as regular

Variable Name:
OHQ070Q
SAS Label:
How long use this dentist/lab as regular
English Text:
For how long has this been {your/SP's} regular source of dental care?
English Instructions:
ENTER NUMBER (OF DAYS, WEEKS, MONTHS OR YEARS)
Target:
Both males and females 2 YEARS - 150 YEARS
Hard Edits:
1 to 99
Code or Value Value Description Count Cumulative Skip to Item
1 to 72 Range of Values 6119 6119
77777 Refused 0 6119
99999 Don't know 24 6143
. Missing 3984 10127

OHQ070U - Unit of measure (days/wks/mos/yrs)

Variable Name:
OHQ070U
SAS Label:
Unit of measure (days/wks/mos/yrs)
English Text:
UNIT OF MEASURE
English Instructions:
ENTER UNIT
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Days 14 14
2 Weeks 39 53
3 Months 480 533
4 Years 5586 6119
7 Refused 0 6119
9 Don't know 0 6119
. Missing 4008 10127

OHQ075 - CHECK ITEM

Variable Name:
OHQ075
English Instructions:
CHECK ITEM OHQ.075: IF SP AGE >= 18, CONTINUE. OTHERWISE, GO TO END OF SECTION.
Target:
Both males and females 2 YEARS - 150 YEARS

OHQ085 - Sip liquids to aid swallowing foods

Variable Name:
OHQ085
SAS Label:
Sip liquids to aid swallowing foods
English Text:
{Do you/Does SP} sip liquids to aid in swallowing any foods?
Target:
Both males and females 18 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 413 413
2 No 5394 5807
7 Refused 3 5810
9 Don't know 0 5810
. Missing 4317 10127

OHQ095 - Amount of saliva in mouth

Variable Name:
OHQ095
SAS Label:
Amount of saliva in mouth
English Text:
Does the amount of saliva in {your/SP's} mouth seem to be too little, too much, or {do you/does s/he} not notice it?
Target:
Both males and females 18 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Too little 253 253
2 Too much 278 531
3 Doesn't notice it 5259 5790
7 Refused 3 5793
9 Don't know 17 5810
. Missing 4317 10127

OHQ105 - Difficulties swallowing foods

Variable Name:
OHQ105
SAS Label:
Difficulties swallowing foods
English Text:
{Do you/Does SP} have difficulties swallowing any foods?
Target:
Both males and females 18 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 270 270
2 No 5533 5803
7 Refused 3 5806
9 Don't know 4 5810
. Missing 4317 10127

OHQ115 - Mouth feel dry when eating meal

Variable Name:
OHQ115
SAS Label:
Mouth feel dry when eating meal
English Text:
Does {your/SP's} mouth feel dry when {you/s/he} eat{s} a meal?
Target:
Both males and females 18 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 278 278
2 No 5517 5795
7 Refused 3 5798
9 Don't know 12 5810
. Missing 4317 10127

Appendix 1

The Oral Health collaborator group (NIH/NIDCR, CDC/NCCDPHP/DOH, and CDC/NCHS) has provided the following SAS code to promote transparency and uniformity in the analyses of the current NHANES data. The sample code is divided into five topic areas: Dental Caries Status, Dental Sealants, Dental Fluorosis, Home Interview Questions, and Administrative. Please see the accompanying data document entitled NHANES 2001-2002 Yr3-Yr4 Data Release Oral Health Data Appendix.