• Component Description
• Eligible Sample
• Protocol and Procedure
• Quality Assurance & Quality Control
• Data Processing and Editing
• Analytic Notes
• Codebook
  • SEQN - Respondent sequence number
  • OHDEXSTS - Overall Oral Health Exam Status
  • OHDRCSTS - Recommendation Care Status Code
  • OHAREC - Overall recommendation for care
  • OHAROCDT - Decayed teeth
  • OHAROCGP - Gum disease/problem
  • OHAROCOH - Oral hygiene
  • OHAROCCI - Clinical impression soft tissue conditon
  • OHAROCDE - Denture/Partial Denture/Plates
  • OHARNF - No significant findings
  • OHAROTH - Some other finding (specify w/referral)
  • OHAPOS - Was participant exam position recumbent

National Health and Nutrition Examination Survey

2009-2010 Data Documentation, Codebook, and Frequencies

Oral Health - Recommendation of Care (OHXREF_F)

Data File: OHXREF_F.xpt

First Published: April 2012

Last Revised: NA

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:

• Assessing the prevalence of major oral health diseases and conditions including dental caries, periodontal disease, and dental fluorosis
• Assessing prevention and treatment efforts including the prevalence of dental sealants
• Evaluating specific public health programs/new policies and initiatives
• Monitoring the oral health status of minority/underserved populations
• Evaluating Healthy People 2010 and 2020 objectives related to oral health
• Supporting research activities as identified in the 2000 Surgeon General’s Report on Oral Health in the United States

The oral health examination section (OHX) provides information on a number of oral health topics. These topic areas and related target population groups in the OHX section include:

• Tooth count (3-19 and 30 yrs and older)
• Basic Screening Exam (assess the presence of at least one tooth with dental decay, a dental restoration, and a dental sealant) (3-19 yrs)
• Dental fluorosis assessment (6-19 yrs)
• Periodontal pockets, recession, and loss of attachment (30 yrs and older)
• Recommendations for dental care (3-19 and 30 yrs and older)

 

Eligible Sample

All survey participants 3-19 and 30 years and older were eligible for the oral health examination. Participants aged 30 years and older were eligible for the periodontal evaluation if they had at least one tooth (excluding third molars) and did not meet any of the health exclusion criteria. Medical health-screening questions were asked to the participants by the oral health examiners prior to beginning to oral health examination in accordance with approved study protocols for the prevention of infective endocarditis.

 

Protocol and Procedure

All examiners for 2009-10 oral health examination were dental hygienists registered in at least one U.S. state. In 2009-10, the basic screening exam construct is similar to the assessment conducted in 2005-08. The dental fluorosis assessment was limited to the upper six anterior teeth. The 2009-10 periodontal examination was a full-mouth, six-site per tooth assessment.

 

Quality Assurance & Quality Control

The quality of data in this survey is controlled by (1) an intense training period for the health technologists who were assigned to conduct the oral health examinations with calibration of OH examiners prior to the beginning of the survey, (2) periodic monitoring and recalibration of OH examiners, and (3) periodic retraining of OH examination teams. The reference examiner will visit each team three times per year to observe field operations and to replicate 20 to 25 OH 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. An annual retraining session for each dental examiner also is conducted by the reference examiner to reinforce existing protocols and to accommodate protocol updates as needed. All OH training, calibration, and field replicate exams were conducted by the NHANES survey expert dentist.

Automated data collection procedures for the survey were introduced in NHANES 1999. In the mobile examination centers (MECs), data for the oral health component are recorded directly onto a computerized data collection form. The system is integrated centrally and it allows for ongoing monitoring of much of the data. As part of an on-going quality control practice, all data are reviewed systematically for logical inconsistencies and examiner error. Internal quality control data review indicates that data quality is acceptable.

 

Data Processing and Editing

Frequency counts were checked, "skip" patterns were verified, and the reasonableness of responses to the questions was reviewed.

 

Analytic Notes

The oral health data is released in three separate data files as follows: Dentition Exam (ohxden_f):

• Tooth count and basic screening exam.
• Periodontal Exam (ohxper_f): Periodontal pockets, recession, and loss of attachment.
• Referral (ohxref_f): Report of findings-dental care recommendations, and miscellaneous.

Oral health data from these 3 files can be linked using the unique survey participant identifier, SEQN. In addition to the oral health examination data, oral health questionnaire data can be found in the oral health section of the NHANES 2009–2010 Home Interview Files (OHQ). These data may be linked using the unique survey participant identifier, SEQN. Although these data were collected as part of the household questionnaire, if they are merged with the MEC exam data, exam sample weights should be used for the analyses. Please refer to the Analytic Guidelines on the NHANES website for further details on the use of sample weights and other analytic issues. The Analytic Guidelines are available on the NHANES website.

If data from this release is combined with oral health data data from previous data cycles for analysis, users should understand that methodological differences (in data collection) may exist among similar, earlier assessments and this may bias the analysis conducted.

At the time of this first release of the NHANES 2009-2010 oral health data, the 2009-2010 dental fluorosis data was not available for release because of ongoing data review.

 

Codebook and Frequencies