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:

  • 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 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 1 yr and older)
  • Dental caries 1 yr and older)
  • Dental sealants 3 to 19 yrs)
  • Dental fluorosis assessment (6-19 yrs)
  • Periodontal pockets, recession, and loss of attachment (30 yrs and older)
  • Recommendations for dental care (1 yr and older)

Eligible Sample

All survey participants 1 year 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 adult participants by the oral health examiners prior to beginning  the  oral health examination in accordance with approved study protocols for the prevention of infective endocarditis.

Protocol and Procedure

All examiners for 2011-12 oral health examination were dentists (D.D.S./D.M.D.) licensed in at least one U.S. state. In 2011-12, the tooth count, dental caries, dental sealants and fluorosis assessments  followed the same protocols conducted in 2003-04. The 2011-12 periodontal examination was a full-mouth, six-site per tooth assessment following similar protocols used in 2009-10.

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 dentists prior to the beginning of the survey, (2) periodic monitoring and recalibration of dentists, and (3) periodic retraining of OH examination teams. The reference examiner visited each team up to 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 dentists 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 the dentists 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 reference examiner.

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_g): Tooth count, dental caries, dental sealants and fluorosis.
  • Periodontal Exam (ohxper_g): Periodontal pockets, recession, and loss of attachment.
  • Referral (ohxref_g): 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 2011–2012 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 are combined with oral health data from previous data cycles for analyses, users should understand that methodological differences (in data collection) may exist among similar, earlier assessments and this may bias the analysis conducted.

References

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 1 YEARS - 150 YEARS

OHDEXSTS - Overall Oral Health Exam Status

Variable Name:
OHDEXSTS
SAS Label:
Overall Oral Health Exam Status
English Text:
Overall Oral Health Exam Status
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Complete 8073 8073
2 Partial 399 8472
3 Not Done 484 8956
. Missing 0 8956

OHDRCSTS - Recommendation Care Status Code

Variable Name:
OHDRCSTS
SAS Label:
Recommendation Care Status Code
English Text:
Recommendation Care Status Code
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Complete 8394 8394
2 Partial 6 8400
3 Not Done 556 8956
. Missing 0 8956

OHAREC - Overall recommendation for care

Variable Name:
OHAREC
SAS Label:
Overall recommendation for care
English Text:
Overall recommendation for care
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 See a dentist immediately 1 1
2 See a dentist within the next 2 weeks 201 202
3 See a dentist at your earliest convenience 3187 3389
4 Continue your regular routine care 5007 8396
. Missing 560 8956

OHAROCDT - Decayed teeth

Variable Name:
OHAROCDT
SAS Label:
Decayed teeth
English Text:
Decayed teeth
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 2047 2047
2 No 27 2074
. Missing 6882 8956

OHAROCGP - Gum disease/problem

Variable Name:
OHAROCGP
SAS Label:
Gum disease/problem
English Text:
Gum disease/problem
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 1840 1840
2 No 19 1859
. Missing 7097 8956

OHAROCOH - Oral hygiene

Variable Name:
OHAROCOH
SAS Label:
Oral hygiene
English Text:
Oral hygiene
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 1466 1466
2 No 9 1475
. Missing 7481 8956

OHAROCCI - Impression of soft tissue condition

Variable Name:
OHAROCCI
SAS Label:
Impression of soft tissue condition
English Text:
Clinical impression of soft tissue condition
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 36 36
2 No 26 62
. Missing 8894 8956

OHAROCDE - Denture/Partial Denture/Plates

Variable Name:
OHAROCDE
SAS Label:
Denture/Partial Denture/Plates
English Text:
Denture/Partial Denture/Plates
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 531 531
2 No 2 533
. Missing 8423 8956

OHARNF - No significant findings

Variable Name:
OHARNF
SAS Label:
No significant findings
English Text:
No significant findings
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 4991 4991
2 No 43 5034
. Missing 3922 8956

OHAROTH - Some other finding (specify w/referral)

Variable Name:
OHAROTH
SAS Label:
Some other finding (specify w/referral)
English Text:
Some other finding (specify w/referral letter)
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 3 3
2 No 0 3
. Missing 8953 8956

OHAPOS - Was participant exam position recumbent

Variable Name:
OHAPOS
SAS Label:
Was participant exam position recumbent
English Text:
Was the SP in a recumbent (laying down) position for all eligible assessments of the oral health exam?
English Instructions:
Was the SP in a recumbent (laying down) position for all eligible assessments of the oral health exam (Oral-facial--Loss of Attachment)?
Target:
Both males and females 1 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 6893 6893
2 No 113 7006
. Missing 1950 8956