Table of Contents

Locator Record

Title: Oral Health, Referral (OHXREF_B )
Contact Number: 1-866-441-NCHS
Years of Content: 2001 - 2002
First Published: June, 2005
Revised: May, 2006
Access Constraints: None
Use Constraints: None
Geographic Coverage: National
Subject:Oral Health
Record Source: NHANES 2001 - 2002
Survey Methodology: NHANES 2001 - 2002 is a stratified multistage probability sample of the civilian non-institutionalized population of the U.S.
Medium: NHANES Web site; SAS transport files

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 are eligible. A positive response to any of the following medical health-screening questions asked of participants aged 13 years or older will exclude them from the periodontal and root caries assessments. Participants aged 13-15 years must have a health proxy signed by a parent/guardian to participate in the oral health examination.

Protocol and Procedure

The oral health exam is performed by trained dentists who hold a state dental license in a U.S. jurisdiction. One of up to seven trained oral health recorders is paired with a dentist to form a dental examination team. Two teams function independently throughout the data collection period. All oral health exam data are collected in the mobile examination center. Oral health data obtained during the home interview are collected by trained interviewers. Interview and examination protocols are discussed in detail in the NHANES Oral Health Home Interview and Exam Training Manuals. These manuals are available at: http://www.cdc.gov/nchs/about/major/nhanes/currentnhanes.htm#Exam.

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 examiner will visit each team three times per year to observe field operations and to replicate 20–25 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. 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. 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.

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.

Analytic Notes

The oral health data is released in the configuration of six “chapters.” The oral health chapters and subcomponents in parentheses are matched as follows:

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 for dental caries status, dental fluorosis, dental sealants, and periodontal status is provided at the Oral Health Data Resource Center: http://drc.nidcr.nih.gov/

It is recommended that data users merge relevant 2001–2002 oral health data files with 1999–2000 oral health data files to ensure adequate sample size for analyses of many of the oral health outcome measures available in these files. The four-year sample weight (WTMEC4YR) should be used for the combined analyses of NHANES 1999–2000 and NHANES 2001–2002 examination data. Additional analytical details are available at: http://www.cdc.gov/nchs/data/nhanes/nhanes_general_guidelines_june_04.pdf.

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 by using the unique survey participant identifier SEQN. The Oral Health Exam (OHX) and Oral Health Questionnaire (OHQ) data are publicly available at: http://www.cdc.gov/nchs/about/major/nhanes/nhanes01-02.htm

The oral health exam was modified in 2001 and again in 2002. In 2001, the gingival sweep used to assess for gingival bleeding was replaced with assessments for bleeding from probing. Moreover, a third probing site (Disto-facial) was added, and the mid-facial probing site for molars was moved from the mid-point of the mesial root to the mid-facial furcation area. The age of eligibility for participation in the periodontal assessment was lowered to 13 years-of-age or older.

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 completed 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, and 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 modified slightly. 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 reflect accurately what respondents were reporting “yes” to. For this data release, a bridge variable (OHD130) was created for 2001 and 2002 data collection periods.

Acknowledgement

The 2001–2002 NHANES Oral Health Component is a collaborative effort between the National Institute of Dental and Craniofacial Research (NIDCR), the National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health (NCCDPHP/DOH), and the National Center for Health Statistics (NCHS).

 

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 2 YEARS - 150 YEARS

OHAEXSTS - Overall Oral Health Exam Status

Variable Name:
OHAEXSTS
SAS Label:
Overall Oral Health Exam Status
English Text:
Overall Oral Health Exam Status
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Complete 7853 7853
2 Partial 1157 9010
3 Not done 588 9598
. Missing 0 9598

OHASCST5 - Referral Status Code

Variable Name:
OHASCST5
SAS Label:
Referral Status Code
English Text:
Referral Status Code
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Complete 8964 8964
2 Partial 41 9005
3 Not done 593 9598
. Missing 0 9598

OHQ131 - Must always take antibiotics?

Variable Name:
OHQ131
SAS Label:
Must always take antibiotics?
English Text:
Q1. Has a doctor or dentist ever told you that you must ALWAYS take antibiotics (e.g. penicillin) before you get a dental check up or care?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 249 249
2 No 6360 6609
7 Refused 0 6609
9 Don't know 4 6613
. Missing 2985 9598

OHQ132 - Had a heart problem?

Variable Name:
OHQ132
SAS Label:
Had a heart problem?
English Text:
Q2. A heart problem?
English Instructions:
Before we begin, I would like to read you a list of health conditions that some people have. As I read off each condition, please tell me whether or not a doctor has ever told you that you have the condition. Has a doctor ever told you that you have...
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 559 559
2 No 5801 6360
. Missing 3238 9598

OHQ134 - Had congenital heart murmurs?

Variable Name:
OHQ134
SAS Label:
Had congenital heart murmurs?
English Text:
Q3. Congenital heart murmurs?
English Instructions:
Was the heart problem due to:
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 116 116
2 No 440 556
7 Refused 0 556
9 Don't know 4 560
. Missing 9038 9598

OHQ136 - Had heart valve problem?

Variable Name:
OHQ136
SAS Label:
Had heart valve problem?
English Text:
Q4. Heart valve problem?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 40 40
2 No 404 444
7 Refused 0 444
9 Don't know 0 444
. Missing 9154 9598

OHQ138 - Had congenital heart disease?

Variable Name:
OHQ138
SAS Label:
Had congenital heart disease?
English Text:
Q5. Congenital heart disease?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 4 4
2 No 399 403
7 Refused 0 403
9 Don't know 2 405
. Missing 9193 9598

OHQ140 - Had bacterial endocarditis?

Variable Name:
OHQ140
SAS Label:
Had bacterial endocarditis?
English Text:
Q6. Bacterial endocarditis?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 2 2
2 No 399 401
. Missing 9197 9598

OHQ142 - Had rheumatic fever?

Variable Name:
OHQ142
SAS Label:
Had rheumatic fever?
English Text:
Q7. Rheumatic fever?
English Instructions:
Has a doctor ever said you have:
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 41 41
2 No 6148 6189
7 Refused 0 6189
9 Don't know 10 6199
. Missing 3399 9598

OHQ144 - Have kidney disease w/ renal dialysis?

Variable Name:
OHQ144
SAS Label:
Have kidney disease w/ renal dialysis?
English Text:
Q8. Kidney disease requiring renal dialysis?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 11 11
2 No 6148 6159
7 Refused 0 6159
9 Don't know 0 6159
. Missing 3439 9598

OHQ146 - Have other artificial material?

Variable Name:
OHQ146
SAS Label:
Have other artificial material?
English Text:
Q11. Other artificial material in your heart, veins, or arteries?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 48 48
2 No 6091 6139
7 Refused 0 6139
9 Don't know 0 6139
. Missing 3459 9598

OHQ148 - Have a hip, bone, or joint replacement?

Variable Name:
OHQ148
SAS Label:
Have a hip, bone, or joint replacement?
English Text:
Q12. A hip, bone, or joint replacement?
Target:
Both males and females 13 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 113 113
2 No 5980 6093
7 Refused 0 6093
9 Don't know 0 6093
. Missing 3505 9598

OHQ160 - Past 30 days / painful tooth?

Variable Name:
OHQ160
SAS Label:
Past 30 days / painful tooth?
English Text:
During the past 30 days have you experienced a toothache or painful tooth, (including pain with biting or chewing, or sensations to hot, cold or sweets)?
English Instructions:
These questions concern conditions of the teeth, mouth, or face. Tell me if you experienced any of these conditions for any reason (including "cavities", injury, or any other reason).
Target:
Both males and females 10 YEARS - 69 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 1757 1757
2 No 4677 6434
. Missing 3164 9598

OHQ170 - How many days / painful tooth?

Variable Name:
OHQ170
SAS Label:
How many days / painful tooth?
English Text:
For how many days in the past 30 days did you have these sensations?
Target:
Both males and females 10 YEARS - 69 YEARS
Hard Edits:
1 to 30
Code or Value Value Description Count Cumulative Skip to Item
1 to 30 Range of Values 1757 1757
77 SP refused 0 1757
99 Don't know 0 1757
. Missing 7841 9598

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 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 See a dentist immediately 15 15
2 See a dentist within the next 2 weeks 434 449
3 See a dentist at your earliest convenience 3917 4366
4 Continue your regular routine care 4591 8957
. Missing 641 9598

OHAROCDT - Untreated Caries / Restorative needs

Variable Name:
OHAROCDT
SAS Label:
Untreated Caries / Restorative needs
English Text:
A. Decayed teeth
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 2148 2148
. Missing 7450 9598

OHAROCGP - Periodontal needs

Variable Name:
OHAROCGP
SAS Label:
Periodontal needs
English Text:
B. Gums/gum disease
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 1755 1755
. Missing 7843 9598

OHAROCOH - Gingival / OHI needs

Variable Name:
OHAROCOH
SAS Label:
Gingival / OHI needs
English Text:
C. Oral hygiene
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 2997 2997
. Missing 6601 9598

OHAROCCI - Assessment of soft tissue lesion

Variable Name:
OHAROCCI
SAS Label:
Assessment of soft tissue lesion
English Text:
D. Clinical impression of soft tissue condition
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 9 9
. Missing 9589 9598

OHAROTH - Some other finding

Variable Name:
OHAROTH
SAS Label:
Some other finding
English Text:
Some other finding (specify w/ referral letter)
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 207 207
. Missing 9391 9598

OHARNF - No significant needs

Variable Name:
OHARNF
SAS Label:
No significant needs
English Text:
F. No significant findings
Target:
Both males and females 2 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 4541 4541
. Missing 5057 9598