Child Indicators

Oral Health Data includes the following indicators of children’s oral health from the National Oral Health Surveillance System (NOHSS):

  • Caries Experience. Percentage of 3rd grade students with caries experience, including treated and untreated tooth decay.
  • Untreated Tooth Decay. Percentage of 3rd grade students with untreated tooth decay.
  • Dental Sealants. Percentage of 3rd grade students with dental sealants on at least one permanent molar tooth.

Oral Health Data displays prevalence estimates for these indicators provided by state oral health programs. If a state provided both a crude estimate and an estimate adjusted for non-response, the adjusted estimate is displayed. See the Data Portal for detailed information on estimates.


For more information about the indicators, see National Oral Health Surveillance System.

Data sources and methods

State Oral Health Survey

State oral health surveys are the data sources for these indicators. States periodically conduct independent screening surveys of a sample designed to be representative of all third-grade students in the state. Most states use a probability sample; a census some times is used instead of a sample. Some states also survey Head Start program enrollees or students in other grades. This surveillance activity is voluntary. A state submits its data to the Association of State and Territorial Dental Directors (ASTDD), where the survey design and data are reviewed for quality and compliance with NOHSS criteria before being sent to CDC to be uploaded to Oral Health Data. To be included in NOHSS, data must be collected and analyzed using a protocol able to provide estimates of NOHSS indicators that can be compared among states. ASTDD developed the Basic Screening Survey (BSS) protocol to guide the reporting of NOHSS Child Indicators.
The State Oral Health Surveys that use the BSS or a comparable protocol form a standardized set. These surveys are designed to collect information on the observed oral health of participants; observed or self-reported age, gender, race, and Hispanic ethnicity; and self-reported access to care for preschool, school-age, and adult populations. The surveys are cross-sectional and descriptive. In the observed oral health survey, a dentist, dental hygienist, or other state-approved health care worker records gross dental or oral lesions. The examiner records presence of untreated cavities and urgency of need for treatment for all age groups and caries experience (treated and untreated decay) for preschool and school-age children. School-age children are also examined for presence of sealants on permanent molars.
For more information on the Basic Screening Survey protocol used by many states, see
For more information on the state-specific protocols used, see NOHSS Child Indicator Methods by Starting Year of Survey shown below.

Data sources and methods

Indian Health Service Oral Health Survey

The Indian Health Service (IHS) conducts routine ongoing oral health surveillance of the American Indian/Alaska Native (AI/AN) population. The IHS Oral Health Survey of AI/AN children is the data source for child indicators shown in Oral Health Data. Data are collected from elementary school students in kindergarten, first, second, and third grades. The first survey for elementary school students was completed during the 2011-2012 school year, and the second was completed during the 2016-2017 school year. Future surveys are planned, and data will be displayed as they become available.
A systematic probability proportional to size sampling scheme is used to select a national-level sample. The sampling frame represents approximately 35% of all AI/AN children in Bureau of Indian Education (BIE) public and private schools. Race is recorded as “AI/AN” or “Other.” Only children classified as AI/AN are included in the analyses. The survey is designed to obtain national, rather than IHS area estimates; therefore, IHS area-specific data are not presented.
The IHS Oral Health Survey of AI/AN children uses the Basic Screening Survey (BSS) protocol also used in State Oral Health Surveys. Use of this protocol provides standardized data that can be reported as estimates for the NOHSS child indicators. IHS child estimates are comparable to state estimates. For more information about survey methodology, see the IHS Dental Portal and