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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 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; rarely, a census is used instead of a sample. Some states also conduct surveys of students in other grades in school, or of Head Start program enrollees. This surveillance activity is voluntary. States submit their data to the Association of State and Territorial Dental Directors (ASTDD), where the survey design and data collected are reviewed for quality and against the criteria for inclusion in NOHSS, before being sent to CDC for inclusion in Oral Health Data. For state oral health survey data to be included in NOHSS, the data must be collected and analyzed using a protocol that can provide estimates for the NOHSS indicators that can be compared among states. ASTDD developed the Basic Screening Survey (BSS) protocol as a tool to guide states in reporting the NOHSS Child indicators.

The State Oral Health Surveys that use the BSS protocol, or a comparable protocol, form a standardized set of surveys. These state surveys are designed to collect information on the observed oral health of participants, self-report or observed information on age, gender, race and Hispanic ethnicity, and self-report information on access to care for preschool, school-age, and adult populations. The surveys are cross-sectional and descriptive. In the observed oral health survey, gross dental or oral lesions are recorded by dentists, dental hygienists, or other appropriate health care workers in accordance with state law. The examiner records presence of untreated cavities and urgency of need for treatment for all age groups. In addition, for preschool and school-age children, caries experience (treated and untreated decay) is also recorded. School-age children are also examined for presence of sealants on permanent molars. Edentulism (no natural teeth) is recorded for adults. Training materials are provided with the surveys and technical assistance from ASTDD on sampling and analysis is available to states undertaking these surveys using the standard protocol. BSS was developed by ASTDD with technical assistance from CDC.

For more information on the Basic Screening Survey protocol used by many of these states, see the ASTDD website.

For more information on the state-specific protocols used, see NOHSS Child Indicator Methods by Starting Year of Survey.