Need Information? NOHSS Is There For You

Jan. 1, 2008
Dental hygienists are developing programs and activities for public health initiatives more in the last decade than ever before.

by Christine Nathe, RDH, MS

Dental hygienists are developing programs and activities for public health initiatives more in the last decade than ever before. When proposing a new program, it’s important to have appropriate data regarding dental needs and preventive strategies within a community. Although it may require more detailed data once the program is approved (for effective program evaluation), it may be helpful to have data ready for the proposal that reflects dental needs of the individual state. In addition, neighboring state and national dental needs data are available for comparison.

This data is available as part of the National Oral Health Surveillance System (NOHSS) at The NOHSS is a collaborative effort between the CDC Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD). It’s designed to monitor oral disease, use of the oral health care delivery system, and preventive modalities on both a national and state level.

The Council of State and Territorial Epidemiologists (CSTE) and the National Association of Chronic Disease Directors (NACDD) were instrumental in developing the framework for oral health indicators. Oral health indicators are areas of oral health such as diseases or conditions and determinant or risk factors related to lifestyle that are critical to oral health, and can be used to monitor dental diseases, conditions and issues that may be indicative of problems within dental care delivery. The specific oral health indicators that are used within the NOHSS are:

  • Dental Visit. Adults aged 18 or older who have visited a dentist or dental clinic in the past year. Routine dental visits aid in the prevention, early detection, and treatment of tooth decay, oral soft tissue disease, and periodontal diseases.
  • Teeth Cleaning. Adults aged 18 or older who have had their teeth cleaned in the past year (among adults with natural teeth who have ever visited a dentist or dental clinic). Having one’s teeth cleaned by a dentist or dental hygienist is an indicator of preventive behavior.
  • Complete Tooth Loss. Adults aged 65 or older who have lost all of their natural teeth due to tooth decay or gum disease. Loss of all natural permanent teeth (complete tooth loss) may substantially impair a person’s quality of life, self-image, and daily functioning.
  • Lost Six or More Teeth. Adults aged 65 or older who have lost six or more teeth due to tooth decay or gum disease. Tooth loss can have an impact on food choices, quality of life, and self image.
  • Fluoridation Status. Percentage of people served by public water systems who receive fluoridated water. Water fluoridation plays an important role in reducing tooth decay and tooth loss.
  • Dental Sealants. Percentage of third grade students with dental sealants on at least one permanent molar tooth. Plastic coatings applied to decay susceptible tooth surfaces (the pits and fissures) can reduce tooth decay. The Task Force on Community Preventive Services strongly recommended school-based or school-linked dental sealant programs in their 2001 report. These materials have been approved for use for many years, and are recommended by professional health associations and public health agencies, particularly for children at high risk for tooth decay.
  • Caries Experience. Percentage of third grade students with caries experience, including treated and untreated tooth decay. Dental caries (tooth decay) is the single most common chronic childhood disease.
  • Untreated Tooth Decay. Percentage of third grade students with untreated tooth decay. To avoid pain and discomfort, decayed teeth need to be restored (filled). To keep as much of the natural tooth as possible, tooth decay should be discovered early and treated promptly so that fillings may be kept small.
  • Cancer of the Oral Cavity and Pharynx. Oral and pharyngeal cancer comprises a diverse group of malignant tumors that affect the oral cavity and pharynx (mouth and throat). Each year, some 28,000 new cases of oral and pharyngeal cancer are diagnosed, and 7,200 people die from the disease. Source:

With more emphasis being placed in program development and dental public health, the NOHSS has a wealth of information for dental hygienists. As dental health providers, we need to know about the resources available and use them!