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Introduction
The Association of State and Territorial Dental Directors(ASTDD) along with the Council of State and Territorial Epidemiologists (CSTE) devised the National Public Health Surveillance System(NOHS) in 1999 ( CSTE, 2013). It is used for measuring the prevalence of oral diseases and the effectiveness of the oral health care system, as well as, the state of water fluoridation (CDC, 2015). NOHSS is designed for the analysis of national and state-level oral health data. Oral health indicators can be divided into three different groups: adult indicators, child indicators, and water fluoridation indicators. This paper will discuss the nine oral health indicators in these categories and propose a new one.
Adult Indicators
Dental visits among adults allow monitoring the utilization of oral health services. Frequent use of dental services is commonly associated with better oral health for the adult population from all social strata (CSTE, 2013). Teeth cleaning is another important health indicator that is used to assess the number of adults who have cleaned their teeth during the period of the last year (CSTE, 2013). It is being used along with the dental visit indicator; therefore, its inclusion in NOHS is essential. It is also very important to measure the rates of the loss of 6 or more permanent teeth among adults because even a partial dental loss can significantly compromise the nutritional status. Another parameter of dental health is the obvious signs of tooth decay. It is related to the reduction of the quality of life and, therefore, must be included in NOHS. Complete tooth loss indicator helps to monitor the percentage of the adult population from 65 to 74 years who had a permanent loss of their teeth (CSTE, 2013).
Child Indicators
Caries Experience is the indicator that helps to track the treated and untreated tooth decay for both preschool and school-age children (CSTE, 2013). It was included only in the child category because of the high likelihood of experiencing caries in the adult age. Untreated tooth decay indicator helps to reduce the proportion of children with untreated decay of the primary teeth (CSTE, 2013). The presence of sealants on permanent teeth is the factor that is being measured by the dental sealants indicator. It is essential to have this question in NOHS because it would help increase the number of children with dental sealants on one or more of their permanent first molar teeth (CSTE, 2013).
Water Fluoridation Indicator
Water fluoridation indicator is being used to provide information on the state and country rates of water fluoridation (CSTE, 2013). The data is being gathered every two years, and it serves to reflect the proportion of the United States population that is supplied with the optimum level of fluoridated water (CSTE, 2013). It is essential to have the question of water fluoridation on NOHSS to develop a better understanding of the relationship between the addition of fluoride to water and the prevention of tooth decay.
SES Indicator
Various researchers have argued that the difference in access to health care between people with different incomes is the main factor behind the oral health disparities (Hudson, Stockard, & Ramberg, 2007). The inclusion of the socioeconomic status (SES) indicator in NOHS will help to establish a better connection between people from various social positions and the state of their dental health. It will also allow developing a comprehensive approach towards the elimination of the oral health disparities.
References
CDC. (2015). National Oral Health Surveillance System (NOHSS). Web.
CSTE. (2013). Proposed new and revised indicators for the National Oral Health Surveillance System. Web.
Hudson, K., Stockard, J., & Ramberg, Z. (2007). The Impact of Socioeconomic Status and Race-Ethnicity on Dental Health. Sociological Perspectives, 50(1), 7-25.
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