Association of State
and Territorial Dental Directors
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National Oral Health Surveillance System (NOHSS)
NOHSS is a collaborative effort between CDC's Division of Oral Health and
the Association of State and Territorial Dental Directors (ASTDD). NOHSS is
designed to help public health programs monitor the burden of oral disease,
use of the oral health care delivery system, and the status of community
water fluoridation on both a state and national level. NOHSS includes
indicators of oral health, information on state dental programs, and links
to other important sources of oral health information.
NOHSS is designed to track eight basic oral health surveillance
indicators as its main focus. This is a minimal set of indicators,
to be expanded in the future, based on data sources and
surveillance capacity available to most states. The Council of
State and Territorial Epidemiologists (CSTE) and the Association
of State and Territorial Chronic Disease Program Directors (ASTCDPD) were
instrumental in developing the framework for chronic disease
surveillance indicators, including these oral health indicators.
Data sources for NOHSS include national surveys (NHANES, NHIS,
Fluoridation Census) and state-based surveys (BRFSS, YRBSS, PRAMS,
ASTDD's Basic Screening Survey and annual State Synopses).
Oral Health Indicators
- Dental Visits. Percentage of people who visited the
dentist or dental clinic within 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. Percentage of people who had their teeth
cleaned in the past year. Having one's teeth cleaned by a dentist or dental hygienist
is indicative of preventive behavior.
- Complete Tooth Loss. Percentage of people aged 65 years and older who have lost all
natural permanent teeth. Loss of all natural permanent teeth (complete tooth loss) may substantially
reduce quality of life, self-image, and daily functioning.
- 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.
- Caries Experience. Percentage of 3rd grade
students with caries experience, including treated and untreated tooth decay. Dental
caries is the single most common chronic disease of childhood, occurring five to eight times as frequently as asthma, the second most common
chronic disease in children.
- Untreated Tooth Decay. Percentage of 3rd 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, decayed teeth should be discovered
early and repaired promptly so that fillings may be kept small.
- Dental Sealants. Percentage of 3rd grade students with dental
sealants on at least one permanent molar tooth. Plastic coatings applied to decay-susceptible tooth surfaces (the pits and
fissures) reduce tooth decay, 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.
- Cancer of the Oral Cavity and Pharynx. Oral and pharyngeal cancer comprises a diversity of malignant
tumors that affect the oral cavity and pharynx (mouth and throat). Each year, some 30,000 new cases of oral and pharyngeal cancer are
diagnosed and 8,000 people die from the disease. For more information on oral cancer, see
Oral Health Resources: Oral Cancer and
Cancer Prevention and Control: National Cancer Data.
Related Information
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