VALIDITY OF 2 METHODS FOR ASSESSING ORAL HEALTH-STATUS OF POPULATIONS

Objective: This investigation assessed two methods for estimating epid emiologic indicators of oral health status among children: (1) a visua l-only screening, performed independently by a dental hygienist and a registered nurse; and (2) a parent- or guardian-completed questionnair e. The indicators included dichotomous variables measuring dental cari es and treatment needs, presence of sealants, injuries to the anterior teeth, and dental fluorosis. Methods: Following training and calibrat ion, data were collected over an eight-day period in April 1994 among 632 elementary schoolchildren (aged 5 to 12 years) in Monticello, Geor gia. Both screening and questionnaire findings were compared pairwise with results from visual-tactile examinations done by a dentist. Valid ity, represented by sensitivity, specificity, and predictive values, w as assessed for screening results from the dental hygienist, the nurse , and the parent-completed questionnaire. Results: Validity was high f or screening for caries and treatment needs (>90% for sensitivity, spe cificity, and predictive values in a sample having 30% to 40% prevalen ce). Less valid data - mainly an effect of false negatives - were obta ined for fluorosis, injuries, and presence of sealants. No significant difference in validity was observed between the nurse and the dental hygienist. One-third of respondents to the questionnaire did not know if their children needed fillings (a proxy for untreated decay) or had received sealants; only knowledge of restorations was comparable to r esults from screening. Intraexaminer reliability far the two screeners ranged from 85 to 100 for percent agreement and 0.70 to 0.93 for kapp a scores. Conclusions: Screening by dental hygienists or nurses can pr ovide valid data far surveillance of dental caries and treatment needs . Training for visual assessment of fluorosis and injuries must be imp roved to diminish the proportion of false negatives A parent-completed questionnaire is less effective than visual screening for evaluating oral health status in children.